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Sample records for hemodialysis saline solutions

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

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    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. HPLC based method using sample precolumn cleanup for the determination of triazines and thiolcarbamates in hemodialysis saline solutions.

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    do Nascimento, Paulo C; Rohlfes, Ana L B; Bohrer, Denise; de Carvalho, Leandro M; Pilau, Eduardo J

    2005-01-15

    Solid-phase extraction (SPE) procedures for cleanup and preconcentration followed by HPLC-UV method were investigated for the simultaneous determination of seven low-dosed pesticides in saline concentrates for hemodialysis. The target compounds were ametryn, desmetryn, prometryn, terbutryn, molinate, triallate and butylate. Polyethylene (three different types), teflon, polyurethane and polystyrene, in powder form, were investigated as adsorbents for solid-phase extraction of the analytes from the saline samples. Quantification was performed at 222nm and the analytes were separated on a LiChrosorb RP-18 (5mum, 125mm x 4mm i.d.) column using gradient elution with water/acetonitrile as mobile phase. The duration each chromatographic run was 18min including column reconditioning. The efficiency of the different SPE substrates for retaining the analytes from the highly concentrated saline (HCS) samples was discussed. The best performance was achieved with polystyrene as SPE material considering preconcentration factor, precolumn clogging, reusing capability and similarity between the mobile phases for SPE and HPLC procedures. Analyte concentrations as low as 1mugL(-1) could be determined in spiked HCS samples after preconcentration on polystyrene SPE precolumns. Recoveries between 98.7 and 102.2% were obtained from commercial spiked samples. Detection limits ranging from 4.8 (for prometryn) to 46mugL(-1) (for butylate) were calculated (without preconcentration). The within-day relative standard deviations (n = 9) ranged from 2.3 to 4.8%.

  3. Hemodialysis

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    ... Events Advocacy Donate A to Z Health Guide Hemodialysis Print Email Healthy kidneys clean your blood and ... you when you should start dialysis. How does hemodialysis work? In hemodialysis, a dialysis machine and a ...

  4. Correcting Acidosis during Hemodialysis: Current Limitations and a Potential Solution.

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    Tovbin, David; Sherman, Richard A

    2016-01-01

    The deleterious catabolic and pro-inflammatory effects of acidosis in hemodialysis (HD) patients and the importance of its correction for limiting mineral bone disease (MBD) are well known. Although oral base therapy could be a solution for correcting acidosis in HD patients, it increases their already enormous medication load and sodium intake; this approach is not used commonly. Therefore, we need to rely more on correcting acidosis during the HD procedure, which is difficult to achieve, in part, because HD is an intermittent therapy. The currently used fixed dialysate bicarbonate concentrations are associated with pre-HD acidosis and intra-dialytic alkalosis. We suggest that a decreasing dialysate bicarbonate concentration from an initially high concentration be considered as a means of correcting acidosis with limited intra-dialytic alkalosis. Some evidence, as well as theoretical considerations, supports such an approach. © 2015 Wiley Periodicals, Inc.

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

    African Journals Online (AJOL)

    Salinity is a problem that has increased annually and among the viable alternatives for the reintegration of saline areas to the productive system is the cultivation of tree species. This study aimed to evaluate the growth, dry matter distribution and organic solutes accumulation in Tabebuia aurea Manso (Benth and Hook) ...

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

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    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.

  7. Dialysis - hemodialysis

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    Artificial kidneys - hemodialysis; Dialysis; Renal replacement therapy - hemodialysis; End-stage renal disease - hemodialysis; Kidney failure - hemodialysis; Renal failure - hemodialysis; Chronic kidney disease - hemodialysis

  8. Sodium citrate versus saline catheter locks for non-tunneled hemodialysis central venous catheters in critically ill adults: a randomized controlled trial.

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    Hermite, Laure; Quenot, Jean-Pierre; Nadji, Abdelouaid; Barbar, Saber David; Charles, Pierre-Emmanuel; Hamet, Maël; Jacquiot, Nicolas; Ghiringhelli, François; Freysz, Marc

    2012-02-01

    Sodium citrate has antibacterial and anticoagulant properties that are confined to the catheter when used as a catheter lock. Studies of its use as a catheter lock in chronic hemodialysis patients suggest it may be efficacious in preventing infection and thrombotic complications. We compared sodium citrate with saline catheter locks for non-tunneled hemodialysis central venous catheters in critically ill adult patients. Primary endpoint was catheter life span without complication. This was a randomized, controlled, open-label trial involving intensive care patients with acute renal failure requiring hemodialysis. Events were defined as catheter-related bloodstream infection and catheter malfunction. Seventy-eight patients were included. Median catheter life span without complication was 6 days (saline group) versus 12 days (citrate group) [hazard ratio (HR) 2.12 (95% CI 1.32-3.4), p = 0.0019]. There was a significantly higher rate of catheter malfunction in the saline group compared with in the citrate group (127 catheter events/1,000 catheter-days, saline group vs. 26 events/1,000 catheter-days, citrate group, p catheter life span. This study shows for the first time that citrate lock reduced catheter complications and increased catheter life span as compared to saline lock in critically ill adults requiring hemodialysis.

  9. Nebulised hypertonic saline solution for acute bronchiolitis in infants.

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    Zhang, Linjie; Mendoza-Sassi, Raúl A; Wainwright, Claire; Klassen, Terry P

    2013-07-31

    Airway oedema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulised hypertonic saline solution may reduce these pathological changes and decrease airway obstruction. To assess the effects of nebulised hypertonic (≥ 3%) saline solution in infants with acute viral bronchiolitis. We searched CENTRAL 2013, Issue 4, OLDMEDLINE (1951 to 1965), MEDLINE (1966 to April week 4, 2013), EMBASE (1974 to May 2013), LILACS (1985 to May 2013) and Web of Science (1955 to May 2013). Randomised controlled trials (RCTs) and quasi-RCTs using nebulised hypertonic saline alone or in conjunction with bronchodilators as an active intervention and nebulised 0.9% saline as a comparator in infants up to 24 months of age with acute bronchiolitis. Two review authors independently performed study selection, data extraction and assessment of risk of bias in included studies. We conducted meta-analyses using the Cochrane statistical package RevMan 5.2. We used the random-effects model for meta-analyses. We used mean difference (MD) and risk ratio (RR) as effect size metrics. We included 11 trials involving 1090 infants with mild to moderate acute viral bronchiolitis (500 inpatients, five trials; 65 outpatients, one trial; and 525 emergency department patients, four trials). All but one of the included trials were of high quality with a low risk of bias. A total of 560 patients received hypertonic saline (3% saline n = 503; 5% saline n = 57). Patients treated with nebulised 3% saline had a significantly shorter mean length of hospital stay compared to those treated with nebulised 0.9% saline (MD -1.15 days, 95% confidence interval (CI) -1.49 to -0.82, P saline group also had a significantly lower post-inhalation clinical score than the 0.9% saline group in the first three days of treatment (day 1: MD -0.88, 95% CI -1.36 to -0.39, P = 0.0004; day 2: MD -1.32, 95% CI -2.00 to -0.64, P = 0.001; day 3: MD -1.51, 95% CI -1.88 to -1.14, P

  10. First-principles modeling of fluid and solute exchange in the human during normal and hemodialysis conditions.

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    Fernandez de Canete, J; Del Saz Huang, P

    2010-09-01

    A first-principles computer model of fluid and solute exchange under both physiological and hemodialysis condition is presented. The whole system has been modeled and simulated under the MODELICA integrated environment, which uses a hierarchical modeling strategy. The model performance has been analyzed by simulation in the light of existing hypothesis and physiological data used here for validation purposes. The results obtained provide a physiological interpretative key to patient's hemodynamic behavior during hemodialysis. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Nebulized hypertonic saline solution for acute bronchiolitis in infants.

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    Zhang, Linjie; Mendoza-Sassi, Raúl A; Wainwright, Claire; Klassen, Terry P

    2008-10-08

    Airway edema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline solution may reduce these pathological changes and decrease airway obstruction. To assess the effects of nebulized hypertonic saline solution in infants with acute viral bronchiolitis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, issue 4), which contains the Cochrane Acute Respiratory Infections Group Specialized Register; OLDMEDLINE (1951 to 1965); MEDLINE (1966 to November 2007); EMBASE (1974 to November 2007); and LILACS (November 2007). Randomised controlled trials (RCTs) and quasi-RCTs using nebulized hypertonic saline alone or in conjunction with bronchodilators as an active intervention in infants up to 24 months of age with acute bronchiolitis. Two review authors (ZL, MRA) independently performed data extraction and study quality assessment. We pooled the data from individual trials using the Cochrane statistical package Review Manager (RevMan). We included four trials involving 254 infants with acute viral bronchiolitis (189 inpatients and 65 outpatients) in this review. Patients treated with nebulized 3% saline had a significantly shorter mean length of hospital stay compared to those treated with nebulized 0.9% saline (mean difference (MD) -0.94 days, 95% CI -1.48 to -0.40, P = 0.0006). The 3% saline group also had a significantly lower post-inhalation clinical score than the 0.9% saline group in the first three days of treatment (day 1: MD -0.75, 95% CI -1.38 to -0.12, P = 0.02; day 2: MD -1.18, 95% CI -1.97 to -0.39, P = 0.003; day 3: MD -1.28, 95% CI -2.57 to 0.00, P = 0.05). The effect of nebulized hypertonic saline in improving clinical score was greater among outpatients than inpatients. No adverse events related to 3% saline inhalation were reported. Current evidence suggests nebulized 3% saline may significantly reduce the length of hospital stay

  12. Kt/Vurea and Nonurea Small Solute Levels in the Hemodialysis Study

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    Sirich, Tammy L.; Fong, Kara D.; Plummer, Natalie S.; Shafi, Tariq; Hwang, Seungyoung; Banerjee, Tanushree; Zhu, Yunnuo; Powe, Neil R.; Hai, Xin; Hostetter, Thomas H.

    2016-01-01

    The Hemodialysis (HEMO) Study showed that high-dose hemodialysis providing a single-pool Kt/Vurea of 1.71 provided no benefit over a standard treatment providing a single-pool Kt/Vurea of 1.32. Here, we assessed whether the high-dose treatment used lowered plasma levels of small uremic solutes other than urea. Measurements made ≥3 months after randomization in 1281 patients in the HEMO Study showed a range in the effect of high-dose treatment compared with that of standard treatment: from no reduction in the level of p-cresol sulfate or asymmetric dimethylarginine to significant reductions in the levels of trimethylamine oxide (−9%; 95% confidence interval [95% CI], −2% to −15%), indoxyl sulfate (−11%; 95% CI, −6% to −15%), and methylguanidine (−22%; 95% CI, −18% to −27%). Levels of three other small solutes also decreased slightly; the level of urea decreased 9%. All-cause mortality did not significantly relate to the level of any of the solutes measured. Modeling indicated that the intermittency of treatment along with the presence of nondialytic clearance and/or increased solute production accounted for the limited reduction in solute levels with the higher Kt/Vurea. In conclusion, failure to achieve greater reductions in solute levels may explain the failure of high Kt/Vurea treatment to improve outcomes in the HEMO Study. Furthermore, levels of the nonurea solutes varied widely among patients in the HEMO Study, and achieved Kt/Vurea accounted for very little of this variation. These results further suggest that an index only on the basis of urea does not provide a sufficient measure of dialysis adequacy. PMID:27026365

  13. Behaviour of wetting films of sodium hyaluronate saline solutions.

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    Ribeiro, Walkíria; Orfão, Marta; Mata, José Luís; Saramago, Benilde

    2008-01-15

    The behaviour of wetting films of sodium hyaluronate (NaHA) saline solutions, at physiological conditions, is investigated using interferometry. Concentrations in the range of dilute and semi-dilute regimes were chosen to assess the role of bulk molecular interactions on the surface forces. The transition from dilute to semi-dilute solutions is known to occur at c*=0.59 mg mL(-1). Dilute solutions form stable films whose behaviour is explained by van der Waals interactions. For semi-dilute solutions, the disjoining pressure vs film thickness isotherms show branches attributed to stepwise thinning or film stratification, which is interpreted in terms of a network as predicted by the theory of semi-dilute polyelectrolyte solutions. The distance between branches is 16 nm for the NaHA concentration of 2 mg mL(-1) and 12 nm for the concentration of 3.5 mg mL(-1), in agreement with the calculated correlation lengths of the polymeric network. Since no experimental evidence exists for the presence of a stable network in the bulk, this tendency for self-association should be the result of the liquid confinement. To our knowledge, the existence of oscillatory disjoining pressure isotherms in the presence of excess salt was never observed for other polyelectrolyte solutions.

  14. Phenol-containing saline solution as a diluent for adenosine 5'-monophosphate in bronchial challenge testing.

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    Prieto, Luis; Badiola, Carlos; Cortijo, Julio; Pérez-Francés, Carmen; Gutiérrez, Valentina; Lanuza, Amparo

    2005-01-01

    To investigate the effect of dissolving adenosine 5'-monophosphate (AMP) with phenol-containing saline solution on the stability and the bronchoconstrictive properties of this indirect agonist. Eleven subjects with asthma well controlled with short-acting inhaled beta2-agonists as required or with inhaled corticosteroids were studied. Bronchial challenge tests with AMP dissolved with either normal saline solution or saline solution containing 0.4% phenol were performed on separate days. Furthermore, to assess the potential influence of the phenol-containing saline solution on the stability of the bronchoconstrictor agent, AMP solutions in concentrations of 40 microg/mL and 400 microg/mL were prepared in saline solution and phenol-containing saline solution and, after 30 min, the AMP levels were determined by high-performance liquid chromatography (HPLC) assay. The geometric mean AMP provocative concentration causing a 20% fall in FEV1 (PC20) was 13.49 mg/mL (95% confidence interval [CI], 6.76 to 26.91) for the saline solution method, and AMP PC20 for the saline solution with phenol method was 8.91 mg/mL (95% CI, 3.39 to 23.44) [p = 0.18]. No significant differences were found between the concentrations of AMP made in saline solution compared to those made in phenol-containing saline solution measured by HPLC. These observations indicate that normal saline solution with or without phenol can be used as the diluent for AMP. However, since a potential risk with AMP of industrial sources is the bacterial contamination, adding a preservative such as phenol to a saline solution diluent might be recommended.

  15. Limited reduction in uremic solute concentrations with increased dialysis frequency and time in the Frequent Hemodialysis Network Daily Trial.

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    Sirich, Tammy L; Fong, Kara; Larive, Brett; Beck, Gerald J; Chertow, Glenn M; Levin, Nathan W; Kliger, Alan S; Plummer, Natalie S; Meyer, Timothy W

    2017-05-01

    The Frequent Hemodialysis Network Daily Trial compared conventional three-times weekly treatment to more frequent treatment with a longer weekly treatment time in patients receiving in-center hemodialysis. Evaluation at one year showed favorable effects of more intensive treatment on left ventricular mass, blood pressure, and phosphate control, but modest or no effects on physical or cognitive performance. The current study compared plasma concentrations of uremic solutes in stored samples from 53 trial patients who received three-times weekly in-center hemodialysis for an average weekly time of 10.9 hours and 30 trial patients who received six-times weekly in-center hemodialysis for an average of 14.6 hours. Metabolomic analysis revealed that increased treatment frequency and time resulted in an average reduction of only 15 percent in the levels of 107 uremic solutes. Quantitative assays confirmed that increased treatment did not significantly reduce levels of the putative uremic toxins p-cresol sulfate or indoxyl sulfate. Kinetic modeling suggested that our ability to lower solute concentrations by increasing hemodialysis frequency and duration may be limited by the presence of non-dialytic solute clearances and/or changes in solute production. Thus, failure to achieve larger reductions in uremic solute concentrations may account, in part, for the limited benefits observed with increasing frequency and weekly treatment time in Frequent Hemodialysis Daily Trial participants. Published by Elsevier Inc.

  16. Tunneled catheters with taurolidine-citrate-heparin lock solution significantly improve the inflammatory profile of hemodialysis patients.

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    Fontseré, Néstor; Cardozo, Celia; Donate, Javier; Soriano, Alex; Muros, Mercedes; Pons, Mercedes; Mensa, Josep; Campistol, Josep M; Navarro-González, Juan F; Maduell, Francisco

    2014-07-01

    Mortality and morbidity are significantly higher among patients with dialysis catheters, which has been associated with chronic activation of the immune system. We hypothesized that bacteria colonizing the catheter lumen trigger an inflammatory response. We aimed to evaluate the inflammatory profile of hemodialysis patients before and after locking catheters with an antimicrobial lock solution. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), IL-10, and tumor necrosis factor alpha (TNF-α) were measured in serum, and levels of mRNA gene expression of IL-6, IL-10, and TNF-α were analyzed in peripheral blood mononuclear cells (PBMC). Samples were obtained at baseline and again after 3 months' use of taurolidine-citrate-heparin lock solution (TCHLS) in 31 hemodialysis patients. The rate of catheter-related bloodstream infections (CRBSI) was 1.08 per 1,000 catheter-days in the heparin period and 0.04 in the TCHLS period (P = 0.023). Compared with the baseline data, serum levels of hs-CRP and IL-6 showed median percent reductions of 18.1% and 25.2%, respectively (P profile in hemodialysis patients with tunneled catheters. Further studies are needed to evaluate the potential beneficial effects on clinical outcomes. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

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

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    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.

  18. Nebulized 3% hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms.

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    Sarrell, E Michael; Tal, Guy; Witzling, Michaela; Someck, Eli; Houri, Sion; Cohen, Herman A; Mandelberg, Avigdor

    2002-12-01

    To determine the utility of inhaled hypertonic saline solution to treat ambulatory infants with viral bronchiolitis. Randomized, double-blind, controlled trial. Sixty-five ambulatory infants (mean +/- SD age, 12.5 +/- 6 months) with viral bronchiolitis received either of the following: inhalation of 0.5 mL (5 mg) terbutaline added to 2 mL of 0.9% saline solution as a wet nebulized aerosol (control; group 1; n = 32) or 0.5 mL (5 mg) terbutaline added to 2 mL of 3% saline solution administered in the same manner as above (treatment; group 2; n = 33). This therapy was repeated three times every day for 5 days. The clinical severity (CS) scores at baseline on the first day of treatment were 6.4 +/- 1.8 in group 1 and 6.6 +/- 1.5 in group 2 (not significant). After the first day, the CS score was significantly lower (better) in group 2 as compared to group 1 on each of the treatment days (p hypertonic saline solution-treated patients (group 2) as compared to the 0.9% saline solution-treated patients (group 1) [p = 0.01; Fig 1 ]. We conclude that in nonasthmatic, nonseverely ill ambulatory infants with viral bronchiolitis, aerosolized 3% saline solution plus 5 mg terbutaline is effective in decreasing symptoms as compared to 0.9% saline solution plus 5 mg terbutaline.

  19. Nebulized 3% hypertonic saline solution treatment in hospitalized infants with viral bronchiolitis.

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    Mandelberg, Avigdor; Tal, Guy; Witzling, Michaela; Someck, Eli; Houri, Sion; Balin, Ami; Priel, Israel E

    2003-02-01

    To determine the utility of inhaled hypertonic saline solution to treat infants hospitalized with viral bronchiolitis. Randomized, double-blind, controlled trial. Fifty-two hospitalized infants (mean +/- SD age, 2.9 +/- 2.1 months) with viral bronchiolitis received either inhalation of epinephrine, 1.5 mg, in 4 mL of 0.9% saline solution (group 1; n = 25) or inhalation of epinephrine, 1.5 mg, in 4 mL of 3% saline solution (group 2; n = 27). This therapy was repeated three times every hospitalization day until discharge. The percentage improvement in the clinical severity scores after inhalation therapy was not significant in group 1 on the first, second, and third days after hospital admission (3.5%, 2%, and 4%, respectively). In group 2, significant improvement was observed on these days (7.3%, 8.9%, and 10%, respectively; p saline solution decreased the hospitalization stay by 25%: from 4 +/- 1.9 days in group 1 to 3 +/- 1.2 days in group 2 (p infants hospitalized with viral bronchiolitis, aerosolized 3% saline solution/1.5 mg epinephrine decreases symptoms and length of hospitalization as compared to 0.9% saline solution/1.5 mg epinephrine.

  20. Heparinized and Saline Solutions in the Maintenance of Arterial and Central Venous Catheters After Cardiac Surgery.

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    Ziyaeifard, Mohsen; Alizadehasl, Azin; Aghdaii, Nahid; Sadeghi, Ali; Azarfarin, Rasoul; Masoumi, Gholamreza; Golbargian, Ghodrat

    2015-08-01

    Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters. Even at low dose, heparin administration can be associated with serious complications. Normal saline solution can maintain patency of arterial catheters and central venous pressure monitoring catheters. The current study aimed to compare the efficacy of normal saline with that of heparinized one to maintain patency of arterial and central venous catheters after cardiac surgery. In the current randomized controlled trial, 100 patients, with an age range of 18 - 65 years of valve and coronary artery surgery were studied in Rajaie heart center, Tehran, Iran. Patients were randomized to receive either heparinized saline (n = 50) or normal saline flush solutions (n = 50). In the study, arterial catheters and central venous pressure monitoring catheters were daily checked for any signs of occlusion in three postoperative days as primary end-point of the study. According to the information obtained from the study, four (8%) arterial catheters in the saline group (P value: 0.135) and three (6%) arterial catheters in the heparin group (P value = 0.097) were obstructed. Statistical analysis showed that the incidence of obstruction and changes in all other parameters between the two groups during the three-day follow-up was not significant (all P values > 0.05). It seems that there is no difference in the use of heparinized and normal saline solutions to prevent catheter occlusion of arterial and central venous pressure.

  1. (Ab)normal saline and physiological Hartmann's solution: a randomized double-blind crossover study.

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    Reid, Fiona; Lobo, Dileep N; Williams, Robert N; Rowlands, Brian J; Allison, Simon P

    2003-01-01

    In this double-blind crossover study, the effects of bolus infusions of 0.9% saline (NaCl) and Hartmann's solution on serum albumin, haematocrit and serum and urinary biochemistry were compared in healthy subjects. Nine young adult male volunteers received 2-litre intravenous infusions of 0.9% saline and Hartmann's solution on separate occasions, in random order, each over 1 h. Body weight, haematocrit and serum biochemistry were measured pre-infusion and at 1 h intervals for 6 h. Biochemical analysis was performed on pooled post-infusion urine. Blood and plasma volume expansion, estimated by dilutional effects on haematocrit and serum albumin, were greater and more sustained after saline than after Hartmann's solution (P Hartmann's solution. Subjects voided more urine (median: 1,000 compared with 450 ml) of higher sodium content (median: 122 compared with 73 mmol) after Hartmann's than after saline (both P =0.049), despite the greater sodium content of the latter. The time to first micturition was less after Hartmann's than after saline (median: 70 compared with 185 min; P =0.008). There were no significant differences between the effects of the two solutions on serum sodium, potassium, urea or osmolality. After saline, all subjects developed hyperchloraemia (>105 mmol/l), which was sustained for >6 h, while serum chloride concentrations remained normal after Hartmann's (P Hartmann's solution, due possibly to the more physiological [Na(+)]/[Cl(-)] ratio in Hartmann's solution (1.18:1) than in saline (1:1) and to the hyperchloraemia caused by saline.

  2. Effect of concentration and temperature on surface tension of sodium hyaluronate saline solutions.

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    Ribeiro, Walkiria; Mata, José Luis; Saramago, Benilde

    2007-06-19

    The effect of concentration and temperature on the surface tension of sodium hyaluronate (NaHA) saline solutions was investigated using the technique of the shape of pendant drops. The decay rate of the surface tension with the increase of NaHA concentration was well-described by the empirical Hua-Rosen equation. Adsorption at the air-liquid interface was estimated using the Gibbs equation. The temperature dependence of a dilute solution and a semidilute entangled solution was numerically fitted with a second-order polynomial equation. The surface behavior of the NaHA saline solutions was interpreted in terms of their known viscoelastic properties.

  3. Isotonic versus hypotonic saline solution for maintenance intravenous fluid therapy in children: a systematic review.

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    Padua, April P; Macaraya, Josep Ryan G; Dans, Leonila F; Anacleto, Francisco E

    2015-07-01

    The administration of hypotonic saline solution for maintenance intravenous fluid (IVF) therapy has been the standard of care, but recent evidence has shown this treatment to be associated with hyponatremia-related complications. The aim of this systematic review was to determine which IVF, i.e., a hypotonic or an isotonic saline solution, poses less risk for the development of hyponatremia among hospitalized children who require maintenance IVF therapy. Medline, Cochrane Library, LILACS, Current Controlled Trials, reference lists, and abstract proceedings were searched for randomized controlled trials (RCTs) comparing hypotonic and isotonic saline solutions for maintenance IVF therapy in hospitalized children. Two reviewers independently assessed all potentially relevant studies and subsequently extracted data and evaluated the methodological quality of the RCTs. Studies were then combined and analyzed using a random effects model. Eleven RCTs met the inclusion criteria. Our analysis of these 11 RCTs showed that among hospitalized children receiving maintenance IVF therapy, isotonic solutions significantly decreased the risk of developing hyponatremia [relative risk (RR) 0.50, 95% confidence interval (CI) 0.40-0.62] without significantly increasing the risk for hypernatremia (RR 0.83, 95% CI 0.41-1.67). Current evidence does not support the standard practice of prescribing a hypotonic saline solution as maintenance IVF therapy to hospitalized children. Although there is no single IVF composition ideal for all children, an isotonic saline solution does appear to be the safer choice when maintenance IVF therapy is used in the general pediatric population.

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

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    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.

  5. Nebulized hypertonic saline/salbutamol solution treatment in hospitalized children with mild to moderate bronchiolitis.

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    Luo, Zhengxiu; Liu, Enmei; Luo, Jian; Li, Subi; Zeng, Fengqiong; Yang, Xiqiang; Fu, Zhou

    2010-04-01

    The objective of this study was to determine the efficacy and safety of nebulized 3% hypertonic saline solution and salbutamol in the treatment of mild to moderate bronchiolitis. In a randomized controlled trial, 93 infants with mild to moderate bronchiolitis were divided into two groups. The infants received inhalation of 2.5 mg (0.5 mL) salbutamol dissolved in either 4.0 mL normal (0.9%) saline (control group, n= 43) or 4.0 mL hypertonic (3%) saline (treatment group, n= 50). The therapy was repeated three times daily until discharge. Cough, wheezing, pulmonary physical signs, and the length of hospital stay were recorded. Wheezing remission time was 3.8 + or - 1.1 days in the control group and 2.7 + or - 0.9 days in the treatment group (P saline solution and salbutamol is a safe and effective therapy for patients with mild to moderate bronchiolitis.

  6. 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.

  7. Modelling density-dependent flow and solute transport at the Lake Tutchewop saline disposal complex, Victoria

    Science.gov (United States)

    Simmons, Craig T.; Narayan, Kumar A.

    1998-05-01

    Intercepted saline groundwaters and drainage effluent from irrigation are commonly stored in both natural and artificial saline disposal basins throughout the Murray-Darling Basin of Australia. Their continued use as wastewater evaporation sites requires an understanding of existing groundwater dynamics. The useful of individual basins, their sustainability and possible environmental impacts remain largely unknown. In this work, the movement of salt to the underlying groundwater system from Lake Tutchewop, a saline disposal complex in north-central Victoria, was modelled in cross-section. Due to the salinity contrast between the hypersaline basin waters and the regional groundwater, it was necessary to simulate density-dependent flow behaviour. Under certain conditions, these density-stratified systems may become unstable leading to the onset of convective behaviour, which greatly increases the movement of salt from the basin to the groundwater system. Modelled concentration profiles in the aquifer system and calculated seepage rates from the basin show that Lake Tutchewop is stable under its present operating regime. The downward movement of salt is mainly controlled by diffusion and dispersion. The calibrated model was used to assess the impact of several management scenarios using time-dependent boundary conditions for lake salinity and water levels. The influence of heterogeneous basin linings on ensuing salt flux rates is examined, and results show that increased solute transport will occur under such conditions. A sensitivity analysis performed on governing variables showed that salt fluxes were most sensitive to lake salinity levels. A solute Rayleigh number defined in terms of basin salinity and hydrogeologic parameters is seen to be an effective tool for predicting the long term behaviour of such saline disposal basins. The models and concepts developed in this work may find application in the design and management of saline disposal complexes.

  8. Voltammetric determination of Se(IV) and Se(VI) in saline samples-Studies with seawater, hydrothermal and hemodialysis fluids

    Energy Technology Data Exchange (ETDEWEB)

    Nascimento, Paulo C. do, E-mail: npaulo@quimica.ufsm.br [Departamento de Quimica, Universidade Federal de Santa Maria, C.P. 5051, 97105-970 Santa Maria, RS (Brazil); Jost, Cristiane L.; Carvalho, Leandro M. de; Bohrer, Denise [Departamento de Quimica, Universidade Federal de Santa Maria, C.P. 5051, 97105-970 Santa Maria, RS (Brazil); Koschinsky, Andrea [School of Engineering and Science, Geosciences and Astrophysics, Jacobs University Bremen GmbH, P.O. Box 750561, D-28725 Bremen (Germany)

    2009-08-26

    Determination of Se(IV) and Se(VI) in high saline media was investigated by cathodic stripping voltammetry (CSV). The voltammetric method was applied to assay selenium in seawater, hydrothermal and hemodialysis fluids. The influence of ionic strength on selenium determination is discussed. The CSV method was based on the co-electrodeposition of Se(IV) with Cu(II) ions and Se(VI) determined by difference after sample UV-irradiation for photolytic selenium reduction. UV-irradiation was also used as sample pre-treatment for organic matter decomposition. Detection limit of 0.030 {mu}g L{sup -1} (240 s deposition time) and relative standard deviation (RSD) of 6.19% (n = 5) for 5.0 {mu}g L{sup -1} of Se(IV) were calculated. Linear calibration range for selenium was observed from 1.0 to 100.0 {mu}g L{sup -1}. Concerning the pre-treatment step, best results were obtained by using 60 min UV-irradiation interval in H{sub 2}O{sub 2}/HCl medium. Se(VI) was reduced to the Se(IV) electroactive species with recoveries between 91.7% and 112.9%. Interferents were also investigated.

  9. Intradermal normal saline solution, self-selected music, and insertion difficulty effects on intravenous insertion pain.

    Science.gov (United States)

    Jacobson, A F

    1999-01-01

    To examine the effect of listening to self-selected music versus an intradermal injection of normal saline solution on the intensity and distress of intravenous (IV) catheter insertion pain. Prospective, randomized, controlled study. Inpatient and outpatient units in 2 university-affiliated southwestern medical centers. One hundred ten adult inpatients and outpatients undergoing IV therapy. Pain intensity, pain distress, and IV insertion difficulty visual analog scales. Patients were randomly assigned to receive an intradermal injection of normal saline solution, listen with headphones to self-selected music, or be in a control group for IV insertion. A MANOVA revealed no statistically significant multivariate or univariate differences in pain by treatment group, but significantly higher pain distress scores with failed IV insertions. The pain intensity and distress scores were significantly higher in the saline solution group when compared with the music and control groups combined. Insertion difficulty was significantly positively correlated with pain intensity and distress for the entire sample, with weak, nonsignificant correlations in the music group. Intradermal unpreserved saline solution contributes to greater pain intensity and distress, greater insertion difficulty, and a higher failure rate than the use of music or routine IV insertion. Listening to preferred music attenuates the effect of insertion difficulty on IV insertion pain. Intravenous insertion attempts were unsuccessful in more than one third of the subjects, resulting in higher pain distress scores. Further research is needed on interventions to reduce IV insertion pain and on factors contributing to IV insertion failure.

  10. Evaluating Battery-like Reactions to Harvest Energy from Salinity Differences using Ammonium Bicarbonate Salt Solutions.

    Science.gov (United States)

    Kim, Taeyoung; Rahimi, Mohammad; Logan, Bruce E; Gorski, Christopher A

    2016-05-10

    Mixing entropy batteries (MEBs) are a new approach to generate electricity from salinity differences between two aqueous solutions. To date, MEBs have only been prepared from solutions containing chloride salts, owing to their relevance in natural salinity gradients created from seawater and freshwater. We hypothesized that MEBs could capture energy using ammonium bicarbonate (AmB), a thermolytic salt that can be used to convert waste heat into salinity gradients. We examined six battery electrode materials. Several of the electrodes were unstable in AmB solutions or failed to produce expected voltages. Of the electrode materials tested, a cell containing a manganese oxide electrode and a metallic lead electrode produced the highest power density (6.3 mW m(-2) ). However, this power density is still low relative to previously reported NaCl-based MEBs and heat recovery systems. This proof-of-concept study demonstrated that MEBs could indeed be used to generate electricity from AmB salinity gradients. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. 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.

  12. 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.

  13. Effect of saline solutions and salt stress on seed germination of some tropical forest tree species

    Directory of Open Access Journals (Sweden)

    D. A. Agboola

    1998-12-01

    Full Text Available The effect of several saline solutions (as given by six salts and salt stress (as given by 0.1 - 2m sodium chloride solutions on the germination of seeds of six selected tropical forest tree species was investigated. Saline solutions (0.2m of the six salts used had highly significant effects on seed germination in most of the tree species. Sodium sulphate (Na2So4 permitted germination in the seeds of Ceiba pentandra and Tectona grandis presoaked in its 0.2m solution for 36 and 48h respectively. The Zinc sulphate (ZnSO4 solution enhanced the germination of seeds of Terminalia ivorensis and Terminalia superba. Solution of Potassium per Manganate favoured the germination of seeds of T. grandis, T. ivorensis and T. superba. In general, increase in molar concentration of NaCl adversely affected the germination rate of seeds. Sees of the two Terminalia species could withstand NaCl salt stress. Seeds of T. grandis have high ability to withstand salt stress comparatively.

  14. [State of the art and outlook for promoting Russian-made hemodialysis equipment with regeneration of dialyzing solution].

    Science.gov (United States)

    Viktorov, V A; Varin, A N; Grinval'd, V M; Maksimov, E P; Fomicheva, N N; Zavalishin, Iu K; Leshchinskiĭ, G M; Razhev, I I; Noskov, S G; Shadiev, B Sh; Rodin, V V; Strelkov, S I; Shukov, O V; Turiaev, A D; Shishkin, S V

    2003-01-01

    Radical improvements in the physiological features and self-sufficiency of hemodialysis equipment, an essential reduction of the volume of dialyzate contacting with patient's body and elimination of dependence of the equipment operation on the availability of a water-supply network can be ensured by applying a regime of circulation of a relatively small volume (3-5 l) of dialyzate through the regenerating device. The regeneration unit must eliminate the organic products of dialysis from the dialyzate and stabilize the ionic composition of the purified dialyzate according to the preset parameters. Modern methods and technical means for regenerating the used dialyzate are discussed; a regeneration unit, which ensures an electrochemical oxidation (in the used dialyzate) of nitrogen-containing organic metabolites with a subsequent sorption-type additional purification of electrochemically-processed dialyzate, is offered. The regeneration unit is made up of an electrolyser, a sorption-type additional-purification device and a gas utilizer; it eliminates organic metabolites, phosphorus, calcium and potassium from the used dialyzate and stabilizes the pH solution.

  15. 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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    ), 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...

  17. Comparative effectiveness of 30 % trisodium citrate and heparin lock solution in preventing infection and dysfunction of hemodialysis catheters: a randomized controlled trial (CITRIM trial).

    Science.gov (United States)

    Correa Barcellos, Franklin; Pereira Nunes, Bruno; Jorge Valle, Luciana; Lopes, Thiago; Orlando, Bianca; Scherer, Cintia; Nunes, Marcia; Araújo Duarte, Gabriela; Böhlke, Maristela

    2017-04-01

    Central venous catheters (CVC) are the only option when hemodialysis is needed for patients without definitive vascular access. However, CVC is associated with complications, such as infection, thrombosis, and dysfunction, leading to higher mortality and expenditures. The aim of this study was to compare the effectiveness of 30 % trisodium citrate (TSC30 %) with heparin as CVC lock solutions in preventing catheter-related bloodstream infections (CRBSI) and dysfunction in hemodialysis patients. Randomized, double-blind controlled trial comparing the event-free survival of non-tunneled CVC locked with heparin or TSC30 % in adult hemodialysis patients. The study included 464 catheters, 233 in heparin group, and 231 in TSC30 % group. The CRBSI-free survival of TSC30 % group was significantly shorter than that of heparin group. When stratified by insertion site, heparin was better than TSC30 % only in subclavian CVC. The dysfunction-free survival was not different between groups in the main analysis, but there is also a shorter survival among subclavian CVC locked with TSC30 % in stratified analysis. There was no difference on CRBSI-free or dysfunction-free survival between jugular vein CVC locked with heparin or 30 % citrate. However, subclavian CVC locked with 30 % citrate presented shorter event-free survival. This difference may be related to anatomical and positional effects, CVC design, and hydraulic aspects of the lock solution. CLINICALTRIALS. NCT02563041.

  18. 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 groundwater salinity and height above the water table remained significant factors, but the root fresh mass density was no longer significant. Regression of data from the 200 and 400 mM NaCl treatments showed that the rate of Na+ accumulation in the soil increased until the Na+ concentration reached ~250 mM within the root zone; subsequent decreases in accumulation were associated with decreases in stomatal conductance. Salinization of the soil solution therefore had a feedback effect on further salinization within the root zone. © 2017 John Wiley & Sons Ltd.

  19. Effects of hypertonic saline solution associated to remote ischemic perconditioning in kidney ischemia/reperfusion injury in rats.

    Science.gov (United States)

    Brito, Marcus Vinicius Henriques; Yasojima, Edson Yuzur; Percário, Sandro; Ribeiro, Rubens Fernando Gonçalves; Cavalcante, Lainy Carollyne da Costa; Monteiro, Andrew Moraes; Couteiro, Rodrigo Paracampo; Rodrigues, Ivone Aline da Silva; Santos, Hellen Aparecida Geyer Dos

    2017-03-01

    To evaluate the effects of hypertonic saline solution associated to remote ischemic perconditioning in renal ischemia/reperfusion injury in rats. Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Hypertonic saline solution group (HSS) treated with hypertonic saline solution (4ml/kg); remote ischemic perconditioning + Hypertonic saline solution group (Per+HSS) with both treatments. After reperfusion, blood samples were collected for BUN and creatinine serum levels analyzes. TBARS were evaluated in plasma and renal tissue to assess oxidative stress. Kidney histopathological examination were performed. Per+HSS group showed a lower degree of renal dysfunction in relation to I/R group, whereas the technique of remote ischemic perconditioning isolated or associated with saline solution significantly reduced oxidative stress and histological damage. Remote ischemic perconditioning associated or not to saline solution promoted reduction of acute renal injury induced by ischemia/reperfusion.

  20. Corrosion behaviour of niobium in phosphate buffered saline solutions with different concentrations of bovine serum albumin

    Energy Technology Data Exchange (ETDEWEB)

    Wang Wei, E-mail: msewei@interchange.ubc.ca [Department of Materials Engineering, University of British Columbia, Vancouver, BC (Canada); Mohammadi, Farzad; Alfantazi, Akram [Department of Materials Engineering, The University of British Columbia, Vancouver, BC (Canada)

    2012-04-15

    Highlights: Black-Right-Pointing-Pointer Corrosion of Nb was investigated in phosphate buffered saline solutions. Black-Right-Pointing-Pointer Addition of bovine serum albumin lowered the open circuit potential of Nb. Black-Right-Pointing-Pointer Open circuit potential, polarization resistance and impedance increased with time. Black-Right-Pointing-Pointer Bovine serum albumin molecules and PO{sub 4}{sup 3-} competitively adsorbed on Nb surface. Black-Right-Pointing-Pointer A surface distribution of time-constants was proposed. - Abstract: The corrosion behaviour of Nb was studied in phosphate buffered saline (PBS) solutions at a presence of 0-6 g L{sup -1} bovine serum albumin (BSA). Addition of BSA to PBS solutions lowered the open circuit potential (OCP). OCP, polarization resistance and impedance increased over immersion time. The adsorption process of BSA on Nb surface was found to be faster than that of the PO{sub 4}{sup 3-}. According to X-ray Photoelectron Spectroscopy (XPS) a competitive adsorption between PO{sub 4}{sup 3-} and BSA was in effect during the immersion process. Based on the analysis of effective capacitances, a surface distribution of time-constants was proposed.

  1. 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

  2. Management of hemodialysis catheter-related bacteremia with an adjunctive antibiotic lock solution.

    Science.gov (United States)

    Krishnasami, Zipporah; Carlton, Donna; Bimbo, Lisa; Taylor, Maria E; Balkovetz, Daniel F; Barker, Jill; Allon, Michael

    2002-03-01

    Tunneled dialysis catheters are complicated by frequent systemic infections. Standard therapy of catheter-associated bacteremia involves both systemic antibiotics and catheter replacement. Recent data suggest that biofilms in the catheter lumen are responsible for the bacteremia, and that instillation of an antibiotic lock (highly concentrated antibiotic solution) into the catheter lumen after dialysis sessions can eradicate the biofilm. We analyzed prospectively the efficacy of an antibiotic lock protocol, in conjunction with systemic antibiotics, for treatment of patients with dialysis catheter-associated bacteremia without catheter removal. Protocol success was defined as resolution of fever and negative surveillance cultures one week following completion of the protocol. Protocol failure was defined as persistence of fever or surveillance cultures positive for any pathogen. In addition, infection-free catheter survival was compared to that observed in institutional historical control patients treated with catheter replacement. Blood cultures were positive in 98 of 129 of episodes (76%) in which patients dialyzing with a catheter had fever or chills. Protocol success occurred in 40 of 79 infected patients (51%) treated with the antibiotic lock. Protocol failure occurred in 39 cases (49%): 7 had persistent fever, 15 had positive surveillance cultures (9 for Candida and 6 for bacteria), and 17 required catheter removal due to malfunction. Each of the pathogens in the surveillance cultures was different from the original pathogen in that patient. Eight of the 9 secondary Candida infections and all 6 secondary bacterial infections resolved after catheter exchange and specific antimicrobial treatment. Overall catheter survival with the antibiotic lock protocol was similar to that observed among patients managed with catheter replacement (median survival, 64 vs. 54 days, P = 0.24). Use of an antibiotic lock, in conjunction with systemic antibiotic therapy, can

  3. Evaluation of the Maintained Effect of 3% Hypertonic Saline Solution in an Animal Model of Intracranial Hypertension.

    Science.gov (United States)

    Sousa, Leonardo M; de Andrade, Almir F; Belon, Alessandro R; Soares, Matheus S; Amorim, Robson Luis; Otochi, Jose Pinhata; Teixeira, Manoel J; Paiva, Wellingson S

    2016-10-25

    BACKGROUND Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol solutions. Previous studies have shown that hypertonic solutions are particularly effective. Although several concentrations of saline solution have been proposed, a 3% solution is the most widely used. The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension. MATERIAL AND METHODS A porcine model of reversible intracranial hypertension was created by inserting a balloon catheter into the brain parenchyma, which was inflated and deflated to simulate intracranial hypertension and its surgical correction. The experiment included 3 groups of animals (A, B, and C) with different balloon inflation volumes. In group B, balloons were inflated 2 times to simulate reexpansion. A 20 mL/kg bolus of 3% saline solution was infused using a pump 90 minutes after the start of balloon inflation, and the effects of intracranial pressure were evaluated 60 minutes after infusion. RESULTS No increases outside of the normal range were observed in mean serum sodium concentrations (p=0.09). In addition, we identified no differences within each group in serum sodium levels measured during hypertonic saline infusion (p=0.21). No significant reductions in intracranial pressure were observed in any of the 3 groups. CONCLUSIONS Bolus infusion of 3% hypertonic saline solution with the aid of a pump does not significantly reduce intracranial pressure in an animal model of intracranial hypertension.

  4. Microbial degradation of phenol in high-salinity solutions in suspensions and hollow fiber membrane contactors.

    Science.gov (United States)

    Juang, Ruey-Shin; Wu, Cheng-Ying

    2007-01-01

    A microporous polypropylene (PP) hollow fiber membrane contactor was used as a bioreactor to degrade phenol in aqueous solutions by Pseudomonas putida BCRC 14365 at 30 degrees C. The fibers were pre-wetted by ethanol to make them more hydrophilic. The initial cell density was fixed at 0.025 gl(-1). The effects of added NaCl concentration (0-1.78 M) and pH (3-8) in substrate solution on the biodegradation were studied. The experimental results by suspended cells were discussed. It was shown that the cells in microporous hollow fibers were unable to tolerate substrate solution pH to a larger range than those in suspensions. The suspended cells grew well on 100 mg l(-1) of phenol only at NaCl concentrations below 0.44 M. However, the cells in microporous hollow fibers could completely degrade 500 mg l(-1) of phenol in solutions containing NaCl concentration up to 1.52 M, which was due to the enhanced tolerance limit to salinity effect by the membrane-attached biofilms and the sufficiently slow mass transfer of NaCl through the membrane pores.

  5. Stability of Norepinephrine Solutions in Normal Saline and 5% Dextrose in Water

    Science.gov (United States)

    Walker, Scott E; Law, Shirley; Garland, Jill; Fung, Esther; Iazzetta, John

    2010-01-01

    Background: Most previous stability studies for norepinephrine have reported the percentage of drug remaining in IV solutions after only 24 h. No previously published study has evaluated the effect of light on the stability of this drug. Objective: To evaluate the stability of norepinephrine (64 mg/L) in either normal saline (NS; 0.9% sodium chloride) or 5% dextrose in water (D5W) with storage at either 4°C or room temperature (23°C) in polyvinyl chloride (PVC) bags exposed to or protected from normal room lighting for 2 months. Methods: Thirty-two PVC bags were prepared, each containing norepinephrine at 64 mg/L; half of the bags had normal saline as the diluent and the other half had D5W. The bags were stored at either 4°C or room temperature (23°C), with protection from or exposure to ambient fluorescent room light. Overall, there were 4 bags for each combination of diluent, temperature, and light condition. The concentration of norepinephrine in each bag was determined by a validated, stability-indicating liquid chromatographic method on study days 0, 1, 2, 3, 4, 8, 9, 10, 11, 14, 18, 21, 23, 25, 28, 30, 36, 42, and 61. Results: Analysis of variance revealed differences in percentage remaining as a function of study day (p 0.99). Conclusions: Solutions of norepinephrine 64 mg/L in NS or D5W can be stored in PVC bags at 4°C for up to 61 days with protection from light. This expiry date allows for up to 24 h storage at 23°C. Solutions that are not protected from light will retain only 90% of the initial concentration after storage for 39 days at 4°C. This storage period could include up to 24 h at room temperature, without protection from light. PMID:22478966

  6. Home Hemodialysis

    Science.gov (United States)

    ... weeks of home hemodialysis training. Diet and Liquids Strict limits on liquids, phosphorus, sodium, and potassium Fewer ... Health Information Diabetes Digestive Diseases Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  7. 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....

  8. Cold glycerol-saline: the promising quenching solution for accurate intracellular metabolite analysis of microbial cells.

    Science.gov (United States)

    Villas-Bôas, Silas G; Bruheim, Per

    2007-11-01

    Microbial metabolomics has been seriously limited by our inability to perform a reliable separation of intra- and extracellular metabolites with efficient quenching of cell metabolism. Microbial cells are sensitive to most (if not all) quenching agents developed to date, resulting in leakage of intracellular metabolites to the extracellular medium during quenching. Therefore, as yet we are unable to obtain an accurate concentration of intracellular metabolites from microbial cell cultures. However, knowledge of the in vivo concentrations of intermediary metabolites is of fundamental importance for the characterization of microbial metabolism so as to integrate meaningful metabolomics data with other levels of functional genomics analysis. In this article, we report a novel and robust quenching method for microbial cell cultures based on cold glycerol-saline solution as the quenching agent that prevents significant leakage of intracellular metabolites and, therefore, permits more accurate measurement of intracellular metabolite concentrations in microbial cells.

  9. 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.

  10. Core temperature cooling in healthy volunteers after rapid intravenous infusion of cold and room temperature saline solution.

    Science.gov (United States)

    Moore, Tracy M; Callaway, Clifton W; Hostler, David

    2008-02-01

    Studies have suggested that inducing mild hypothermia improves neurologic outcomes after traumatic brain injury, major stroke, traumatic hemorrhage, and cardiac arrest. Although infusion of cold normal saline solution is a simple and inexpensive method for initiating hypothermia, human cold-defense mechanisms potentially make this route stressful or ineffective. We hypothesize that rapid infusion of 30 mL/kg of cold (4 degrees C, 39.2 degrees F) 0.9% saline solution during 30 minutes to healthy subjects (aged 27 [standard deviation (SD) 4] years) will reduce core body temperature to the therapeutic range of 33 degrees C to 35 degrees C (91.4 degrees F to 95 degrees F). Sixteen subjects were randomly assigned to receive either cold (4 degrees C, 39.2 degrees F) or room temperature (23 degrees C, 73.4 degrees F) normal saline solution. Subjects were not informed of their assignment, but blinding was not possible after initiation of the infusion. Core temperature, skin temperature, and vital signs were recorded every 2 minutes. Subjects indicated global discomfort during the infusion on a 100-mm visual analog scale at 5-minute intervals. Core temperature decreased in both the cold saline solution (1.0 degrees C [SD 0.4 degrees C]/1.8 degrees F [0.7 degrees F]) and room temperature saline solution (0.5 degrees C [SD 0.1 degrees C]/0.9 degrees F [0.2 degrees F]) groups, whereas skin temperature was unchanged. Slopes calculated from the core temperature cooling curves indicate that the majority of cooling occurred during the first half of the infusion. Examination of the core temperature cooling curves revealed a 2-phase temporal pattern in 30-minute cooling curves. The early phase, spanning 0 to 14 minutes, demonstrated rapid cooling in both groups, with a larger effect observed in subjects receiving cold saline solution. In this pilot study of healthy volunteers, rapid administration of cold saline solution to awake normothermic volunteers resulted in 1 degrees C (1

  11. An ethanol/sodium citrate locking solution compared to heparin to prevent hemodialysis catheter-related infections: a randomized pilot study.

    Science.gov (United States)

    Vercaigne, Lavern M; Allan, Don R; Armstrong, Sean W; Zacharias, James M; Miller, Lisa M

    2016-01-01

    The objective of this study was to compare the initial safety and efficacy of a novel 30% ethanol/4% sodium citrate catheter-locking solution to heparin in a hemodialysis population. This was a prospective, randomized, pilot study of 40 hemodialysis patients randomized to a 30% ethanol/4% sodium citrate or heparin 1000 units/mL locking solution. The primary outcome was identification of any serious adverse events over the study duration. Secondary outcomes included the rate per 1000 catheter days for catheter-related bloodstream infections (CRBSI), alteplase use, catheter dysfunction, and catheter removal. Three serious adverse events were reported as possibly related to the catheter solutions. Only one CRBSI was observed during the study in the heparin arm. The rate of alteplase use was 1.5/1000 catheter days in the heparin arm compared to 2.8/1000 catheter days in the ethanol/citrate arm (rate ratio = 1.85, 90% CI 0.48, 7.07, p value = 0.45), while the rate of catheter dysfunction was 6.8/1000 catheter days in the heparin arm compared to 1.9/1000 catheter days in the ethanol citrate arm (rate ratio = 0.27, 90% CI 0.10, 0.74, p value = 0.04). Catheter survival to first catheter outcome was longer in the ethanol/citrate group compared to heparin and there were no catheter removals due to bacteremia or thrombosis. The ethanol/sodium citrate locking solution was safely used in this study. It appears to prevent CRBSI and may improve catheter survival compared to heparin. ClinicalTrials.gov Identifier: NCT01394458.

  12. 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.

  13. Endovenous laser ablation of great saphenous veins performed using tumescent cold saline solution without local anesthesia.

    Science.gov (United States)

    Cavallini, Alvise; Marcer, Daniela; Bernardini, Giovanni; Ferrari Ruffino, Salvatore

    2014-05-01

    In recent years, laser systems with higher wavelengths, associated with new optical fibers, have shown excellent short-term results in treating saphenous veins and reducing the side effects and, in particular, the postoperative pain. However, if the patients are not anesthetized, they may feel pain even when using low energy with the high-wavelength laser; the only tumescent local anesthesia often does not guarantee a complete pain control during endovenous laser ablation (EVLA). Aim of this study was to demonstrate that the local anesthesia during EVLA of great saphenous veins (GSVs) is not essential for the perioperative comfort of the patient if a mild sedation is made. Forty-nine incompetent GSVs were treated by EVLA with a cold saline tumescent solution (CSTS) without local anesthetic drugs. EVLA was performed with a 1540-nm diode laser and a 600-μc ball-tipped fiber. Intraoperative ultrasonography was then used to guide delivery of CSTS (cold saline solution 0.9% at 5°C) using a motor pump under intravenous sedation. The gravity of chronic venous disease was determined according to the clinical-etiology-anatomy-pathophysiology classification. Patients rated surgery global pain according to 4 types: "extremely," "rather," "slightly," and "not at all" painful. Twenty-five cases (51%) were classified as C3, 20 (41%) as C2, 6 (13%) as C4, and 1 (2%) as C6. Midazolam 2.5 mg + a mean of 0.16 mg of fentanil (minimum: 0.10; maximum: 0.20; standard deviation [SD]: 0.4) + a mean of 178.21 mg of propofol (minimum: 100; maximum: 300; SD: 47.1) were administrated as intravenous sedation. The total average linear endovenous energy density was 57.7 J/cm. Approximately 250 mL (minimum: 100; maximum: 780) of CSTS was administered. No Patient has had pain during the procedure. All patients were discharged 2.5 hrs after surgery. EVLA under sedation using CSTS without diluted anesthetic drugs is a suitable technique in an outpatients clinic, especially useful if the ablation

  14. 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.

  15. 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.

  16. Protective effect of hydrogen rich saline solution on experimental ovarian ischemia reperfusion model in rats.

    Science.gov (United States)

    Gokalp, Nurcan; Basaklar, Abdullah Can; Sonmez, Kaan; Turkyilmaz, Zafer; Karabulut, Ramazan; Poyraz, Aylar; Gulbahar, Ozlem

    2017-03-01

    The present study aimed to investigate the effects of hydrogen rich saline solution (HRSS) in a rat model of ovarian ischemia-reperfusion injury. Thirty-six female Wistar-albino rats were grouped randomly, into six groups of six rats. The groups were classified as: sham (S), hydrogen (H), torsion (T), torsion/detorsion (TD), hydrogen-torsion (HT), and hydrogen-torsion/detorsion (HTD). Bilateral adnexal torsion was performed for 3h in all torsion groups. HRSS was given 5ml/kg in hydrogen groups intraperitoneally. Malondialdehyde (MDA) and glutathione-S-transferase (GST) levels were measured in both the plasma and tissue samples. Tissue sections were evaluated histopathologically, and the apoptotic index was detected by TUNEL assay. The results were analyzed by Kruskal-Wallis and Pearson chi-square tests using computer software, SPSS Version 20.0 for Windows. The MDA levels were higher and GST levels were lower in the torsion and detorsion groups when compared to other groups, but the differences were insignificant (P>0.05). The MDA levels were lower and GST levels were higher in the HT and HTD groups compared with the T and TD groups (P>0.05). Follicular injury, edema, vascular congestion, loss of cohesion and apoptotic index were higher in the torsion groups but decreased in the groups that received HRSS. According to histopathological and biochemical examinations, HRSS is effective in attenuating ischemia-reperfusion induced ovary injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 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.

  18. Nasal irrigation with saline solution significantly improves oxygen saturation in infants with bronchiolitis.

    Science.gov (United States)

    Schreiber, Silvana; Ronfani, Luca; Ghirardo, Sergio; Minen, Federico; Taddio, Andrea; Jaber, Mohamad; Rizzello, Elisa; Barbi, Egidio

    2016-03-01

    Published guidelines do not recommend nasal irrigation in bronchiolitis, but it is common practice in Italy, despite a lack of data on its benefits or adverse effects. This single-blind, multicentre, randomised controlled trial compared nasal irrigation using either isotonic 0.9% sodium chloride or hypertonic 3% sodium chloride with simple supportive care in infants with bronchiolitis. We randomly assigned 133 infants up one year of age, who were admitted to the emergency department with bronchiolitis and an oxygen saturation (SpO2) of between 88 and 94%, to the isotonic (n = 47), hypertonic (n = 44) or standard care (n = 42) groups. Variations in SpO2 and the wheeze, air exchange, respiratory rate, muscle use (WARM) respiratory distress score were recorded at zero, five, 15, 20 and 50 minutes. Five minutes after the intervention, the median SpO2 value (95%) in the isotonic group was higher than both the hypertonic (94%) and the standard care (93%) groups. The differences between the isotonic and standard treatment groups were statistically significant at each time point, while the hypertonic group only reached significantly higher values after 50 minutes. However, the WARM score did not improve. A single nasal irrigation with saline solution significantly improved oxygen saturation in infants with bronchiolitis. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Vascular Access for Hemodialysis

    Science.gov (United States)

    ... Adequacy Eating & Nutrition for Hemodialysis Vascular Access for Hemodialysis What is a vascular access? A vascular access ... Set Up the Vascular Access Well before Starting Hemodialysis Patients should set up a vascular access well ...

  20. Salinity, dissolved organic carbon and water hardness affect peracetic acid (PAA) degradation in aqueous solutions

    DEFF Research Database (Denmark)

    Liu, Dibo; Steinberg, Christian E.W.; Straus, David L.

    2014-01-01

    -degradation of three commercial products, Wofasteril® E400, Wofasteril® E250 and Wofasteril® Lspez, at a nominal concentration of 1 mg L−1 in relation to two levels of salinity, water hardness, or dissolved organic carbon (DOC). The results showed that salinity and DOC stimulate PAA-degradation, while water hardness...

  1. 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.

  2. Normal saline solution nasal-pharyngeal irrigation improves chronic cough associated with allergic rhinitis.

    Science.gov (United States)

    Lin, Lin; Chen, Zhongchun; Cao, Yitan; Sun, Guangbin

    2017-03-01

    Upper airway inflammation is one of the most commonly identified causes of chronic cough, although the underlying mechanism is not clear. This study compared normal saline solution nasal-pharyngeal irrigation (NSNPI) and fluticasone propionate nasal spray (FPNS) treatment for chronic cough associated with allergic rhinitis (AR). Patients with suspected AR to house-dust mite were enrolled, and the symptom of cough was assessed by a cough symptom score and the Leicester Cough Questionnaire, and cough response to capsaicin was evaluated. AR was assessed by using the visual analog scale (VAS) and the Mini Juniper Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Mediators, including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein from nasal lavage fluid (NLF) were examined. The patients were treated with NSNPI (the NSNPI group) or FPNS (the FPNS group) for 30 days, after which they were reassessed. Forty-five of 50 patients completed this study. The scores of the cough symptom and the Leicester Cough Questionnaire, and the capsaicin cough threshold all improved statistically after NSNPI but did not change after FPNS. There were statistically significant changes in the evaluations of the MiniRQLQ and the mediators, including histamine and leukotriene C4, in the NLF in the NSNPI group. However, significant changes were found in the assessments of VAS, MiniRQLQ, and all above mediators including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein in the NLF of the FPNS group. Furthermore, the assessments of VAS and all the mediators were reduced more in the FPNS group compared with those in the NSNPI group. The patients with suspected AR to house-dust mite reported a better relief of the cough symptom after 30 days of treatment with NSNPI compared with that after nasal corticosteroid.

  3. Controlled trial of Hartmann's solution versus 0.9% saline for diabetic ketoacidosis.

    Science.gov (United States)

    Yung, Michael; Letton, Georgia; Keeley, Steve

    2017-01-01

    We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid-base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS). We conducted a double-blind, randomised controlled trial comparing HS to NS as the initial intravenous fluid in children with DKA. Patients were stratified by severity (pH < 7.1) and known or new diabetes. Electrolytes, venous blood gases and glucose were measured every 2 h until intravenous fluids were ceased. The primary outcome was the time for the plasma bicarbonate to reach 15 mmol/L. Secondary outcomes included time to normalise pH (7.3), time to receive subcutaneous (SC) insulin, change in sodium and insulin requirement. A total of 77 children were enrolled. The groups were similar at baseline. There was no difference in the time to reach a bicarbonate of 15 mmol/L: geometric mean (SD) 8.6 (2.3) h for NS versus 6.2 (4.7) h for HS, ratio 1.4 (95% confidence interval 0.8-2.5), and no difference in time to normalise pH: NS 8.5 (2.3) h versus HS group 7.5 (1.8) h, ratio 1.1 (0.8-1.6). Kaplan-Meier survival estimates showed shorter times for these end-points in the severe subgroup: log-rank test P = 0.0277 and 0.0024, respectively. There was no difference in time to SC insulin, NS: 15.2 (2.4) h versus HS 14.3 (1.6) h, ratio 1.1 (0.8-1.5). Patients treated with HS received significantly less total fluids/kg. HS is an acceptable alternative to NS in DKA and may benefit those with severe DKA. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  4. Reactivity classification in saline solution of magnetron sputtered or EBPVD pure metallic, nitride and Al-based alloy coatings

    Energy Technology Data Exchange (ETDEWEB)

    Creus, J., E-mail: jcreus@univ-lr.fr [LEMMA, Universite de la Rochelle, Av. Michel Crepeau, F-17042 La Rochelle Cdx (France); Berziou, C.; Cohendoz, S.; Perez, A.; Rebere, C.; Reffass, M.; Touzain, S. [LEMMA, Universite de la Rochelle, Av. Michel Crepeau, F-17042 La Rochelle Cdx (France); Allely, C. [Arcelor Mittal, Voie Romaine, BP 30320, F-57283 Maizieres les Metz Cdx (France); Gachon, Y.; Heau, C. [HEF R and D, Rue Benoit Fourneyron, F-42166 Andrezieux Boutheon Cdx (France); Sanchette, F. [CEA Grenoble DRT/LITEN/DTMN/LTS, 17 rue des Martyrs, F-38054 Grenoble (France); LERMPS, UTBM, F-90010 Belfort (France); Billard, A. [LERMPS, UTBM, F-90010 Belfort (France)

    2012-04-15

    Highlights: Black-Right-Pointing-Pointer Morphological and structural characterisation of metals and alloys deposited by PVD. Black-Right-Pointing-Pointer Electrochemical reactivity of Al-based alloys in saline solution. Black-Right-Pointing-Pointer Influence of incorporation of transition metals on the pitting corrosion of aluminium. Black-Right-Pointing-Pointer Reactivity classification of Al coatings deposited by vacuum deposition techniques. Black-Right-Pointing-Pointer Classification of mechanical properties in terms of micro-hardness measurements. - Abstract: In this study, various metallic or nitride coatings elaborated by Electron Beam Physical Vapour Deposition (EBPVD) or magnetron sputtering techniques are characterised in terms of mechanical properties and corrosion behaviour in saline solution. The incorporation of transition metals permits to modify the mechanical or physico-chemical characteristics of aluminium coatings, so several alloying elements are compared. These alloys are also compared with pure metallic coatings and/or coatings synthesized by reactive magnetron sputtering. Evolution of microstructure of the Al based coatings was discussed versus the alloying element content. Different compositions of alloys were examined. This paper presents the synthesis of the main tendency reported during the evaluation of the mechanical and corrosion properties of these alloys. The objective is to build a reactivity classification in saline solution of several Al based coatings synthesized by vacuum deposition techniques. Combined with the classification of mechanical properties, these standards would become relevant guides in the choice of PVD coatings and/or alloys for applications exposed to saline environments. In our study, this guide is helpful in the synthesis of nanometric multilayer architectures, which proves to be a promising way to combine improved mechanical properties with sacrificial character for the future coating configurations.

  5. Changes in Serum Bicarbonate Levels Caused by Acetate-Containing Bicarbonate-Buffered Hemodialysis Solution: An Observational Prospective Cohort Study.

    Science.gov (United States)

    Panesar, Mandip; Shah, Neal; Vaqar, Sarosh; Ivaturi, Kaushik; Gudleski, Gregory; Muscarella, Mary; Lambert, Judy; Su, Winnie; Murray, Brian

    2017-04-01

    Fresenius Medical Care's NaturaLyte dialysate has been associated with increased risk of sudden cardiac death by causing metabolic alkalosis from its acetate content based on retrospective data using pre-dialysis bicarbonate levels only. The study objective was to measure inter/intra-dialytic changes in serum bicarbonate and degree of alkalosis conferred by varying concentrations of NaturaLyte bicarbonate dialysate. Thirty-nine hemodialysis patients were divided into four groups based on prescribed bicarbonate dialysate concentrations; Group 1 (N = 9): 30-32 mEq/L, Group 2 (N = 5): 33-34 mEq/L, Group 3 (N = 10): 35-36 mEq/L, Group 4 (N = 15): 37-40 mEq/L. Serial (pre-dialysis, immediate post-dialysis, 2 h post-dialysis, and 68 h post-dialysis) bicarbonate levels were measured. Mean pre-dialysis serum bicarbonate levels (representing 44 h post-dialysis levels) in all four groups were not statistically different. Pre-dialysis and 68 h post-dialysis bicarbonate levels in each group were also not significantly different. However, immediate post-dialysis and 2 h post-dialysis bicarbonate levels were significantly increased in all four groups proportional to dialysate dose. There was statistically significant inter-group bicarbonate level difference (P bicarbonate dialysate causes large and rapid fluctuations in serum bicarbonate levels during the intra/inter-dialytic period, which returns to baseline within 44 to 68 h after dialysis. This refutes the necessity to correct pre-dialysis acidosis with high bicarbonate dialysate since rapid equilibration is likely to occur and unnecessarily exposes patients to large shifts in their acid base balance. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  6. Cardiopulmonary effects of 7.2% saline solution compared with gelatin infusion in the early postoperative period after coronary artery bypass grafting

    National Research Council Canada - National Science Library

    FCPS, Rashid Mazhar; Samenesco, Adrian; Royston, David; Rees, Alun

    1998-01-01

    ...: We report a clinical study on the use of 7.2%, 2400 mOsm/L, hypertonic saline solution compared with gelatin in early postoperative period after coronary artery bypass surgery. Methods: Two groups ( n  = 10 each...

  7. Investigations of PAA degradation in aqueous solutions: Impacts of water hardness, salinity and DOC

    Science.gov (United States)

    Peracetic acid (PAA) is used in aquaculture under various conditions for disinfection purposes. However, there is lack of information about its environmental fate. Therefore, the impact of water hardness, salinity, and dissolved organic carbon (DOC) on PAA-degradation within 5 hours was investigat...

  8. 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

  9. 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.

  10. The effects of magnetic fields exposure on relative permittivity of saline solutions measured by a high resolution SPR system.

    Science.gov (United States)

    Jiang, Li; Zhao, Xinyuan; Fei, Yue; Yu, Dongdong; Qian, Jun; Tong, Jinguang; Chen, Guangdi; He, Sailing

    2016-04-28

    A measurement system for the relative permittivity of a physiological solution under 50 Hz magnetic fields (MF) is presented. It is based on a phase-sensitive surface plasmon resonance (SPR) system. Relative permittivity was analyzed for different solute concentrations of sodium chloride under various MF exposure parameters. We found that MF exposure at 0.2-4.0 mT step-wise decreased significantly the SPR phase signal of a 0.9% sodium chloride solution while 0.1 mT of MF exposure did not. The decreases in the SPR phase signal depended on the duration of MF exposure, and the signal reached a plateau after 15 min of exposure. Interestingly, the decreased SPR phase signal showed a gradual increase and approached the background level when the exposure was drawn off. In addition, we found that the response of the sodium chloride solution to MF also depended on its concentration. In brief, the relative permittivity of sodium chloride in solutions appears to be practically affected by 50 Hz MF exposure. Our data indicates that the relative permittivity of the saline solution influenced by MF exposure should be considered when investigating the biological effects of MF exposure on organisms in experimental study.

  11. 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.

  12. 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.

  13. Proteomic Investigations into Hemodialysis Therapy.

    Science.gov (United States)

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

    2015-12-10

    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.

  14. Antihypertensive Agents in Hemodialysis Patients: A Current Perspective

    OpenAIRE

    Inrig, Jula K.

    2010-01-01

    Hypertension affects most hemodialysis patients and is often poorly controlled. Adequate control of blood pressure is difficult with conventional hemodialysis alone but is important to improve cardiovascular outcomes. Nonpharmacologic interventions to improve blood pressure include educating patients about limiting sodium intake, ensuring adequate sodium solute removal during hemodialysis, and achieving target “dry weight.” However, most patients require a number of antihypertensive medicatio...

  15. Does antimicrobial lock solution reduce catheter-related infections in hemodialysis patients with central venous catheters? A Bayesian network meta-analysis.

    Science.gov (United States)

    Zhang, Jun; Wang, Bo; Li, Rongke; Ge, Long; Chen, Kee-Hsin; Tian, Jinhui

    2017-04-01

    The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial lock solutions (ALS) for prevention of catheter-related infections (CRI) in patients with hemodialysis (HD) and ranking these ALS for practical consideration. We searched six electronic databases, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared ALS for preventing episodes of CRI in patients with HD either head-to-head or against control interventions using non-ALS. Two authors independently assessed the methodological quality of included studies using the Cochrane risk of bias tool and extracted relevant information according to a predesigned extraction form. Data were analysed using the WinBUGS (V.1.4.3) and the Stata (V.13.0). Finally, 18 studies involving 2395 patients and evaluating 9 ALS strategies were included. Network meta-analysis showed that gentamicin plus citrate (OR 0.07, 95% CrI 0.00-0.48) and gentamicin plus heparin (OR 0.04, 95% CrI 0.00-0.23) were statistically superior to heparin alone in terms of reducing CRBSI. For exit site infection and all-cause mortality, no significant difference in the intervention effect (p > 0.05) was detected for all included ALS when compared to heparin. Moreover, all ALS were similar in efficacy (p > 0.05) from each other for CRBSI, exit site infection and all-cause mortality. Our findings indicated that gentamicin plus heparin may be selected for the prophylaxis of CRI in patients undergoing HD with CVCs. Whether this strategy will lead to antimicrobial resistance remains unclear in view of the relatively short duration of included studies. More attentions should be made regarding head-to-head comparisons of the most commonly used ALS in this field.

  16. Resuscitation of Intraoperative Hypovolemia: Comparison of Normal Saline and Hyperosmotic/Hyperoncotic Solutions in Swine

    Science.gov (United States)

    1991-05-01

    hypocalcemia , hyperkalemia, metabolic acidosis, coagulation derangements, as well as viral infections (11. Isotonic crystalloid solutions are only...Nakayama S,Gunther R, Holcroft J. A comparison of several hypertonic solutions for resuscitation of bled sheep . J Surg Res 1965;39:517-528. 14. Wade

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

    OpenAIRE

    Jessica Nover; Benjamin Wirth; Charles J Coronella; M Toufiq Reza

    2016-01-01

    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 phospho...

  18. Ultrapure dialysate for home hemodialysis?

    Science.gov (United States)

    Ouseph, Rosemary; Ward, Richard A

    2007-07-01

    Use of ultrapure dialysate (bacteria home hemodialysis. More frequent dialysis also appears to reduce inflammation, and whether combining more frequent dialysis with use of ultrapure dialysate will have an additive effect on inflammation and its consequences remains unclear. Routinely producing ultrapure dialysate in a home environment with a conventional hemodialysis machine poses technical challenges related to the design of the equipment and the intermittent nature of hemodialysis. Solutions to these problems include use of a system in which the water-treatment equipment is fully integrated with the dialysis machine, use of dry-powder cartridges or sterile prepackaged liquids for bicarbonate concentrate, and use of a bacteria-retentive and endotoxin-retentive filter for final purification of the dialysate immediately before it enters the dialyzer. Alternatively, ultrapure dialysate may be achieved with newer machines designed specifically for home hemodialysis that use a new batch of dialysate for each treatment. The volume of dialysate available with these machines, however, currently limits their use to short-daily dialysis.

  19. The effects of balanced versus saline-based hetastarch and crystalloid solutions on acid-base and electrolyte status and gastric mucosal perfusion in elderly surgical patients.

    Science.gov (United States)

    Wilkes, N J; Woolf, R; Mutch, M; Mallett, S V; Peachey, T; Stephens, R; Mythen, M G

    2001-10-01

    The IV administration of sodium chloride solutions may produce a metabolic acidosis and gastrointestinal dysfunction. We designed this trial to determine whether, in elderly surgical patients, crystalloid and colloid solutions with a more physiologically balanced electrolyte formulation, such as Hartmann's solution and Hextend, can provide a superior metabolic environment and improved indices of organ perfusion when compared with saline-based fluids. Forty-seven elderly patients undergoing major surgery were randomly allocated to one of two study groups. Patients in the Balanced Fluid group received an intraoperative fluid regimen that consisted of Hartmann's solution and 6% hetastarch in balanced electrolyte and glucose injection (Hextend). Patients in the Saline group were given 0.9% sodium chloride solution and 6% hetastarch in 0.9% sodium chloride solution (Hespan). Biochemical indices and acid-base balance were determined. Gastric tonometry was used as a reflection of splanchnic perfusion. Postoperative chloride levels demonstrated a larger increase in the Saline group than the Balanced Fluid group (9.8 vs 3.3 mmol/L, P = 0.0001). Postoperative standard base excess showed a larger decline in the Saline group than the Balanced Fluid group (-5.5 vs -0.9 mmol/L, P = 0.0001). Two-thirds of patients in the Saline group, but none in the Balanced Fluid group, developed postoperative hyperchloremic metabolic acidosis (P = 0.0001). Gastric tonometry indicated a larger increase in the CO2 gap during surgery in the Saline group compared with the Balanced Fluid group (1.7 vs 0.9 kPa, P = 0.0394). In this study, the use of balanced crystalloid and colloid solutions in elderly surgical patients prevented the development of hyperchloremic metabolic acidosis and resulted in improved gastric mucosal perfusion when compared with saline-based solutions. This prospective, randomized, blinded trial showed that, in elderly surgical patients, the use of balanced IV solutions can

  20. Cardiopulmonary effects of 7.2% saline solution compared with gelatin infusion in the early postoperative period after coronary artery bypass grafting.

    Science.gov (United States)

    Mazhar, R; Samenesco, A; Royston, D; Rees, A

    1998-01-01

    We report a clinical study on the use of 7.2%, 2400 mOsm/L, hypertonic saline solution compared with gelatin in early postoperative period after coronary artery bypass surgery. Two groups (n = 10 each) received 5 ml/kg of either saline solution or gelatin over 1 hour. Cardiac index, central venous pressure, pulmonary capillary wedge pressure, systemic and pulmonary vascular resistance indices, arterial oxygen tension, plasma osmolarity, electrolytes, and urinary output were recorded before starting the infusion and subsequently at 10, 30, 60, 90, 120, 240 and 600 minutes. Plasma creatinine, urea, electrolytes, urinary volume, and sodium excretion were measured at 12 and 24 hours. There were no significant demographic or operative difference between the groups. Patients receiving saline solution had a larger diuresis at 12 (p = 0.0008) and 24 hours (p = 0.002), with less positive balance at 12 hours (p = 0.0008). The group receiving saline solution had better cardiorespiratory recovery with shorter extubation time (p = 0.033), and earlier increase in cardiac index with a positive correlation between plasma sodium content and cardiac index. Maximum increase in cardiac index (+31%) occurred at 60 minutes (p = 0.025) associated with 8% increase in plasma sodium content (r = 0.51, p = 0.01), without a concomitant rise in pulmonary capillary wedge pressure. The group receiving gelatin had a linear increase in cardiac index with increasing pulmonary capillary wedge pressure, reaching +16% from baseline by 90 minutes. Compared with the gelatin-treated group, patients receiving saline solution had unchanged systemic vascular resistance index but a significantly lower pulmonary vascular resistance index with a negative correlation to plasma sodium content. There was no difference in levels of urea and creatinine. No side-effect attributable to the use of saline solution was observed.

  1. 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.

  2. The dynamics of vascular volume and fluid shifts of lactated Ringer's solution and hypertonic-saline-dextran solutions infused in normovolemic sheep.

    Science.gov (United States)

    Tølløfsrud, S; Elgjo, G I; Prough, D S; Williams, C A; Traber, D L; Kramer, G C

    2001-10-01

    Infusions of hyperosmotic-hyperoncotic solutions such as hypertonic saline dextran (HSD) are used in Europe for resuscitation of traumatic shock and perioperative volume support as an adjunct to conventional isotonic crystalloids. Whereas plasma volume expansion of HSD has been measured at single time points after the intravascular volume expansion, the detailed time course of fluid shifts during and after infusions have not been reported. We compared the time course of volume expansion during and after 30-min infusions of 4 mL/kg HSD and 25 mL/kg lactated Ringer's solution (LR) in normovolemic conscious splenectomized sheep. Peak plasma volume (Evans blue and hemoglobin dilution) expansion was similar for HSD (7.8 +/- 0.9 mL/kg) and the larger sixfold volume of LR (7.2 +/- 0.5 mL/kg). However, 30 min after the 30-min infusion (T60), plasma expansion remained larger after HSD (5.1 +/- 0.9 mL/kg) than after LR (1.7 +/- 0.6 mL/kg). Both solutions caused an equivalent diuresis. Intravascular volume expansion efficiency (VEE), defined as milliliter plasma expansion/milliliter fluid infused at 0 (T30), 30 (T60), and 60 (T90) min after infusion ended was 1.8, 1.3, and 0.8, respectively for HSD, whereas LR provided a VEE of only 0.27, 0.07, and 0.07. The relative expansion efficiency of HSD versus LR, calculated as the ratio (VEE(HSD)/VEE(LR)), was 7-fold that of LR at the end of infusion T30, and 20-fold at T60, but decreased to 9-fold by T120. Intravascular volume dynamic studies of different volume expanders in animals and patients may provide anesthesiologists with a new tool for monitoring the effectiveness of fluid therapy. Hypertonic saline dextran (HSD) is a new plasma expander recently approved for clinical use in Europe. We compared the plasma volume expansion of HSD versus lactated Ringers (LR) in normovolemic sheep. After a 30 min infusion, HSD was 7 times as effective at expanding volume as an equal volume of LR, but for the next 90 minutes the relative

  3. 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

  4. 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.

  5. 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.

  6. 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 (MoS2) 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 depressants

  7. A comparison of equivolume, equiosmolar solutions of hypertonic saline and mannitol for brain relaxation during elective supratentorial craniotomy.

    Science.gov (United States)

    Hernández-Palazón, Joaquín; Fuentes-García, Diego; Doménech-Asensi, Paloma; Piqueras-Pérez, Claudio; Falcón-Araña, Luis; Burguillos-López, Sebastián

    2016-01-01

    Hyperosmolar solutions have been used in neurosurgery to reduce brain volume and facilitate surgical exposure. The purpose of this study was to compare the effects of equivolume, equiosmolar solutions of mannitol and hypertonic saline (HS) on brain relaxation, intensive care unit (ICU) and hospital stay, postoperative outcomes and incidence of side-effects in patients undergoing elective supratentorial craniotomy. In a randomised, prospective, double-blind study, 60 patients undergoing elective supratentorial craniotomy were randomised 1:1 to receive 3 ml/kg of either 20% mannitol or 3% HS. The primary outcome was the surgical condition of the brain assessed by the neurosurgeon using a 4-point scale after opening the dura (1 = relaxed, 2 = satisfactory, 3 = firm and 4 = bulging). Secondary outcomes were electrolytes, blood gases, plasma osmolality and haemodynamic variables measured at 0 min, 30 min, 2 h and 6 h after infusion. Also, predefined postoperative complications, length of ICU and hospital stay were recorded. Appropriate statistical tests were used for comparison; p mannitol, 1(1-3) versus HS, 1(1.4) points; p = 0.55]. Patients with brain midline shift showed a worse response to hyperosmolar solutions than those without midline shift: 37% versus 8%, respectively; OR = 6.6 (95% CI, 1.54-28.83); p = 0.006. Plasma osmolality increased during the study period (6 h) in both the groups (p mannitol and 3% HS are safe and effective for intraoperative brain debulking during elective supratentorial craniotomy, but less effective in patients with pre-existing mass effect and midline shift.

  8. Hypertonic Saline Solution Drives Neutrophil from Bystander Organ to Infectious Site in Polymicrobial Sepsis: A Cecal Ligation and Puncture Model

    Science.gov (United States)

    Theobaldo, Mariana Cardillo; Llimona, Flavia; Petroni, Ricardo Costa; Rios, Ester Correia Sarmento; Velasco, Irineu Tadeu; Soriano, Francisco Garcia

    2013-01-01

    The effects of hypertonic saline solution (HSS) have been shown in several animal models of ischemia and shock. Literature has shown potential benefits of HSS modulating inflammatory response after sepsis in an animal model. We studied the HSS effects in sepsis through cecal ligation and puncture (CLP) in Balb-C mice. Groups studied: 1- CLP without treatment (CLP-C); 2- CLP treated with normal saline solution NaCl 0.9% – 34 ml/Kg (CLP-S); 3- CLP treated with HSS NaCl 7.5% – 4 ml/Kg (CLP-H); and 4- group (Basal) without no CLP or treatment. Volume infusion was always applied 30 min after CLP. Lung and peritoneal lavage were harvested after 6h and 24h of CLP to analyze cytokines amount, oxide nitric, lipid peroxidation and neutrophil infiltration. Neutrophil infiltration, ICAM-1, CXCR-2, and CXCL-1 in lung were reduced by HSS (CLP-H) compared to CLP-C or CLP-S. Neutrophil in peritoneal lavage was increased in 24h with HSS (CLP-H) compared to CLP and CLP-S. Peritoneal CXCR-2 was increased in CLP-C and CLP-S but presented a lower increase with HSS (CLP-H) after 6 hours. GRK-2 presented difference among the groups at 24 h, showing a profile similar to neutrophil infiltration. Pro-inflammatory cytokines (TNF-α and IL-6) were reduced by HSS treatment; CLP-S increased TNF-α. IL-10 was increased in lung tissue by the HSS treatment. The oxidative stress (TBARS and nitric oxide biochemistry markers) was reduced with HSS. Animal survival was 33.3% in CLP-C group, 46.6% in CLP-S group and 60% in the CLP-H group after the sixth day. The HSS protects the animal against sepsis. Our results suggest that the volume replacement modulate pro and anti-inflammatory mediators of an inflammatory response, but HSS presented a more effective and potent effect. PMID:24069301

  9. Hypertonic saline solution reduces mesenteric microcirculatory dysfunctions and bacterial translocation in a rat model of strangulated small bowel obstruction.

    Science.gov (United States)

    Luiz Zanoni, Fernando; Costa Cruz, José Walber Miranda; Martins, Joilson Oliveira; Benabou, Simon; Vicente Greco, Karin; Ramos Moreno, Ana Carolina; Baquerizo Martinez, Marina; Ferraro Calderaro, Franco; Rocha e Silva, Mauricio; Sannomiya, Paulina

    2013-07-01

    We examined the effects of hypertonic saline (HS) on inflammatory, metabolic variables, and bacterial translocation (BT) in rats submitted to intestinal obstruction and ischemia (IO). Male Wistar rats were submitted to IO and treated, 2 h thereafter, with lactated Ringer's (LR) (4 mL/kg per 5 min, i.v.) or HS (7.5% NaCl, 4 mL/kg per 5 min, i.v.). Twenty-four hours after IO, rats were also submitted to enterectomy/enteroanastomosis to resection of necrotized small bowel. Leukocyte-endothelial interactions were investigated by intravital microscopy and the expression of P-selectin and intercellular adhesion molecule 1 by immunohistochemistry. Bacterial cultures of mesenteric lymph nodes, liver, spleen, and blood were used to evaluate BT. Levels of chemokines (cytokine-induced neutrophil chemoattractants 1 and 2), insulin, and corticosterone were determined by enzyme-linked immunosorbent assay. Intestinal histology, serum urea and creatinine levels, and hepatic enzymes activities were performed to evaluate local and remote damage. Relative to IO and LR-treated rats, which exhibited increases in the number of rolling (1.5-fold), adhered (3.5-fold) and migrated (9.0-fold) leukocytes, and increased expression of P-selectin (3-fold) and intercellular adhesion molecule 1 (3-fold) on mesenteric microcirculation, treatment with HS followed by enterectomy reduced leukocyte-endothelial interactions and expression of both adhesion molecules to values attained in sham rats. Serum chemokines were normalized after treatment with both solutions followed by enterectomy. Hypertonic saline-treated rats demonstrated a significant reduction in BT to 50% in liver and spleen samples and bacteremia (14%), compared with 82% of BT in liver and spleen samples of IO and LR-treated rats and bacteremia (57%). Local intestinal damage was attenuated, and renal and hepatic function preserved by treatment with HS followed by enterectomy. Survival rate increased to 86% up to 15 days. Data presented

  10. 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.

  11. 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)

  12. Preparation of non-aggregating aqueous fullerenes in highly saline solutions with a biocompatible non-ionic polymer.

    Science.gov (United States)

    Aich, Nirupam; Boateng, Linkel K; Flora, Joseph R V; Saleh, Navid B

    2013-10-04

    Size-tunable stable aqueous fullerenes were prepared with different concentrations of biocompatible block-copolymer pluronic (PA) F-127, ranging from 0.001% to 1% (w/v). Size uniformity increased with the increase in PA concentration, yielding optimum 58.8 ± 5.6 and 61.8 ± 5.6 nm nC₆₀s and nC₇₀s, respectively (0.10%w/v PA), as observed using a dynamic light scattering technique. Fullerene aqueous suspensions also manifested enhanced stability in saline solution, Dulbecco's modified Eagle medium (DMEM), and Roswell Park Memorial Institute (RPMI) culture medium. Transmission electron microscopy was performed to elaborate on the morphology and size specificity of fullerene clusters. Physicochemical characterizations of the suspended fullerenes were performed through UV-vis spectroscopy and electrophoretic mobility measurements. PA molecules showed size restriction by encasement, as observed via molecular dynamics simulations. Such solubilization with controllable size and non-aggregating behavior can facilitate application enhancement and mechanistic environmental and toxicological studies of size-specific fullerenes.

  13. 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

  14. Characteristics of urine sodium and potassium after oral ingestion of solutions containing sodium and potassium which is isotonic to the physiological saline--a quantitative study.

    Science.gov (United States)

    Nishimuta, Mamoru

    2006-10-01

    The effects of orally ingesting 500 mL of four kinds of test solutions that were isotonic to physiological saline (i.e., containing sodium (Na) and potassium (K) as chloride with Na/K molar ratios of 1, 2, 3 and 4) on urine flow, Na and K excretions from Japanese male students were investigated. The subjects assembled at the National Institute of Nutrition the day before the oral ingestions, which were conducted three times for each subject. They were permitted to eat freely until 8:00 pm, and then the intake of food and drinks except tap water was prohibited until 10:00 pm. After that, no food or drinks except the test solution used, were permitted to be ingested until the end of the final collection of urine. Subjects were woken up at 7:00 am the next morning, at which time they emptied their bladder. At 8:00 am, after sampling control urine before ingestion, they ingested 500 mL of water, the physiological saline or one of the test solutions. Urine was collected every 30 min for 4 h after ingestion. Urine flow was significantly higher for those who drank solutions Na/ K = 1 and 2 than those who drank the saline (paired-t test), but that for those who drank solutions Na/K = 3 and 4 was not significantly higher. For those who drank solution Na/ k=2, urine Na was significantly higher than that of those who drank the saline 30 to 60 min after ingestion. An increase in urine flow after K ingestion may be an essential factor for K-induced Na uresis.

  15. Removal of Soluble Strontium via Incorporation into Biogenic Carbonate Minerals by Halophilic Bacterium Bacillus sp. Strain TK2d in a Highly Saline Solution.

    Science.gov (United States)

    Horiike, Takumi; Dotsuta, Yuma; Nakano, Yuriko; Ochiai, Asumi; Utsunomiya, Satoshi; Ohnuki, Toshihiko; Yamashita, Mitsuo

    2017-10-15

    Radioactive strontium ( 90 Sr) leaked into saline environments, including the ocean, from the Fukushima Daiichi Nuclear Power Plant after a nuclear accident. Since the removal of 90 Sr using general adsorbents (e.g., zeolite) is not efficient at high salinity, a suitable alternative immobilization method is necessary. Therefore, we incorporated soluble Sr into biogenic carbonate minerals generated by urease-producing microorganisms from a saline solution. An isolate, Bacillus sp. strain TK2d, from marine sediment removed >99% of Sr after contact for 4 days in a saline solution (1.0 × 10 -3 mol liter -1 of Sr, 10% marine broth, and 3% [wt/vol] NaCl). Transmission electron microscopy and energy-dispersive X-ray spectroscopy showed that Sr and Ca accumulated as phosphate minerals inside the cells and adsorbed at the cell surface at 2 days of cultivation, and then carbonate minerals containing Sr and Ca developed outside the cells after 2 days. Energy-dispersive spectroscopy revealed that Sr, but not Mg, was present in the carbonate minerals even after 8 days. X-ray absorption fine-structure analyses showed that a portion of the soluble Sr changed its chemical state to strontianite (SrCO 3 ) in biogenic carbonate minerals. These results indicated that soluble Sr was selectively solidified into biogenic carbonate minerals by the TK2d strain in highly saline environments. IMPORTANCE Radioactive nuclides ( 134 Cs, 137 Cs, and 90 Sr) leaked into saline environments, including the ocean, from the Fukushima Daiichi Nuclear Power Plant accident. Since the removal of 90 Sr using general adsorbents, such as zeolite, is not efficient at high salinity, a suitable alternative immobilization method is necessary. Utilizing the known concept that radioactive 90 Sr is incorporated into bones by biomineralization, we got the idea of removing 90 Sr via incorporation into biominerals. In this study, we revealed the ability of the isolated ureolytic bacterium to remove Sr under high-salinity

  16. Phytosiderophore release by wheat genotypes differing in zinc deficiency tolerance grown with Zn-free nutrient solution as affected by salinity.

    Science.gov (United States)

    Daneshbakhsh, Bahareh; Khoshgoftarmanesh, Amir Hossein; Shariatmadari, Hossein; Cakmak, Ismail

    2013-01-01

    There is limited information concerning the effect of salinity on phytosiderophores exudation from wheat roots. The aim of this hydroponic experiment was to investigate the effect of salinity on phytosiderophore release by roots of three bread wheat genotypes differing in Zn efficiency (Triticum aestivum L. cvs. Rushan, Kavir, and Cross) under Zn deficiency conditions. Wheat seedlings were transferred to Zn-free nutrient solutions and exposed to three salinity levels (0, 60, and 120 mM NaCl). The results indicated that Cross and Rushan genotypes exuded more phytosiderophore than did the Kavir genotype. Our findings suggest that the adaptive capacity of Zn-efficient 'Cross' and 'Rushan' wheat genotypes to Zn deficiency is due partly to the higher amounts of phytosiderophore release. Only 15 days of Zn deficiency stress was sufficient to distinguish between Zn-efficient (Rushan and Cross) and Zn-inefficient (Kavir) genotypes, with the former genotypes exuding more phytosiderophore than the latter. Higher phytosiderophore exudation under Zn deficiency conditions was accompanied by greater Fe transport from root to shoot. The maximum amount of phytosiderophore was exuded at the third week in 'Cross' and at the fourth week in 'Kavir' and 'Rushan'. For all three wheat genotypes, salinity stress resulted in higher amounts of phytosiderophore exuded by the roots. In general, for 'Kavir', the largest amount of phytosiderophore was exuded from the roots at the highest salinity level (120mM NaCl), while for 'Cross' and 'Rushan', no significant difference was found in phytosiderophore exudation between the 60 and 120 mM NaCl treatments. More investigation is needed to fully understand the physiology of elevated phytosiderophore release by Zn-deficient wheat plants under salinity conditions. Copyright © 2012 Elsevier GmbH. All rights reserved.

  17. Hemodialysis access -- self care

    Science.gov (United States)

    ... hemodialysis. Taking good care of your access helps make it last longer. Prevent Infection in Your Access Keep your access clean. Wash the access with soap and water every day to decrease your risk of infection. ...

  18. 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

  19. Comparison of heparin to citrate as a catheter locking solution for non-tunneled central venous hemodialysis catheters in patients requiring renal replacement therapy for acute renal failure (VERROU-REA study): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Bruyère, Rémi; Soudry-Faure, Agnès; Capellier, Gilles; Binquet, Christine; Nadji, Abdelouaid; Torner, Stephane; Blasco, Gilles; Yannaraki, Maria; Barbar, Saber Davide; Quenot, Jean-Pierre

    2014-11-19

    The incidence of acute kidney injury (AKI) is estimated at 10 to 20% in patients admitted to intensive care units (ICU) and often requires renal replacement therapy (RRT). ICU mortality in AKI patients can exceed 50%. Venous catheters are the preferred vascular access method for AKI patients requiring RRT, but carry a risk of catheter thrombosis or infection. Catheter lock solutions are commonly used to prevent such complications. Heparin and citrate locks are both widely used for tunneled, long-term catheters, but few studies have compared citrate versus heparin for patients with short-term, non-tunneled catheters. We aim to compare citrate 4% catheter lock solution versus heparin in terms of event-free survival of the first non-tunneled hemodialysis catheter inserted in ICU patients with AKI requiring RRT. Secondary objectives are the rate of fibrinolysis, incidence of catheter thrombosis and catheter-related infection per 1,000 catheter days, length of stay in ICU and in-hospital and 28-day mortality. The VERROU-REA study is a randomized, prospective, multicenter, double-blind, parallel-group, controlled superiority study carried out in the medical, surgical and nephrological ICUs of two large university hospitals in eastern France. A catheter lock solution composed of trisodium citrate at 4% will be compared to unfractionated heparin at a concentration of 5,000 IU/mL. All consecutive adult patients with AKI requiring extracorporeal RRT, and in whom a first non-tunneled catheter is to be inserted by the jugular or femoral approach, will be eligible. Catheters inserted by the subclavian approach, patients with acute liver failure, thrombopenia or contraindication to systemic anticoagulation will be excluded. Patients will be followed up daily in accordance with standard practices for RRT until death or discharge. Data is scarce regarding the use of non-tunneled catheters in the ICU setting in patients with AKI. This study will provide an evidence base for

  20. Salinity, water hardness, and dissolved organic carbon modulate degradation of peracetic acid (PAA) compounds in aqueous solutions

    Science.gov (United States)

    Peracetic acid (PAA) is used in aquaculture under different conditions for disinfection purposes. However, there is a lack of information about its environmental fate, particularly its persistence in aquatic systems with different chemistries. Therefore, the impact of water hardness, salinity, and d...

  1. A randomised controlled trial of Hartmann's solution versus half normal saline in postoperative paediatric spinal instrumentation and craniotomy patients.

    Science.gov (United States)

    Coulthard, Mark G; Long, Debbie A; Ullman, Amanda J; Ware, Robert S

    2012-06-01

    To compare the difference in plasma sodium at 16-18 h following major surgery in children who were prescribed either Hartmann's and 5% dextrose or 0.45% saline and 5% dextrose. A prospective, randomised, open label study. The paediatric intensive care unit (650 admissions per annum) in a tertiary children's hospital in Brisbane, Australia. The study group comprised 82 children undergoing spinal instrumentation, craniotomy for brain tumour resection, or cranial vault remodelling. Patients received either Hartmann's and 5% dextrose at full maintenance rate or 0.45% saline and 5% dextrose at two-thirds maintenance rate. plasma sodium at 16-18 h postoperatively; secondary outcome measure: number of fluid boluses administered. Mean postoperative plasma sodium levels of children receiving 0.45% saline and 5% dextrose were 1.4 mmol/l (95% CI 0.4 to 2.5) lower than those receiving Hartmann's and 5% dextrose (p=0.008). In the 0.45% saline group, seven patients (18%) became hyponatraemic (Na <135 mmol/l) at 16-18 h postoperatively; in the Hartmann's group no patient became hyponatraemic (p=0.01). No child in either fluid group became hypernatraemic. The postoperative fall in plasma sodium was smaller in children who received Hartmann's and 5% dextrose compared to those who received 0.45% saline and 5% dextrose. It is suggested that Hartmann's and 5% dextrose should be administered at full maintenance rate postoperatively to children who have undergone major surgery in preference to hypotonic fluids.

  2. 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.

  3. 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.

  4. Corrosion behavior of Mg-3Zn/bioglass (45S5) composite in simulated body fluid (SBF) and phosphate buffered saline (PBS) solution

    Science.gov (United States)

    Ab llah, N.; Jamaludin, S. B.; Daud, Z. C.; Zaludin, M. A. F.; Jamal, Z. A. Z.; Idris, M. S.; Osman, R. A. M.

    2016-07-01

    Magnesium has emerged as promising materials in biomaterials research due to its good mechanical and physical properties closer to human bones. However, magnesium has poor corrosion resistance to chloride ions that exist in human blood plasma thus preventing its application in biomedical. The addition of zinc and bioglass can reduce magnesium corrosion rate. In this work, the effect of different solution media (Simulated Body Fluid and Phosphate Buffered Saline) to the corrosion behavior of Mg-Zn/bioglass (45S5) composites was investigated. The composites of Mg-3Zn added with 5, 10, 15, 20, 15 and 30 wt. % bioglass were fabricated by powder metallurgy. The composites were prepared by mixing at 140 rpm for 1 hour, pressing at 500 MPa and sintering in an argon environment at a temperature of 450°C for 3 hours. Sintered samples were immersed in Simulated Body Fluid (SBF) and Phosphate Buffered Saline (PBS) in order to investigate the corrosion behavior. Samples mass loss was determined after 3 days of immersion. Samples microstructure and corrosion products were analyzed using optical microscope and x-ray diffraction (XRD) respectively. The results revealed that the samples immersed in the Phosphate Buffered Saline (PBS) shows lower mass loss compare to the samples immersed in the Simulated Body Fluid (SBF) for all composition except for Mg-3Zn without bio-glass. The results indicated that the existence of high phosphate ions in PBS has retarded the corrosion rate of composite Mg-3Zn/45S5. The pH value of the PBS solution after immersion showed significant increase between 10.3 and 11.09. Diffraction pattern (XRD) showed the presence of Mg(OH)2 as the major corrosion product for samples immersed in the SBF and PBS solutions. The mass loss of samples decreased with the addition of bio-glass.

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

    Energy Technology Data Exchange (ETDEWEB)

    Jing, Zhang, E-mail: hbtjzj@yahoo.com.cn [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Lang, Chen, E-mail: langc731@yahoo.com.cn [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Qiu-Xia, Wang, E-mail: guaiqiuqiu1981@163.com [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Rong, Liu, E-mail: rongr007@yahoo.com.cn [Department of Ophthalmology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Xin, Luo, E-mail: hoyoho2000@sina.com [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Wen-Zhen, Zhu, E-mail: zhuwenzhen@hotmail.com [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Li-Ming, Xia, E-mail: limingxia@tjh.tjmu.edu.cn [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); Jian-Pin, Qi, E-mail: qijp2k01@yahoo.com [Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030 (China); He, Wang, E-mail: he.wang@ge.com [GE Healthcare, 1 Build, 2F C109, 1 Hua TuoRoad, Zhang Jiang Hi-Tech Park, Shanghai 201203 (China)

    2013-09-15

    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.

  6. Hemodialysis removal of norfloxacin.

    Science.gov (United States)

    Lau, A H; Tang, I; Fitzloff, J; Jain, R

    1994-01-01

    The effect of hemodialysis on norfloxacin removal was evaluated in 7 patients. Single 800-mg doses of the drug were given to the subjects prior to dialysis using cuprophan hollow fiber dialyzers. Arterial and venous sample pairs were obtained at hourly intervals during treatment. Norfloxacin plasma concentrations were determined by HPLC. The mean hemodialysis clearance and extraction ratio were 38.84 +/- 10.92 ml/min and 0.19 +/- 0.06, respectively. Small differences in these parameters were observed between dialyzers with different surface areas (p > 0.05) and also between treatments using different blood flow rates (p > 0.05). Since a relatively small amount of norfloxacin is removed by hemodialysis, dosage adjustment is not necessary to compensate for the extracorporeal removal.

  7. 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

  8. Extenuation of Saline Solutes in Shallow Aquifer of a Small Tropical Island: A Case Study of Manukan Island, North Borneo

    Directory of Open Access Journals (Sweden)

    Ahmad Zaharin Aris

    2010-01-01

    Full Text Available Intensive exploitation of groundwater from Manukan Island’s aquifer has disturbed the natural equilibrium between fresh and saline water and has resulted in the increase of groundwater salinity and the hydrochemical complexities of freshwater-seawater contact. It was observed that the mixing between freshwater-seawater has created diversity in the geochemical processes of Manukan Island’s aquifer and altered the freshwater and seawater mixture away from the theoretical composition line. The results from reactive transport modelling confirmed that the migration of seawater into the fresher parts of the aquifer apparently leads to a calcification of the aquifer despite the seawater being supersaturated for carbonate minerals and shows that the composition of the near coast zone and further landward area may vary and have a significant effect on the processes during the intrusion. It was observed that the effect of freshening aquifer in the landward area near the recharge zone of the study area has incriminated the calcite saturation states of the area. The accumulation of Ca as the interface travels landward up to 100 m from the coast leads to an increasing calcite supersaturation with travelled distance and possibly to the precipitation of calcite.

  9. Innovative strategy with potential to increase hemodialysis efficiency and safety

    Science.gov (United States)

    Chen, Hsiao-Chien; Lin, Hsiu-Chen; Chen, Hsi-Hsien; Mai, Fu-Der; Liu, Yu-Chuan; Lin, Chun-Mao; Chang, Chun-Chao; Tsai, Hui-Yen; Yang, Chih-Ping

    2014-03-01

    Uremic toxins are mainly represented by blood urine nitrogen (BUN) and creatinine (Crea) whose removal is critically important in hemodialysis (HD) for kidney disease. Patients undergoing HD have a complex illness, resulting from: inadequate removal of organic waste, dialysis-induced oxidative stress and membrane-induced inflammation. Here we report innovative breakthroughs for efficient and safe HD by using a plasmon-induced dialysate comprising Au nanoparticles (NPs)-treated (AuNT) water that is distinguishable from conventional deionized (DI) water. The diffusion coefficient of K3Fe(CN)6 in saline solution can be significantly increased from 2.76, to 4.62 × 10-6 cm s-1, by using AuNT water prepared under illumination by green light-emitting diodes (LED). In vitro HD experiments suggest that the treatment times for the removals of 70% BUN and Crea are reduced by 47 and 59%, respectively, using AuNT water instead of DI water in dialysate, while additionally suppressing NO release from lipopolysaccharide (LPS)-induced inflammatory cells.

  10. 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.

  11. A new method to detect air leakage in a patient with pneumothorax using saline solution and multidetector-row spiral CT scan.

    Science.gov (United States)

    Nakanishi, Kozo; Shimotakahara, Akihiro; Asato, Yuko; Ishihara, Toshihiro

    2013-09-01

    The purpose of this study was to establish a new CT scan method to show signs of air leakage and to detect the point of the lung leak in patients with spontaneous pneumothorax by using saline solution and phonation. Eleven patients with spontaneous pneumothorax who had a chest tube placed and underwent an operation because of continuing air leakage were studied. After a plain chest CT scan was performed, 0.9% saline was injected into the affected pleural cavity. A CT scan was acquired again while the patient vocalized continuously. The CT images were evaluated by two thoracic surgeons. All patients underwent video-assisted thoracoscopic surgery to confirm their points of leakage and were treated for spontaneous pneumothorax. Bubble shadows were seen in nine of 11 cases. In seven of those nine cases, multiple bubbles formed foam or wave shadows. These cases had a small pleural fistula. In the other two cases with a large fistula, air-fluid level in bulla and ground-glass attenuation areas were seen in the pulmonary parenchyma. In all 11 cases, some air-leakage signs were seen on CT scan, and a culprit lesion was presumed to exist by analyzing CT imaging findings and confirming with a surgical air-leak test. With a saline injection and vocalization, CT scan could demonstrate air-leak signs in patients with spontaneous pneumothorax. This method does not require contrast medium, special instruments, or high skill and, thus, is a novel and useful examination to detect the culprit lesion in pneumothorax.

  12. Intensive Hemodialysis Associates with Improved Survival Compared with Conventional Hemodialysis

    Science.gov (United States)

    Lindsay, Robert M.; Cuerden, Meaghan S.; Garg, Amit X.; Port, Friedrich; Austin, Peter C.; Moist, Louise M.; Pierratos, Andreas; Chan, Christopher T.; Zimmerman, Deborah; Lockridge, Robert S.; Couchoud, Cécile; Chazot, Charles; Ofsthun, Norma; Levin, Adeera; Copland, Michael; Courtney, Mark; Steele, Andrew; McFarlane, Philip A.; Geary, Denis F.; Pauly, Robert P.; Komenda, Paul; Suri, Rita S.

    2012-01-01

    Patients undergoing conventional maintenance hemodialysis typically receive three sessions per week, each lasting 2.5–5.5 hours. Recently, the use of more intensive hemodialysis (>5.5 hours, three to seven times per week) has increased, but the effects of these regimens on survival are uncertain. We conducted a retrospective cohort study to examine whether intensive hemodialysis associates with better survival than conventional hemodialysis. We identified 420 patients in the International Quotidian Dialysis Registry who received intensive home hemodialysis in France, the United States, and Canada between January 2000 and August 2010. We matched 338 of these patients to 1388 patients in the Dialysis Outcomes and Practice Patterns Study who received in-center conventional hemodialysis during the same time period by country, ESRD duration, and propensity score. The intensive hemodialysis group received a mean (SD) 4.8 (1.1) sessions per week with a mean treatment time of 7.4 (0.87) hours per session; the conventional group received three sessions per week with a mean treatment time of 3.9 (0.32) hours per session. During 3008 patient-years of follow-up, 45 (13%) of 338 patients receiving intensive hemodialysis died compared with 293 (21%) of 1388 patients receiving conventional hemodialysis (6.1 versus 10.5 deaths per 100 person-years; hazard ratio, 0.55 [95% confidence interval, 0.34–0.87]). The strength and direction of the observed association between intensive hemodialysis and improved survival were consistent across all prespecified subgroups and sensitivity analyses. In conclusion, there is a strong association between intensive home hemodialysis and improved survival, but whether this relationship is causal remains unknown. PMID:22362910

  13. Change in organic molecule adhesion on α-alumina (Sapphire) with change in NaCl and CaCl2 solution salinity

    DEFF Research Database (Denmark)

    Juhl, Klaus; Bovet, Nicolas Emile; Hassenkam, Tue

    2014-01-01

    We investigated the adhesion of two functional groups to α-alumina as a model for the adsorption of organic molecules on clay minerals. Interactions between organic compounds and clay minerals play an important role in processes such as drinking water treatment, remediation of contaminated soil, ...... in surface properties, controlling surface tension (i.e., contact angle) and adsorption affinity on α-alumina and, by analogy, on clay minerals.......H surface at pH surface interaction with the carboxylic acid and pyridine groups. We interpret the results as evidence...... protonated surface. The results demonstrate that the alumina surface at pH 3 has a higher affinity for inorganic cations than for -COO(H) or -C5H5N(H+), in spite of the known positive surface charge of α-alumina {0001} wafers. These results demonstrate that solution salinity plays an important role...

  14. Does nebulized epinephrine improve the efficacy of hypertonic saline solution in the treatment of hospitalized moderate acute bronchiolitis? A double blind, randomized clinical trial.

    Science.gov (United States)

    Flores-González, Jose Carlos; Dominguez-Coronel, Maria Teresa; Matamala Morillo, Miguel Angel; Aragón Ramírez, Miriam; García Ortega, Rosa María; Dávila Corrales, Francisco Javier; García Palacios, Maria Victoria; Perez Guerrero, Juan Jesus; García García, Laura; Lechuga Sancho, Alfonso María

    2016-04-01

    Nebulized 3% hypertonic saline solution (HSS 3%) has proven to reduce hospital stay in infants with acute bronchiolitis, as compared with nebulized physiological saline solutions. There are no studies assessing the effectiveness of nebulized epinephrine in patients treated with HSS 3%. The aim of this study was to compare the length of stay (LOS) in hospitalized patients treated with HSS 3% with placebo vs. HSS 3% with epinephrine. Secondarily we aimed to assess the effectiveness and safety of both treatments. We performed a prospective, randomized, double-blind, parallel-group study, including infants hospitalized for moderate acute bronchiolitis. Both groups received standard life support and were randomly treated with nebulized HSS 3% (7 mL) with either placebo 3 mL or epinephrine 3 mL. Nebulizations were initially administered every four hours and this interval was modified according to the patient's response. Sixty-four infants were included, 32 patients in each group. No statistically significant differences were found between the two groups (P=0.948) in length of stay, disease severity, SatO2, respiratory rate or heart rate. On the third day of hospitalization, severity and respiratory rate in the HSS 3%+E presented a non statistically significant trend to an earlier improvement, (P=0.063 and P=0.096 repectively). No adverse events occurred. Four patients (two from each group) required transfer to the pediatric intensive care unit. With a third of the final estimated sample, we find a trend to an earlier clinical recovery in the epinephrine group, even though no statistical significant differences in LOS were found. The study needs to be continued until the total sample is recruited.

  15. Hemodialysis for Lactic Acidosis.

    Science.gov (United States)

    Karthiraj, N; Ramakrishnan, Nagarajan; Mani, Ashwin K

    2017-08-01

    Lactic acidosis (Type A) is common in critically ill patients and usually treated by correcting the underlying etiology. We present the case of a young female who presented with life-threatening lactic acidosis secondary to hematological malignancy. Timely initiation of hemodialysis was lifesaving. The case highlights the importance of considering Type B lactic acidosis (in this case secondary to a hematological malignancy) and also initiating renal replacement therapy when routine measures are ineffective.

  16. Hemodialysis for lactic acidosis

    OpenAIRE

    Karthiraj, N.; Nagarajan Ramakrishnan; Mani, Ashwin K.

    2017-01-01

    Lactic acidosis (Type A) is common in critically ill patients and usually treated by correcting the underlying etiology. We present the case of a young female who presented with life-threatening lactic acidosis secondary to hematological malignancy. Timely initiation of hemodialysis was lifesaving. The case highlights the importance of considering Type B lactic acidosis (in this case secondary to a hematological malignancy) and also initiating renal replacement therapy when routine measures a...

  17. Does antibiotic lock therapy prevent catheter-associated bacteremia in hemodialysis?

    Directory of Open Access Journals (Sweden)

    Macarena Jiménez

    2015-01-01

    Full Text Available Central venous catheter-related blood stream infection is a major cause of morbidity and mortality in patients with renal disease treated with hemodialysis. Antibiotic lock solutions can be effective in preventing this complication in patients with hemodialysis. Searching in Epistemonikos database, which is maintained by screening more than twenty databases, we identified eight systematic reviews including seventeen randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that antibiotic lock solutions probably decrease catheter-related blood stream infection in hemodialysis patients.

  18. Biochar-manure compost in conjunction with pyroligneous solution alleviated salt stress and improved leaf bioactivity of maize in a saline soil from central China: a 2-year field experiment.

    Science.gov (United States)

    Lashari, Muhammad Siddique; Ye, Yingxin; Ji, Haishi; Li, Lianqing; Kibue, Grace Wanjiru; Lu, Haifei; Zheng, Jufeng; Pan, Genxing

    2015-04-01

    Salinity is a major stress threatening crop production in dry lands. A 2-year field experiment was conducted to assess the potential of a biochar product to alleviate salt-stress to a maize crop in a saline soil. The soil was amended with a compost at 12 t ha(-1) of wheat straw biochar and poultry manure compost (BPC), and a diluted pyroligneous solution (PS) at 0.15 t ha(-1) (BPC-PS). Changes in soil salinity and plant performance, leaf bioactivity were examined in the first (BPC-PS1) and second (BPC-PS2) year following a single amendment. While soil salinity significantly decreased, there were large increases in leaf area index, plant performance, and maize grain yield, with a considerable decrease in leaf electrolyte leakage when grown in amendments. Maize leaf sap nitrogen, phosphorus and potassium increased while sodium and chloride decreased, leaf bioactivity related to osmotic stress was significantly improved following the treatments. These effects were generally greater in the second than in the first year. A combined amendment of crop straw biochar with manure compost plus pyroligneous solution could help combat salinity stress to maize and improve productivity in saline croplands in arid/semi-arid regions threatened increasingly by global climate change. © 2014 Society of Chemical Industry.

  19. Indicators: Salinity

    Science.gov (United States)

    Salinity is the dissolved salt content of a body of water. Excess salinity, due to evaporation, water withdrawal, wastewater discharge, and other sources, is a chemical sterssor that can be toxic for aquatic environments.

  20. Nutritional status in nocturnal hemodialysis

    NARCIS (Netherlands)

    Ipema, Jacoba Regina

    2016-01-01

    Malnutrition is extremely prevalent in hemodialysis patients and may result in loss of muscle mass and poor physical functioning. Malnutrition is also a major predictor of increased morbidity and mortality. The central theme of this thesis is how the transition from conventional hemodialysis to

  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. Tumescent TAPP: laparoscopic inguinal hernia repair after the preperitoneal tumescent injection of diluted lidocaine and epinephrine saline solution and carbon dioxide gas.

    Science.gov (United States)

    Tokumura, Hiromi; Nomura, Ryohei; Saijo, Fumito; Matsumura, Naoki; Yasumoto, Akihiro; Muto, Mitsuhisa; Katayose, Yu; Takahashi, Kennichi; Haneda, Sho

    2017-01-01

    Laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) is technically difficult and not infrequently followed by postoperative complications and pain, especially when performed by inexperienced surgeons. To simplify TAPP and reduce postoperative pain, we devised a novel procedure whereby TAPP is carried out after the inguinal preperitoneal infiltration of diluted lidocaine and epinephrine saline solution and carbon dioxide gas (tumescent TAPP). This report introduces the concept of tumescent TAPP and summarizes its operative results. About 120 ml of diluted lidocaine and epinephrine solution and 60 ml of CO2 gas were infiltrated into the inguinal preperitoneal space through a transabdominal needle before TAPP. Tumescent TAPP was performed for 400 patients (355 men, 45 women; mean age, 63.2 years). Using tumescent TAPP, we found it easier to confirm the inguinal anatomy and dissect the preperitoneal layer and inguinal floor, with less bleeding. The mean operation time was 101.9 min and there were few perioperative complications and minimal pain. Tumescent TAPP makes conventional TAPP easier and safer; however, this procedure should be verified by a comparative study with conventional TAPP.

  3. Normal saline versus balanced-salt solution as intravenous fluid therapy during neurosurgery: effects on acid-base balance and electrolytes.

    Science.gov (United States)

    Hafizah, Mohamed; Liu, Chian Y; Ooi, Joanna S

    2017-06-01

    This prospective, randomized controlled study compared the changes in acid-base balance and serum electrolytes with the use of intravenous balanced and non-balanced crystalloid solutions intraoperatively during elective neurosurgery. Thirty consented adult patients who underwent craniotomy were randomly allocated into two groups of 15 patients each. The non-balanced group received 0.9% normal saline while the balanced group received Sterofundin®ISO as the intraoperative fluid for maintenance. Biochemical indices for acid-base balance and serum electrolytes were analyzed periodically. In the non-balanced group, significant changes were noted in the pH, base excess and bicarbonate values over time compared to its respective baseline values (P<0.01). Four patients (27.7%) also developed a pH<7.35 and 5 patients (33.3%) developed marked acidosis with base excess <-4.0 at the end of surgery. Both mean sodium and chloride levels were also significantly higher compared to its baseline values respectively (142.6±2.4 versus 138±2.7 mmol/L, P<0.01 and 105.7±4.1 versus 113.2±3.0 mmol/L (P<0.01). A balanced solution (Sterofundin®ISO) provided significantly better control over acid-base balance, sodium and chloride levels when used as intraoperative fluid maintenance and replacement during elective neurosurgery.

  4. The effect of a new formaldehyde-free binder on the dissolution rate of glass wool fibre in physiological saline solution.

    Science.gov (United States)

    Potter, Russell M; Olang, Nassreen

    2013-04-12

    The in-vitro dissolution rate of fibres is a good predictor of the in-vivo behavior and potential health effects of inhaled fibres. This study examines the effect of a new formaldehyde-free carbohydrate-polycarboxylic acid binder on the in-vitro dissolution rate of biosoluble glass fibres. Dissolution rate measurements in pH 7.4 physiological saline solution show that the presence of the binder on wool insulation glass fibres has no effect on their dissolution. There is no measurable difference between the dissolution rates of continuous draw fibres before and after binder was applied by dipping. Nor is there a measurable difference between the dissolution rates of a production glass wool sample with binder and that same sample after removal of the binder by low-temperature ashing. Morphological examination shows that swelling of the binder in the solution is at least partially responsible for the development of open channels around the glass-binder interface early in the dissolution. These channels allow fluid to reach the entire glass surface under the binder coating. There is no evidence of any delay in the dissolution rate as a result of the binder coating.

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

    Science.gov (United States)

    Bellia, Chiara; Clemente, Giuseppe; Pecoraro, Rosaria; Maida, Carlo; Simonetta, Irene; Vassallo, Valerio; Di Bona, Danilo; Gulotta, Eliana; Ciaccio, Marcello; Pinto, Antonio

    2016-01-01

    Introduction 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. Aims 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. Methods 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. Results 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. Discussion 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. PMID:27941973

  6. 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.

  7. Effect of catheter-lock solutions on catheter-related infection and inflammatory syndrome in hemodialysis patients: heparin versus citrate 46% versus heparin/gentamicin.

    Science.gov (United States)

    Venditto, Marcia; du Montcel, Sophie Tezenas; Robert, Jérôme; Trystam, David; Dighiero, Jean; Hue, Danièle; Bessette, Christelle; Deray, Gilbert; Mercadal, Lucile

    2010-01-01

    Prevention strategies are emerging with the use of catheter-lock solutions (CLS) to prevent catheter-related infections. We compared 3 CLS: heparin, citrate (46%) and heparin/gentamicin (H/G). Three periods of 6 months using the three CLS were compared. 265 catheters were studied. The CRI rate per 1,000 catheter-days was 2.9 for heparin, 3.4 for citrate and 0.4 for H/G. The free-infection catheter survival tended to be higher with H/G (log-rank test, p = 0.06) and the CRP had a significant decreasing course (p = 0.03). Since 2006 H/G was used as CLS in our dialysis unit. The resistance to gentamicin of Enterobacteriaceae increased in the nephrology department and in the entire hospital. On the other hand, the resistance of Staphylococcus aureus to gentamicin dropped to nil. CLS with heparin/gentamicin tended to decrease CRI compared to citrate 46% and heparin and frankly improved the CRP course after catheter insertion. Gentamicin resistance should be monitored.

  8. 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

  9. Hemodialysis Catheters: How to Keep Yours Working Well

    Science.gov (United States)

    ... Events Advocacy Donate A to Z Health Guide Hemodialysis Catheters: How to Keep Yours Working Well Print ... access also see Hemodialysis Access What is a hemodialysis catheter? The catheter used for hemodialysis is a ...

  10. Solar-assisted hemodialysis.

    Science.gov (United States)

    Agar, John W M; Perkins, Anthony; Tjipto, Alwie

    2012-02-01

    Hemodialysis resource use-especially water and power, smarter processing and reuse of postdialysis waste, and improved ecosensitive building design, insulation, and space use-all need much closer attention. Regarding power, as supply diminishes and costs rise, alternative power augmentation for dialysis services becomes attractive. The first 12 months of a solar-assisted dialysis program in southeastern Australia is reported. A 24-m(2), 3-kWh rated solar array and inverter-total cost of A$16,219-has solar-assisted the dialysis-related power needs of a four-chair home hemodialysis training service. All array-created, grid-donated power and all grid-drawn power to the four hemodialysis machines and minireverse osmosis plant pairings are separately metered. After the grid-drawn and array-generated kilowatt hours have been billed and reimbursed at their respective commercial rates, financial viability, including capital repayment, can be assessed. From July of 2010 to July of 2011, the four combined equipment pairings used 4166.5 kWh, 9% more than the array-generated 3811.0 kWh. Power consumption at 26.7 c/kWh cost A$1145.79. Array-generated power reimbursements at 23.5 c/kWh were A$895.59. Power costs were, thus, reduced by 76.5%. As new reimbursement rates (60 c/kWh) take effect, system reimbursements will more than double, allowing both free power and potential capital pay down over 7.7 years. With expected array life of ∼30 years, free power and an income stream should accrue in the second and third operative decades. Solar-assisted power is feasible and cost-effective. Dialysis services should assess their local solar conditions and determine whether this ecosensitive power option might suit their circumstance.

  11. 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

  12. [Hemodialysis and cardiovascular outcome].

    Science.gov (United States)

    Panicali, Laura; Brigante, Fabiana; Mancini, Elena

    2017-03-01

    Hemodialysis patients often present multiple comorbidities and have a high mortality rate (15-20% per year), mostly due to cardiovascular events. Besides predisposing pathological conditions related to uremia (heart failure, coronary heart disease, left ventricular hypertrophy, arrhythmias), they also have specific risk factors linked to the hemodialysis (HD) treatment in itself: chronic inflammation, fluid overload, autonomic nervous system dysfunction, arterovenous fistula. These factors may affect the hemodynamic compensatory systems (vascular refilling, arteriolar and venous tone, autonomic nervous system response) to fluid removal, with high risk of intra-dialysis hypotension (IDH) episodes or arrhythmic events. IDH is recognized as associated to a negative long term outcome, due to the repeated episodes of organ hypoperfusion with ischemic damage to heart, brain and gut. Over the years, dialysis technology has greatly improved, with the development of continuous and noninvasive monitoring systems, able to control some hemodynamic parameters affecting blood pressure (mainly blood volume and body temperature), with positive results in terms of hemodynamic instability during HD. Furthermore, recent studies suggest that hemodiafiltration may reduce the risk of IDH and cardiovascular mortality, compared with conventional HD. Diabetic and/or old patients, as well as those with a previous cardiovascular event, are the first patients who should receive the new treatment options. Overall, the HD prescription needs to be tailored to each patient's need, to improve the hemodynamic tolerance to treatment and the cardiovascular outcome. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  13. Adequacy of hemodialysis in Nepalese patients undergoing maintenance hemodialysis

    OpenAIRE

    P Sultania; Sanjib Kumar Sharma; Sharma SK

    2009-01-01

    INTRODUCTION: Inadequate dialysis accounts for the high mortality in patients with end stage renal disease (ESRD). In Nepal, due to various factors including financial and logistic limitations, hemodialysis is mostly performed twice-a-week. This study was undertaken to look at adequacy of dialysis in patients undergoing maintenance hemodialysis in Nepal where the patients profile, in terms of diet, body muscle mass, nutritional status etc are different from western world. METHODS: In...

  14. Is there a future for electrochemically assisted hemodialysis? Focus on the application of polypyrrole-nanocellulose composites.

    Science.gov (United States)

    Ferraz, Natalia; Mihranyan, Albert

    2014-05-01

    This work summarizes the various aspects of using electrochemically assisted solute removal techniques in hemodialysis with a focus on blood electrodialysis and electrochemically controlled uremic retention solute removal using polypyrrole. In particular, the feasibility of using highly porous conductive polypyrrole-Cladophora cellulose membranes for hemodialysis are overviewed as a part of our dedicated research efforts during the past 4 years. The potential benefits and the current limitations associated with using the electrochemically controlled uremic retention solute removal techniques are discussed in detail.

  15. 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.

  16. Hemodialysis-related headaches

    Directory of Open Access Journals (Sweden)

    Đurić Marija

    2007-01-01

    Full Text Available Background/Aim. Hemodialysis (HD is a therapeutic procedure used to partially correct homeostatic disorders and prevent complications of uremia to appear in the terminal stage of renal insufficiency. The aim of this study was to evaluate and analyze the incidence and features of headaches in patients undergoing hemodialysis. Methods. A total of 143 patients, 50 women and 93 men, undergoing hemodialysis, were questioned about their problems with headache using a questionnaire designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders from 2004. The patients were separated into two groups: the patients without headache and the patients with repeated headaches. Afterwards, the patients with headaches were further divided into subgroups: the patients who had the headaches before the beginning of HD and patients who experienced repeated headaches with the beginning of HD headache (HDH. In the group of patients with headaches we analyzed characteristics of headache according to which diagnoses of headaches were made, as well as the effects of HD on headaches. We also analyzed features of HDH. The patients with headache were compared to the patients without headache regarding sex, age, duration of HD, causes of end-stage renal disease, arterial diastolic and systolic blood pressure and serum concentration of hemoglobin, urea nitrogen, creatinine, sodium and potassium. The results were statistically compared. Results. In the group of 143 patients examined, 27 (18.9% patients had headaches. There were no statistically significant differences between the group of patients with headaches and those without headache regarding to sex, age, duration of HD, causes of end-stage renal disease, serum concentration of hemoglobin, urea nitrogen, creatinine, sodium and potassium. The patients with headaches showed significantly higher mean values of systolic blood pressure during HD in comparison to the patients

  17. Observational study on the performance of the Narhinel method (nasal aspirator and physiological saline solution) versus physiological saline solution in the prevention of recurrences of viral rhinitis and associated complications of the upper respiratory tract infections (URTI), with a special focus on acute rhinosinusitis and acute otitis of the middle ear.

    Science.gov (United States)

    Montanari, G; Ceschin, F; Masotti, S; Bravi, F; Chinea, B; Quartarone, G

    2010-02-01

    The aim of this study was to assess the validity of Narhinel method in the prevention of recurrences of viral rhinitis and of any associated sequelae, in particular acute otitis of the middle ear (AOM) and acute rhinosinusitis (AR). This was a prospective observational study, in children aged from two months to two years, observed for five months during the cold season and carried out by family pediatricians (FIMP association) in Friuli Venezia Giulia, Italy. The study enrolled 435 patients. The observed population consisted of two groups: the first one of 238 children treated with Narhinel method and the second one of 197 patients treated only with the physiological saline solution. In compliance with the guidelines of an observational trial, the children were prescribed the therapeutic treatments used as a routine. The patients were recruited for the trial after the responsible parent had signed the informed consent form. The study protocol had been approved by the Ethics Committee of the area of Pordenone. In order to be recruited, patients had to comply with the following criteria: symptoms suggestive of the common cold; age > or =2 months common cold; systemic and/or topical use of antibiotics and/or corticosteroids at the moment of recruitment. During the five months of the observation period, all the therapies that the investigators had decided it was necessary to administer had been included and recorded in the CRF. Patients evaluations were carried out for five months. The clinical assessment was performed at baseline (B), in the first week (Fw) and monthly and described as M1 to 5; several clinical parameters were analyzed (anterior and posterior rhinorrhoea, oral respiration, noisy nasal respiration, and nasally transmitted thoracic sounds) and measured by the pediatrician at all examinations from B to M5. Other parameters were derived from the parents' daily observations, recorded in a diary and made note of the quality of sleep, diet and respiration

  18. under salinity stress

    African Journals Online (AJOL)

    ajl yemi

    2011-11-14

    Nov 14, 2011 ... (2002) reported that K and Zn deficiencies in the plant were mainly induced by soil salinity. Zhang et al. (2011) investigated the effects of applying different concentra- tions of the macronutrients K+, Ca2+ and Mg2+ on the responses of contrasting rice (O. sativa L.) genotypes under salt stress. A solution ...

  19. Liquid-Phase Microextraction and Gas Chromatographic-Mass Spectrometric Analysis of Antidepressants in Vitreous Humor: Study of Matrix Effect of Human and Bovine Vitreous and Saline Solution.

    Science.gov (United States)

    dos Santos, Marcelo Filonzi; Yamada, Adrian; Seulin, Saskia Carolina; Leyton, Vilma; Pasqualucci, Carlos Augusto Gonçalves; Muñoz, Daniel Romero; Yonamine, Mauricio

    2016-04-01

    In forensic bioanalytical methods, there is a general agreement that calibrators should be prepared by fortifying analytes in matrix-based blank samples (matrix-based). However, in the case of vitreous humor (VH), the collection of blank samples for the validation and for routine analysis would require the availability of many cadavers. Besides the difficulty of obtaining enough blank VH, this procedure could also represent an ethical issue. Here, a study of matrix effect was performed taking into consideration human and bovine vitreous and saline solution (SS) (NaCl 0.9%). Tricyclic antidepressants [amitriptyline (AMI), nortriptyline (NTR), imipramine (IMI) and desipramine (DES)] were used as model analytes and were extracted from samples by means of liquid-phase microextraction and detected by gas chromatography-mass spectrometry. Samples of human and bovine VH and SS were prepared in six different concentrations of antidepressants (5, 40, 80, 120, 160 and 200 ng/mL) and were analyzed. Relative matrix effect was evaluated by applying a two-tailed homoscedastic Student's t-test, comparing the results obtained with the set of data obtained with human VH and bovine VH and SS. No significant matrix effect was found for AMI and NTR in the three evaluated matrices. However, a great variability was observed for IMI and DES for all matrices. Once compatibilities among the matrices were demonstrated, the method was fully validated for AMI and NTR in SS. The method was applied to six VH samples deriving from real cases whose femoral whole blood (FWB) was analyzed by a previously published method. An average ratio (VH/FWB) of ∼ 0.1 was found for both compounds. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Troponin I release after intravenous treatment with high furosemide doses plus hypertonic saline solution in decompensated heart failure trial (Tra-HSS-Fur).

    Science.gov (United States)

    Parrinello, Gaspare; Di Pasquale, Pietro; Torres, Daniele; Cardillo, Mauro; Schimmenti, Caterina; Lupo, Umberto; Iatrino, Rossella; Petrantoni, Rossella; Montaina, Carla; Giambanco, Salvatore; Paterna, Salvatore

    2012-09-01

    High values of cardiac troponin in acute decompensated congestive heart failure (ADHF) identify patients at higher risk and worsened prognosis. A cardiac troponin increase during therapy indicates the need for more appropriate intervention, aimed at compensating cardiac disease and effectively minimizing myocardial wall stress and subsequent cytolysis. This study evaluated the effects of an intravenous high dose of furosemide with (group A) or without small volume hypertonic saline solution (HSS) (group B) on myocardial cytolysis in patients with ADHF. A total of 248 consecutive patients with ADHF (148 men, mean age 74.9 ± 10.9 years) were randomly assigned to group A or B. Plasma levels of cardiac troponin-I, brain natriuretic peptide, glomerular filtration rate by Modification of Diet in Renal Disease formula, bioelectrical impedance analysis measurements, and delta pressure/delta time (dP/dt) rate were observed on admission and discharge for all patients. We observed a significant reduction of cardiac troponin in both groups and a significant improvement in renal function, hydration state, pulmonary capillary wedge pressure (P < .0001), end diastolic volume (P < .01), ejection fraction (P < .01), and dP/dt (P < .004) in group A. We also observed a significant reduction in body weight (64.4 vs 75.8 kg) (P < .001), cardiac troponin I (0.02 vs 0.31 ng/mL) (P < .0001) and brain natriuretic peptide (542 vs 1,284 pg/mL) (P < .0001), and hospitalization time (6.25 vs 10.2 days) (P < .0001) in the HSS group. These data demonstrate that intravenous high doses of furosemide do not increase myocardial injury and, in addition, when associated to HSS, significantly reduce cardiac troponin I release. This behavior is mirrored by the achievement of improved hemodynamic compensation at echocardiography and body hydration normalization. Copyright © 2012 Mosby, Inc. All rights reserved.

  1. Oleic acid vs saline solution lung lavage-induced acute lung injury: effects on lung morphology, pressure-volume relationships, and response to positive end-expiratory pressure.

    Science.gov (United States)

    Luecke, Thomas; Meinhardt, Juergen P; Herrmann, Peter; Weiss, Andreas; Quintel, Michael; Pelosi, Paolo

    2006-08-01

    To compare two lung injury models (oleic acid [OA] and saline solution washout [SW]) regarding lung morphology, regional inflation, and recruitment during static pressure-volume (PV) curves, and the effects of positive end-expiratory pressure (PEEP) below and above the lower inflection point (Pflex). Fourteen adult pigs underwent OA or SW lung injury. Lung volumes were measured using CT. PV curves were obtained with simultaneous CT scanning at lung apex and base. Fractional inflation and recruitment were compared to data on PEEP above and below Pflex. Severity of lung injury was comparable. At zero PEEP, SW showed an increased amount of edema and poorly aerated lung volume, recruitment during inspiration, and a better oxygenation response with PEEP. Whole-lung PV curves were similar in both models, reflecting changes in alveolar inflation or deflation. On the inspiratory PV limb, recruitment and inflation were on the same line, while there was a substantial difference between deflation and derecruitment on the expiratory limb. PEEP-induced recruitment at lung apex and base was at or above the derecruitment line on the expiratory limb and showed no relationship to the whole-lung expiratory PV curve. The following conclusions were made: (1) OA and SW models are comparable in mechanics but not in lung injury characteristics; (2) neither inspiratory nor expiratory whole-lung PV curves are useful to select PEEP in order to optimize recruitment; and (3) after recruitment, there is no difference in derecruitment between the models at high PEEP, while more collapse occurs at lower PEEP in the basal sections of SW lungs.

  2. Salinity Energy.

    Science.gov (United States)

    Schmitt, Walter R.

    1987-01-01

    Discussed are the costs of deriving energy from the earth's natural reserves of salt. Argues that, as fossil fuel supplies become more depleted in the future, the environmental advantages of salinity power may prove to warrant its exploitation. (TW)

  3. 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...... to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events) trial included patients with and without diabetes, we conducted a post hoc analysis to determine whether rosuvastatin might reduce the risk of cardiac events in diabetic patients...... receiving hemodialysis. Among the 731 participants with diabetes, traditional risk factors such as LDL-C, smoking, and BP did not associate with cardiac events (cardiac death and nonfatal myocardial infarction). At baseline, only age and high-sensitivity C-reactive protein were independent risk factors...

  4. Phosphate kinetic models in hemodialysis

    DEFF Research Database (Denmark)

    Laursen, Sisse Heiden; Vestergaard, Peter; Hejlesen, Ole K.

    2018-01-01

    BACKGROUND: Understanding phosphate kinetics in dialysis patients is important for the prevention of hyperphosphatemia and related complications. One approach to gain new insights into phosphate behavior is physiologic modeling. Various models that describe and quantify intra- and/or interdialytic...... phosphate kinetics have been proposed, but there is a dearth of comprehensive comparisons of the available models. The objective of this analysis was to provide a systematic review of existing published models of phosphate metabolism in the setting of maintenance hemodialysis therapy. STUDY DESIGN......: Systematic review. SETTING & POPULATION: Hemodialysis patients. SELECTION CRITERIA FOR STUDIES: Studies published in peer-reviewed journals in English about phosphate kinetic modeling in the setting of hemodialysis therapy. PREDICTOR: Modeling equations from specific reviewed studies. OUTCOMES: Changes...

  5. Hemodialysis treatment of cardiorenal syndrome.

    Science.gov (United States)

    Leskovar, Boštjan; Furlan, Tjaša; Poznič, Simona; Potisek, Maja; Adamlje, Anton

    We evaluated the impact of hemodialysis on mortality and hospital readmission in patients with cardiorenal syndrome. All patients were NYHA IV functional class and underwent laboratory testing, echocardiography, and cardiac functional testing. Hemodialysis was indicated in patients with progressive decline of kidney function and consequent failure to titrate heart failure medication as well as in patients with hypervolemia that was resistant to conservative treatment with more than 4 annual hospitalizations due to heart failure and/or concomitant chronic kidney disease stage III - IV. Patients were treated with low-efficacy bicarbonate hemodialysis with permanent central venous catheter used as vascular access. Since 2004, 67 patients were started on hemodialysis because of cardiorenal syndrome. Hospital readmission rate due to heart failure decreased (1 year before dialysis vs. 1 year after dialysis: 0.79 ± 1.32 vs. 0.22 ± 0.65 hospitalizations per year, p = 0.001) together with the duration of annual hospital stay (11.4 ± 21.4 vs. 3.7 ± 10.4 days, p = 0.011). 1-, 2-, 3-, 4- and 5-year survival for our patients was 81%, 61%, 52%, 47%, and 39%, respectively. Chronic renal replacement therapy with hemodialysis and strict uremic, electrolyte, and volume control may be more beneficial for patients with advanced heart failure with preserved or reduced LVEF than ultrafiltration alone. We have observed better survival of terminal cardiorenal patients treated with hemodialysis than in the general NYHA IV population, with lower hospital readmission rate and less hospitalized days for heart failure.
.

  6. Nutritional, Biophysical and Physiological Characteristics of Wild Rocket Genotypes As Affected by Soilless Cultivation System, Salinity Level of Nutrient Solution and Growing Period.

    Science.gov (United States)

    Bonasia, Anna; Lazzizera, Corrado; Elia, Antonio; Conversa, Giulia

    2017-01-01

    With the aim of defining the best management of nutrient solution (NS) in a soilless system for obtaining high quality baby-leaf rocket, the present study focuses on two wild rocket genotypes ("Nature" and "Naturelle"), grown in a greenhouse under two Southern Italy growing conditions-autumn-winter (AW) and winter-spring (WS)-using two soilless cultivation systems (SCS)-at two electrical conductivity values (EC) of NS. The SCSs used were the Floating System (FS) and Ebb and Flow System (EFS) and the EC values were 2.5 and 3.5 dS m(-1) (EC2.5; EC3.5) for the AW cycle and 3.5 and 4.5 dS m(-1) (EC3.5; EC4.5) for the WS cycle. The yield, bio-physical, physiological and nutritional characteristics were evaluated. Higher fresh (FY) (2.25 vs. 1.50 kg m(-2)) and dry (DY) (230.6 vs. 106.1 g m(-2)) weight yield, leaf firmness (dry matter, 104.3 vs. 83.2 g kg(-1) FW; specific leaf area, 34.8 vs. 24.2 g cm(-2)) and antioxidant compounds (vitamin C, 239.0 vs. 152.7 mg kg(-1) FW; total phenols, 997 vs. 450 mg GAE mg kg(-1) FW; total glucosinulates-GLSs, 1,078.8 vs. 405.7 mg kg(-1) DW; total antioxidant capacity-TAC, 11,534 vs. 8,637 μmol eq trolox kg(-1) FW) and lower nitrates (1,470 vs. 3,460 mg kg(-1) FW) were obtained under WS conditions. The seasonal differences were evident on the GLS profile: some aliphatic GLSs (gluconapoleiferin, glucobrassicanapin) and indolic 4-OH-glucobrassicin were only expressed in WS conditions, while indolic glucobrassicin was only detected in the AW period. Compared with EFS, FS improved leaf firmness, visual quality, antioxidant content (TAC, +11.6%) and reduced nitrate leaf accumulation (-37%). "Naturelle" performed better than "Nature" in terms of yield, visual quality and nutritional profile, with differences more evident under less favorable climatic conditions and when the cultivars were grown in FS. Compared to EC2.5, the EC3.5 treatment did not affect DY while enhancing firmness, visual quality, and antioxidant compounds (TAC, +8%), and

  7. Neurotoxicity caused by valacyclovir in a patient on hemodialysis

    NARCIS (Netherlands)

    Linssen-Schuurmans, CD; van Kan, EJM; Feith, GW; Uges, DRA

    The authors report toxicity caused by valacyclovir in a patient on hemodialysis. After initial recuperation resulting from treatment with hemodialysis, the patient experienced a relapse of neurologic symptoms, again necessitating hemodialysis. Although acyclovir and its analogues are generally safe

  8. Changes in body composition, hematologic parameters, and serum biochemistry after rapid intravenous infusion or oral intake of 2 liters of 0.9% saline solution in young healthy volunteers: randomized crossover study.

    Science.gov (United States)

    de Aguilar-Nascimento, José E; Valente, Ana C; Oliveira, Sergio S; Hartmann, Arthur; Slhessarenko, Natasha

    2012-12-01

    The perioperative infusion of 2 L of saline is associated with weight gain and decreased serum albumin and hematocrit. We hypothesized that these parameters would respond differently to oral administration and intravenous infusion of saline solution. This was a crossover study that included 10 healthy young men (ages 18-26 years). At two times, 8 weeks apart, the participants were randomized to receive 2 L of 0.9% saline over 1 h by intravenous (IV) administration to a forearm vein or by oral intake. The participants were weighed and body masses were calculated. Bioelectrical impedance analysis was performed with a single-frequency device using tetrapolar distal limb electrodes. Blood samples were collected 1 h after the administration period for laboratory assays: hematocrit, hemoglobin, blood glucose, serum electrolytes, albumin, creatinine, osmolality. There was an increase in body weight (p<0.01), total body water (p<0.01), and lean body mass (p<0.01) after the experiment in both groups, with no difference between them. The volume of urine output was similar in the two experiments. The hemoglobin (oral group from 14.4±0.8 g/dl to 13.8±0.8 g/dl; IV group from 14.4±0.6 g/dl to 12.6±0.6 g/dl) and hematocrit (oral group from 43.2±1.8% to 43.2±2.8%; IV group from 43.6±2.2% to 40.0±2.6%) significantly decreased (p<0.01) with IV saline. Serum albumin remained stable after oral intake but significantly decreased (p=0.04) after IV infusion. Oral intake of 2 L of 0.9% saline results in minimal variations in serum albumin, hemoglobin, and hematocrit when compared to IV infusion of the same volume.

  9. 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 scenari...

  10. Hemodialysis Tunneled Catheter Noninfectious Complications

    Science.gov (United States)

    Miller, Lisa M.; MacRae, Jennifer M.; Kiaii, Mercedeh; Clark, Edward; Dipchand, Christine; Kappel, Joanne; Lok, Charmaine; Luscombe, Rick; Moist, Louise; Oliver, Matthew; Pike, Pamela; Hiremath, Swapnil

    2016-01-01

    Noninfectious hemodialysis catheter complications include catheter dysfunction, catheter-related thrombus, and central vein stenosis. The definitions, causes, and treatment strategies for catheter dysfunction are reviewed below. Catheter-related thrombus is a less common but serious complication of catheters, requiring catheter removal and systemic anticoagulation. In addition, the risk factors, clinical manifestation, and treatment options for central vein stenosis are outlined. PMID:28270922

  11. 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

  12. Different effects of fluid loading with saline, gelatine, hydroxyethyl starch or albumin solutions on acid-base status in the critically ill

    NARCIS (Netherlands)

    A.M.E. Spoelstra-de Ma (Angélique M. E.); A. Smorenberg (Annemieke); A.B.J. Groeneveld (Johan)

    2017-01-01

    textabstractIntroduction Fluid administration in critically ill patients may affect acid-base balance. However, the effect of the fluid type used for resuscitation on acid-base balance remains controversial. Methods We studied the effect of fluid resuscitation of normal saline and the colloids

  13. Protein intake during hemodialysis maintains a positive whole body protein balance in chronic hemodialysis patients

    NARCIS (Netherlands)

    Veeneman, JM; Kingma, HA; Boer, TS; Stellaard, F; De Jong, PE; Reijngoud, DJ; Huisman, RM

    Protein energy malnutrition is present in 18 to 56% of hemodialysis patients. Because hemodialysis has been regarded as a catabolic event, we studied whether consumption of a protein- and energy-nriched meal improves the whole body protein balance during dialysis in chronic hemodialysis (CHD)

  14. 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.

  15. Stochastic Modeling of Soil Salinity

    Science.gov (United States)

    Suweis, Samir; Rinaldo, Andrea; van der Zee, Sjoerd E. A. T. M.; Maritan, Amos; Porporato, Amilcare

    2010-05-01

    Large areas of cultivated land worldwide are affected by soil salinity. Estimates report that 10% of arable land in over 100 countries, and nine million km2 are salt affected, especially in arid and semi-arid regions. High salinity causes both ion specific and osmotic stress effects, with important consequences for plant production and quality. Salt accumulation in the root zone may be due to natural factors (primary salinization) or due to irrigation (secondary salinization). Simple (e.g., vertically averaged over the soil depth) coupled soil moisture and salt balance equations have been used in the past. Despite their approximations, these models have the advantage of parsimony, thus allowing a direct analysis of the interplay of the main processes. They also provide the ideal starting point to include external, random hydro-climatic fluctuations in the analysis of long-term salinization trends. We propose a minimalist stochastic model of primary soil salinity, 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 long term probability density functions of salt mass and concentration are found by reducing the coupled soil moisture and salt mass balance equation to a stochastic differential equation driven by multiplicative Poisson noise. The novel analytical solutions provide insight on the interplay of the main soil, plant and climate parameters responsible for long-term soil salinization. In fact, soil salinity statistics are obtained as a function of climate, soil and vegetation parameters. These, in turn, can be combined with soil moisture statistics to obtain a full characterization of soil salt concentrations and the ensuing risk of primary salinization. In particular, the solutions show the existence of two quite distinct regimes, the first one where the mean salt mass remains nearly constant with increasing rainfall frequency, and the

  16. Tuberculosis in children undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Gargah Tahar

    2010-04-01

    Full Text Available Gargah Tahar1, Goucha-Louzir Rim2, Lakhoua Mohamed Rachid11Department of Pediatric Nephrology, 2Department of Nephrology, Charles Nicolle Hospital, Tunis, TunisiaAbstract: Tuberculosis (TB remains a public health problem in Tunisia. Its incidence is higher in immunocompromised hosts than in the general population. In children and during hemodialysis, TB is characterized by the frequency of extrapulmonary localizations and diagnostic difficulties. The aim of this retrospective study is to evaluate the incidence of TB in Tunisian children undergoing hemodialysis and to determine its clinical features as well as the results of chemotherapy.Method: This retrospective study includes seven TB children among 112 children on hemodialysis at the pediatric nephrology department in Charles Nicolle Hospital from 2002 to 2008. The diagnosis of TB was established by a combination of clinical, radiological, biochemical, microbiological, and histological examinations. Treatment with anti-TB drugs, the results of therapy, and the outcome of patients were noted.Results: There were four girls and three boys aged 10 to 16 years (mean, 13 years. They had been on hemodialysis for 2 to 5 years (mean, 3 years. Noted clinical features were weight loss and fever in five cases, chest pain in one case, cervical lymph node in one case, and spinal pain in one case. The organ systems involved were pleural in two cases, pulmonary in one case, peritoneal in one case, cervical lymphatic in one case, and spinal in one case. One patient was treated empirically with a good response. Diagnosis was made by isolation of mycobacterium TB in three cases, by specific histological signs observed in a lymph node biopsy in one case, in peritoneal biopsy in one case, and in discovertebral biopsy in one case. In the remaining patient, the clinical and radiological presentations were compatible with pulmonary TB. All patients received four anti-TB drugs: isoniazid, rifampicin, pyrazinamide

  17. 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.

  18. Different effects of fluid loading with saline, gelatine, hydroxyethyl starch or albumin solutions on acid-base status in the critically ill.

    Science.gov (United States)

    Spoelstra-de Man, Angélique M E; Smorenberg, Annemieke; Groeneveld, A B Johan

    2017-01-01

    Fluid administration in critically ill patients may affect acid-base balance. However, the effect of the fluid type used for resuscitation on acid-base balance remains controversial. We studied the effect of fluid resuscitation of normal saline and the colloids gelatine 4%, hydroxyethyl starch (HES) 6%, and albumin 5% on acid-base balance in 115 clinically hypovolemic critically ill patients during a 90 minute filling pressure-guided fluid challenge by a post-hoc analysis of a prospective randomized clinical trial. About 1700 mL was infused per patient in the saline and 1500 mL in each of the colloid groups (Pgelatine- and albumin-loaded patients, independent of lactate concentrations. In clinically hypovolemic, critically ill patients, fluid resuscitation by only 1500-1700 mL of normal saline, gelatine, HES or albumin, resulted in a small decrease in pH, irrespective of the type of fluid used. Therefore, a progressive metabolic acidosis, even with increased anion gap, should not be erroneously attributed to insufficient fluid resuscitation. ISRCTN Registry ISRCTN19023197.

  19. 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

  20. 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...

  1. Urea biosensor for hemodialysis monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Glass, Robert S. (Livermore, CA)

    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.

  2. Urea biosensor for hemodialysis monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Glass, R.S.

    1999-01-12

    This research discloses 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. 9 figs.

  3. DNA methylation: hemodialysis versus hemodiafiltration.

    Science.gov (United States)

    Ghigolea, Adrian-Bogdan; Moldovan, Raluca Argentina; Gherman-Caprioara, Mirela

    2015-04-01

    Aberrant DNA methylation is an emerging characteristic of chronic kidney disease including dialysis patients. It appears to be associated to inflammation. We compared the global DNA methylation status in 10 control subjects compared to 80 dialysis patients (N = 40 on-line hemodiafiltration, N = 40 high-flux hemodialysis) in relation to the dialysis technique and inflammation. Whole blood DNA methylation was assessed with a 5-mc DNA enzyme linked immunosorbent assay Kit. Global DNA methylation was higher in hemodialysis (HD) compared to on-line hemodiafiltration (HDF) patients (0.045 vs. 0.039; P patients according to the median value of 5-mC. DNA methylation was highest in inflamed patients on hemodialysis. The dialysis technique was the only independent predictor of global DNA methylation in dialysis patients. On-line HDF could be associated with a favorable DNA methylation profile. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

  4. SOLUTIONING

    Directory of Open Access Journals (Sweden)

    Maria de Hoyos Guajardo, Ph.D. Candidate, M.Sc., B.Eng.

    2004-11-01

    Full Text Available The theory that is presented below aims to conceptualise how a group of undergraduate students tackle non-routine mathematical problems during a problem-solving course. The aim of the course is to allow students to experience mathematics as a creative process and to reflect on their own experience. During the course, students are required to produce a written ‘rubric’ of their work, i.e., to document their thoughts as they occur as well as their emotionsduring the process. These ‘rubrics’ were used as the main source of data.Students’ problem-solving processes can be explained as a three-stage process that has been called ‘solutioning’. This process is presented in the six sections below. The first three refer to a common area of concern that can be called‘generating knowledge’. In this way, generating knowledge also includes issues related to ‘key ideas’ and ‘gaining understanding’. The third and the fourth sections refer to ‘generating’ and ‘validating a solution’, respectively. Finally, once solutions are generated and validated, students usually try to improve them further before presenting them as final results. Thus, the last section deals with‘improving a solution’. Although not all students go through all of the stages, it may be said that ‘solutioning’ considers students’ main concerns as they tackle non-routine mathematical problems.

  5. 21 CFR 876.5860 - High permeability hemodialysis system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false High permeability hemodialysis system. 876.5860... hemodialysis system. (a) Identification. A high permeability hemodialysis system is a device intended for use... toxemic conditions by performing such therapies as hemodialysis, hemofiltration, hemoconcentration, and...

  6. 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.

  7. Costs and Outcomes in Hemodialysis and Hemodiafiltration

    NARCIS (Netherlands)

    Mazairac, A.H.A.

    2011-01-01

    Both survival and quality of life (QoL) are poor in patients on hemodialysis. Earlier studies have shown their QoL to be lower than in patients with for instance chronic heart failure, arthritis and metastatic colon cancer. Hemodialysis patients do not only face the symptoms of end-stage renal

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

    Science.gov (United States)

    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. PMID:28409034

  9. 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.

  10. 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.

  11. Stochastic Modeling of Soil Salinity

    CERN Document Server

    Suweis, S; Van der Zee, S E A T M; Daly, E; Maritan, A; Porporato, A; 10.1029/2010GL042495

    2012-01-01

    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 long term probability density functions of salt mass and concentration are found by reducing the coupled soil moisture and salt mass balance equation to a single stochastic differential equation driven by multiplicative Poisson noise. The novel analytical solutions 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 long-term soil salinization trend...

  12. Fluctuation of Ultrafiltration Coefficient of Hemodialysis Membrane During Reuse

    Science.gov (United States)

    Arif, Idam; Christin

    2010-12-01

    Hemodialysis treatment for patient with kidney failure is to regulate body fluid and to excrete waste products of metabolism. The patient blood and the dialyzing solution (dialysate) are flowed counter currently in a dialyzer to allow volume flux of fluid and diffusion of solutes from the blood to the dialysate through a semipermiable membrane. The volume flux of fluid depends on the hydrostatic and the osmotic pressure difference between the blood and the dialysate. It also depends on the membrane parameter that represents how the membrane allows the fluid and the solutes to move across as a result of the pressure difference, known as the ultrafiltration coefficient Kuf. The coefficient depends on the number and the radius of membrane pores for the movement of the fluids and the solutes across the membrane. The measured membrane ultrafiltration coefficient of reused dialyzer shows fluctuation between one uses to another without any significant trend of change. This indicates that the cleaning process carried out before reuse does not cause perfect removal of clots that happen in the previous use. Therefore the unblocked pores are forced to work hardly to obtain targeted volume flux in a certain time of treatment. This may increase the unblocked pore radius. Reuse is stopped when there is indication of blood leakage during the hemodialysis treatment.

  13. Effects of Amendment of Biochar and Pyroligneous Solution from wheat straw pyrolysis on Yield and soil and crop salinity in a Salt stressed cropland from Central China Great Plain

    Science.gov (United States)

    Li, L.; Liu, Y.; Pan, W.; Pan, G.; Zheng, J.; Zheng, J.; Zhang, X.

    2012-04-01

    Crop production has been subject to salt stress in large areas of world croplands. Organic and/or bio-fertilizers have been applied as soil amendments for alleviating salt stress and enhancing crop productivity in these salt-stressed croplands. While biochar production systems using pyrolysis of crop straw materials have been well developed in the world, there would be a potential measure to use materials from crop straw pyrolysis as organic amendments in depressing salt stress in agriculture. In this paper, a field experiment was conducted on the effect of biochar and pyroligneous solution from cropstraw pyrolysis on soil and crop salinity, and wheat yield in a moderately salt stressed Entisol from the Central Great Plain of North China. Results indicated that: biochar and pyroligneous solution increased soil SOC, total nitrogen, available potassium and phosphorous by 43.77%, 6.50%, 45.54% and 108.01%, respectively. While Soil bulk density was decreased from 1.30 to 1.21g cm-3; soil pH (H2O) was decreased from 8.23 to 7.94 with a decrease in soluble salt content by 38.87%. Wheat yield was doubled over the control without amendment. In addition, sodium content was sharply declined by 78.80% in grains, and by 70.20% and 67.00% in shoot and root, respectively. Meanwhile, contents of potassium and phosphorus in plant tissue were seen also increased despite of no change in N content. Therefore, the combined amendment of biochar with pyroligneous solution would offer an effective measure to alleviate the salt stress and improving crop productivity in world croplands. Keywords: biochar, salt affected soils, wheat, crop productivity, salinity

  14. Effects of salinity and drought on growth, ionic relations, compatible solutes and activation of antioxidant systems in oleander (Nerium oleander L.)

    Science.gov (United States)

    Kumar, Dinesh; Naranjo, Miguel A.; Agrawal, Veena; Boscaiu, Monica; Vicente, Oscar

    2017-01-01

    Nerium oleander is an ornamental species of high aesthetic value, grown in arid and semi-arid regions because of its drought tolerance, which is also considered as relatively resistant to salt; yet the biochemical and molecular mechanisms underlying oleander’s stress tolerance remain largely unknown. To investigate these mechanisms, one-year-old oleander seedlings were exposed to 15 and 30 days of treatment with increasing salt concentrations, up to 800 mM NaCl, and to complete withholding of irrigation; growth parameters and biochemical markers characteristic of conserved stress-response pathways were then determined in stressed and control plants. Strong water deficit and salt stress both caused inhibition of growth, degradation of photosynthetic pigments, a slight (but statistically significant) increase in the leaf levels of specific osmolytes, and induction of oxidative stress—as indicated by the accumulation of malondialdehyde (MDA), a reliable oxidative stress marker—accompanied by increases in the levels of total phenolic compounds and antioxidant flavonoids and in the specific activities of ascorbate peroxidase (APX) and glutathione reductase (GR). High salinity, in addition, induced accumulation of Na+ and Cl- in roots and leaves and the activation of superoxide dismutase (SOD) and catalase (CAT) activities. Apart from anatomical adaptations that protect oleander from leaf dehydration at moderate levels of stress, our results indicate that tolerance of this species to salinity and water deficit is based on the constitutive accumulation in leaves of high concentrations of soluble carbohydrates and, to a lesser extent, of glycine betaine, and in the activation of the aforementioned antioxidant systems. Moreover, regarding specifically salt stress, mechanisms efficiently blocking transport of toxic ions from the roots to the aerial parts of the plant appear to contribute to a large extent to tolerance in Nerium oleander. PMID:28922384

  15. 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…

  16. Are the effects of hemodialysis on ocular parameters similar during and after a hemodialysis session?

    Directory of Open Access Journals (Sweden)

    Ahmet Elbay

    Full Text Available ABSTRACT Purpose: To evaluate the changes in several ocular parameters, including choroidal thickness, during and after hemodialysis. Methods: Twenty-seven eyes of 27 patients with chronic renal failure undergoing hemodialysis were included. The patients underwent an ophthalmic examination, including intraocular pressure, central corneal thickness, iridocorneal angle, subfoveal choroidal thickness, and blood pressure, just before a hemodialysis session, during the second hour of the session, and half an hour after the end of the session. Body weight was measured before and after the session, and ultrafiltration volume was noted after the session. Central corneal thickness, intraocular pressure, and subfoveal choroidal thickness were measured by optical coherence tomography. Results: In comparison with baseline levels, mean intraocular pressure and central corneal thickness increased significantly during the second hour of hemodialysis (p=0.001 and p=0.011, respectively and showed no significant changes after hemodialysis (p=0.844 and p=0.246, respectively. Mean iridocorneal angle did not significantly change during the second hour of hemodialysis (p=0.101 and after hemodialysis (p=0.589. Mean subfoveal choroidal thickness was significantly lower during the second hour of hemodialysis (p<0.001 and after hemodialysis (p<0.001. Conclusions: Mean intraocular pressure and central corneal thickness increased and subfoveal choroidal thickness decreased during the second half of the hemodialysis session. During the second half of the session, intraocular pressure and central corneal thickness had a trend toward reduction, while subfoveal choroidal thickness had a relatively steady course. Because of possible fluctuations in the values, it would be reasonable to evaluate the changes not only from before to after hemodialysis but also during hemodialysis when analyzing the ocular effects of dialysis.

  17. Conversion of tunneled hemodialysis catheter into HeRO device can provide immediate access for hemodialysis.

    Science.gov (United States)

    Vasquez, Julio C; DeLaRosa, Jacob; Rahim, Fahim; Rahim, Naeem

    2010-11-01

    Patients with central venous occlusion who are ''tunneled catheter dependent'' are a challenge for hemodialysis access. A relatively new option for them is the hemodialysis reliable outflow (HeRO) device that can be totally implanted subcutaneously. However, patients still require a tunneled hemodialysis catheter that is used until the HeRO device is mature, 4 to 6 weeks later. Here, we describe a conversion of an existing tunneled hemodialysis catheter into a HeRO device, which was combined with a ''self-sealing'' Flixene graft. This allowed almost immediate use of the HeRO device without the need for placement of a catheter.

  18. Practically Saline

    Directory of Open Access Journals (Sweden)

    Jonathan Schroeder MD

    2015-11-01

    Full Text Available Introduction. In December 2014, the Food and Drug Administration issued a recall of all Wallcur simulation products due to reports of their use in clinical practice. We present a case of septic shock and multiorgan failure after the accidental intravenous infusion of a nonsterile Wallcur simulation product. Case. The patient presented with symptoms of rigors and dyspnea occurring immediately after infusion of Wallcur Practi-0.9% saline. Initial laboratory evidence was consistent with severe septic shock and multiorgan dysfunction. His initial lactic acid level was 9 mmol/L (reference range = 0.5-2.2, and he had evidence of acute kidney injury and markers of disseminated intravascular coagulation. All 4 blood culture bottles isolated multidrug-resistant Empedobacter brevis. The patient recovered from his illness and was discharged with ciprofloxacin therapy per susceptibilities. Discussion. This patient represents the first described case of severe septic shock associated with the infusion of a Wallcur simulation product. Intravenous inoculation of a nonsterile fluid is rare and exposes the patient to unusual environmental organisms, toxins, or unsafe fluid characteristics such as tonicity. During course of treatment, we identified the possible culprit to be a multidrug-resistant isolate of Empedobacter brevis. We also discuss the systemic failures that led to this outbreak.

  19. Hypernatremia: Correction Rate and Hemodialysis

    Directory of Open Access Journals (Sweden)

    Saima Nur

    2014-01-01

    Full Text Available Severe hypernatremia is defined as serum sodium levels above 152 mEq/L, with a mortality rate ≥60%. 85-year-old gentleman was brought to the emergency room with altered level of consciousness after refusing to eat for a week at a skilled nursing facility. On admission patient was nonverbal with stable vital signs and was responsive only to painful stimuli. Laboratory evaluation was significant for serum sodium of 188 mmol/L and water deficit of 12.0 L. Patient was admitted to medicine intensive care unit and after inadequate response to suboptimal fluid repletion, hemodialysis was used to correct hypernatremia. Within the first fourteen hours, sodium concentration only changed 1 mEq/L with a fluid repletion; however, the concentration dropped greater than 20 mEq/L within two hours during hemodialysis. Despite such a drastic drop in sodium concentration, patient did not develop any neurological sequela and was at baseline mental status at the time of discharge.

  20. Carnitine in maintenance hemodialysis patients.

    Science.gov (United States)

    Guarnieri, Gianfranco

    2015-03-01

    Carnitine is a conditionally essential metabolite that plays a critical role in cell physiology. Carnitine is necessary for fatty acid transport to sites of beta-oxidation in the mitochondria, where it also helps to prevent organic acid accumulation. Because of these key regulatory functions, carnitine represents a crucial determinant of mitochondrial energy metabolism, whose deficiency may lead to metabolic and clinical disturbances. Loss of carnitine through dialytic membranes occurs in maintenance hemodialysis, resulting in potential carnitine depletion and relative increments of esterified carnitine forms. Carnitine supplementation has been reported to counteract some of these alterations and has been associated with some clinical benefits, such as enhanced response to erythropoietin as well as improvement in exercise tolerance, intradialytic symptom, hyperparathyroidism, insulin resistance, inflammatory and oxidant status, protein balance, lipid profile, cardiac function, and quality of life. Carnitine supplementation has an attractive theoretical rationale; however, there are no definitive supportive studies and conclusive evidence that L-carnitine supplementation in maintenance hemodialysis patients could improve these conditions. A trial of carnitine administration could be attempted for 6 to 12 months only in selected patients on dialysis who do not adequately respond to standard therapies, in the presence of symptomatology, and in conjunction with patient dialysis age and documented L-carnitine deficiency. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  1. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

    Full Text Available Carolina Pelegrini Barbosa Gracitelli,1 Francisco Rosa Stefanini,1 Fernando Penha,1 Miguel Ângelo Góes,2 Sérgio Antonio Draibe,2 Maria Eugênia Canziani,2 Augusto Paranhos Junior1 1Ophthalmology Department, 2Division of Nephrology, Federal University of São Paulo – UNIFESP, São Paulo, Brazil Background: Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD because of anterior chamber depth changes during this therapy. Purpose: To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods: A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results: There was no difference in the axial length between the three measurements (P = 0.241. We observed a significantly decreased anterior chamber depth (P = 0.002 during HD sessions. Conclusion: Our results support the idea that there is a change in anterior chamber depth in HD sessions. Keywords: anterior chamber, hemodialysis, axial length, acute angle-closure glaucoma

  2. 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.

  3. Intradialytic Exercise Programs for Hemodialysis Patients

    National Research Council Canada - National Science Library

    Jung, Tae-Du; Park, Sun-Hee

    2011-01-01

    .... This review aimed to investigate the beneficial effects of exercise during hemodialysis and also to introduce various intradialytic exercise programs and their advantages as a first step in combining...

  4. 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.

  5. Bulk Moisture and Salinity Sensor

    Science.gov (United States)

    Nurge, Mark; Monje, Oscar; Prenger, Jessica; Catechis, John

    2013-01-01

    Measurement and feedback control of nutrient solutions in plant root zones is critical to the development of healthy plants in both terrestrial and reduced-gravity environments. In addition to the water content, the amount of fertilizer in the nutrient solution is important to plant health. This typically requires a separate set of sensors to accomplish. A combination bulk moisture and salinity sensor has been designed, built, and tested with different nutrient solutions in several substrates. The substrates include glass beads, a clay-like substrate, and a nutrient-enriched substrate with the presence of plant roots. By measuring two key parameters, the sensor is able to monitor both the volumetric water content and salinity of the nutrient solution in bulk media. Many commercially available moisture sensors are point sensors, making localized measurements over a small volume at the point of insertion. Consequently, they are more prone to suffer from interferences with air bubbles, contact area of media, and root growth. This makes it difficult to get an accurate representation of true moisture content and distribution in the bulk media. Additionally, a network of point sensors is required, increasing the cabling, data acquisition, and calibration requirements. measure the dielectric properties of a material in the annular space of the vessel. Because the pore water in the media often has high salinity, a method to measure the media moisture content and salinity simultaneously was devised. Characterization of the frequency response for capacitance and conductance across the electrodes was completed for 2-mm glass bead media, 1- to 2-mm Turface (a clay like media), and 1- to 2-mm fertilized Turface with the presence of root mass. These measurements were then used to find empirical relationships among capacitance (C), the dissipation factor (D), the volumetric water content, and the pore water salinity.

  6. 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

  7. Factors associated with subendocardial ischemia risk in patients on hemodialysis

    National Research Council Canada - National Science Library

    Silva, Bruno Caldin da; Sanjuan, Adriano; Costa-Hong, Valéria; Reis, Luciene dos; Graciolli, Fabiana; Consolim-Colombo, Fernanda; Bortolotto, Luiz Aparecido; Moyses, Rosa Maria Affonso; Elias, Rosilene Motta

    2016-01-01

    ..., such vascular evaluation in patients on hemodialysis has not been extensively studied. Methods: In this cross-sectional study, hemodialysis patients were submitted to flow-mediated dilation, subendocardial viability ratio...

  8. Salinity tolerance in halophytes.

    Science.gov (United States)

    Flowers, Timothy J; Colmer, Timothy D

    2008-01-01

    Halophytes, plants that survive to reproduce in environments where the salt concentration is around 200 mm NaCl or more, constitute about 1% of the world's flora. Some halophytes show optimal growth in saline conditions; others grow optimally in the absence of salt. However, the tolerance of all halophytes to salinity relies on controlled uptake and compartmentalization of Na+, K+ and Cl- and the synthesis of organic 'compatible' solutes, even where salt glands are operative. Although there is evidence that different species may utilize different transporters in their accumulation of Na+, in general little is known of the proteins and regulatory networks involved. Consequently, it is not yet possible to assign molecular mechanisms to apparent differences in rates of Na+ and Cl- uptake, in root-to-shoot transport (xylem loading and retrieval), or in net selectivity for K+ over Na+. At the cellular level, H+-ATPases in the plasma membrane and tonoplast, as well as the tonoplast H+-PPiase, provide the trans-membrane proton motive force used by various secondary transporters. The widespread occurrence, taxonomically, of halophytes and the general paucity of information on the molecular regulation of tolerance mechanisms persuade us that research should be concentrated on a number of 'model' species that are representative of the various mechanisms that might be involved in tolerance.

  9. Copeptin in Hemodialysis Patients with Left Ventricular Dysfunction

    OpenAIRE

    Kim, Jae Seok; Yang, Jae Won; Chai, Moon Hee; Lee, Jun Young; Park, Hyeoncheol; Kim, Youngsub; Choi, Seung Ok; Han, Byoung Geun

    2015-01-01

    Purpose Copeptin has been considered as a useful marker for diagnosis and prediction of prognosis in heart diseases. However, copeptin has not been investigated sufficiently in hemodialysis patients. This study aimed to investigate the general features of copeptin in hemodialysis and to examine the usefulness of copeptin in hemodialysis patients with left ventricular dysfunction (LV dysfunction). Materials and Methods This study included 41 patients on regular hemodialysis. Routine laboratory...

  10. 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.

  11. 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.

  12. 21 CFR 876.5820 - Hemodialysis system and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hemodialysis system and accessories. 876.5820... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5820 Hemodialysis system and accessories. (a) Identification. A hemodialysis system and accessories is a device that is...

  13. 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...

  14. Intradialytic parenteral nutrition in malnourished children treated with hemodialysis.

    Science.gov (United States)

    Krause, Irit; Shamir, Raanan; Davidovits, Miriam; Frishman, Sigal; Cleper, Roxana; Gamzo, Zahava; Poraz, Irit; Eisenstein, Bella

    2002-01-01

    To examine the feasibility and effectiveness of intradialytic parenteral nutrition (IDPN) in children on hemodialysis. Prospective experimental study with a single intervention group. A pediatric hemodialysis unit. Four malnourished children on hemodialysis (3 girls and 1 boy) 4 to 18 years of age were studied during a period of 1 year. IDPN, which is composed of amino acids (8.5% solution), glucose (as 10% to 15% dextrose), and 20% fat emulsion, was administered at every dialysis session (3 times a week, during 4 hours each time) for 7 to 12 weeks. Oral caloric intake (evaluated by using a 3-day diet history), dry weight (weight after dialysis), body mass index, percent ideal body weight, total lymphocyte count, and serum levels of albumin before, immediately after cessation of IDPN, and 3 months after cessation of IDPN. Oral caloric intake increased markedly after IDPN administration, from 5 to 63 kcal/kg/d (mean, 33 kcal/kg/d) before IDPN administration to 35 to 177 kcal/kg/d (mean, 86 kcal/kg/d) at the time of cessation. Weight did not change during the treatment period but it did increase from 9.5 to 36.4 kg (mean, 25 kg) to 11 to 39 kg (mean, 26.7 kg) 3 months later. Percent ideal body weight increased from 73% to 88% (mean, 78.5%) to 79% to 90% (mean, 85.1%), and body mass index increased from 12.2 to 15 kg/m(2) (mean, 13.5 kg/m(2)) to 13.4 to 15.5 kg/m(2) (mean, 14.6 kg/m(2)). Total lymphocyte count increased from 538 to 2,041 cells/mm(3) (mean, 1,403 cells/mm(3)) to 724 to 2,884 cells/mm(3) (mean, 2,066 cells/mm(3)). Plasma levels of albumin increased in 1 patient but remained unchanged in others. Short-term IDPN treatment may serve as a safe and effective nutritional intervention in malnourished children on hemodialysis. Copyright 2002 by the National Kidney Foundation, Inc.

  15. 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

  16. Hearing loss in geriatric hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Caner Sahin

    2015-01-01

    Full Text Available Introduction: The aim of the study was to evaluate the hearing loss in geriatric hemodialysis patients. Materials and Methods: The study was performed on 16 geriatric hemodialysis patients (age minimum: 65, maximum: 86 years and 16 volunteers (age minimum: 65, maximum: 86 years as a control group. The patients′ pure tone audiometry values between 250 and 8000 Hz frequencies were analyzed. Results: In our study, statistical significance was found between hearing loss and serum urea levels (P = 0.001. Hearing loss values were not statistically significantly different between the study and control groups (P = 0.786. High frequency hearing thresholds were found to be significantly higher in the geriatric hemodialysis patients (P = 0.032. Normal hearing levels at all levels were found in 5 patients in the study group. Mild to moderate hearing loss was found in 11 patients. Conclusions: In our preliminary study, we found statistically significant differences between the increase in hearing thresholds and uremia. Statistically significant changes in hearing thresholds at high frequencies were found between the two groups. Long-term hemodialysis treatment of 10 years or more is a risk factor for hearing loss. Hemodialysis treatment is a risk factor for hearing loss in geriatric patients who are at a risk of presbyacusis.

  17. Epidemiology of hemodialysis patients in Aleppo city

    Directory of Open Access Journals (Sweden)

    Moukeh Ghamez

    2009-01-01

    Full Text Available To determine the characteristics of the hemodialysis (HD patients in Aleppo city, we surveyed the hospitals representing the main dialysis centers in the city including private and community facilities during 2006. Personal patients′ interviews and hospitals records were the source of data. The total number of patients in 2006 undergoing HD was 550 patients; 280 (50.9% were males, and the age ranged from 5-82 years with mean and median age 44.7 and 45 years, respectively. The incidence (IR and prevalence rate (PR for hemodialysis were 60 pmp and 226 pmp, respectively. The major primary renal diseases in the end-stage renal disease (ESRD patients included hypertension (HTN, glomerulonephritis (GN, and diabetes mellitus (DM, 21.1%, 20.5 %, and 19.45, respectively. The percent of Anti-HCV, HBV hepatitis and HBV vaccine were 54.4%, 7.8%, and 52.9%, respectively. This study suggests that the IR of hemodialysis was relatively low due to the high cost of treatment, and the PR for hemodialysis was also relatively low may be due to high mortality rate and low kidney transplantation rate in this country. There was an equal percentage of both genders in the hemodialysis population.

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

    Science.gov (United States)

    Assa, Solmaz; Bakker, Stephan J. L.; Groen, Henk; Westerhuis, Ralf; Gaillard, Carlo A. J. M.; Gansevoort, Ron T.

    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 for copeptin release, i.e. plasma osmolality, blood volume and mean arterial pressure (MAP), are operational in hemodialysis patients. Methods 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. Results 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 (pcopeptin levels during dialysis, whereas there was no significant association between the change in plasma sodium levels and the change in copeptin levels. Conclusions Plasma copeptin levels are elevated predialysis and increase further during hemodialysis. Volume stimuli, i.e. decreases in MAP and blood volume, rather than osmotic stimuli, are associated with change in copeptin levels during hemodialysis. PMID

  19. Massive hemorrhage due to hemodialysis-associated thrombocytopenia.

    Science.gov (United States)

    Vicks, S L; Gross, M L; Schmitt, G W

    1983-01-01

    Marked declines in platelet numbers were noted in association with hemodialysis. This resulted in gastrointestinal bleeding and the need for packed RBC and platelet transfusions. This hemodialysis-associated thrombocytopenia was ameliorated by changing the dialyzer in use. The gastrointestinal bleeding stopped and the need for platelet transfusions was obviated. The degree of platelet loss during hemodialysis is probably affected by the composition of the dialyzer membrane used as well as other factors. Hemodialysis-associated thrombocytopenia may be a contributing factor in the increased bleeding tendency noted in hemodialysis patients.

  20. Prevalence of fibromyalgia in hemodialysis patients.

    Science.gov (United States)

    Samimagham, Hamidreza; Haghighi, Anousheh; Tayebi, Mehdi; Jenabi, Arya; Arabi, Mohsen; Kianmehr, Nahid

    2014-05-01

    This study sought to determine the prevalence of fibromyalgia syndrome and to identify whether fibromyalgia was associated with various clinical symptoms and laboratory parameters in hemodialysis patients. One hundred and forty-eight hemodialysis patients were examined for fibromyalgia symptoms according to the American College of Rheumatology criteria. Demographic characteristics, as well as causes of kidney failure, dialysis duration, and symptoms related to fibromyalgia were investigated. Of 148 patients, 18 (12.2%) were diagnosed with fibromyalgia. Patients with fibromyalgia had significantly poorer sleeping satisfaction than the control group (P = .02).The Beck Depression Inventory score was higher in 77.8% of the fibromyalgia patients than that in the control group (P = .006), but there was no significant difference in the anxiety score between the two groups (P = .86).In conclusion, there was a higher prevalence of fibromyalgia in hemodialysis patients than previously reported. Sleep disturbances and depression levels correlated with fibromyalgia.

  1. [Update on proteomic use in hemodialysis].

    Science.gov (United States)

    Bonomini, Mario; Sirolli, Vittorio; Baroni, Silvia; Urbani, Andrea

    2017-08-01

    Application of proteomics has become one of the leading experimental disciplines for increased understanding of the key role played by proteins and protein-protein interactions in all aspects of cell function. There is an increasing use of proteomic technologies for investigation into renal replacement therapy such as hemodialysis. In the last 10 years, the application of shotgun bottom-up liquid chromatography-mass spectrometry/mass spectrometry approaches has been successfully applied to research in uremic toxicity, with the discovery of novel uremic toxins and the potential to delineate a precise molecular approach to defining the biochemical nature of uremia. Major investigations of proteomics in hemodialysis therapy include molecular definition of uremic toxicity, identification of prognostic biomarkers, blood purification efficiency testing, and biocompatibility assessment of the dialyzer membrane materials. In this article, we review the results of recent proteoic investigations in the setting of chronic hemodialysis therapy. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  2. 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.

  3. Erectile dysfunction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Imen Gorsane

    2016-01-01

    Full Text Available Erectile dysfunction (ED is a common problem seen among patients on hemodialysis (HD, but it is still a taboo subject in our country. The attention given to this sexual problem remained low, and the prevalence of ED among these patients has not been well characterized. We carried out this study in order to determine the prevalence and severity of ED in HD patients. We conducted a descriptive cross-sectional study in our HD unit in March 2013. ED was evaluated using the International Index Erection Function. Thirty patients with a mean age of 49.1 years were eligible for this study. The main causes of chronic kidney disease were hypertension (62.5% and diabetes (41.6%. The prevalence of ED was 80%, including 33.3% severe ED. Plasma levels of gonadotropins: luteinizing hormone (LH, follicule-stimulating hormone were in the standards except for one patient who had an elevated level of LH. Prolactin was elevated in four cases. ED was present in 8.4% of patients before the discovery of renal failure and in 91.6% of patients at the beginning of dialysis. For 19 patients (79.1%, the ED had increased during the dialysis sessions. A significant number of our HD patients presented with ED of varying degrees. Nephrologists should pay attention to the problem of ED in order to improve the quality of their life.

  4. The level of endotoxins in hemodialysis water and dialysate in Lithuanian hemodialysis centers.

    Science.gov (United States)

    Skarupskienė, Inga; Bumblytė, Inga Arūnė; Tamošaitis, Donatas; Venterienė, Jūratė; Kuzminskis, Vytautas

    2010-01-01

    The composition and quality of the dialysis fluid play an important role in the modulation of dialysis-related complications. During hemodialysis, patient's blood has a contact with dialysate through a semipermeable membrane. Bacterial endotoxins can pass through the membrane pores into the patient's blood and cause a silent chronic microinflammation. The aim of this study was to determine the level of endotoxins in hemodialysis water and dialysate in Lithuanian hemodialysis centers. Dialysis water (n=50) and dialysate (n=50) were collected from 91% (n=50) of all hemodialysis centers. The presence of bacterial endotoxins was evaluated using a sensitive Limulus amebocyte lysate test, which detects intact lipopolysaccharides. The level of endotoxins was lower than 0.25 EU/mL in 43 (86%) dialysis water samples and in 46 (92%) dialysate samples, and complied with the recommendations of the European Pharmacopoeia and the European Best Practice Guidelines for pure dialysis fluid. The dialysate of 39 (78%) Lithuanian hemodialysis centers complied with the definition of an ultrapure dialysis fluid. The water and dialysate were of insufficient quality in 14% and in 8% of Lithuanian hemodialysis centers, respectively, and this could be improved by the establishment of routine investigation of endotoxins.

  5. 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;}

  6. Effect of nadroparin on anti-Xa activity during nocturnal hemodialysis

    NARCIS (Netherlands)

    Buitenwerf, Edward; Risselada, Arne J.; van Roon, Eric N.; Veeger, Nic J.G.M.; Hemmelder, Marc H.

    2015-01-01

    Background: Nadroparin is used during hemodialysis to prevent clotting of the extra corporeal system. During nocturnal hemodialysis patients receive an increased dosage of nadroparin compared to conventional hemodialysis. We tested whether the prescribed dosage regimen of nadroparin, according to

  7. Effect of Mealtime During Hemodialysis on Patients’ Complications

    Directory of Open Access Journals (Sweden)

    Seyed Reza Borzou

    2016-12-01

    Full Text Available Introduction: Food intake during hemodialysis increases the risk of problems such as hypotension, nausea, and vomiting in patients undergoing hemodialysis. This study aimed to determine the effect of mealtime during dialysis on the patients’ complications. Methods: This is a quasi-experimental study consisted of all eligible hemodialysis patients in Hamadan teaching hospitals. All of 48 patients were selected through census method. The research was conducted in two sessions. At both sessions, patients were kept fasting prior to hemodialysis. In the first session, after one hour and in the second session after two hours of hemodialysis, a meal containing 350 kcal of energy was given to the patients. Blood pressure and intensity of nausea and vomiting was measured and recorded immediately before the start of hemodialysis, and then every half an hour before the termination of the hemodialysis. Results: The results showed that in both sessions, food intake caused a drop in the systolic and diastolic blood pressure, but changes in the mealtime had no effect on the systolic and diastolic blood pressure. Also, statistical test showed that changes in the mealtime had no significant impact on the intensity of nausea and vomiting. Conclusion: Food intake during hemodialysis had no effect on the nausea and vomiting, but caused a drop in the systolic and diastolic blood pressure, the drop continued for one hour and one and a half hour after the meal. It is suggested, mealtime in the early hours of hemodialysis could be better managed during the hemodialysis process.

  8. 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.

  9. Frequency of Ocular Manifestation in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Eslami F

    2017-06-01

    Full Text Available Introduction: Chronic renal disease compromises of several renal involvements and several causative risk factors such as debates mellitus, hypertension, and old age. Ocular involvement seems to be related to chronic renal failure and hemodialysis as indicated by different studies. The aim of this study was the evaluation of prevalence of ocular manifestation in hemodialysis patients of Hamadan Besat hospital. Methods: This research was a cross sectional descriptive study, in which ocular signs in 74 hemodialysis patients, who referred to Besat hospital of Hamadan, Iran, during year 2015, were evaluated. Collected information related to patients included age, gender, dialysis duration, and background risk factors of chronic renal failure. All patients had been exanimated by an ophthalmologist. Results: Fifty percent of patients in the study were male and 50% were female. Average age of patients was 58.8 years and median duration of dialysis was 40.16 months. Mean visual acuity was 4.58 (of 10. Most common ocular manifestations were: macula abnormality (59.5%, cataract (56.7%, eye pain (56.7%, eye redness (52.7%, dry eyes (50%, and eyelid edema (43.2%, respectively. Conclusions: Hypertension and diabetes mellitus are the most common causes of chronic renal failure. The most common ocular manifestations were macular abnormality followed by cataract. According to high prevalence of these complications in hemodialysis patients, regular monitoring of patients for early detection and thus effective treatment seems to be necessary to improve their quality of life

  10. Multiple Hemodialysis Access Failures Due to Recurrent ...

    African Journals Online (AJOL)

    Introduction: The most common complication of permanent hemodialysis (HD) vascular access is thrombosis, with some cases being related to a hypercoagulable state. Antiphospholipid antibody syndrome (APAS) is a cause of increased thrombotic tendency, and this may complicate the management of such patients on ...

  11. 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

  12. Whole body protein metabolism in chronic hemodialysis

    NARCIS (Netherlands)

    Veeneman, Jorden Marcus

    2004-01-01

    To summarise, evidence suggests that protein-energy malnutrition is associated with mor-bidity and mortality in chronic hemodialysis patients. Urea kinetics are used as a clinical marker for protein intake and oxidation. Chapter 2 focuses on the relation between pro-tein and urea metabolism, which

  13. Acute effect of hemodialysis on arterial elasticity.

    Science.gov (United States)

    Sağ, Saim; Yeşilbursa, Dilek; Yildiz, Abdulmecit; Dilek, Kamil; Şentürk, Tunay; Serdar, Osman Akın; Aydinlar, Ali

    2015-01-01

    Reduced arterial elasticity is an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). Hemodialysis (HD) treatment per se can bring additional risk factors for vascular disease. Our study was designed to determine whether a single hemodialysis session leads to an acute alteration in parameters of arterial elasticity in ESRD. In this study, 58 patients undergoing chronic hemodialysis and 29 healthy controls were enrolled. Large artery elasticity index (LAEI) and the small artery elasticity index (SAEI) were measured by applanation tonometry. The acute effect of a hemodialysis session on arterial elasticity indices was assessed by comparison of prehemodialysis and posthemodialysis determinations. At baseline, LAEI did not differ significantly in patients compared with controls. In contrast, the SAEI was significantly lower in patients (4.1 ± 2.6 mL/mmHg x 100) than in healthy individuals (8.9 ± 3.4 mL/mmHg x 100, P < 0.05). In patients with ESRD, no significant changes in LAEI was observed after HD, but SAEI deteriorated significantly (from 4.1 ± 2.6 mL/mmHg x 100 to 3.4 ± 2.3, P < 0.05). We conclude that ESRD patients face a significant reduction in SAEI, which is exacerbated by a dialysis procedure.

  14. 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

  15. 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.

  16. Hydrogeologic processes in saline systems: Playas, sabkhas, and saline lakes

    Science.gov (United States)

    Yechieli, Y.; Wood, W.W.

    2002-01-01

    Pans, playas, sabkhas, salinas, saline lakes, and salt flats are hydrologically similar, varying only in their boundary conditions. Thus, in evaluating geochemical processes in these systems, a generic water and solute mass-balance approach can be utilized. A conceptual model of a coastal sabkha near the Arabian Gulf is used as an example to illustrate the various water and solute fluxes. Analysis of this model suggests that upward flux of ground water from underlying formations could be a major source of solutes in the sabkha, but contribute only a small volume of the water. Local rainfall is the main source of water in the modeled sabkha system with a surprisingly large recharge-to-rainfall ratio of more than 50%. The contribution of seawater to the solute budget depends on the ratio of the width of the supratidal zone to the total width and is generally confined to a narrow zone near the shoreline of a typical coastal sabkha. Because of a short residence time of water, steady-state flow is expected within a short time (50,000 years). The solute composition of the brine in a closed saline system depends largely on the original composition of the input water. The high total ion content in the brine limits the efficiency of water-rock interaction and absorption. Because most natural systems are hydrologically open, the chemistry of the brines and the associated evaporite deposits may be significantly different than that predicted for hydrologically closed systems. Seasonal changes in temperature of the unsaturated zone cause precipitation of minerals in saline systems undergoing evaporation. Thus, during the hot dry season months, minerals exhibit retrograde solubility so that gypsum, anhydrite and calcite precipitate. Evaporation near the surface is also a major process that causes mineral precipitation in the upper portion of the unsaturated zone (e.g. halite and carnallite), provided that the relative humidity of the atmosphere is less than the activity of water

  17. Hemodialysis without systemic anticoagulation: a prospective randomized trial to evaluate 3 strategies in patients at risk of bleeding.

    Directory of Open Access Journals (Sweden)

    Bruno Guéry

    Full Text Available In this clinical trial, we aimed to compare three means of performing chronic hemodialysis in patients with contra-indication to systemic heparinization.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.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.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.ClinicalTrials.gov NCT00473109.

  18. 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

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    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

  19. Survival analysis of patients on maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    A Chandrashekar

    2014-01-01

    Full Text Available Despite the continuous improvement of dialysis technology and pharmacological treatment, mortality rates for dialysis patients are still high. A 2-year prospective study was conducted at a tertiary care hospital to determine the factors influencing survival among patients on maintenance hemodialysis. 96 patients with end-stage renal disease surviving more than 3 months on hemodialysis (8-12 h/week were studied. Follow-up was censored at the time of death or at the end of 2-year study period, whichever occurred first. Of the 96 patients studied (mean age 49.74 ± 14.55 years, 75% male and 44.7% diabetics, 19 died with an estimated mortality rate of 19.8%. On an age-adjusted multivariate analysis, female gender and hypokalemia independently predicted mortality. In Cox analyses, patient survival was associated with delivered dialysis dose (single pool Kt/V, hazard ratio [HR] =0.01, P = 0.016, frequency of hemodialysis (HR = 3.81, P = 0.05 and serum albumin (HR = 0.24, P = 0.005. There was no significant difference between diabetes and non-diabetes in relation to death (Relative Risk = 1.109; 95% CI = 0.49-2.48, P = 0.803. This study revealed that mortality among hemodialysis patients remained high, mostly due to sepsis and ischemic heart disease. Patient survival was better with higher dialysis dose, increased frequency of dialysis and adequate serum albumin level. Efforts at minimizing infectious complications, preventing cardiovascular events and improving nutrition should increase survival among hemodialysis patients.

  20. [Simulation in medicine: first experiences under hemodialysis].

    Science.gov (United States)

    Duranti, Ennio; Calzeroni, Gino; Venneri, Francesco; Marziali, Mauro

    2013-01-01

    Education and practical training in medicine is neglected and pass directly from theory to do on the field, while also each task requires the acquisition of health behaviors that are aware and accountable to the outreach. In hemodialysis is necessary to create synergies and partnerships between different cooperating figures. Addressing organizational and legal protection of the professionals (Clinical Risk). Acquiring operational capabilities of team work. Managing the team roles and functions.It is necessary then to acquire a modern methodology where the simulation represents the main tool, "the mistake" need to "learn" and the acquisition of "awareness" about event handling (in this case on Hemodialysis), in the context of clinical scenarios absolutely realistic.The methodology is based on simulated tasks using past experience as a business tool and innovative research. Debriefing and discussion with those involved and finally debrief collegiate looking for active/latent errors and use of international guidelines. Use of indicators to measure and review of performance during the various events and proactively promoting the reduction of the error.Among the types of participants was clear the minor presence of doctors of hemodialysis, probably for the wrong feeling of being checked and then judged in carrying out of actions made complex by urgency. In addition participating physicians have all stressed the usefulness of simulations of unusual events within the Hemodialysis treatment, but that if not solved can lead to death of the patient.Simulation under hemodialysis, although its first steps, appears to be an effective methodology able to stimulate self-criticism of the operators, but still with hesitations and fears above all by the nephrologists timorous of being judged more on technical skills than on organizational skills and leadership.

  1. 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.

  2. Biomaterial-Based Approaches to Address Vein Graft and Hemodialysis Access Failures.

    Science.gov (United States)

    Boire, Timothy C; Balikov, Daniel A; Lee, Yunki; Guth, Christy M; Cheung-Flynn, Joyce; Sung, Hak-Joon

    2016-12-01

    Veins used as grafts in heart bypass or as access points in hemodialysis exhibit high failure rates, thereby causing significant morbidity and mortality for patients. Interventional or revisional surgeries required to correct these failures have been met with limited success and exorbitant costs, particularly for the US Centers for Medicare & Medicaid Services. Vein stenosis or occlusion leading to failure is primarily the result of neointimal hyperplasia. Systemic therapies have achieved little long-term success, indicating the need for more localized, sustained, biomaterial-based solutions. Numerous studies have demonstrated the ability of external stents to reduce neointimal hyperplasia. However, successful results from animal models have failed to translate to the clinic thus far, and no external stent is currently approved for use in the US to prevent vein graft or hemodialysis access failures. This review discusses current progress in the field, design considerations, and future perspectives for biomaterial-based external stents. More comparative studies iteratively modulating biomaterial and biomaterial-drug approaches are critical in addressing mechanistic knowledge gaps associated with external stent application to the arteriovenous environment. Addressing these gaps will ultimately lead to more viable solutions that prevent vein graft and hemodialysis access failures. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Risk factors of periodontal disease in maintenance hemodialysis patients.

    Science.gov (United States)

    Hou, Yue; Wang, Xin; Zhang, Cong-Xiao; Wei, Yu-Dan; Jiang, Li-Li; Zhu, Xiao-Yu; Du, Yu-Jun

    2017-09-01

    To explore the characteristics and relevant risk factors of periodontal disease (PD) among hemodialysis patients.Uremic patients on maintenance hemodialysis from November 2015 to March 2016 were retrospectively reviewed. Patients were divided into a PD group and a non-PD group. Demographic and laboratory data were collected and analyzed.In all, 136 uremic patients (79 males and 57 females, aged 50.8 ± 15.3 years) on maintenance hemodialysis were included in this study. The incidence of PD increased with age. Hemodialysis patients most likely developed PD if they were male, smokers, or diabetic (P = .009, maintenance hemodialysis patients against PD.Identification of risk factors provides a theoretical basis for prevention and improvement of PD among maintenance hemodialysis patients.

  4. A dose-finding, long-term study on the use of calcium chloride in saline solution as a method of nonsurgical sterilization in dogs: evaluation of the most effective concentration with the lowest risk

    OpenAIRE

    Leoci, Raffaella; Aiudi, Giulio; Silvestre, Fabio; Lissner, Elaine A; Marino, Fabio; Lacalandra, Giovanni M

    2014-01-01

    Background Canine overpopulation is a global issue with serious health and welfare implications. Nonsurgical methods of sterilization could yield positive impacts on this problem, but no long-term data on such methods are available. The objective of the current investigation was to determine the effects of intratesticular injections of calcium chloride dihydrate (CaCl2) in saline in dogs over a one year period. Five concentrations (0%, 10%, 20%, 30%, 60%) of CaCl2 in saline were administered ...

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

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    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.

  6. Effect of Mealtime During Hemodialysis on Patients? Complications

    OpenAIRE

    Seyed Reza Borzou; Fahimeh Mahdipour; Khodayar Oshvandi; Mohsen Salavati; Neda Alimohammadi

    2016-01-01

    Introduction: Food intake during hemodialysis increases the risk of problems such as hypotension, nausea, and vomiting in patients undergoing hemodialysis. This study aimed to determine the effect of mealtime during dialysis on the patients’ complications. Methods: This is a quasi-experimental study consisted of all eligible hemodialysis patients in Hamadan teaching hospitals. All of 48 patients were selected through census method. The research was...

  7. Cost Analysis of Private Hemodialysis Centers in Turkey

    OpenAIRE

    TATAR, Mehtap; ERGİN, Gülpembe; Ecder, Tevfik

    2013-01-01

    Chronic kidney disease is a worldwide public health problem. There is a continuing increase in the prevalence of patients on renal replacement therapies which causes an enormous economic burden to the healthcare system. Center hemodialysis is the most common type of renal replacement therapy in patients with end-stage renal disease. The aim of this study was to assess the cost of hemodialysis in private hemodialysis centers in Turkey. The study included a total of 296 centers with patient num...

  8. [Work capacity in patients on hemodialysis].

    Science.gov (United States)

    Orlić, Lidija; Matić-Glazar, Durdica; Sladoje Martinović, Branka; Vlahović, Ana

    2004-01-01

    The quality of life is considerably impaired in patients on regular hemodialysis has been changed. It is difficult to determine it because there are no general definitions or measuring instruments. There are objective and subjective components of the quality of life, one among them being occupational ability. During the progression of chronic renal disease (CRD) to terminal renal failure (TRF) physical activity of the patients becomes poorer. In this stage, their physical activity is by 40-60% below the value expected for the same healthy age cohort. The intention of this analysis was to determine occupational ability in patients on regular hemodialysis. The analysis included 161 patients on hemodialysis, 78 (48.5%) female and 83 (51.5%) male, mean age 61.2 +/- 13.1 years, and mean time on hemodialysis was 54 +/- 71.9 months. All patients filled-out a self-administered questionnaire on schooling and occupational ability. The cause of TRF was glomerulonephritis in 45 (26.8%), diabetes mellitus in 42 (26.3%), nephrosclerosis in 26 (16.1%), and pyelonephritis in 12 (7.4%) patients. Age distribution was as follows: 0-19 years 1 patient, 20-44 years 14 (8.7%); 45-64 years 64 (39.8%) and 65 years 82 (50.9%) patients. Educational structure: elementary school 65 (40.4%), secondary school 79 (49.1%), college 10 (6.2%), and university 6 (3.7%) patients. Occupational structure: retired 123 (76.4%), housekeeper 20 (12.4%), never employed 4 (2.5%), employed 10 (6.2%), unemployed 2 (1.2%), 1 child and 1 student. Among employed patients there were 7 men and 3 women. Their educational level was as follow: elementary school 1 patient, secondary school 8 patients, college 1 patient. At the beginning of hemodialysis their occupational status was: full-time employment 30 (18.6%) patients, part-time employment 1 patient, longer time on sick-leave payment (3.1%), retired 95 (59%), pupils and students 3, unemployed 2, and 1 child did not attended school. Time interval between the

  9. Decreased percentage of peripheral naïve T cells is independently associated with ischemic stroke in patients on hemodialysis.

    Science.gov (United States)

    Chen, Rongyi; Hu, Jiachang; Xiang, Fangfang; Tan, Xiao; Shen, Bo; Liu, Zhonghua; Lv, Wenlv; Ding, Xiaoqiang; Cao, Xuesen; Zou, Jianzhou

    2017-11-01

    Cerebrovascular complications, including ischemic stroke, account for poor outcomes in patients on hemodialysis. T cell responses may be involved in the pathogenesis of ischemic stroke. We aimed to evaluate the role of naïve T cells in development of ischemic stroke in patients on hemodialysis. In this cross-sectional study, 156 patients on hemodialysis in our blood purification center were included. These patients were divided into the ischemic stroke (IS) group (61 cases) and non-ischemic stroke (non-IS) group (95 cases) according to a new diagnosis after initiation of hemodialysis. After being lysed with red blood cell lysis solution, peripheral blood was tested by flow cytometry to detect the expression of CD45RO and CCR7 in CD4 T and CD8 T cells. Correlation analysis and logistic regression analysis were conducted to identify potential independent risk factors for ischemic stroke. The percentage of peripheral naïve T cells was lower in the IS group [median (interquartile range (IQR)) 13.9% (8.6-22.9%)] compared with the non-IS group [median (IQR) 22.7% (15.9-32.2%), P T cells were negatively associated with ischemic stroke (r = -0.308, P T cells had an independent negative association with ischemic stroke in patients on hemodialysis (odds ratio 0.933, 95% CI 0.883, 0.986; P = 0.013). A decrease in percentage of peripheral CD4 naïve T cells is a risk factor for ischemic stroke in patients on hemodialysis.

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

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    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

  11. The Process of Transition to Hemodialysis: A Grounded Theory Research.

    Science.gov (United States)

    Hassani, Parkhideh; Otaghi, Masoumeh; Zagheri-Tafreshi, Mansoureh; Nikbakht-Nasrabadi, Alireza

    2017-01-01

    Transition is a passage or movement from one state, condition, or place to another. Patients with chronic disorders such as end-stage renal disease experience transitions. This study aims to explore the process of transition to hemodialysis. This is a qualitative grounded theory of a doctoral dissertation. Twenty-four participants (19 patients on hemodialysis, 2 family members, 2 nurses, and a physician) were selected through purposive and theoretical sampling until data saturation. Data collection was conducted through semi-structured interviews, as well as field notes and memos. Data analysis was done concurrently with data collection in three levels of open, axial, and selective coding according to the Strauss and Corbin (1998) method. Core variable was appeared at the end of selecting coding stage. Confronting unexpected situation of hemodialysis, challenge of accepting hemodialysis, comprehensive and pervasive changes, efforts made to self-management, and integration of hemodialysis with everyday life were considered to be the main themes of the process of transition to hemodialysis. The results would increase evidence-based knowledge regarding the process of transition to hemodialysis. Through identification of this process, effective factors such as determining strategies for management would lead to facilitate more specialized care of people undergoing hemodialysis, appropriate nursing interventions and more effective training programs to prepare patients and their families during the process of transition to hemodialysis. These results can be used for conducting and preparing other qualitative and quantitative studies.

  12. Infrequent dialysis: a new paradigm for hemodialysis initiation.

    Science.gov (United States)

    Rhee, Connie M; Unruh, Mark; Chen, Jing; Kovesdy, Csaba P; Zager, Phillip; Kalantar-Zadeh, Kamyar

    2013-01-01

    Nearly a half-century ago, the thrice-weekly hemodialysis schedule was empirically established as a means to provide an adequate dialysis dose while also treating the greatest number of end-stage renal disease (ESRD) patients using limited resources. Landmark trials of hemodialysis adequacy have historically been anchored to thrice-weekly regimens, but a recent randomized controlled trial demonstrated that frequent hemodialysis (six times per week) confers cardiovascular and survival benefits. Based on these collective data and experience, clinical practice guidelines advise against a less than thrice-weekly treatment schedule in patients without residual renal function, yet provide limited guidance on the optimal treatment frequency when substantial native kidney function is present. Thus, during the transition from Stage 5 chronic kidney disease to ESRD, the current paradigm is to initiate hemodialysis on a "full-dose" thrice-weekly regimen even among patients with substantial residual renal function. However, emerging data suggest that frequent hemodialysis accelerates residual renal function decline, and infrequent regimens may provide better preservation of native kidney function. Given the high mortality rates during the first 6 months of hemodialysis and the survival benefits of preserved native kidney function, initiation with twice-weekly treatment schedules ("infrequent hemodialysis") with an incremental increase in frequency over time may provide an opportunity to optimize patient survival. This review outlines the clinical benefits of post-hemodialysis residual renal function, studies of twice-weekly treatment regimens, and the potential risks and benefits of infrequent hemodialysis. © 2013 Wiley Periodicals, Inc.

  13. Salinity and water quality

    NARCIS (Netherlands)

    Sonneveld, C.; Voogt, W.

    2009-01-01

    The impact of salinity on greenhouse grown crops, especially when grown in substrate systems, differs from the impact of salinity on crops grown under field conditions. The most striking difference between greenhouse and field conditions is the overall much higher concentrations of nutrients in

  14. Salinity in rose production

    Directory of Open Access Journals (Sweden)

    Michele Reis

    2016-09-01

    Full Text Available The rose is one of the most important ornamental plants in the world. However, the cultivation systems used for roses often impose salt stress. Saline conditions occur naturally in some regions or by human activity in others with use of low quality water or excessive fertilizer application. In general, roses are considered sensitive to salinity. However, tolerance levels can be different among roses species and cultivars. Therefore, studies are needed that take into account characteristics of each species and how the exposure to salinity occurs. Management of water and nutrients can be important tools for mitigating the effects of high salt concentrations. Also, advances in biotechnology can be used for a better understanding of the physiological responses to salinity and to develop more salt tolerant rose cultivars. Thus, this paper aims to review the progress made and future prospects of salinity tolerance in commercial rose production.

  15. Remote sensing of salinity

    Science.gov (United States)

    Thomann, G. C.

    1975-01-01

    The complex dielectric constant of sea water is a function of salinity at 21 cm wavelength, and sea water salinity can be determined by a measurement of emissivity at 21 cm along with a measurement of thermodynamic temperature. Three aircraft and one helicopter experiments using two different 21 cm radiometers were conducted under different salinity and temperature conditions. Single or multiple ground truth measurements were used to calibrate the data in each experiment. It is inferred from these experiments that accuracies of 1 to 2%/OO are possible with a single surface calibration point necessary only every two hours if the following conditions are met--water temperatures above 20 C, salinities above 10%/OO, and level plane flight. More frequent calibration, constraint of the aircraft's orientation to the same as it was during calibration, and two point calibration (at a high and low salinity level) rather than single point calibration may give even better accuracies in some instances.

  16. Nebulized hypertonic saline without adjunctive bronchodilators for children with bronchiolitis.

    Science.gov (United States)

    Ralston, Shawn; Hill, Vanessa; Martinez, Marissa

    2010-09-01

    The goal was to determine an adverse event rate for nebulized hypertonic saline solution administered without adjunctive bronchodilators for infants with bronchiolitis. This was a retrospective cohort study of the use of nebulized 3% saline for childrenbronchiolitis at a single academic medical center. The medical records of study participants were analyzed for the use of nebulized 3% saline solution and any documented adverse events related to this therapy. Other clinical outcomes evaluated included respiratory distress scores, timing of the use of bronchodilators in relation to 3% saline solution, transfer to a higher level of care, and readmission within 72 hours after discharge. A total of 444 total doses of 3% saline solution were administered, with 377 doses (85%) being administered without adjunctive bronchodilators. Four adverse events occurred with these 377 doses, for a 1.0% adverse event rate (95% confidence interval: 0.3%-2.8%). Adverse events were generally mild. One episode of bronchospasm was documented, for a rate of 0.3% (95% confidence interval: saline solution without adjunctive bronchodilators for inpatients with bronchiolitis had a low rate of adverse events in our center. Additional clinical trials of 3% saline solution in bronchiolitis should evaluate its effectiveness in the absence of adjunctive bronchodilators.

  17. Anaphylactic Shock at the Beginning of Hemodialysis.

    Science.gov (United States)

    Sayeed, Khaleel; Murdakes, Charlene; Spec, Andrej; Gashti, Casey

    2016-01-01

    In patients who receive hemodialysis, most hypersensitivity reactions to components of the dialysis circuit are due to ethylene oxide or complement activating bio-incompatible membranes. We present a case of a 59 year-old female, with a 4-year history of uneventful hemodialysis using a cellulose based dialyzer membrane at her outpatient dialysis center, who developed repeated anaphylactic reactions associated with markers of an IgE mediated hypersensitivity reaction when a polysulfone based dialyzer membrane was used while she was hospitalized. Only when the patient's dialyzer was changed back to her usual cellulose based membrane, did these reactions cease. On the basis of her clinical course and laboratory findings, we concluded that the patient's symptoms were due to exposure to polysulfone. This case reminds us that "biocompatible" membranes are not free from dialyzer reactions, and can be especially severe if the mechanism is an IgE mediated anaphylactic hypersensitivity reaction. © 2015 Wiley Periodicals, Inc.

  18. Portable calibration instrument of hemodialysis unit

    Science.gov (United States)

    Jin, Liang-bing; Li, Dong-sheng; Chen, Ai-jun

    2013-01-01

    For the purpose of meeting the rapid development of blood purification in China, improve the level of blood purification treatment, and get rid of the plight of the foreign technology monopolization to promise patients' medical safety, a parameter-calibrator for the hemodialysis unit, which can detect simultaneously multi-parameter, is designed. The instrument includes a loop, which connects to the hemodialysis unit. Sensors are in the loop in series, so that the dialysis can flow through this loop and the sensors can acquisitive data of various parameters. In order to facilitate detection and carrying, the integrated circuit part modularly based on the ultralow-power microcontrollers,TI MSP430 is designed. High-performance and small-packaged components are used to establish a modular, high-precision, multi-functional, portable system. The functions and the key technical indexes of the instrument have reached the level of products abroad.

  19. 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.

  20. 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.

  1. Hemodialysis for cefepime intoxication: A case report

    OpenAIRE

    Mani, L.Y.; Kissling, S.; Burnier, M.; Buclin, T.; Renard, D.

    2013-01-01

    Introduction: We report a case of cefepime intoxication with acute severe neurologic symptoms, which was treated by temporary hemodialysis. Patients (or Materials) and Methods: Cefepime 2 g BID for endovascular prosthesis infection was prescribed to a frail, chronically ill 88-year-old woman with a serum creatinine of 199 μmol/L and an estimated creatinine clearance of 13 mL/min (Cockroft formula). Two days later, she was transferred to a neurocritical care unit because o...

  2. Relationship between platelet count and hemodialysis membranes

    Directory of Open Access Journals (Sweden)

    Nasr R

    2013-08-01

    Full Text Available Rabih Nasr,1 Chadi Saifan,1 Iskandar Barakat,2 Yorg Al Azzi,2 Ali Naboush,2 Marc Saad,2 Suzanne El Sayegh1 1Department of Nephrology, Staten Island University Hospital, Staten Island, NY, USA; 2Department of Medicine, Staten Island University Hospital, Staten Island, NY, USA Background: One factor associated with poor outcomes in hemodialysis patients is exposure to a foreign membrane. Older membranes are very bioincompatible and increase complement activation, cause leukocytosis by activating circulating factors, which sequesters leukocytes in the lungs, and activates platelets. Recently, newer membranes have been developed that were designed to be more biocompatible. We tested if the different “optiflux” hemodialysis membranes had different effects on platelet levels. Methods: Ninety-nine maintenance hemodialysis patients with no known systemic or hematologic diseases affecting their platelets had blood drawn immediately prior to, 90 minutes into, and immediately following their first hemodialysis session of the week. All patients were dialyzed using a Fresenius Medical Care Optiflux polysulfone membrane F160, F180, or F200 (polysulfone synthetic dialyzer membranes, 1.6 m2, 1.8 m2, and 2.0 m2 surface area, respectively, electron beam sterilized. Platelet counts were measured from each sample by analysis using a CBC analyzer. Results: The average age of the patients was 62.7 years; 36 were female and 63 were male. The mean platelet count pre, mid, and post dialysis was 193 (standard deviation ±74.86, 191 (standard deviation ±74.67, and 197 (standard deviation ±79.34 thousand/mm3, respectively, with no statistical differences. Conclusion: Newer membranes have no significant effect on platelet count. This suggests that they are, in fact, more biocompatible than their predecessors and may explain their association with increased survival. Keywords: platelet count, polysulfone membranes, complement activation, electron beam sterilized

  3. Standardized Definitions for Hemodialysis Vascular Access

    OpenAIRE

    Lee, Timmy; Mokrzycki, Michele; Moist, Louise; Maya, Ivan; Vazquez, Miguel; Lok, Charmaine

    2011-01-01

    Vascular access dysfunction is one of the leading causes of morbidity and mortality among end-stage renal disease patients 1,2. Vascular access dysfunction exists in all 3 types of available accesses: arteriovenous fistulas, arteriovenous grafts, and tunneled catheters. In order to improve clinical research and outcomes in hemodialysis access dysfunction, the development of a multidisciplinary network of collaborative investigators with various areas of expertise, and common standards for ter...

  4. Use of dynamometry in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ingrid Denise Karpenko Wilman

    2017-05-01

    Full Text Available Introduction: Dynamometry is a cheap, simple and easily reproduced method to assess muscle strength (MS, which, like other processes of obtaining measurements, displays high sensitivity and specificity for the early detection of any change in the nutritional status. Objectives: To evaluate factors concerning the reduction in MS in patients undergoing hemodialysis (HD. Methods: A single center, crosssectional study was carried out. The following clinical variables were analyzed: sex, age, blood pressure, weight, significant weight loss within the last 36 months, body mass index (BMI, weight gain in between dialysis sessions, hemodialysis treatment time, diabetes, energy and protein intake. Other factors taken into account were: laboratory findings (hemoglobin, hepatogram, electrolyte panel, calcium test, phosphate test, lipid profile, protein analysis, transferrin saturation and hand grip strength (before and after dialysis, on both arms measured through dynamometry. The patients' muscle strength values were compared to those of healthy subjects. Values below the 10th percentile were regarded as abnormal. Mean, median, standard deviation as well as the X2 and the Student's t tests were considered where applicable. A p<0.05 constituted a significant value. Results: There were 73 patients included in this study and 47.95% of them showed low MS with significant strength loss on the arm having the vascular access when compared to the other arm (p 0.00019. A longer hemodialysis treatment time (p 0.026 and a lower BMI (p 0.046 were found to be the two variables with the highest impact on MS. Conclusions: Muscle strength loss in patients undergoing hemodialysis is very common and is associated with a longer HD treatment time and a lower BMI.

  5. The Continued Benefit to users in hemodialysis

    Directory of Open Access Journals (Sweden)

    Nathalia Maria Barbosa

    2014-12-01

    Full Text Available User's hemodialysis move away from work for factors involving the treatment and the world of work. This situation is an aggravating factor for the uninsured social security. For these, we have only the Continuous Cash Benefit (BPC, as the only means of access to income. However, when accessing it are faced with some contradictions. This article analyzes the contradictions and difficulties in access to the benefit.

  6. Vascular access profile in maintenance hemodialysis patients.

    Science.gov (United States)

    Gowda, Anoop; Pavan, Malleshappa; Babu, Kishore

    2014-05-01

    The aims of this study was to evaluate maintenance hemodialysis population in a tertiary care hospital based dialysis unit for vascular access (VA) types, to compare native arteriovenous fistula (AVF) and arteriovenous graft (AVG) survival, and to assess risk factors for access failure. A total of 182 patients on maintenance hemodialysis were evaluated and followed up in terms of VA type and VA outcomes. Among 103 prevalent patients, 15.5% initiated dialysis with AVF. At the time of the study, 67.9% of the prevalent patients had an AVF and 29.1% had AVG. Of 79 incident patients, 64% were followed up for more than 3 months by nephrologists before initiation of dialysis. Among these patients, 13.6% were initiated with AVF. There were 25 primary failures and 50 secondary failure episodes. Of the 50 secondary failures, 15 were AVF failures and 31 AVG failures. Vascular access survival was significantly superior with AVF as compared with AVG (P = .03). With longer dialysis periods, failure rates were higher. Follow-up with nephrologists prior to initiation of dialysis had a major influence on VA. Arteriovenous fistula is the best VA for maintenance hemodialysis. However, when the vasculature is not ideal for AVF, AVG should be constructed. A small percentage of our patients had fistula at initiation of dialysis. This is mainly due to late nephrology referrals and also due to reluctance of patients to undergo surgical access placement when they are relatively asymptomatic.

  7. Hemodialysis Patients' Information and Associated Characteristics.

    Science.gov (United States)

    Polikandrioti, Maria; Koutelekos, Ioannis; Vasilopoulos, George; Babatsikou, Fotoula; Gerogianni, Georgia; Zyga, Sofia; Panoutsopoulos, George

    2017-09-01

    of this study was to explore characteristics associated with hemodialysis patients' degree of information. The sample of the study included 650 patients undergoing hemodialysis. For data collection a questionnaire specially designed for the needs of the research was used. More specifically, socio-demographic, clinical and other patients' characteristics were associated with the degree of information as it was reported by patients. of the 650 participants, 55.4% was men while 58.6% of the sample was aged over 60 years. Regarding information level, results showed that only 9.8% was "little" or "not all" informed about their health problem, 61,7% was "enough" informed whereas 28.5% were "very" informed. Statistically significant association was observed between degree of information and age (p=information and whether patients had other disease or not (p=0.037), whether patients reported adherence to treatment guidelines (p=information and relations with nursing staff (p=information interventions for orienting hemodialysis patients is increasingly important to evaluate socio-demographic, clinical and other patients ' characteristics and incorporate them in their project.

  8. Experimental hypocalcemia induced by hemodialysis in goats.

    Science.gov (United States)

    Yamagishi, N; Oishi, A; Sato, J; Sato, R; Naito, Y

    1999-12-01

    To evaluate whether hemodialysis with a dialysate containing no calcium (Ca-free HD) can induce hypocalcemia and restore the clinical signs and blood biochemical changes in naturally occurred hypocalcemic disorder in ruminants, the clinical signs and the changes in plasma electrolytes and minerals concentrations were observed in goats during 6-hr hemodialysis. The four goats received hemodialysis with the dialysate containing calcium (Ca HD), and 10 days later they had Ca-free HD. The plasma ionized Ca (Ca++) and total Ca (TCa) concentrations were not affected by Ca HD, whereas the levels significantly decreased during whole period of Ca-free HD. The Ca++ and TCa concentrations were 0.69+/-0.06 mmol/l and 5.9+/-0.3 mg/dl at 6 hr of Ca-free HD, respectively. The clinical signs observed during Ca-free HD seemed to resemble to those in naturally occurred hypocalcemic cases that were reported previously. Therefore, Ca-free HD was suggested to be one of the possible methods to induce experimental hypocalcemia in ruminants.

  9. Augmenting solute clearance in peritoneal dialysis

    NARCIS (Netherlands)

    Krediet, R. T.; Douma, C. E.; van Olden, R. W.; Ho-Dac-Pannekeet, M. M.; Struijk, D. G.

    1998-01-01

    BACKGROUND: The removal of low molecular weight solutes by peritoneal dialysis is less than by hemodialysis. The targets for Kt/Vurea and creatinine clearance formulated in the Dialysis Outcome Quality Initiative are unlikely to be achieved in a substantial portion of peritoneal dialysis patients.

  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. Vitamin D deficiency in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2012-01-01

    Full Text Available Background : Vitamin D [(25(OHD] deficiency and insufficiency is common in patients with chronic kidney disease (CKD. 25(OHD has been found to have beneficial effects on bone, cardiovascular and immune functions. There are little data about vitamin D levels in Indian patients on dialysis. This study was undertaken to determine the vitamin D status of Indian CKD patients on hemodialysis. Materials and Methods : We included 45 patients on maintenance hemodialysis coming to Medanta, Medicity, Gurgaon. 25(OHD levels were measured with radioimmunoassay (Diasorin method and parathyroid hormone (PTH was measured using electrochemiluminiscence immunoassay (ECLIA. Results : The mean age of patients was 55 ± 13 years. 32/45 (71% were males. 23/45 (51% were diabetics. The median duration of hemodialysis was 5.5 months (range 1-74 months. 33/45 (74% patients were on thrice weekly hemodialysis. The mean level of vitamin D was 10.14 ± 8.7 ng/ml. Majority of the patients [43/45 (95.5%] were either vitamin D deficient or had insufficient levels. 40/45 (88.9% were vitamin D deficient (levels <20 ng/ml; of these, 29/40 (64.4% had severe vitamin D deficiency (levels <10 ng/ml and 3/45 (6.7% had insufficient levels (20-30 ng/ml of vitamin D. Only 2/45 (4.4% patients had normal levels of vitamin D. 23/45 (51% of patients were receiving calcitriol. The mean levels of serum calcium, phosphorus, alkaline phosphatase, and albumin were 8.8 ± 0.64 mg/dl, 5.0 ± 0.7 mg/dl, 126 ± 10.3 IU/l and 3.6 ± 0.62 g/dl, respectively. PTH levels ranged from 37 to 1066 pg/ml, and the median was 195.8 pg/ml. There was a weak correlation between 25(OHD levels and weight, sex, hemoglobin, albumin, alkaline phosphatase, and presence of diabetes. There was, however, no correlation with duration of dialysis or PTH levels. Conclusion : Vitamin D deficiency and insufficiency are universal in our hemodialysis patients, with severe vitamin D deficiency in two-third of patients.

  12. Hemodialysis, plea of availability versus adequecy gezira experience

    African Journals Online (AJOL)

    Methods: Pre and post hemodialysis blood sample were obtained from the study group, spKt/V and urea reduction ratio were calculated. Results: Mean Kt/v was ... of patients on regular hemodialysis by encouraging the patients to take the other renal replacement therapy (peritoneal dialysis and renal transplantations).

  13. Non invasive assessment of liver fibrosis in chronic hemodialysis ...

    African Journals Online (AJOL)

    The liver biopsy has long been the "gold standard" for assessing liver fibrosis in patients with hepatitis C. It's an invasive procedure which is associated with an elevated bleeding, especially in chronic hemodialysis patients. Main goal is to assess liver fibrosis in chronic hemodialysis with HCV by Fibroscan and by biological ...

  14. Five Years Survival on Hemodialysis Predicted by Artificial Neural ...

    African Journals Online (AJOL)

    Five Years Survival on Hemodialysis Predicted by Artificial Neural Network Model. ... Introduction: Maintenance hemodialysis (HD) patients' morbidity and mortality remain unacceptably high. It is important to identify risk factors affecting outcome and define their relative contribution. Methods: The data of 93 patients who ...

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

    African Journals Online (AJOL)

    Tarek A. Ghonemy

    2015-08-18

    Aug 18, 2015 ... Abstract Background: Morbidity related to vascular access is the leading cause of hospitalization for chronic hemodialysis patients and is associated with high cost. Since data on vascular access complications are scarce, this study was designed to focus on vascular access complications in hemodialysis ...

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

    African Journals Online (AJOL)

    Background: Morbidity related to vascular access is the leading cause of hospitalization for chronic hemodialysis patients and is associated with high cost. Since data on vascular access complications are scarce, this study was designed to focus on vascular access complications in hemodialysis patients. Methods: 119 ...

  17. Safety of gadolinium contrast agent in hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Okada, S. [Nippon Medical School, Chiba-Hokuso Hospital (Japan). Dept. of Radiology; Katagiri, K.; Kumazaki, T. [Nippon Medical School, Tokyo (Japan). Dept. of Radiology; Yokoyama, H. [Ishinkai Clinic, Chiba (Japan). Dept. of Urology

    2001-05-01

    Purpose: We evaluated the safety of a gadolinium (Gd) contrast agent in hemodialysis patients. Material and Methods: Seventy hemodialysis patients underwent contrast-enhanced MR examination. After the examination, the patients were hemodialyzed on a usual schedule, i.e., 3 times per week at 4 h each session. The hemodialysis was performed on the same day in 16 patients, the next day in 34, 2 days later in 14 and 3 days later in 6 patients. Serum Gd concentrations before and after the first to fourth hemodialysis sessions were analyzed in 11 patients. Cardiovascular, cutaneous, respiratory, psycho-neurological and digestive side effects were evaluated in all patients. Changes in liver and kidney functions, blood counts, and electrolytes were also checked. Results and Conclusion: Neither side effects nor blood changes were noted in any of the patients. Average excretory rates were 78.2%, 95.6%, 98.7% and 99.5% in the first to fourth hemodialysis sessions, respectively. These results suggest that Gd contrast agents can be used in hemodialysis patients if hemodialysis is carried out promptly after the examination. Key words: Renal failure, hemodialysis; contrast agent, gadolinium.

  18. 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.

  19. Copeptin in Hemodialysis Patients with Left Ventricular Dysfunction.

    Science.gov (United States)

    Kim, Jae Seok; Yang, Jae Won; Chai, Moon Hee; Lee, Jun Young; Park, Hyeoncheol; Kim, Youngsub; Choi, Seung Ok; Han, Byoung Geun

    2015-07-01

    Copeptin has been considered as a useful marker for diagnosis and prediction of prognosis in heart diseases. However, copeptin has not been investigated sufficiently in hemodialysis patients. This study aimed to investigate the general features of copeptin in hemodialysis and to examine the usefulness of copeptin in hemodialysis patients with left ventricular dysfunction (LV dysfunction). This study included 41 patients on regular hemodialysis. Routine laboratory data and peptides such as the N-terminal of the prohormone brain natriuretic peptide and copeptin were measured on the day of hemodialysis. Body fluid volume was estimated by bioimpedance spectroscopy, and the E/Ea ratio was estimated by echocardiography. Copeptin increased to 171.4 pg/mL before hemodialysis. The copeptin had a positive correlation with pre-dialysis body fluid volume (r=0.314; p=0.04). The copeptin level decreased along with body fluid volume and plasma osmolality during hemodialysis. The copeptin increased in the patients with LV dysfunction more than in those with normal LV function (218.7 pg/mL vs. 77.6 pg/mL; p=0.01). Receiver operating characteristic curve analysis showed that copeptin had a diagnostic value in the hemodialysis patients with LV dysfunction (area under curve 0.737; p=0.02) and that the cut-off value was 125.48 pg/mL (sensitivity 0.7, specificity 0.8, positive predictive value 0.9, negative predictive value 0.6). Copeptin increases in hemodialysis patients and is higher in patients with LV dysfunction. We believe that copeptin can be a useful marker for the diagnosis of LV dysfunction in hemodialysis patients.

  20. Nutritional status in short daily hemodialysis versus conventional hemodialysis patients in China.

    Science.gov (United States)

    Jiang, Jielong; Ni, Lijun; Ren, Wei; Zhou, Xiaowan; Su, Keliang; Wang, Lihua; Lan, Lei; Chen, Wei; Wu, Yuanbo

    2018-02-05

    Malnutrition is the main determinant of mortality and morbidity in maintenance hemodialysis patients. In many countries except for China, it has been reported that short daily hemodialysis (SDHD) could improve nutritional status. We will report here the nutritional results obtained in the SDHD therapy period compared with conventional hemodialysis (cHD) therapy period in Chinese patients. This study compared 29 SDHD patients (SDHD group), each patient served as his own control, with 30 cHD patients (cHD group) serving as the parallel controls. The hematologic parameters, anthropometric measurements, modified quantitative subjective global assessment (MQSGA) score, weekly standard Kt/V (std Kt/V) and average daily intake of protein were measured at baseline (SDHD 0 or cHD 0 period), at 3 months (SDHD 1 or cHD 1 period) and at 6 months (SDHD 2 or cHD 2 period). The average daily intake of protein, dry weight, body mass index, mid-arm circumference, mid-arm muscle circumference, serum albumin, prealbumin, cholesterol, hemoglobin, weekly std Kt/V values at SDHD 2 were higher than the corresponding values at SDHD 0 (p nutritional status compared with cHD in Chinese patients undergoing maintenance hemodialysis.

  1. Influence of hemodialysis on regadenoson clearance in an in vitro hemodialysis model.

    Science.gov (United States)

    Gharibian, Katherine N; Murthy, Venkatesh L; Mueller, Bruce A

    2018-02-01

    Regadenoson is a novel pharmacological stress agent whose disposition during hemodialysis is not known. The purpose of this study was to determine the clearance of regadenoson under varying dialytic conditions using an in vitro hemodialysis model. Whole human blood was used to analyze the effect of hemodialysis on the clearance of regadenoson. Regadenoson transmembrane clearance (CL D ) was assessed for both a standard permeability and a high permeability polysulfone hemodialyzer with blood/dialysate flow rates of 300/600 and 400/800 mL/min. A two-tailed, paired Student's t test was used to compare regadenoson CL D between hemodialyzer types and flow rates. The mean ± SD regadenoson CL D values ranged between 62.5 ± 11.8 and 89.1 ± 24.0 mL/min for all dialytic conditions. There was no significant difference in regadenoson CL D between hemodialyzer types and flow rates (p > .05). Hemodialysis enhances the clearance of regadenoson independent of hemodialyzer permeability and blood/dialysate flow rate. This clearance is modest relative to total body clearance and is unlikely to produce a clinically significant outcome.

  2. Citrate compared to low molecular weight heparin anticoagulation in chronic hemodialysis patients.

    Science.gov (United States)

    Janssen, M J; Deegens, J K; Kapinga, T H; Beukhof, J R; Huijgens, P C; van Loenen, A C; van der Meulen, J

    1996-03-01

    Citrate and nadroparin calcium, a low molecular weight heparin (LMWH), were compared in a randomized cross-over trial in 21 chronic hemodialysis patients regarding anticoagulation, calcium and magnesium kinetics, biocompatibility, dialysis efficiency, and aluminum contamination. Citrate was infused into the arterial line at a minimum rate of 0.68 mmol/min, combined with a calcium and magnesium-free dialysate and intravenous supplementation of calcium and magnesium at rates of 0.22 and 0.10 mmol/min, respectively. Seven patients with a dialysis session of six hours, received 2/3 of the nadroparin dose predialysis, and 1/3 after 2.5 hours (divided dose (DD) group). A single predialysis bolus injection of nadroparin was administered to eight patients not on coumarins [single dose (SD) group] and to six patients on coumarins [single dose + coumarins (SD + C) group], all with a dialysis session of four hours. Nineteen patients received a nadroparin dose of 200 ICU/kg. Two patients with a single dose, one of them on coumarins, received a dose of 150 ICU/kg because of a hematocrit containing 1.5 mmol/liter calcium and 0.75 mmol/liter magnesium used in combination with nadroparin. Ionized calcium increments during citrate were significant after the end of dialysis, while the dialysate containing 1.5 mmol/liter calcium induced significant increments during and postdialysis. No differences were observed between citrate and nadroparin regarding biocompatibility), (expressed as dialysis-induced leukopenia and thrombocytopenia), and dialysis efficiency [measured as dialyzer urea and creatinine clearance, normalized weekly whole body urea clearance (Kt/Vurea) and time averaged urea concentration (TACurea)]. The citrate solution, if sterilized in glass bottles, contained 2 to 3 micrograms aluminum per mmol citrate, the nadroparin solution 0.009 microgram per 1,000 ICU. Aluminum contamination of the citrate solution was prevented by sterilizing the solution in polypropylene

  3. Improving volume status by comprehensive dietary and dialytic sodium management in chronic hemodialysis patients.

    Science.gov (United States)

    Penne, E Lars; Levin, Nathan W; Kotanko, Peter

    2010-01-01

    Chronic volume overload is highly prevalent in chronic hemodialysis patients and leads to hypertension, left ventricular hypertrophy and increased hospitalization and mortality rates. Volume overload is caused primarily by a positive sodium balance and can be improved by sodium restriction. The main sources of sodium excess are a high-sodium diet in the interdialytic period and a positive sodium balance during dialysis. Here we discuss different approaches to achieve neutral or negative sodium balance, including reducing dietary sodium intake, individualizing dialysate sodium prescription, abandonment of sodium profiling, and reducing saline infusion for treatment of intradialytic symptoms and as part of dialyzer rinsing and priming procedures. All of these approaches should be combined for a maximal reduction of volume overload.

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

    African Journals Online (AJOL)

    Jane

    2011-08-15

    Aug 15, 2011 ... 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.

  5. 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 ...

  6. Endotoxins and inflammation in hemodialysis patients.

    Science.gov (United States)

    El-Koraie, Ahmed F; Naga, Yasmine S; Saaran, Amina M; Farahat, Nahla G; Hazzah, Walaa A

    2013-07-01

    Long-term endotoxin challenge may promote frequent complications in dialysis patients, namely malnutrition, chronic inflammation, and atherosclerosis, which are recognized as the so-called MIA syndrome. Circulating soluble vascular cell adhesion molecule-1 (sVCAM-1) levels may be used to determine the stage of atherosclerosis. This study aimed to assess endotoxin level in hemodialysis (HD) patients and its role in inducing inflammation. The study was conducted on 50 HD patients, chosen from four dialysis centers in Alexandria. Serum blood samples were collected for the determination of albumin and C-reactive protein (CRP), and whole blood samples were used for the measurement of hemoglobin level. A heparinized whole blood sample was taken postdialysis for endotoxin assay by limulus amebocyte lysate test, and in addition to sVCAM-1 was estimated using enzyme-linked immunosorbent assay. The mean endotoxin level was 76.30 pg/mL;80% exhibited values higher than 60 pg/mL. Half the studied patients had CRP values that exceeded the upper limit of the laboratory reference range (endotoxin and CRP levels (r = 0.47, P = 0.001). The mean pre-HD level of VCAM was 1851.00 ng/mL, while the mean post-HD level was 2829.00 ng/mL with statistically significant correlation (r = 0.354, P = 0.012) and it also correlated significantly with endotoxin as well as CRP levels. Endotoxemia may play an important role in the aggravation of endothelial dysfunction in HD patients as indicated by the post-HD rise in sVCAM-1. © 2012 The Authors. Hemodialysis International © 2012 International Society for Hemodialysis.

  7. 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.

  8. Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients.

    Science.gov (United States)

    de Moraes, Thyago Proença; Fortes, Paulo Cesar Nunes; Ribeiro, Silvia Carreira; Riella, Miguel Carlos; Pecoits-Filho, Roberto

    2011-01-01

    To investigate and compare glucose and lipid metabolism biomarkers in non-diabetic peritoneal dialysis and hemodialysis patients. The study followed a prospective and cross-sectional design. Participants included all prevalent end-stage renal disease patients under renal replacement therapy treated in a university-based clinic. There were no interventions. Blood samples were taken after 8 hours of fasting. Insulin serum levels were determined by chemiluminescence. Insulin resistance were assessed by the insulin sensitivity check index (QUICKI) determined as follow: 1/[log(Io) + log(Go)], where Io is the fasting insulin, and Go is the fasting glucose. HOMA index was also measured: (FPG × FPI)/22.5; FPG = fasting plasma glucose (mmol/L); FPI = fasting plasma insulin (mU/mL). The others biochemical exams were measured utilizing the routine tests. We screened 154 patients (80 on hemodialysis and 74 on peritoneal dialysis). Seventy-four diabetic patients were excluded. Of the remaining 80 patients (55% males, mean age 52 ± 15 years), 35 were on peritoneal dialysis and 45 on hemodialysis. Fasting glucose of peritoneal dialysis patients compared to hemodialysis patients were 5.0 ± 0.14 versus 4,58 ± 0.14 mmol/L, pprofile of lipid and glucose metabolism biomarkers in peritoneal dialysis patients (lower insulin sensitivity and higher fasting glucose, HbA1c, total cholesterol and LDL-c) when compared to hemodialysis, potentially due to the glucose-based dialysis solutions utilized in the peritoneal dialysis population.

  9. [Hemodialysis as kidney replacement therapy].

    Science.gov (United States)

    Descoeudres, C

    1989-08-08

    Haemodialysis is the most frequently used renal replacement therapy and in Europe keeps alive more than 80,000 patients with end-stage renal failure. Three times weekly the patient is connected to the artificial kidney and uraemic toxins are removed using a filter permeable for water and small solutes. This treatment lasts about 3-4 hours and can be performed in hospitals, dialysis centers or in the patient's own home. With haemodialysis, patients can survive for many years with a good quality of life. However, dialysis treatment is time-consuming, there are dietary restrictions, and the patients become increasingly dependent on medical personnel and relatives. It is therefore not surprising that most dialysis patients hope for a kidney transplantation.

  10. The role of intraoperative hemodialysis in liver transplant patients.

    Science.gov (United States)

    Sedra, Ashraf H; Strum, Earl

    2011-06-01

    Orthotopic liver transplant (OLT) is a major surgical procedure that can be both challenging and lengthy. One of the common findings in end-stage liver disease is renal failure, whether acute or chronic, which may complicate the intraoperative course. The use of intraoperative hemodialysis is described by several centers to aid during OLT cases with impaired renal function or kidney failure. Unfortunately, there is a paucity of available data, which is limited to sporadic case reports, and only few structured studies in which continuous renal replacement therapy was used versus intraoperative hemodialysis, which is the main focus of this article. The rationale behind the use of intraoperative hemodialysis during OLT in patients with kidney dysfunction or failure is that the procedure is usually complicated by major hemodynamic changes, metabolic derangement, and coagulation abnormalities, which we think can be better managed intraoperatively using hemodialysis. In our institution, we performed over 140 cases of OLT using intraoperative hemodialysis since 2003 until the present. A retrospective cohort study is being conducted during the writing of this article. Preliminary data collection report zero percentage intraoperative mortality and 48 h postoperatively. Hemodialysis is widely acknowledged as a treatment option to stabilize patients with renal failure, and one of the most challenging situations is during OLT in which the role of intraoperative hemodialysis is becoming more important today more than ever before.

  11. Correlation of serum leptin with levels of hemoglobin in hemodialysis

    Directory of Open Access Journals (Sweden)

    Rafieian-Kopaei Mahmoud

    2012-04-01

    Full Text Available To examine the association of serum leptin level with anemia in hemodialysis, we investigated 36 patients (males: 21, diabetics: 11 under regular hemodialysis. For patients, complete blood counts, iron profile, serum leptin, and adequacy of hemodialysis were assessed. In this study a significant correlation of serum leptin with level of hemoglobin and body mass index was detected. An association between serum leptin and total iron binding capacity was observed. No correlation of serum ferritin with leptin level was seen. Our findings attest previous findings showing that greater serum leptin levels are associated with greater hemoglobin levels.

  12. 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.

  13. Serum Protein Profile Alterations in Hemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, G A; Davies, R W; Choi, M W; Perkins, J; Turteltaub, K W; McCutchen-Maloney, S L; Langlois, R G; Curzi, M P; Trebes, J E; Fitch, J P; Dalmasso, E A; Colston, B W; Ying, Y; Chromy, B A

    2003-11-18

    Background: Serum protein profiling patterns can reflect the pathological state of a patient and therefore may be useful for clinical diagnostics. Here, we present results from a pilot study of proteomic expression patterns in hemodialysis patients designed to evaluate the range of serum proteomic alterations in this population. Methods: Surface-Enhanced Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (SELDI-TOFMS) was used to analyze serum obtained from patients on periodic hemodialysis treatment and healthy controls. Serum samples from patients and controls were first fractionated into six eluants on a strong anion exchange column, followed by application to four array chemistries representing cation exchange, anion exchange, metal affinity and hydrophobic surfaces. A total of 144 SELDI-TOF-MS spectra were obtained from each serum sample. Results: The overall profiles of the patient and control samples were consistent and reproducible. However, 30 well-defined protein differences were observed; 15 proteins were elevated and 15 were decreased in patients compared to controls. Serum from one patient exhibited novel protein peaks suggesting possible additional changes due to a secondary disease process. Conclusion: SELDI-TOF-MS demonstrated dramatic serum protein profile differences between patients and controls. Similarity in protein profiles among dialysis patients suggests that patient physiological responses to end-stage renal disease and/or dialysis therapy have a major effect on serum protein profiles.

  14. Prescribing dialysate bicarbonate concentrations for hemodialysis patients.

    Science.gov (United States)

    Heineken, F G; Brady-Smith, M; Haynie, J; Van Stone, J C

    1988-01-01

    A rearranged equation of Sargent and Gotch (1) was used to determine dialysate bicarbonate concentrations for hemodialysis patients. Parameters in this equation include an estimate of the acid generated by each patient between treatments, an estimate for the dialyzer dialysance for bicarbonate, ultrafiltration rate, blood flow rate and a targeted mid-dialysis plasma bicarbonate concentration of 25 mEq/L. Nine patients were studied over a 35 week period to verify this method of determining each patient's dialysate bicarbonate concentration. Prescribed dialysate bicarbonate concentrations for the nine patients varied from 29 to 38 mEq/L with five patients having a prescribed value of 35 mEq/L. After a baseline period of five weeks, five patients switched from a 37 mEq/L acetate dialysate to their prescribed dialysate bicarbonate concentration. Four patients who had already been on bicarbonate dialysis at a concentration of 35 mEq/L were dialyzed with their prescribed dialysate bicarbonate concentrations. Patients were then followed for a study period of 30 weeks. The prescribed dialysate bicarbonate concentration resulted in more normal acid/base chemistries for both groups of patients. The results also demonstrate that chronic hemodialysis patients require individualization of dialysate bicarbonate concentrations.

  15. 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.

  16. Catheter related infection in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Nabi Zahid

    2009-01-01

    Full Text Available To determine the frequency of hemodialysis (HD catheter related infection, causative microorganisms and predisposing factors contributing to these infections at our center, we con-ducted a prospective study in 2007 involving 57 (45.6% males patients in whom a temporary catheter was inserted for HD. The patients were followed for one month to document any episodes of hemodialysis catheter related infection (HCRI. There were 11 (19.3% patients who developed HCRI proven by blood culture; 5 patients were infected with more than one organism. Staphyloco-ccus Coagulase negative and Staphylococcus aureus (S. aureus remain the most common patho-gens. All the organisms were sensitive to antibiotics administered empirically, however, 3 patients developed multiple resistant S. aureus (MRSA. All the infected patients experienced previous epi-sodes of HCRI, which formed a risk factor in addition to low albumin when compared to the non-infected group (P=0.024 and P= 0.001, respectively. We conclude that the rate of HCRI and the causative organisms found in our study is comparable to previous reports. We still need to adopt measures to minimize the use of temporary vascular accesses by creation of fistulas in a timely fashion.

  17. Pregnancy during Hemodialysis: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Bahadi Abdelali

    2010-01-01

    Full Text Available Successful pregnancy outcome is an uncommon occurrence in women requiring chronic dialysis treatment. We reviewed the course and outcome of 9 pregnancies occurred in women on chronic hemodialysis in our center from 1999-2007; 5 of them ended with delivery of alive newborns, 2 with fetal deaths in-utero, and 2 with abortions. The average age of patients was 34 years. The etiology of the original kidney disease was unknown in 44.4% of the cases, and only 22.2% of the patients maintained diuresis. Dialysis started in 8 cases before the diagnosis of pregnancy. The average gestational age at diagnosis was 14 weeks. We modified the prescription of dialysis in 4 patients by increasing the frequency of the dialysis sessions to 6 per week and in 3 by increasing the duration of each session to 6 hours. Anemia was present in all the cases; 3 patients received erythropoietin and 4 patients required transfusion. The pregnancy was com-plicated in 44% of the cases by a polyhydramnios. The average time at delivery was 33 weeks and it was achieved in 80% of pregnancies through vaginal route. The average weight of newborns was to 2380 g. We conclude that pregnancy in women on hemodialysis is possible. The success of pregnancy may be influenced by the residual diuresis and early diagnosis to improve the quality of dialysis by increasing the dialysis dose.

  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. Comparison of the in vitro effects of saline, hypertonic hydroxyethyl starch, hypertonic saline, and two forms of hydroxyethyl starch on whole blood coagulation and platelet function in dogs.

    Science.gov (United States)

    Wurlod, Virginie A; Howard, Judith; Francey, Thierry; Schweighauser, Ariane; Adamik, Katja N

    2015-01-01

    To compare the in vitro effects of hypertonic solutions and colloids to saline on coagulation in dogs. In vitro experimental study. Veterinary teaching hospital. Twenty-one adult dogs. Blood samples were diluted with saline, 7.2% hypertonic saline solution with 6% hydroxyethylstarch with an average molecular weight of 200 kDa and a molar substitution of 0.4 (HH), 7.2% hypertonic saline (HTS), hydroxyethyl starch (HES) 130/0.4 or hydroxyethyl starch 600/0.75 at ratios of 1:22 and 1:9, and with saline and HES at a ratio of 1:3. Whole blood coagulation was analyzed using rotational thromboelastometry (extrinsic thromboelastometry-cloting time (ExTEM-CT), maximal clot firmness (MCF) and clot formation time (CFT) and fibrinogen function TEM-CT (FibTEM-CT) and MCF) and platelet function was analyzed using a platelet function analyzer (closure time, CTPFA ). All parameters measured were impaired by saline dilution. The CTPFA was prolonged by 7.2% hypertonic saline solution with 6% hydroxyethylstarch with an average molecular weight of 200 kDa and a molar substitution of 0.4 (HH) and HTS but not by HES solutions. At clinical dilutions equivalent to those generally administered for shock (saline 1:3, HES 1:9, and hypertonic solutions 1:22), CTPFA was more prolonged by HH and HTS than other solutions but more by saline than HES. No difference was found between the HES solutions or the hypertonic solutions. ExTEM-CFT and MCF were impaired by HH and HTS but only mildly by HES solutions. At clinically relevant dilutions, no difference was found in ExTEM-CFT between HTS and saline or in ExTEM-MCF between HH and saline. No consistent difference was found between the 2 HES solutions but HH impaired ExTEM-CFT and MCF more than HTS. At high dilutions, FibTEM-CT and -MCF and ExTEM-CT were impaired by HES. Hypertonic solutions affect platelet function and whole blood coagulation to a greater extent than saline and HES. At clinically relevant dilutions, only CTPFA was markedly more

  20. N-Acetylcysteine plus Saline Hydration versus Saline Hydration

    African Journals Online (AJOL)

    ) in patients undergoing coronary angiography pretreated with N-acetylcysteine NAC plus saline hydration or saline hydration alone and to determine the association between various risk factors and RCIN. Methods: Patients were ...

  1. Nadir Hemoglobin Levels after Discontinuation of Epoetin in Hemodialysis Patients

    OpenAIRE

    Calvo, Jose A.; Miskulin, Dana C.; Meyer, Klemens B.; Weiner, Daniel E.

    2010-01-01

    Background and objectives: In hemodialysis patients, both hemoglobin variability and targeting normalization of hemoglobin may have adverse consequences. There are few data on epoetin management in patients achieving high hemoglobin levels.

  2. Hemodynamic stability during hemodialysis : A role for vasopressin?

    NARCIS (Netherlands)

    Ettema, Esmee Marlien

    2016-01-01

    Despite technological advances, intradialytic hypotension remains a serious complication for hemodialysis patients. A measure to prevent intradialytic hypotension is the biofeedback system Hemocontrol. The mechanism behind the improved hemodynamic stability with Hemocontrol dialysis is not fully

  3. Chronic pain in hemodialysis patients: Role of bone mineral ...

    African Journals Online (AJOL)

    Tarek A. Ghonemy

    a Internal Medicine Department, Nephrology Unit, Zagazig University Hospital, Egypt b Clinical Pathology Department, Zagazig University Hospital, Egypt. Received 7 July 2015; revised 10 November 2015; accepted 10 December 2015. Available online 31 December 2015. KEYWORDS. Chronic pain;. Hemodialysis;.

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

    Science.gov (United States)

    Park, Hayne Cho; Lee, Young-Ki; Lee, Sang-Ho; Yoo, Kyung Don; Jeon, Hee Jung; Ryu, Dong-Ryeol; Kim, Seong Nam; Sohn, Seung Hwan; Chun, Rho Won; Choi, Kyu Bok

    2017-01-01

    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. PMID:28680819

  5. 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.

  6. 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...

  7. Bacterial contamination of hemodialysis water in three randomly ...

    African Journals Online (AJOL)

    2015-11-05

    associated adverse reactions with high-flux membranes and microbial contamination of liquid bicarbonate concentrate. Contrib Nephrol. 1988;62:24-34. 21. Coulliette AD, Arduino MJ. Hemodialysis and water quality. Semin Dial.

  8. Current Perspective on Hemodialysis Patients with Peripheral Artery Disease.

    Science.gov (United States)

    Okamoto, Shin; Iida, Osamu; Mano, Toshiaki

    2017-06-25

    The prevalence of peripheral artery disease is substantially higher in patients on chronic hemodialysis than in the general population. The presence of calcified lesions characteristic of hemodialysis patients has an adverse influence on the initial success and long-term outcomes of both surgical bypass and endovascular therapy. Although the selection of revascularization strategy depends on whether an autologous vein is available and if the patient has a life expectancy of at least two years, it is difficult to predict the life expectancy in a real-world clinical situation. Endovascular therapy may be appropriate for many hemodialysis patients with poor general condition because of the high risk of perioperative complications and the poor long-term prognosis. Deciding which treatment option is more appropriate should be done on a case-by-case basis, especially in hemodialysis patients with critical limb ischemia.

  9. 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 is a progn......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...

  10. Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco

    OpenAIRE

    Idrissa Diawara; Khadija Bekhti; Driss Elhabchi; Rachid Saile; Naima Elmdaghri; Mohammed Timinouni; Mohamed Elazhari

    2014-01-01

    Background and objectives Staphylococcus aureus (S. aureus) nasal carriage may be responsible for some serious infections in hemodialyzed patients. The main target of this study was to estimate the prevalence of S. aureus nasal carriage in hemodialysis outpatients and medical staff in hemodialysis centers specifically in Fez region. The second target is to identify the risks of colonization, resistance pattern of isolates and their virulence toxin genes. Patients and Methods Nasal swab specim...

  11. [Intermittent hemodialysis, irreplaceable in specific cases of severe poisoning].

    Science.gov (United States)

    Ventresca, M; Teta, D; Burnier, M; Kissling, S

    2015-02-25

    The medical practitioner is in general well aware of the indications for hemodialysis in severe, acute or chronic renal insufficiency. Apart from the traditional indications for renal replacement therapy, there are some cases such as metfomin and ethylene glycol poisoning, lithium intoxication severe hypercalcemia and tumor lysis syndrome, in which intermittent hemodialysis is the most effective treatment, or sometimes the only effective one. Although these situations remain infrequent, it is crucial to recognize them as quickly as possible.

  12. Hemodialysis-associated pseudoporphyria resistant to N-acetylcysteine

    Directory of Open Access Journals (Sweden)

    Driss El Kabbaj

    2011-01-01

    Full Text Available We report a 33-year-old female patient who had hemodialysis-associated pseudo-porphyria which did not respond to treatment with oral N-acetylcysteine. She responded favorably to treatment with the anti-malarial drug, chloroquine. The case is being reported to highlight the difficulty in interpreting the urinary porphyrin assays in patients on hemodialysis. Additionally, the current literature on pseudoporphyria disorders in patients with end-stage renal disease is briefly discussed.

  13. Infrequent Dialysis: A New Paradigm for Hemodialysis Initiation

    Science.gov (United States)

    Rhee, Connie M.; Unruh, Mark; Chen, Jing; Kovesdy, Csaba P.; Zager, Phillip; Kalantar-Zadeh, Kamyar

    2013-01-01

    Nearly a half-century ago, the thrice-weekly hemodialysis schedule was empirically established as a means to provide an adequate dialysis dose while also treating the greatest number of end-stage renal disease patients using limited resources. Landmark trials of hemodialysis adequacy have historically been anchored to thrice-weekly regimens, but a recent randomized controlled trial demonstrated that frequent hemodialysis (six times per week) confers cardiovascular and survival benefits. Based on these collective data and experience, clinical practice guidelines advise against a less than thrice-weekly treatment schedule in patients without residual renal function, yet provide limited guidance on the optimal treatment frequency when substantial native kidney function is present. Thus, during the transition from Stage 5 chronic kidney disease to end-stage renal disease, the current paradigm is to initiate hemodialysis on a “full dose” thrice-weekly regimen even among patients with substantial residual renal function. However, emerging data suggests that frequent hemodialysis accelerates residual renal function decline, and infrequent regimens may provide better preservation of native kidney function. Given the high mortality rates during the first 90 days of hemodialysis and the survival benefits of preserved native kidney function, initiation with twice-weekly treatment schedules (“infrequent hemodialysis”) with an incremental increase in frequency over time may provide an opportunity to optimize patient survival. This review outlines the clinical benefits of post-hemodialysis residual renal function, studies of twice-weekly treatment regimens, and the potential risks and benefits of infrequent hemodialysis. PMID:24016197

  14. 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

  15. 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.

  16. Hemodialysis Key Features Mining and Patients Clustering Technologies

    Directory of Open Access Journals (Sweden)

    Tzu-Chuen Lu

    2012-01-01

    Full Text Available The kidneys are very vital organs. Failing kidneys lose their ability to filter out waste products, resulting in kidney disease. To extend or save the lives of patients with impaired kidney function, kidney replacement is typically utilized, such as hemodialysis. This work uses an entropy function to identify key features related to hemodialysis. By identifying these key features, one can determine whether a patient requires hemodialysis. This work uses these key features as dimensions in cluster analysis. The key features can effectively determine whether a patient requires hemodialysis. The proposed data mining scheme finds association rules of each cluster. Hidden rules for causing any kidney disease can therefore be identified. The contributions and key points of this paper are as follows. (1 This paper finds some key features that can be used to predict the patient who may has high probability to perform hemodialysis. (2 The proposed scheme applies k-means clustering algorithm with the key features to category the patients. (3 A data mining technique is used to find the association rules from each cluster. (4 The mined rules can be used to determine whether a patient requires hemodialysis.

  17. Cloxacillin-induced seizure in a hemodialysis patient.

    Science.gov (United States)

    El Nekidy, Wasim; Dziamarski, Nicole; Soong, Derrick; Donaldson, Christine; Ibrahim, Muhieldean; Kadri, Albert

    2015-10-01

    We are reporting a cloxacillin-induced seizure in a patient with stage 5 chronic kidney disease requiring hemodialysis. To our knowledge, there are no published case reports of seizures induced by parenteral cloxacillin in hemodialysis patients. A young hemodialysis female was admitted to the hospital with decreased level of consciousness. Blood cultures revealed methicillin-sensitive Staphylococcus aureus where cloxacillin 2 g intravenously every 4 hours was initiated. Head computed tomography (CT) was not significant. After 14 hours of cloxacillin therapy (4 doses), the patient demonstrated tonic/clonic seizure activity, where phenytoin and lorazepam were initiated. The anti-seizure medications partially reduced seizure activity. Once the cloxacillin was discontinued, the seizures stopped. Two weeks later, all anti-seizure medications were stopped with no further seizure activity. Cloxacillin elimination in hemodialysis patients is similar to patients with normal kidney function. Although cloxacillin does not significantly cross the blood-brain barrier, the correlation between the start of seizures and cloxacillin initiation was confirmed by the negative CT and blood chemistry laboratory results. Moreover, seizure activity was terminated upon discontinuation of cloxacillin. Although further investigation for the cause of such seizures is warranted, clinicians should use caution when giving high doses of cloxacillin in hemodialysis patients. © 2015 International Society for Hemodialysis.

  18. 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

  19. The control of saline groundwater

    NARCIS (Netherlands)

    Talsma, T.

    1963-01-01

    A study was made of the effect of the watertable, water-conducting properties of the soil, climatic factors and groundwater salinity on the salinization of soils in the Murrumbidgee Irrigation Areas, Australia.

    Average daily capillary flow rates were calculated from measured salinization (by

  20. A dose-finding, long-term study on the use of calcium chloride in saline solution as a method of nonsurgical sterilization in dogs: evaluation of the most effective concentration with the lowest risk.

    Science.gov (United States)

    Leoci, Raffaella; Aiudi, Giulio; Silvestre, Fabio; Lissner, Elaine A; Marino, Fabio; Lacalandra, Giovanni M

    2014-10-14

    Canine overpopulation is a global issue with serious health and welfare implications. Nonsurgical methods of sterilization could yield positive impacts on this problem, but no long-term data on such methods are available. The objective of the current investigation was to determine the effects of intratesticular injections of calcium chloride dihydrate (CaCl2) in saline in dogs over a one year period. Five concentrations (0%, 10%, 20%, 30%, 60%) of CaCl2 in saline were administered via intratesticular injection to groups of 10 dogs each. Total sperm count and motility, blood levels of testosterone, and side effects were examined at 0, 2, 6, and 12 months post-injection (PI). Testicular size and semen volume were examined at 0 and 12 months PI. Total sperm count, semen volume and testosterone showed significant dose-dependent decreases upon treatment with 10%-60% CaCl2 compared with either the control group (0% CaCl2) or baseline for each treatment group. Azoospermia was achieved for at least 12 months PI in 60% and 80% of treated dogs after administration of a 10% and 20% CaCl2, respectively. Treatment with 30% or 60% CaCl2 resulted in azoospermia in 100% of dogs, but more side effects were observed, while no side effects were noticed at lower doses. For each treatment group, testosterone levels had decreased an average of 35%-70% at 6 months following treatment. However, testosterone levels rebounded by the 12-month time point in all groups except the highest dosage group (60% CaCl2), which remained at the low end of physiological range throughout the study. Sperm motility dropped to zero or near zero in all dogs treated with CaCl2. Testicular size was significantly smaller at 12 months PI for all groups when compared to baseline. This first long-term study confirms reports of the efficacy of CaCl2 sterilization. However, at dosages free of adverse events, calcium chloride in saline may not provide permanent sterilization as previously believed. Future work should

  1. Bacterial use of choline to tolerate salinity shifts in sea-ice brines

    DEFF Research Database (Denmark)

    Firth, E.; Carpenter, S. D.; Sørensen, H. L.

    2016-01-01

    of starting salinities, when salinity was increased, 14C-solute (choline or derivatives) was preferentially retained as an intracellular osmolyte; when salinity was decreased, 14C-choline was preferentially respired to 14CO2. Additional experiments with cold-adapted bacteria in culture indicated......Bacteria within the brine network of sea ice experience temperature-driven fluctuations in salinity on both short and long temporal scales, yet their means of osmoprotection against such fluctuations is poorly understood. One mechanism used to withstand the ion fluxes caused by salinity shifts...... brines drained from sea ice in Kanajorsuit Bay (2013) and Kobbefjord (2014), Greenland, we measured the utilization of 14C-choline (precursor to glycine betaine, a common compatible solute) at -1°C upon salinity shifts to double and to half the starting salinity. In all cases and across a range...

  2. Genistein Modified Polymer Blends for Hemodialysis Membranes

    Science.gov (United States)

    Chang, Teng; Kyu, Thein; Define, Linda; Alexander, Thomas

    2012-02-01

    A soybean-derived phytochemical called genistein was used as a modifying agent to polyether sulfone/polyvinyl pyrrolidone (PES/PVP) blends to produce multi-functional hemodialysis membranes. With the aid of phase diagrams of PES/PVP/genistein blends, asymmetric porous membranes were fabricated by coagulating in non-solvent. Both unmodified and genistein modified PES/PVP membranes were shown to be non-cytotoxic to the blood cells. Unmodified PES/PVP membranes were found to reduce reactive oxygen species (ROS) levels, whereas the genistein modified membranes exhibited suppression for ˜60% of the ROS levels. Also, the genistein modified membranes revealed significant suppression of pro-inflammatory cytokines: IL-1β, IL-6, and TNF-α. Moreover, addition of PVP to PES showed the reduced trend of platelet adhesion and then leveled off. However, the modified membranes exhibited suppression of platelet adhesion at low genistein loading, but beyond 15 wt%, the platelet adhesion level rised up.

  3. 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.

  4. Urgent peritoneal dialysis or hemodialysis catheter dialysis.

    Science.gov (United States)

    Lok, Charmaine E

    2016-03-01

    Worldwide, there is a steady incident rate of patients with end-stage kidney disease (ESKD) who require renal replacement therapy. Of these patients, approximately one-third have an "unplanned" or "urgent" start to dialysis. This can be a very challenging situation where patients have either not had adequate time for education and decision making regarding dialysis modality and appropriate dialysis access, or a decision was made and plans were altered due to unforeseen circumstances. Despite such unplanned starts, clinicians must still consider the patient's ESKD "life-plan", which includes the best initial dialysis modality and access to suit the patient's individual goals and their medical, social, logistic, and facility circumstances. This paper will discuss the considerations of peritoneal dialysis and a peritoneal dialysis catheter access and hemodialysis and central venous catheter access in patients who require an urgent start to dialysis.

  5. 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.

  6. Analysis of urea distribution volume in hemodialysis.

    Science.gov (United States)

    Maduell, F; Sigüenza, F; Caridad, A; Miralles, F; Serrato, F

    1994-01-01

    According to the urea kinetic model it is considered that the urea distribution volume (V) is that of body water, and that it is distributed in only one compartment. Since the V value is different to measure, it is normal to use 58% of body weight, in spite of the fact that it may range from 35 to 75%. In this study, we have calculated the value of V by using an accurate method based on the total elimination of urea from the dialysate. We have studied the V, and also whether the different dialysis characteristics modify it. Thirty-five patients were included in this study, 19 men and 16 women, under a chronic hemodialysis programme. The dialysate was collected in a graduated tank, and the concentration of urea in plasma and in dialysate were determined every hour. Every patient received six dialysis sessions, changing the blood flow (250 or 350 ml/min), the ultrafiltration (0.5 or 1.5 l/h), membrane (cuprophane or polyacrylonitrile) and/or buffer (bicarbonate or acetate). At the end of the hemodialysis session, the V value ranged from 43 to 72% of body weight; nevertheless, this value was practically constant in every patient. The V value gradually increased throughout the dialysis session, 42.1 +/- 6.9% of body weight in the first hour, 50.7 +/- 7.5% in the second hour and 55.7 +/- 7.9% at the end of the dialysis session. The change of blood flow, ultrafiltration, membrane or buffer did not alter the results. The V value was significantly higher in men in comparison with women, 60.0 +/- 6.6% vs. 50.5 +/- 5.9% of body weight (p < 0.001).

  7. 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

  8. Hemodialysis-Induced Regional Left Ventricular Systolic Dysfunction and Inflammation : A Cross-sectional Study

    NARCIS (Netherlands)

    Assa, Solmaz; Hummel, Yoran M.; Voors, Adriaan A.; Kuipers, Johanna; Westerhuis, Ralf; Groen, Henk; Bakker, Stephan J. L.; Muller Kobold, Anneke C.; van Oeveren, Wim; Struck, Joachim; de Jong, Paul E.; Franssen, Casper F. M.

    Background: Hemodialysis may acutely induce regional left ventricular (LV) systolic dysfunction, which is associated with increased mortality and progressive heart failure. We tested the hypothesis that hemodialysis-induced regional LV systolic dysfunction is associated with inflammation and

  9. The impact of multidisciplinary rehabilitation on the quality of life of hemodialysis patients in Iran

    Directory of Open Access Journals (Sweden)

    Tahereh Toulabi

    2016-07-01

    Conclusion: Rehabilitation programs improve the quality of life of hemodialysis patients. By this finding, implementation of rehabilitation programs is recommended in hemodialysis centers with participation of experts from different fields including nurses, physiotherapists, and clinical psychologists.

  10. Body Composition Monitor Assessing Malnutrition in the Hemodialysis Population Independently Predicts Mortality

    NARCIS (Netherlands)

    Rosenberger, Jaroslav; Kissova, Viera; Majernikova, Maria; Straussova, Zuzana; Boldizsar, Jan

    Objective: Malnutrition is a known predictor of mortality in the general and hemodialysis populations. However, diagnosing malnutrition in dialysis patients remains problematic. Body composition monitoring (BCM) is currently used mainly for assessing overhydratation in hemodialysis patients, but it

  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

    BackgroundHemodialysis 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. 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.

  13. Obese and diabetic patients with end-stage renal disease: Peritoneal dialysis or hemodialysis?

    Science.gov (United States)

    Ekart, Robert; Hojs, Radovan

    2016-07-01

    Obesity is a chronic disease that is increasingly prevalent around the world and is a well-recognized risk factor for type 2 diabetes and hypertension, leading causes of end-stage renal disease (ESRD). The obese diabetic patient with ESRD is a challenge for the nephrologist with regard to the type of renal replacement therapy that should be suggested and offered to the patient. There is no evidence that either peritoneal dialysis or hemodialysis is contraindicated in obese ESRD patients. In the literature, we can find a discrepancy in the impact of obesity on mortality among hemodialysis vs. peritoneal dialysis patients. Several studies in hemodialysis patients suggest that a higher BMI confers a survival advantage - the so-called "reverse epidemiology". In contrast, the literature among obese peritoneal dialysis patients is inconsistent, with various studies reporting an increased risk of death, no difference, or a decreased risk of death. Many of these studies only spanned across a few years, and this is probably too short of a time frame for a realistic assessment of obesity's impact on mortality in ESRD patients. The decision for dialysis modality in an obese diabetic patient with ESRD should be individualized. According to the results of published studies, we cannot suggest PD or HD as a better solution for all obese diabetic patients. The obese patient should be educated about all their dialysis options, including home dialysis therapies. In this review, the available literature related to the dialysis modality in obese patients with diabetes and ESRD was reviewed. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  14. The effect of Omega 3 fatty acid on the lipid profile of hemodialysis patient

    OpenAIRE

    O. Taziki; M. Lesan Pezeshki

    2005-01-01

    Coronary heart diseases (CHD) are the main cause of mortality in hemodialysis patients. Lipid profile abnormality in hemodialysis patients including hypertriglyceridemia , normal total cholesterol, modest decline in HDL rise in LDL are effected by omega 3 speculative. The purpose of this study was to investigate the effects of omega 3 fatty acid on lipid profile in hemodialysis patients. this clinical trial was performed on 16 hemodialysis patients with hypertriglyceridemia. They were asked t...

  15. Validity and Reliability of the Turkish Version of the Thirst Distress Scale in Patients on Hemodialysis

    OpenAIRE

    KARA, Belgüzar

    2013-01-01

    Purpose: Thirst has been reported as an important source of distress for patients on hemodialysis. However, there is no instrument available that assesses thirst distress of Turkish patients on hemodialysis. Therefore, the aim of this study was to examine the psychometric properties of the Turkish version of the Thirst Distress Scale (TDS-T) for patients on hemodialysis. Methods: This study was conducted methodologically. A convenience sample of 142 Turkish patients on hemodialysis partici...

  16. The relationship between emotional intelligence and quality of life hemodialysis patients

    OpenAIRE

    Masoome Shahnavazi; Zohreh Parsa Yekta; Fatemeh Rigi; Mir Saeed Yekaninejad

    2016-01-01

    Hemodialysis treatment methods in patients with chronic kidney failure increase the life span of these patients, but hemodialysis affects all life aspects of patients and diminishes the quality of life patients. The aim of the study was to examine the relationship between emotional intelligence and quality of life for hemodialysis patients . This study was a descriptive – correlational research conducted in 2014 on 98 hemodialysis patients Referred to Hospitals of University Medical Sci...

  17. Survival after acute hemodialysis in Pennsylvania, 2005-2007: a retrospective cohort study.

    Science.gov (United States)

    Ramer, Sarah J; Cohen, Elan D; Chang, Chung-Chou H; Unruh, Mark L; Barnato, Amber E

    2014-01-01

    Little is known about acute hemodialysis in the US. Here we describe predictors of receipt of acute hemodialysis in one state and estimate the marginal impact of acute hemodialysis on survival after accounting for confounding due to illness severity. This is a retrospective cohort study of acute-care hospitalizations in Pennsylvania from October 2005 to December 2007 using data from the Pennsylvania Health Care Cost Containment Council. Exposure variable is acute hemodialysis; dependent variable is survival following acute hemodialysis. We used multivariable logistic regression to determine propensity to receive acute hemodialysis and then, for a Cox proportional hazards model, matched acute hemodialysis and non-acute hemodialysis patients 1∶5 on this propensity. In 2,131,248 admissions of adults without end-stage renal disease, there were 6,657 instances of acute hemodialysis. In analyses adjusted for predicted probability of death upon admission plus other covariates and stratified on age, being male, black, and insured were independent predictors of receipt of acute hemodialysis. One-year post-admission mortality was 43% for those receiving acute hemodialysis, compared to 13% among those not receiving acute hemodialysis. After matching on propensity to receive acute hemodialysis and adjusting for predicted probability of death upon admission, patients who received acute hemodialysis had a higher risk of death than patients who did not over at least 1 year of follow-up (hazard ratio 1·82, 95% confidence interval 1·68-1·97). In a populous US state, receipt of acute hemodialysis varied by age, sex, race, and insurance status even after adjustment for illness severity. In a comparison of patients with similar propensity to receive acute hemodialysis, those who did receive it were less likely to survive than those who did not. These findings raise questions about reasons for lack of benefit.

  18. Survival after acute hemodialysis in Pennsylvania, 2005-2007: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah J Ramer

    Full Text Available BACKGROUND: Little is known about acute hemodialysis in the US. Here we describe predictors of receipt of acute hemodialysis in one state and estimate the marginal impact of acute hemodialysis on survival after accounting for confounding due to illness severity. MATERIALS AND METHODS: This is a retrospective cohort study of acute-care hospitalizations in Pennsylvania from October 2005 to December 2007 using data from the Pennsylvania Health Care Cost Containment Council. Exposure variable is acute hemodialysis; dependent variable is survival following acute hemodialysis. We used multivariable logistic regression to determine propensity to receive acute hemodialysis and then, for a Cox proportional hazards model, matched acute hemodialysis and non-acute hemodialysis patients 1∶5 on this propensity. RESULTS: In 2,131,248 admissions of adults without end-stage renal disease, there were 6,657 instances of acute hemodialysis. In analyses adjusted for predicted probability of death upon admission plus other covariates and stratified on age, being male, black, and insured were independent predictors of receipt of acute hemodialysis. One-year post-admission mortality was 43% for those receiving acute hemodialysis, compared to 13% among those not receiving acute hemodialysis. After matching on propensity to receive acute hemodialysis and adjusting for predicted probability of death upon admission, patients who received acute hemodialysis had a higher risk of death than patients who did not over at least 1 year of follow-up (hazard ratio 1·82, 95% confidence interval 1·68-1·97. CONCLUSIONS: In a populous US state, receipt of acute hemodialysis varied by age, sex, race, and insurance status even after adjustment for illness severity. In a comparison of patients with similar propensity to receive acute hemodialysis, those who did receive it were less likely to survive than those who did not. These findings raise questions about reasons for lack of

  19. 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.

  20. Characterization of Hemodialysis Reverse Osmosis Wastewater From Yazd Educational Hospitals

    Directory of Open Access Journals (Sweden)

    Mohammad Saleh Ali-Taleshi

    2016-05-01

    Full Text Available This paper evaluates the technical feasibility of reusing hemodialysis reverse osmosis wastewater from educational hospitals in Yazd, Iran, as an alternative water source. For this study, from October to December 2013, hemodialysis reverse osmosis wastewater samples were obtained from two dialysis facilities and analyzed for biochemical oxygen demand (BOD, chemical oxygen demand (COD, pH, and electrical conductivity (EC using standard methods. Furthermore, concentrations of heavy metals such as Ag, Ba, Cd, Cu, Pb, Se, and Zn were calculated. Results were analyzed using the one sample t-test and independent t-test in SPSS 16 software. Mean concentrations of Ag, Ba, Cd, Cu, Fe, Pb, Se, and Zn in the hemodialysis reverse osmosis wastewater were 0.0960, 0.0611, 0.0186, 0.3381, 0.2153, 0.2212, 0.4196, and 0.0667 mg/L at S. Dr. Rahnamoon hospital, and 0.0963, 0.0849, 0.0177, 0.2942, 0.2160, 0.1827, 0.3420, and 0.0867 mg/L at S. Sadoughi hospital, respectively. The results also showed that the important challenges for reusing hemodialysis wastewater were its high EC and the presence of some elements, such as Se and Pb. Unlike Se and Pb, the concentrations of the other parameters were below discharge emission standards. Because of the large volumes of water used in hemodialysis, it is important to study the potential for reusing or recycling it. Through evaluation of the technical feasibility of hemodialysis wastewater reuse, this study draws attention to this neglected issue, especially in hemodialysis therapy.

  1. Clinical Question: Nasal saline or intranasal corticosteroids to treat allergic rhinitis in children.

    Science.gov (United States)

    Madison, Stefani; Brown, Elizabeth Aubrey; Franklin, Rachel; Wickersham, Elizabeth A; McCarthy, Laine H

    2016-01-01

    In pediatric populations, is nasal saline irrigation as effective as intranasal corticosteroids at relieving allergic rhinitis symptoms? No. Intranasal steroids are more effective than nasal saline alone to reduce symptoms of allergic rhinitis (AR) in children. Combination therapy further improves symptom reduction. LEVEL OF EVIDENCE FOR THE ANSWER: B SEARCH TERMS: Allergic Rhinitis, Nasal Saline, Nasal corticosteroids, children younger than age 18. DATE SEARCH WAS CONDUCTED: August and September 2014, October 2015. Meta-analyses, randomized controlled trials, systematic reviews, cohort studies, nasal spray, hypertonic saline solution, nasal lavage, rhinitis, intranasal administration, nasal saline, human, English language. Antihistamines, Adults, Articles older than 2008.

  2. Effects of salinity on leaf breakdown: Dryland salinity versus salinity from a coalmine.

    Science.gov (United States)

    Sauer, Felix G; Bundschuh, Mirco; Zubrod, Jochen P; Schäfer, Ralf B; Thompson, Kristie; Kefford, Ben J

    2016-08-01

    Salinization of freshwater ecosystems as a result of human activities represents a global threat for ecosystems' integrity. Whether different sources of salinity with their differing ionic compositions lead to variable effects in ecosystem functioning is unknown. Therefore, the present study assessed the impact of dryland- (50μS/cm to 11,000μS/cm) and coalmine-induced (100μS/cm to 2400μS/cm) salinization on the leaf litter breakdown, with focus on microorganisms as main decomposer, in two catchments in New South Wales, Australia. The breakdown of Eucalyptus camaldulensis leaves decreased with increasing salinity by up to a factor of three. Coalmine salinity, which is characterised by a higher share of bicarbonates, had a slightly but consistently higher breakdown rate at a given salinity relative to dryland salinity, which is characterised by ionic proportions similar to sea water. Complementary laboratory experiments supported the stimulatory impact of sodium bicarbonates on leaf breakdown when compared to sodium chloride or artificial sea salt. Furthermore, microbial inoculum from a high salinity site (11,000μS/cm) yielded lower leaf breakdown at lower salinity relative to inoculum from a low salinity site (50μS/cm). Conversely, inoculum from the high salinity site was less sensitive towards increasing salinity levels relative to inoculum from the low salinity site. The effects of the different inoculum were the same regardless of salt source (sodium bicarbonate, sodium chloride and artificial sea salt). Finally, the microorganism-mediated leaf litter breakdown was most efficient at intermediate salinity levels (≈500μS/cm). The present study thus points to severe implications of increasing salinity intensities on the ecosystem function of leaf litter breakdown, while the underlying processes need further scrutiny. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  3. 21 CFR 876.5600 - Sorbent regenerated dialysate delivery system for hemodialysis.

    Science.gov (United States)

    2010-04-01

    ... hemodialysis. 876.5600 Section 876.5600 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5600 Sorbent regenerated dialysate delivery system for hemodialysis. (a) Identification. A sorbent regenerated dialysate delivery system for hemodialysis is a device that is part of an artificial kidney system...

  4. 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…

  5. Digital infarction in a hemodialysis patient due to embolism from a thrombosed brachial arteriovenous fistula.

    Science.gov (United States)

    Yj, Anupama

    2015-10-01

    Acute onset of digital ischemia and infarction is an unusual complication in patients undergoing hemodialysis. This is a report of a patient on regular hemodialysis who presented with acute distal extremity ischemia, progressing to digital infarction and on evaluation was found to have thrombosis of brachial arteriovenous fistula with embolization to the distal arteries causing digital artery occlusion. © 2014 International Society for Hemodialysis.

  6. Bacterial use of choline to tolerate salinity shifts in sea-ice brines

    Directory of Open Access Journals (Sweden)

    E. Firth

    2016-08-01

    Full Text Available Abstract Bacteria within the brine network of sea ice experience temperature-driven fluctuations in salinity on both short and long temporal scales, yet their means of osmoprotection against such fluctuations is poorly understood. One mechanism used to withstand the ion fluxes caused by salinity shifts, well-known in mesophilic bacteria, is the import and export of low molecular weight organic solutes that are compatible with intracellular functions. Working with the marine psychrophilic gammaproteobacterium, Colwellia psychrerythraea 34H, and with natural microbial assemblages present in sackhole brines drained from sea ice in Kanajorsuit Bay (2013 and Kobbefjord (2014, Greenland, we measured the utilization of 14C-choline (precursor to glycine betaine, a common compatible solute at −1°C upon salinity shifts to double and to half the starting salinity. In all cases and across a range of starting salinities, when salinity was increased, 14C-solute (choline or derivatives was preferentially retained as an intracellular osmolyte; when salinity was decreased, 14C-choline was preferentially respired to 14CO2. Additional experiments with cold-adapted bacteria in culture indicated that an abrupt downshift in salinity prompted rapid (subsecond expulsion of retained 14C-solute, but that uptake of 14C-choline and solute retention resumed when salinity was returned to starting value. Overall, the results indicate that bacteria in sea-ice brines use compatible solutes for osmoprotection, transporting, storing and cycling these molecules as needed to withstand naturally occurring salinity shifts and persist through the seasons. Because choline and many commonly used compatible solutes contain nitrogen, we suggest that when brines freshen and bacteria respire such compatible solutes, the corresponding regeneration of ammonium may enhance specific biogeochemical processes in the ice, possibly algal productivity but particularly nitrification. Measurements

  7. The influence of maintenance quality of hemodialysis machines on hemodialysis efficiency

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    Azar Ahmad

    2009-01-01

    Full Text Available Several studies suggest that there is a correlation between dose of dialysis and machine maintenance. However, in spite of the current practice, there are conflicting reports regarding the relationship between dose of dialysis or patient outcome, and machine maintenance. In order to evaluate the impact of hemodialysis machine maintenance on dialysis adequacy Kt/V and session performance, data were processed on 134 patients on 3-times-per-week dialysis regimens by dividing the patients into four groups and also dividing the hemodialysis machines into four groups according to their year of installation. The equilibrated dialysis dose eq Kt/V, urea reduction ratio (URR and the overall equipment effectiveness (OEE were calculated in each group to show the effect hemodialysis machine efficiency on the overall session performance. The average working time per machine per month was 270 hours. The cumulative number of hours according to the year of installation was: 26,122 hours for machines installed in 1998; 21,596 hours for machines installed in 1999, 8362 hours for those installed in 2003 and 2486 hours for those installed in 2005. The mean time between failures (MTBF was 1.8, 2.1, 4.2 and 6 months between failures for machines installed in 1999, 1998, 2003 and 2005, respectively. Statistical analysis demonstrated that the dialysis dose eq Kt/V and URR were increased as the overall equipment effectiveness (OEE increases with regular maintenance procedures. Maintenance has become one of the most expedient approaches to guarantee high machine dependability. The efficiency of dialysis machine is relevant in assuring a proper dialysis adequacy.

  8. 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....

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

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    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.

  10. Association of Peritonitis with Hemodialysis Catheter Dependence after Modality Switch

    Science.gov (United States)

    Thamer, Mae; Zhang, Yi; Zhang, Qian; Allon, Michael

    2016-01-01

    Background and objectives Few studies have evaluated vascular access use after transition from peritoneal dialysis to hemodialysis. Our study characterizes vascular access use after switch to hemodialysis and its effect on patient mortality and evaluates whether a peritonitis event preceding the switch was associated with the timing of permanent vascular access placement and use. Design, setting, participants, & measurements The US Renal Data System data were used to evaluate the establishment of a permanent vascular access in 1165 incident Medicare–insured adult patients on dialysis who initiated peritoneal dialysis between July 1, 2010 and June 30, 2011 and switched to hemodialysis within 1 year. Results The proportions of patients using a hemodialysis catheter were 85% (744 of 879), 76% (513 of 671), and 51% (298 of 582) at 30, 90, and 180 days, respectively, after the switch from peritoneal dialysis to hemodialysis. Patients who switched from peritoneal dialysis to hemodialysis with a previous peritonitis episode were more likely to dialyze with a catheter at 30 days (90% [379 of 421] versus 80% [365 of 458]; P=0.03), 90 days (82% [275 of 334] versus 71% [238 of 337]; P=0.03), and 180 days (57% [166 of 289] versus 45% [132 of 293]; P=0.04) after the switch and less likely to dialyze with an arteriovenous fistula at 30 days (8% [32 of 421] versus 16% [73 of 458]; P=0.01), 90 days (13% [42 of 334] versus 23% [76 of 337]; P=0.03), and 180 days (31% [91 of 289] versus 43% [126 of 293]; P=0.04). Patients using a permanent vascular access 180 days after switching from peritoneal dialysis to hemodialysis had better adjusted survival during the ensuing year than those using a catheter (hazard ratio, 0.66; 95% confidence interval, 0.44 to 1.00; P=0.05). Conclusions Among patients who switch from peritoneal dialysis to hemodialysis, prior peritonitis is associated with a higher rate of persistent hemodialysis catheter use, which in turn, is associated with lower

  11. Treatment of accidental ethanol intoxication with hemodialysis in a dog.

    Science.gov (United States)

    Keno, Lisa A; Langston, Cathy E

    2011-08-01

    To describe the successful treatment of accidental ethanol intoxication with hemodialysis in a dog. A 1.5-year-old female intact mixed breed dog was presented in a comatose state believed to be due to ethanol intoxication. The initial 9 hours of supportive care treatment were complicated by multiple seizures and hypothermia, and resulted in only minimal improvement in the dog's level of consciousness. Hemodialysis was implemented and resulted in rapid clinical recovery, corresponding to a rapid decline in serum ethanol concentration. To the authors' knowledge, this is the first reported case of using hemodialysis to treat accidental ethanol intoxication in a dog. The patient's initial serum ethanol concentration was higher than those previously reported for cases of accidental ethanol intoxication in dogs, and the serum ethanol concentration was shown to rapidly decline during hemodialysis. Treatment with hemodialysis for severe ethanol intoxication was effective in this case and may be able to decrease morbidity and mortality in some cases. © Veterinary Emergency and Critical Care Society 2011.

  12. Vitamin K intake and status are low in hemodialysis patients.

    Science.gov (United States)

    Cranenburg, Ellen C M; Schurgers, Leon J; Uiterwijk, Herma H; Beulens, Joline W J; Dalmeijer, Gerdien W; Westerhuis, Ralf; Magdeleyns, Elke J; Herfs, Marjolein; Vermeer, Cees; Laverman, Gozewijn D

    2012-09-01

    Vitamin K is essential for the activity of γ-carboxyglutamate (Gla)-proteins including matrix Gla28 protein and osteocalcin; an inhibitor of vascular calcification and a bone matrix protein, respectively. Insufficient vitamin K intake leads to the production of non-carboxylated, inactive proteins and this could contribute to the high risk of vascular calcification in hemodialysis patients. To help resolve this, we measured vitamin K(1) and K(2) intake (4-day food record), and the vitamin K status in 40 hemodialysis patients. The intake was low in these patients (median 140 μg/day), especially on days of dialysis and the weekend as compared to intakes reported in a reference population of healthy adults (mean K(1) and K(2) intake 200 μg/day and 31 μg/day, respectively). Non-carboxylated bone and coagulation proteins were found to be elevated in 33 hemodialysis patients, indicating subclinical hepatic vitamin K deficiency. Additionally, very high non-carboxylated matrix Gla28 protein levels, endemic to all patients, suggest vascular vitamin K deficiency. Thus, compared to healthy individuals, hemodialysis patients have a poor overall vitamin K status due to low intake. A randomized controlled trial is needed to test whether vitamin K supplementation reduces the risk of arterial calcification and mortality in hemodialysis patients.

  13. Longitudinal study of leptin levels in chronic hemodialysis patients

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    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.

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

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    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.

  15. Decoration of heparin and bovine serum albumin on polysulfone membrane assisted via polydopamine strategy for hemodialysis.

    Science.gov (United States)

    Xie, Bingwu; Zhang, Ranran; Zhang, Huan; Xu, Anxiu; Deng, Yi; Lv, Yalin; Deng, Feng; Wei, Shicheng

    2016-06-01

    Renal failure brings about abnormality of waste and toxins and deposition in the body. In clinic, the waste and toxins in vitro are eliminated by hemodialysis device with polysulfone (PSF) porous membranes. In the work, decoration of heparin (Hep) and bovine serum albumin (BSA) on PSF membranes would be beneficial to improve the hemocompatibility and reduce the anaphylatoxin formation during hemodialysis. The PSF porous membranes are surface-modified by simply dipping them into dopamine aqueous solution for 8 h. Then, Hep and BSA are immobilized covalently onto the resultant membrane. Attenuated total reflectance Fourier transform infrared spectra (ATR-FTIR) confirms that Hep and BSA are successfully introduced onto the surface of PSF membranes. Scanning electronic microscopy (SEM) and atomic force microscopy (AFM) display the changes of surface morphologies after modification. The result of water contact angle measurement shows that the hydrophilicity of PSF membranes is remarkably improved after coating polydopamine (pDA) and binding Hep and BSA. The experiments of hemocompatibility indicate that Hep and BSA grafted onto membranes suppress the adhesion of platelet and enhance the anticoagulation ability of PSF membranes. Furthermore, the protein adsorption tests reveal that Hep and BSA immobilized onto membranes depress the protein absorption and develop antifouling-protein ability of pristine membrane. This study proves a convenient and simple approach to graft two functional organic polymers which, respectively, play a vital role and then improve the hemocompatibility and biocompatibility of PSF membranes for their biomedical and blood-contacting applications.

  16. Effects of chitosan on oxidative stress and related factors in hemodialysis patients.

    Science.gov (United States)

    Anraku, Makoto; Tanaka, Motoko; Hiraga, Ayumu; Nagumo, Kohei; Imafuku, Tadashi; Maezaki, Yuji; Iohara, Daisuke; Uekama, Kaneto; Watanabe, Hiroshi; Hirayama, Fumitoshi; Maruyama, Toru; Otagiri, Masaki

    2014-11-04

    In recent world-wide studies, chitosans were tested as a dietary supplement for inhibiting the absorption of certain lipids and bile acids. We previously demonstrated the antioxidative and renoprotective potential of chitosan supplementation in chronic renal failure using 5/6 nephrectomized rats. In this study, we report the effects of chitosan on oxidative stress and related factors in hemodialysis patients. The ingestion of chitosan over a 12-week period resulted in a significant decrease in serum indoxyl sulfate and phosphate levels, compared with the levels prior to the start of the study. The ingestion of chitosan also resulted in a lowered ratio of oxidized to reduced albumin and a decrease in the level of advanced oxidized protein products. In in vitro studies, chitosan solutions were found to bind 38.5% of the indoxyl sulfate and 17.8% of the phosphate, respectively. Further, the oxidized albumin ratio was correlated with serum indoxyl sulfate levels in vivo. These results suggest that the ingestion of chitosan results in a significant reduction in the levels of pro-oxidants, which include uremic toxins, in the gastrointestinal tract, thereby inhibiting the subsequent development of oxidative stress in the systemic circulation. In addition, the long-term ingestion of chitosan has the potential for use in treating hyperphosphatemia in hemodialysis patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Association of interleg BP difference with overall and cardiovascular mortality in hemodialysis.

    Science.gov (United States)

    Chen, Szu-Chia; Chang, Jer-Ming; Tsai, Yi-Chun; Tsai, Jer-Chia; Su, Ho-Ming; Hwang, Shang-Jyh; Chen, Hung-Chun

    2012-10-01

    An interarm BP difference has been associated with atherosclerosis and adverse cardiovascular outcomes. This study investigated whether an interleg BP difference was associated with peripheral vascular disease and overall and cardiovascular mortality in hemodialysis patients. This study enrolled 210 hemodialysis patients from December 2006 to January 2007. Bilateral leg BPs were measured simultaneously by an ankle-brachial index (ABI)-form device before hemodialysis. The mean follow-up period was 4.4±1.5 years. ABI hemodialysis patients. Detection of an interleg BP difference may identify hemodialysis patients at increased risk of peripheral vascular disease and overall and cardiovascular mortality.

  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...... and underdiagnosed comorbidity in patients on chronic hemodialysis. Spirometry should be considered in all patients on dialysis in order to address dyspnea adequately. Hemodialysis induced a small fall in mean FEV1 and FVC, which was more pronounced in patients with little or no fluid removal, but the FEV1 /FVC...

  19. 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.

  20. MICROBIAL EVALUATION OF NORMAL SALINE USED BY CONTACT LENS WEARERS

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    CHUA SIEW SIANG

    2006-01-01

    Full Text Available Contact lens solutions should only be used for four weeks after first opening but this practice is not always followed. Therefore, the present study was conducted to determine the duration that contact lens wearers could use their normal saline without microbial contamination. Two brands of normal saline, OpticareTM and Klean & KareTM, were used by 30 contact lens wearers on alternate days. Samples were collected weekly for microbial evaluation. On an average, the duration of use without microbial contamination was four weeks. Half of the participants were able to use both bottles of their normal saline without microbial contamination for at least four weeks after first opening and this included nine participants who were able to use for at least eight weeks. The brands of normal saline, the frequency of use, the place where the normal saline was stored or used were not significantly related to the duration of contamination-free period. Of the 27 samples tested, 11 grew gram-positive bacteria and 16, gram-negative bacteria. The most common bacteria found were Staphylococcus aureus and Pseudomonas species. None of the samples had Acanthamoeba spp. and no eye infection or irritation was reported. It was concluded that on an average, a bottle of sterile normal saline can be used for at least four weeks after first opening. Some users may be able to extend this expiry date to eight weeks, depending on the way the solution was used.

  1. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

    DEFF Research Database (Denmark)

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

    2009-01-01

    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......: In patients undergoing hemodialysis, the initiation of treatment with rosuvastatin lowered the LDL cholesterol level but had no significant effect on the composite primary end point of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. (ClinicalTrials.gov number, NCT00240331.)...... 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...

  2. 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....

  3. Three cases of spontaneous lumbar artery rupture in hemodialysis patients.

    Science.gov (United States)

    Hwang, Na Kyoung; Rhee, Harin; Kim, Il Young; Seong, Eun Young; Lee, Dong Won; Lee, Soo Bong; Kwak, Ihm Soo; Kim, Chang Won; Song, Sang Heon

    2017-01-01

    We encountered three cases of retroperitoneal hematoma caused by spontaneous lumbar artery rupture, a rare vascular complication. At the time of retroperitoneal hematoma, two patients were on anticoagulant/antiplatelet therapy. One patient was not taking any anticoagulant/antiplatelet agents but was receiving hemodialysis treatment with heparin. Lumbar artery rupture was successfully controlled by transcatheter arterial embolization in all patients, but one patient developed multiple organ failure and died. We suggest that spontaneous lumbar artery rupture may occur in patients being treated with maintenance hemodialysis or anticoagulant/antiplatelet therapy. Therefore, clinicians should suspect lumbar artery rupture in patients with unstable vital signs and rapid onset of anemia because early diagnosis and appropriate intervention are necessary to decrease the risks of morbidity and mortality. © 2016 International Society for Hemodialysis.

  4. 7% Hypertonic saline in acute bronchiolitis: a randomized controlled trial.

    Science.gov (United States)

    Jacobs, Jonathan D; Foster, Megan; Wan, Jim; Pershad, Jay

    2014-01-01

    Research suggests that hypertonic saline (HS) may improve mucous flow in infants with acute bronchiolitis. Data suggest a trend favoring reduced length of hospital stay and improved pulmonary scores with increasing concentration of nebulized solution to 3% and 5% saline as compared with 0.9% saline mixed with epinephrine. To our knowledge, 7% HS has not been previously investigated. We conducted a prospective, double-blind, randomized controlled trial in 101 infants presenting with moderate to severe acute bronchiolitis. Subjects received either 7% saline or 0.9% saline, both with epinephrine. Our primary outcome was a change in bronchiolitis severity score (BSS), obtained before and after treatment, and at the time of disposition from the emergency department (ED). Secondary outcomes measured were hospitalization rate, proportion of admitted patients discharged at 23 hours, and ED and inpatient length of stay. At baseline, study groups were similar in demographic and clinical characteristics. The decrease in mean BSS was not statistically significant between groups (2.6 vs 2.4 for HS and control groups, respectively). The difference between the groups in proportion of admitted patients (42% in HS versus 49% in normal saline), ED or inpatient length of stay, and proportion of admitted patients discharged at 23 hours was not statistically significant. In moderate to severe acute bronchiolitis, inhalation of 7% HS with epinephrine does not appear to confer any clinically significant decrease in BSS when compared with 0.9% saline with epinephrine.

  5. Evaluation of hand functions in hemodialysis patients.

    Science.gov (United States)

    Tander, Berna; Akpolat, Tekin; Durmus, Dilek; Canturk, Ferhan

    2007-01-01

    Patients with end stage renal disease (ESRD) have many musculoskeletal abnormalities, including hand dysfunction. The Sollerman test evaluates hand grip function in daily activities. The relationships between Sollerman test (dominant hand) with Duruoz's Hand Index (DHI), Health Assessment Questionnaire (HAQ), and Beck Depression Inventory (BDI) tests have not been investigated previously. The aims of this study are to evaluate hand grip function using the Sollerman test in hemodialysis (HD) patients, correlate this test with other measures evaluating hand function or psychosocial status, and investigate factors that can affect Sollerman test. One-hundred twenty HD patients (64 male, 56 female, mean age 51 +/- 1.4 years, mean duration of HD therapy 5.3 +/- 3.7 years) were included in this study. The HAQ, DHI, and BDI scores were determined by standard techniques. All patients underwent the Jamar grip test and Sollerman test for the dominant (D) and non-dominant hand (ND). We found a positive correlation between Sollerman test (dominant hand) with Sollerman test-ND, Jamar-D, and Jamar-ND tests. There were negative correlations between Sollerman test with age, HAQ, BDI, and DHI tests. The relationships between Sollerman test (dominant hand) with DHI, HAQ, and BDI tests have not been investigated previously. This study showed the correlations between the Sollerman test (dominant hand) and other tests (either positive or negative). Psychosocial problems can affect hand functions.

  6. Diabetic nephropathy in hemodialysis patients in casablanca.

    Science.gov (United States)

    Khanfri, N; Medkouri, G; Aghai, R; Hachim, K; Benghanem, M G; Ramdani, B; Zaid, D

    2005-01-01

    Diabetes is the main cause of end-stage renal disease (ESRD) in the developed countries and its prevalence and incidence have been constantly increasing over the years. To determine the prevalence and profile of diabetic nephropathy in our ESRD population, we retrospectively studied 564 hemodialysis patients in ten dialysis units in Casablanca. The mean age was 49 +/-16.2 years. The diabetic nephropathy came at the third rank with a prevalence of 13.5% behind chronic glomerulonephritis (21.8%) and hypertensive nephropathy (14.7%). Almost 74% of our diabetics were type 2. From the time of diagnosis the type 2 diabetics reached the ESRD earlier than the type 1 diabetics with a mean period of 15.1 +/- 7 years and 18.8 +/- 5 years, respectively; however, the difference was not statistically significant. There was at least another microangiopathic complication in 95.4% of the patients and macroangiopathic complication in 82%. The median hemoglobin A1C in all patients was higher than normal value. We conclude that ESRD is a serious complication of diabetes, which is constantly increasing. The appropriate management of diabetes and a multidisciplinary approach are necessary to avoid it or at least delay its occurrence.

  7. Telematics Service for Home and Satellite Hemodialysis.

    Science.gov (United States)

    Agroyannis, Basil; Fourtounas, Costas; Romagnoli, Gianfranco; Skiadas, Marios; Tsavdaris, Charalambos; Chassomeris, Costas; Tzanatos, Helen; Kopelias, Ioannis; Lymberopoulos, Dimitrios; Psarras, John

    1999-01-01

    Home hemodialysis (HD) for the treatment of end-stage renal disease was first implemented about 30 years ago. In this paper the application of telematics monitoring services for supporting patients who need home HD or satellite HD is described. Two modified HD machines were located in two renal units, and a central control station (CCS, UNIX workstation with multimedia PC terminal) was located in another room of the hospital. Bidirectional communication between the modified HD machines and the CCS was managed using ISDN (Integrated Services Digital Network) links. Nine patients had 150 HD sessions performed using these HD machines over a period of 5 months. This system, called the HOMER-D system, provided on-line, remote supervision of the HD machine-related functions and the clinical condition of the patients through measurement of blood pressure, pulse rate, PO2 (pulse oxymetry), and ECG from the CCS. Any disturbances in the functioning of the HD machines were both visible and audible in the CCS, and the observer could give teleconsultation to the renal unit staff. No major dialysis-associated complications were observed; all data and alarms were transmitted correctly; and patients received adequate HD treatment.

  8. Trace elements in renal disease and hemodialysis

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    Miura, Yoshinori E-mail: yomiura@iwate-med.ac.jp; Nakai, Keiko; Suwabe, Akira; Sera, Koichiro

    2002-04-01

    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.

  9. Rationale for Antioxidant Supplementation in Hemodialysis Patients

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    Morena Marion

    2001-01-01

    Full Text Available Oxidative stress, which results from an imbalance between reactive oxygen species (ROS production and antioxidant defense mechanisms, is now a well recognized pathogenic process in hemodialysis (HD patients that could be involved in dialysis-related pathologies such as accelerated atherosclerosis, amyloidosis and anemia. This review is aimed at evaluating the rationale for preventive intervention against oxidative damage during HD as well as the putative causal factors implicated in this imbalance. The antioxidant system is severely impaired in uremic patients and impairment increases with the degree of renal failure. HD further worsens this condition mainly by losses of hydrophilic unbound small molecular weight substances such as vitamin C, trace elements and enzyme regulatory compounds. Moreover, inflammatory state due to the hemo-incompatibility of the dialysis system plays a critical role in the production of oxidants contributing further to aggravate the pro-oxidant status of uremic patients. Prevention of ROS overproduction can be achieved by improvement of dialysis biocompatibility, a main component of adequate dialysis, and further complimented by antioxidant supplementation. This could be achieved either orally or via the extracorporeal circuit. Antioxidants such as vitamin E could be bound on dialyzer membranes. Alternatively, hemolipodialysis consisting of loading HD patients with vitamin C or E via an ancillary circuit made of vitamin E-rich liposomes may be used.

  10. 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.

  11. 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.

  12. Salinity Gradients for Sustainable Energy: Primer, Progress, and Prospects.

    Science.gov (United States)

    Yip, Ngai Yin; Brogioli, Doriano; Hamelers, Hubertus V M; Nijmeijer, Kitty

    2016-11-15

    Combining two solutions of different composition releases the Gibbs free energy of mixing. By using engineered processes to control the mixing, chemical energy stored in salinity gradients can be harnessed for useful work. In this critical review, we present an overview of the current progress in salinity gradient power generation, discuss the prospects and challenges of the foremost technologies - pressure retarded osmosis (PRO), reverse electrodialysis (RED), and capacitive mixing (CapMix) and provide perspectives on the outlook of salinity gradient power generation. Momentous strides have been made in technical development of salinity gradient technologies and field demonstrations with natural and anthropogenic salinity gradients (for example, seawater-river water and desalination brine-wastewater, respectively), but fouling persists to be a pivotal operational challenge that can significantly ebb away cost-competitiveness. Natural hypersaline sources (e.g., hypersaline lakes and salt domes) can achieve greater concentration difference and, thus, offer opportunities to overcome some of the limitations inherent to seawater-river water. Technological advances needed to fully exploit the larger salinity gradients are identified. While seawater desalination brine is a seemingly attractive high salinity anthropogenic stream that is otherwise wasted, actual feasibility hinges on the appropriate pairing with a suitable low salinity stream. Engineered solutions are foulant-free and can be thermally regenerative for application in low-temperature heat utilization. Alternatively, PRO, RED, and CapMix can be coupled with their analog separation process (reverse osmosis, electrodialysis, and capacitive deionization, respectively) in salinity gradient flow batteries for energy storage in chemical potential of the engineered solutions. Rigorous techno-economic assessments can more clearly identify the prospects of low-grade heat conversion and large-scale energy storage

  13. Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates.

    Science.gov (United States)

    Fenton, S S; Schaubel, D E; Desmeules, M; Morrison, H I; Mao, Y; Copleston, P; Jeffery, J R; Kjellstrand, C M

    1997-09-01

    Although kidney transplantation is the preferred treatment method for patients with ESRD, most patients are placed on dialysis either while awaiting transplantation or as their only therapy. The question of which dialytic method provides the best patient survival remains unresolved. Survival analyses comparing hemodialysis and continuous ambulatory peritoneal dialysis/continuous cyclic peritoneal dialysis (CAPD/CCPD), a newer and less costly dialytic modality, have yielded conflicting results. Using data obtained from the Canadian Organ Replacement Register, we compared mortality rates between hemodialysis and CAPD/CCPD among 11,970 ESRD patients who initiated treatment between 1990 and 1994 and were followed-up for a maximum of 5 years. Factors controlled for include age, primary renal diagnosis, center size, and predialysis comorbid conditions. The mortality rate ratio (RR) for CAPD/CCPD relative to hemodialysis, as estimated by Poisson regression, was 0.73 (95% confidence interval: 0.68 to 0.78). No such relationship was found when an intent-to-treat Cox regression model was fit. Decreased covariable-adjusted mortality for CAPD/CCPD held within all subgroups defined by age and diabetes status, although the RRs increased with age and diabetes prevalence. The increased mortality on hemodialysis compared with CAPD/CCPD was concentrated in the first 2 years of follow-up. Although continuous peritoneal dialysis was associated with significantly lower mortality rates relative to hemodialysis after adjusting for known prognostic factors, the potential impact of unmeasured patient characteristics must be considered. Notwithstanding, we present evidence that CAPD/CCPD, a newer and less costly method of renal replacement therapy, is not associated with increased mortality rates relative to hemodialysis.

  14. A Trial of Extending Hemodialysis Hours and Quality of Life.

    Science.gov (United States)

    Jardine, Meg J; Zuo, Li; Gray, Nicholas A; de Zoysa, Janak R; Chan, Christopher T; Gallagher, Martin P; Monaghan, Helen; Grieve, Stuart M; Puranik, Rajesh; Lin, Hongli; Eris, Josette M; Zhang, Ling; Xu, Jinsheng; Howard, Kirsten; Lo, Serigne; Cass, Alan; Perkovic, Vlado

    2017-06-01

    The relationship between increased hemodialysis hours and patient outcomes remains unclear. We randomized (1:1) 200 adult recipients of standard maintenance hemodialysis from in-center and home-based hemodialysis programs to extended weekly (≥24 hours) or standard (target 12-15 hours, maximum 18 hours) hemodialysis hours for 12 months. The primary outcome was change in quality of life from baseline assessed by the EuroQol 5 dimension instrument (3 level) (EQ-5D). Secondary outcomes included medication usage, clinical laboratory values, vascular access events, and change in left ventricular mass index. At 12 months, median weekly hemodialysis hours were 24.0 (interquartile range, 23.6-24.0) and 12.0 (interquartile range, 12.0-16.0) in the extended and standard groups, respectively. Change in EQ-5D score at study end did not differ between groups (mean difference, 0.04 [95% confidence interval, -0.03 to 0.11]; P=0.29). Extended hours were associated with lower phosphate and potassium levels and higher hemoglobin levels. Blood pressure (BP) did not differ between groups at study end. Extended hours were associated with fewer BP-lowering agents and phosphate-binding medications, but were not associated with erythropoietin dosing. In a substudy with 95 patients, we detected no difference between groups in left ventricular mass index (mean difference, -6.0 [95% confidence interval, -14.8 to 2.7] g/m2; P=0.18). Five deaths occurred in the extended group and two in the standard group (P=0.44); two participants in each group withdrew consent. Similar numbers of patients experienced vascular access events in the two groups. Thus, extending weekly hemodialysis hours did not alter overall EQ-5D quality of life score, but was associated with improvement in some laboratory parameters and reductions in medication burden. (Clinicaltrials.gov identifier: NCT00649298). Copyright © 2017 by the American Society of Nephrology.

  15. A case of scrub typhus requiring maintenance hemodialysis

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    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.

  16. 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.

  17. Quality of Life and Self-Efficacy in Three Dialysis Modalities: Incenter Hemodialysis, Home Hemodialysis, and Home Peritoneal Dialysis.

    Science.gov (United States)

    Wright, Linda S; Wilson, Linda

    2015-01-01

    Previous research has demonstrated improved outcomes for patients on dialysis who have better quality of life and self-efficacy, but has focused almost exclusively on those receiving hemodialysis. The goal of this study was to describe the quality of life and self-efficacy of patients receiving incenter hemodialysis versus those receiving a home dialysis modality (hemodialysis or peritoneal dialysis). The study utilized a correlational cross-sectional design and quota sampling methods. Participants were recruited from outpatient dialysis facilities and included 77 community dwelling adult patients who had been on dialysis for at least six months. Quality of life was measured using the Kidney Disease Quality of Life instrument, and self-efficacy was measured using the Strategies Used by People to Promote Health instrument. Findings suggest equal outcomes between treatment groups, with no contraindication to the use of home therapies.

  18. 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

  19. Prospective study on prevalence of dermatological changes in patients under hemodialysis in hemodialysis units in Tanta University hospitals, Egypt

    Directory of Open Access Journals (Sweden)

    Mourad B

    2014-11-01

    Full Text Available Basma Mourad,1 Doaa Hegab,1 Kamal Okasha,2 Sarah Rizk3 1Dermatology and Venereology Department, 2Internal Medicine Department, Faculty of Medicine, Tanta University, 3Ministry of Health, Tanta, EgyptIntroduction: Chronic hemodialysis patients experience frequent and varied mucocutaneous manifestations in addition to hair and nail disorders. The aim of this study was to evaluate the prevalence of dermatological changes among patients with end-stage renal disease under hemodialysis in a hemodialysis unit in Tanta University hospitals over a period of 6 months, and to evaluate the relations of these dermatological disorders with the duration of hemodialysis as well as with different laboratory parameters in these patients.Patients and methods: Ninety-three patients with end-stage renal disease on regular hemodialysis (56 males and 37 females were selected and included in this cross-sectional, descriptive, analytic study. Their ages ranged from 18–80 years. All patients underwent thorough general and dermatological examinations. Laboratory investigations (complete blood counts, renal and liver function tests, serum parathormone levels, serum electrolytes, alkaline phosphatase, random blood sugar, and Hepatitis C virus (HCV antibodies were evaluated.Results: This study revealed that most patients had nonspecific skin changes, including xerosis, pruritus, pallor, ecchymosis, hyperpigmentation, and follicular hyperkeratosis. Nail and hair changes were commonly found, especially half and half nail, koilonychia, subungal hyperkeratosis, melanonychia, onychomycosis, and brittle and lusterless hair. Mucous membrane changes detected were pallor, xerostomia, macroglossia, bleeding gums, aphthous stomatitis, and yellow sclera. There was a significant positive correlation between the presence of pruritus and serum parathormone level. There was a significant negative correlation between the presence of mucous membrane changes and hemoglobin level

  20. Stochastic modeling of soil salinity

    NARCIS (Netherlands)

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

    2010-01-01

    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 long term probability density functions of salt mass and

  1. Saline agriculture in Mediterranean environments

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    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.

  2. Acute hemodialysis effects on doppler echocardiographic indices

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    Leila Abid

    2014-01-01

    Full Text Available Conventional echocardiographic (ECHO parameters of systolic and diastolic func-tion of the left ventricular (LV have been shown to be load dependent. However, the impact of pre-load reduction on tissue Doppler (TD parameters of LV function is incompletely understood. To evaluate the effect of a single hemodialysis (HD session on LV systolic and diastolic function using pulsed Doppler echocardiography and pulsed tissue Doppler imaging (TDI, we studied 81chronic HD patients (40 males; mean age 52.4 ± 16.4 years with these tools. ECHO parameters were obtained 30 min before and 30 min after HD. Fluid volume removed by HD was 1640 ± 730 cm [3] . HD led to reduction in LV end-diastolic volume (P <0.001, end-systolic volume (P <0.001, left atrium area (P <0.001, peak early (E-wave trans-mitral flow velocity (P <0.001, the ratio of early to late Doppler velocities of diastolic mitral inflow (P <0.001 and aortic time velocity integral (P <0.001. No significant change in peak S velocity of pulmonary vein flow after HD was noted. Early and late diastolic (E′ TDI velocities and the ratio of early to late TDI diastolic velocities (E′/A′ on the lateral side of the mitral annulus decreased signi-ficantly after HD (P = 0.013; P = 0.007 and P = 0.008, respectively. Velocity of flow progres-sion (Vp during diastole was not affected by pre-load reduction. Pulmonary artery systolic pressure and the diameter of the inferior vena cava decreased significantly (P <0.001 and P <0.001, respectively after HD. We conclude that most of the Doppler-derived indices of diastolic function are pre-load-dependent and velocity of flow progression was minimally affected by pre-load reduction in HD patients.

  3. Perceived illness intrusion among patients on hemodialysis

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    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.

  4. Restless legs syndrome in patients on hemodialysis

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    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.

  5. Microbiology of Water and Fluids for Hemodialysis

    Directory of Open Access Journals (Sweden)

    Rolf Nystrand

    2008-05-01

    Full Text Available In hemodialysis, huge amounts of water are used for diluting the concentrates to produce dialysis fluid. The water is pro-duced on site by reverse osmosis units. The chemical and microbiological quality of the water is essential for dialysis patients. Reverse osmosis units produce water of acceptable chemical quality that can be kept throughout the water system. The microbiological water quality, on the other hand, does not depend on the reverse osmosis unit but on the maintenance of the whole water system. All over the world, dialysis units take water samples and send them to laborato-ries for cultivation and endotoxin tests. Depending on the method of microbiological analysis, the water may be judged to be very good even if in reality it is much worse and outside of standard recommendations. When standardizing the meth-ods with adequate cultivation of water samples, the accuracy of the tests will be better, and as a result, dialysis units can use their resources for keeping the water systems in good shape, i.e. disinfect preventively and frequently and use less effort in collecting samples. This will benefit patients, who will receive a high-quality dialysis fluid, thus eliminating the effects of microbiological impacts such as increased levels of inflammation markers (e.g. C-reactive protein. In the situation of performing hemodiafiltration by producing the substitution fluid “on-line”, it is even more important to have a sensitive method of microbiological verification to follow-up the hygienic quality. [J Chin Med Assoc 2008;71(5:223–229

  6. Food intake in patients on hemodialysis

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    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.

  7. [Systemic and renal effects of preventing contrast nephrotoxicity with isotonic (0.9%) and hypotonic (0.45%) saline].

    Science.gov (United States)

    Marrón, Belén; Ruiz, Elisa; Fernández, Cristina; Almeida, Pedro; Horcajada, Cristina; Navarro, Felipe; Caramelo, Carlos

    2007-10-01

    Physiological and hypotonic saline solutions have been used interchangeably for preventing contrast media nephrotoxicity. No analysis of the possible differential effects of the two solutions on the milieu interieur or intercompartmental fluid volumes has been performed. Our aim was to study the systemic and renal effects of two types of saline solution regularly used to prevent contrast media nephrotoxicity in patients undergoing coronary angiography. Changes in electrolyte levels and volume distribution were studied in 71 individuals who were randomized to receive either 0.9% isotonic saline (n=36) or 0.45% hypotonic saline (n=35) during the 12 hours before and after contrast injection (2000 mL in each period). The creatinine level was elevated equally often in the isotonic and hypotonic saline groups. Isotonic saline administration led to reductions in hemoglobin level, hematocrit and plasma albumin level, and to increases in plasma volume, by 12.3% and 10.4% at 24 and 48 hours, respectively. These changes were significant compared with baseline measurements and compared with the group that received hypotonic saline. Neither of the two saline solutions resulted in a change in plasma atrial natriuretic peptide level. Plasma and urine osmolality decreased only with hypotonic saline. The increase in plasma creatinine level was similar with both isotonic and hypotonic saline. During standard therapy for preventing contrast media nephrotoxicity, (1) isotonic saline, but not hypotonic saline, increased plasma volume; (2) this increase did not raise the atrial natriuretic peptide level; and (3) no difference in the increase in serum creatinine level was observed between the two saline solutions. These findings provide evidence that 0.45% saline, at a dose suitable for preventing contrast media nephrotoxicity, is associated with a lower risk of volume expansion. This result is important for patients with severely impaired ventricular function.

  8. Responses of spinach to salinity and nutrient deficiency in growth, physiology and nutritional value

    Science.gov (United States)

    Salinity and nutrient depleted soil are major constraints to crop production, especially for vegetable crops. The effects of salinity and nutrient deficiency on spinach were evaluated in sand cultures under greenhouse conditions. Plants were watered every day with Hoagland nutrition solution, depriv...

  9. Hyperspectral Imaging to Evaluate the Effect of IrrigationWater Salinity in Lettuce

    National Research Council Canada - National Science Library

    Lara, Miguel; Diezma, Belén; Lleó, Lourdes; Roger, Jean; Garrido, Yolanda; Gil, María; Ruiz-Altisent, Margarita

    2016-01-01

    .... This research focuses on the effect of salinity on the growth of lettuce plants; three solutions with different levels of salinity were considered and compared (S1 = 50, S2 = 100 and S3 = 150 mM NaCl...

  10. 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

  11. The Spectrum of Hand Dysfunction After Hemodialysis Fistula Placement

    OpenAIRE

    Rehfuss, Jonathan P.; Berceli, Scott A.; Sarah M. Barbey; He, Yong; Kubilis, Paul S.; Beck, Adam W.; Huber, Thomas S.; Salvatore T Scali

    2017-01-01

    Contemporary dogma has classically attributed hand dysfunction following hemodialysis arteriovenous fistula (AVF) placement to regional ischemia. We hypothesize that hemodynamic perturbations alone do not entirely explain the postoperative changes in hand function and, furthermore, that various elements of hand function are differentially affected following surgery. Methods: Bilateral wrist and digital pressures and upper extremity nerve conduction tests were recorded preoperatively and at...

  12. HEPATITIS B VIRUS INFECTION PROFILE IN CENTRAL BRAZILIAN HEMODIALYSIS POPULATION

    Directory of Open Access Journals (Sweden)

    TELES Sheila A.

    1998-01-01

    Full Text Available Hepatitis B has proved to be a major health hazard in hemodialysis patients. In order to investigate the hepatitis B virus (HBV infection profile in the hemodialysis population of Goiânia city - Central Brazil, all dialysis patients (N=282 were studied. The prevalence of any HBV marker (HBsAg, anti-HBs, and anti-HBc was 56.7% (95% CI: 51.1-62.7, ranging from 33.3% to 77.7% depending on dialysis unit. HBV-DNA was detected in 67.6% and 88.2% of the HBsAg-positive serum samples, in 91.3% and 100% of the HBsAg/HBeAg-positive samples, and in 18.2% and 63.6% of the HBsAg/anti-HBe-reactive sera by hybridization and PCR, respectively. The length of time on hemodialysis was significantly associated with HBV seropositivity. Only 10% of the patients reported received hepatitis B vaccination. The findings of a high HBV infection prevalence in this population and the increased risk for HBV infection on long-term hemodialysis suggest the environmental transmission, emphasizing the urgent need to evaluate strategies of control and prevention followed in these units.

  13. [Lipid profile of patients on chronic hemodialysis (Morocco)].

    Science.gov (United States)

    Elmachtani Idrissi, Samira; Dami, Abdellah; Bouhsain, Sanae; Ouzzif, Zohra; Aatif, Toufik; El Mezouari, Mustapha; Asseraji, Mohammed; Maoujoud, Omar; El Allam, Mustapha; Oualim, Zouhir; Tellal, Saida

    2011-01-01

    Patients with end-stage renal disease (ESRD) receiving chronic hemodialysis show a high incidence and prevalence of cardiovascular disease of multifactorial etiology and an association between dyslipidemia and accelerated atherosclerosis. Our aim was to study lipid profiles in ESRD patients receiving dialysis regularly at our hospital (Morocco).Subjects and methods : The patient population consisted of 30 ESRD patients on maintenance haemodialysis. Matched control subjects were recruited among healthy normolipidemic patients. Concentrations of triglycerides (TG), total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C) and low-density-lipoprotein cholesterol (LDL-C) were measured. The atherogenic index (AI = TC/HDL-C ratio) was calculated. The TG, the HDL-C levels and atherogenic index were significantly higher in groups of hemodialysis patients. We saw no increase in the levels of TC and LDL-C. The prevalence of dyslipidemia in hemodialysis group was high (80%). The most frequent lipid alterations were decreased HDL-C (70%), increased TG (33,3%) and increased LDL-C (23,3%); 50% of ESRD patients have more than two different dyslipidemic findings. AI was higher (≥ 5) in 33,3% of cases. The prevalence of dyslipidemia is higher than normal in ESRD patients on maintenance hemodialysis. Classically, these patients have had low levels of HDL-C and elevated TG levels. Strict control of dyslipidemia should be part of the cardiovascular risk prevention strategy in this population.

  14. 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 ...

  15. Serum Leptin and Bone Mineral Density in Hemodialysis Patients ...

    African Journals Online (AJOL)

    Introduction: Leptin is a hormone secreted by adipocytes that plays an important role in regulating appetite and energy expenditure. Our aim was to evaluate serum leptin level in hemodialysis (HD) patients with or without chronic liver disease (CLD) and study the relationship between serum leptin level and bone mineral ...

  16. 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.

  17. Bacterial contamination of hemodialysis water in three randomly ...

    African Journals Online (AJOL)

    Background: Hemodialysis (HD) is the most common method of renal replacement therapy for patients with either acute kidney injury in the failure stage or end stage kidney failure in Nigeria. The number of dialysis centers in Nigeria has risen exponentially from 10 centers two decades ago to more than 120 centers in 2015.

  18. Patient perceptions of remote monitoring for nocturnal home hemodialysis.

    Science.gov (United States)

    Cafazzo, Joseph A; Leonard, Kevin; Easty, Anthony C; Rossos, Peter G; Chan, Christopher T

    2010-10-01

    Adoption of nocturnal home hemodialysis (NHHD) has been slow, due in part to patient-perceived barriers, such as anxiety and lack of self-efficacy. This study investigates patient perception of remote monitoring in addressing these barriers. Perceptions of remote patient monitoring (RPM) were studied through a quantitative survey and qualitative interviews. The NHHD and conventional hemodialysis (CHD) were included in the survey (209 in total). Twenty semistructured interviews were conducted as well as a focus group that included NHHD patients and family caregivers. The CHD patients had greater interest in adopting NHHD with RPM than without (1.90±1.37 vs. 1.71±1.28, Premote monitoring will ease the performing of NHHD (r=0.452, P=0.001) and the belief that RPM should be mandatory (r=0.541, P=0.000). Qualitative findings supported three themes: (1) There is an expectation for the use of RPM, (2) RPM should be used at a minimum transitionally, and (3) RPM acts as a surrogate support of family-caregivers. The RPM may lower perceived barriers to the adoption of NHHD, in part through its surrogate support of family caregivers. However, RPM alone is likely insufficient to alter patients' attitudes to undergo NHHD. RPM is a common expectation of CHD patients considering the therapy, at a minimum during the transitional phase. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.

  19. Second-Degree Interatrial Block in Hemodialysis Patients

    Science.gov (United States)

    Enriquez, Andres; D'Amato, Anna; de Luna, Antoni Bayes; Baranchuk, Adrian

    2015-01-01

    Interatrial conduction delays manifest as a prolonged P-wave duration on surface ECG and the term interatrial block (IAB) has been coined. They are usually fixed, but cases of intermittent IAB have been described, suggesting functional conduction block at the Bachmann bundle region. We report 2 cases of patients on chronic hemodialysis therapy presenting with intermittent IAB. PMID:25755895

  20. Second-Degree Interatrial Block in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Andres Enriquez

    2015-01-01

    Full Text Available Interatrial conduction delays manifest as a prolonged P-wave duration on surface ECG and the term interatrial block (IAB has been coined. They are usually fixed, but cases of intermittent IAB have been described, suggesting functional conduction block at the Bachmann bundle region. We report 2 cases of patients on chronic hemodialysis therapy presenting with intermittent IAB.

  1. Use of a token economy to increase compliance during hemodialysis.

    OpenAIRE

    Carton, J S; Schweitzer, J.B.

    1996-01-01

    We report the effects of using a token economy to treat noncompliant behavior in a 10-year-old male hemodialysis patient. The results of an ABAB design indicated that the intervention increased compliant behavior during both treatment phases and that compliance was maintained at 3- and 6-month follow-up observations.

  2. Implementation and Analysis of Hemodialysis in the Unit Operations Laboratory

    Science.gov (United States)

    Madihally, Sundararajan V.; Lewis, Randy S.

    2007-01-01

    To enhance bioengineering in the chemical engineering curriculum, a Unit Operations experiment simulating the hemodialysis of creatinine was implemented. The blood toxin creatinine was used for developing a more realistic dialysis experiment. A dialysis model is presented that allows students to assess the validity of model assumptions. This work…

  3. [The patient on hemodialysis: psychological and management difficulties].

    Science.gov (United States)

    Di Corrado, D; Murgia, M; Agostini, T

    2013-01-01

    Chronic renal failure is a public health problem of great relevance for significant mortality and high socio-economic impact. This study purposed to assess the psychological status in patients on hemodialysis; moreover other purpose is to investigate the possible differences among the first 3 months of hemodialysis treatment replacement. The study was carried out on 12 hemodialysis patients, aged 71.6 years (range: 34-87). Mood was measured by using the Profile of Mood States (POMS) developed in 1971 by Douglas M. McNair. The overall score of mood disorders shows a total negative state in the initial phases of dialysis treatment [F (2,22) = 10.17; p <0.01] and a progressive improvement of the same, with a linear trend [F (1,11) = 12.65; p <0.05]. The model of hemodialysis patients is particularly interesting for several reasons, but especially for the possibility of crosssectional and longitudinal assessments. The aim of future studies will be to characterize and investigate the complex psycho-social variables in this category of patients, to improve their quality of life.

  4. Pulse contour-derived cardiac output in hemodialysis patients

    DEFF Research Database (Denmark)

    Cordtz, Joakim; Ladefoged, Soeren D

    2010-01-01

    analysis, namely the Finometer monitor (FNM) for further use on patients dialyzing on a central vascular catheter. Fifty simultaneous cardiac output measurements were obtained during hemodialysis sessions in 25 patients. The internal variability of the FNM measurements was assessed by comparing 24 pairs...

  5. 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......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......, investigator-independent, automatic analysis of digital volume pulse in 10 healthy subjects and in 20 patients with end-stage renal failure during the hemodialysis session. The reflective index was defined representing the diastolic component of the digital pulse wave. The properties of the reflective index...... were studied in healthy control subjects (n=10). An increased reflective index was due to increased peripheral pulse wave reflection (e.g., vasoconstriction). During a hemodialysis session, the reflective index increased significantly from 36+/-3 arbitrary units to 41+/-3 arbitrary units (n=20; p...

  6. Parameters to Assess Nutritional Status in a Moroccan Hemodialysis ...

    African Journals Online (AJOL)

    Introduction: Malnutrition is common in maintenance hemodialysis (HD) and is associated with increased mortality and morbidity in affected patients. The aim of this study was to determine the prevalence of malnutrition and correlate the methods of nutritional assessment. Methods: We evaluated the nutritional status of 40 ...

  7. 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.

  8. 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

  9. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

    NARCIS (Netherlands)

    Fellström, Bengt C.; Jardine, Alan G.; Schmieder, Roland E.; Holdaas, Hallvard; Bannister, Kym; Beutler, Jaap; Chae, Dong-Wan; Chevaile, Alejandro; Cobbe, Stuart M.; Grönhagen-Riska, Carola; de Lima, José J.; Lins, Robert; Mayer, Gert; McMahon, Alan W.; Parving, Hans-Henrik; Remuzzi, Giuseppe; Samuelsson, Ola; Sonkodi, Sandor; Sci, D.; Süleymanlar, Gultekin; Tsakiris, Dimitrios; Tesar, Vladimir; Todorov, Vasil; Wiecek, Andrzej; Wüthrich, Rudolf P.; Gottlow, Mattis; Johnsson, Eva; Zannad, Faiez; Fellström, B.; Zannad, F.; Schmieder, R. E.; Holdaas, H.; Jardine, A. G.; Johnsson, E.; Gottlow, M.; Bannister, K.; Beutler, J.; Chae, D.; Cobbe, S. M.; Grönhagen-Riska, C.; de Lima, J.; Lins, R.; McMahon, A.; Mayer, G.; Parving, H.-H.; Chevaile, A.; Remuzzi, G.; Samuelsson, O.; Sonkodi, S.; Süleymanlar, G.; Tsakiris, D.; Tesar, V.; Todorov, V.; Wiecek, A.; Wüthrich, R. P.; Dargie, H.; Ritz, E.; Wedel, H.; Zwinderman, A. H.; Brady, A.; Deighan, C.; Macfarlane, P.; Stott, D.; Gillies, A.; Carney, S.; Faull, R.; Surany, M.; Saltissi, D.; Fraenkel, M.; Mount, P.; Irish, A.; Chan, D.; Dogra, S.; Wei, S.; Roger, S.; Pollock, C.; Cooper, B.; Brown, F.; Healy, H.; Hutchinson, B.; Boudville, N.; Senaratne, S.; Luxton, J.; Disney, A.; Russ, G.; Isbel, N.; Johnson, D.; Wong, J.; Herzig, K.; Walker, R.; Leikis, M.; Masterson, R.; Perkovic, V.; Kramar, R.; Robl, B.; Stummvoll, H.-K.; Holzer, H.; Prager, R.; Graf, H.; Neyer, U.; Kovarik, J.; Balcke, P.; Muyshondt, I.; Claes, K.; Maes, B.; Jadoul, M.; Dupont, P.; Marchal, M.; Pirson, Y.; Cambier, P.; Robin, M.; Warling, X.; Tielemans, C.; van der Niepen, P.; van Vlem, B.; Billiouw, J.-M.; de Meester, J.; Krzesinski, J.-M.; Dubois, B.; Delanaye, P.; Gowdak, L.; Barbosa, A.; Abreu, P.; Balda, C.; Canziani, M. E.; Watanabe, R.; Barata, R.; Lisboa, N.; Vilarinho, R.; Pecoits, R.; Teixeira, P.; Fortes, P.; Kraev, Z.; Koteva, A.; Georgiev, M.; Krivoshiev, S.; Popov, A.; Baldev, T.; Terziiska, G.; Rangelov, R.; Ekova, D.; Vitanova, L.; Mitova, V.; Videnova, N.; Dimitrova, B.; Dosev, D.; Vasileva, V.; Dimitrakov, D.; Blagov, B.; Nikolov, D.; Tilkijan, E.; Kapon, E.; Stavrev, P.; Guncheva, N.; Paunova, P.; Tashkov, B.; Bojadziev, D.; Popova, G.; Delibaltov, I.; Markov, M.; Koleva, N.; Petrova, M.; Berall, M.; Pierratos, A.; Mendelssohn, D.; Hercz, G.; Burgess, E.; Cournoyer, S.; Giroux, C.; Soltys, G.; Savoie, L.; Brunet, S.; Begin, V.; Duncan, J.; Yeung, C.; Cameron, E.; Jastrzebski, J.; Shapiro, J.; Copland, M.; Keown, P.; Singh, R.; Jolly, S.; Mustata, S.; Kates, D.; Jung, B.; Jamal, A.; Levin, A.; Chiu, A.; Chan-Yan, C.; Landsberg, D.; Macrae, J. M.; Gill, J.; de Luca, L.; Kiaii, M.; Taylor, P.; Lambert, F.; Berrard, J.; Youmbissi, J.; Bessette, M.; Turcot, R.; Moreau, V.; Davidman, M.; Bencovitch, D.; Frisch, G.; Lipman, M.; Pannu, N.; Davison, S.; Gourishankar, S.; Rehman, F.; Muirhead, N.; House, A.; Pichette, V.; Leblanc, M.; Prud'Homme, L.; Marcotte, J.; Desjardins, M.-H.; Raymond, M.; Tremblay, R.; Richardson, R.; Chan, C.; Sohi, P.; Pippy, C.; Gogan, N.; Handa, S.; Soroka, S.; Hirsh, D.; Panek, R.; Keough-Ryan, T.; Ting, R.; Fung, J.; Ng, P.; Tam, P.; Chow, S.; Zacharias, J.; Wu, G.; Kim, D.; Wong, G.; Wadgymar, J.; Wong, M.; Schuld, R.; Bitterova, Z.; Hanek, T.; Dvorak, K.; Pavlikova, Z.; Fixa, P.; Zahradnik, J.; Suchanova, J.; Krizova, E.; Zavada, J.; Lachmanova, J.; Mokrejsova, M.; Viklicky, O.; Lyerova, L.; Urbanova, M.; Syrovatka, P.; Kukura, S.; Svara, F.; Sagova, M.; Sulkova, S.; Polakovic, V.; Ryba, M.; Koci, P.; Ladefoged, S.; Jensen, H.; Rasmussen, K.; Nielsen, G.; Østergaard, O.; Nielsen, A.; Lynggaard, F.; Otte, K.; Steffensen, G.; Løkkegaard, N.-J.; Danielsen, H.; Hasling, C.; Hansen, S.; Freese, P.; Hansen, J.; Rasmussen, E.; Nielsen, F.; Egfjord, M.; Szpirt, W.; Mustonen, J.; Saha, H.; Ala-Houhala, I.; Ekstrand, A.; Honkanen, E.; Ylinen, K.; Malmström, R.; Rauta, V.; Tertti, R.; Metsärinne, K.; Heiro, M.; Koivuviita, N.; Kananen, K.; Salmela, A.; Lepistö, P.; Ikäheimo, R.; Pikkujämsä, S.; Karhapää, P.; Lumiaho, A.; Pulkkinen, A.; Helanterä, A.; Wallin, M.; Kolunen, M.; Asola, M.; Huhti, J.; Jääskeläinen, K.; Nuortimo, J.; Stenborg, M.; Erkinheimo, J.; Huuskonen, M.; Paldanius, R.; Helin, K.; Norvio, L.; Haapala, M.; Lindström, C.-J.; Monkam, R.; Bataille, P.; Nour, D.; Bouzerjnidj, M.; Wheatley, P.; Billion, S.; Brignon, P.; Maaz, M.; Charpentier, B.; Durrbach, A.; Djeffal, R.; Snanoudj, R.; El Esper, N.; Choukroun, G.; Dahmane, D.; Fessi, H.; Kessler, M.; Bellou-Zerrouki, M.; Cao-Huu, T.; Lamotte, C.; Lebleu, J.; Luong, C.-N.; Bouali, B.; Reach, I.; Mac-Namara, E.; Bourdon, F.; Majdanali, G.; Bouffandeau, A.; Chaghouri, B.; Hugot, V.; Torres, P. A. U.; Binaut, R.; Fleury, D.; Bacri, J.-L.; Maisonneuve, N.; Vanhille, P.; Lemaitre, V.; Lambrey, G.; Zaoui, P.; Kuentz, F.; Palancin, P.; Milongo, R.; Hachache, T.; Dehais, F.; Dupuy, P.; Wehbe, B.; Benarbia, S.; Yver, L.; Pujo, M.; Fourcade, J.; Philit, J.-B.; Ballé, C.; Bambauer, R.; Bittner, K.; Dragoun, G.-P.; Matzkies, F.; Hartmann, H.; Hoffmann, H.-D.; Kliem, V.; Kraatz, U.; Kraatz, G.; Krämer, H.; Krämer, W.; Krämer-Guth, A.; Kühn, R.; Kulzer, P.; Kurth, C.; Liebl, R.; Merker, L.; Meyer, T.; Mohler, C.; Neumann, K.; Nikolay, J.; Reiter, E.; Schannen, G.; Scherberich, J.; Schmieder, R.; Sperschneider, H.; Wagner, J.; Bast, I.; Anding-Rost, K.; Passauer, J.; Scheuermann, E.; Krause, R.-D.; Pommer, W.; Bhandari, S.; Webb, A.; Lewis, D.; Eadington, D.; Collinson, H.; Sellars, L.; Svreck, P.; Brown, A.; Bow, A.; Ahmed, S.; Severn, A.; Henderson, I.; Jardine, A.; Junor, B.; Nolan, C.; Geddes, C.; McGregor, E.; Mark, P.; Patel, R.; Rodger, S.; Main, J.; Reaich, D.; Paterson, A.; Maxwell, P.; Brown, H.; Finn, M.; O'Donoghue, D.; Wood, G.; Espinosa, O.; Middleton, R.; Woodrow, G.; Wright, M.; Rowe, P.; Cramp, H.; Tse, W.; Fox, J.; Macteir, R.; Isles, C.; Streather, C.; Semple, D.; Banerjee, D.; Mitra, S.; Gokal, R.; Bubtana, A.; Asari, A.; Jeffrey, R.; Mumtaz, R.; El Nahas, M.; Kwan, J.; Kumwenda, M.; Douglas, A.; Harron, C.; Courtney, A.; Sunil, J.; Garrett, P.; Maddekar, N.; Bergin, E.; Harty, J.; Conway, B.; Hollywood, M.; Macgregor, M.; Mackenzie, P.; Papagalanis, N.; Biblaki, D.; Ntatsis, G.; Kaperonis, N.; Siapera, V.; Iatrou, C.; Kontouli, T.; Spanou, E.; Kalocheretis, P.; Zerbala, S.; Sofroniadou, S.; Kelesidis, A.; Xanthopoulou, K.; Tsouchnikas, I.; Papakonstantinou, S.; Sobolos, K.; Bamichas, G.; Siamopoulos, K.; Gouva, C.; Kitsos, A.; Katopodis, K.; Nikolopoulos, P.; Vargemezis, V.; Thodis, E.; Yannatos, E.; Katartzi, K.; Panagoutsos, S.; Kiss, E.; Zsom, M.; Kiss, I.; Lakatos, A.; Fodor, E.; Nádori, E.; Arkossy, O.; Koroknai, L.; Mázik, R.; Vezekényi, Z.; Kovács, A.; Samir, N.; Akócsi, K.; Varga, G.; Ferenczi, S.; Villányi, B.; Schneider, K.; Vinkovits, S.; Czégány, Z.; Onody, Z.; Szegedi, J.; Valikovics, F.; Angyal, S.; Zilahi, Z.; Ladányi, E.; Széll, J.; Berta, K.; Szamosfalvi, B.; Ambrus, C.; Deák, G.; Faludi, M.; Molnár, M.; Zakar, G.; Varga, D.; Kovács, L.; Tüsér, Z.; Bodvarsson, M.; Arnadottir, M.; Redden, D.; Mutwali, A.; Griffin, B.; Lenihan, C.; O'Seaghda, C.; Lappin, D.; Gafney, M.; Akram, M.; Marchesi, D.; Mingardi, G.; Allaria, P.; Giangrande, A.; Lucatello, A.; Caligara, F.; Angelo, L.; Deferrari, G.; Robaudo, C.; Lauria, F.; Imbasciati, E.; Barbisoni, F.; Farina, M.; Maggio, M.; Borlandelli, S.; Badalamenti, S.; Finazzi, S.; Angelini, C.; Bianchi, G.; Spotti, D.; Quartagno, R.; Malberti, F.; La Russa, A.; Pecchini, P.; Ghiringhelli, P.; Zoccali, C.; Delfino, D.; Mallamaci, F.; Marino, F.; Curatola, G.; Caridi, G.; Ciccarelli, M.; Borghi, M.; Tagliaferri, M.; Massazza, M.; Espinoza, B.; Torres, M.; López, E.; Montañez, J. L.; Bochicchio, T.; Cruz, J.; Cordero, L.; Hollander, A.; Hoogeveen, E.; Koolen, M.; Bos, W.; Endeman, H.; Vincent, H.; Geers, T.; Rensma, P.; Apperloo, A.; Haest, R.; van de Ven, P.; Alphen, R.; van Buren, M.; Essen, G.; Woittiez, A.; Ouwehand, A.; Vleming, L.; Krol-van Stratten, M.; Janssen, W.; Kremer Horinga, T.; Kloppenburg, W.; Doorenbos, C.; Sluiter, H.; Smak-Gregoor, P.; van Bommel, E.; Jongh, J.; Verseput, G.; Hagen, E.; Stork, A.; Gaillard, C.; Pondman, M.; Bax, W.; van Geelen, J.; Schrama, Y.; Rietveld, A.; Op de Hoek, C.; Diderich, P.; Kaasjager, H.; Bosch, F.; Reichert, L.; Hemmelder, M.; Halma, C.; Broekroelofs, J.; Haanstra, W.; Vastenburg, G.; de Fijter, C.; Groeneveld, J.; Bergrem, H.; Thorud, L.; Viko, H.; Eggesbø, J.; Halvorsen, C.; Hunderi, O.; Abedini, S.; Broch, L.; Heldal, K.; Lyngdal, P.; Iversen, B.; Øien, C.; Selvig, K.; Witkowicz, J.; Spiechowicz-Zatoń, U.; Marcinkowski, W.; Ksiazek, A.; Baranowicz-Gaszczyk, I.; Jóźwiak, L.; Kuczera, M.; Szweblik, J.; Bieńkowski, J.; Wajda, J.; Bogdanowicz, G.; Jaworska-Wieczorek, J.; Myśliwiec, M.; Barczyk, M.; Kalinowski, M.; Mazerska, M.; Trusewicz, W.; Ostrowski, J.; Błaszczyk, E.; Majczyńska, I.; Kazimierczak, J.; Kacki, J.; Kochman, P.; Rutkowski, B.; Białobrzeska, B.; Jankowska, M.; Chmielewski, M.; Zdrojewski, Z.; Debska-Slizień, A.; Switalski, M.; Kepka, A.; Szewczyk, D.; Fusik, J.; Kuriga, M.; Ostrowski, M.; Myszta, T.; Sułowicz, W.; Radziszewski, A.; Walatek, B.; Kaczmarczyk, I.; Drozdz, M.; Piotrowska, M.; Kraśnicka, M.; Koźmiński, P.; Pawłowska, S.; Zygadło, H.; Zalasińska, I.; Chae, D.-W.; Jin, H.; Kim, S.; Song, Y.; Na, K.-Y.; Oh, J.-E.; Oh, K. H.; Kim, Y.-G.; Kim, B.; Baek, H.-J.; Kim, J.-A.; Lee, Y. J.; Chang, Y.-S.; Park, C. W.; Chung, H.-W.; Han, S.; Kim, Y.-S.; Park, J.-A.; Choi, B.-S.; Yoon, H. E.; Hwang, H.; Yoon, J.-M.; Kim, J.-Y.; Han, S.-W.; Kang, C.-M.; Lee, C.-W.; Kim, G.-H.; Choi, N.-W.; Ihm, C.-G.; Jeong, K.-H.; Kim, M.-J.; Lee, S.-H.; Lee, T.-W.; Wikström, B.; Linde, T.; Nisbeth, U.; Mulec, H.; Kronvall, M.; Frisenette-Fich, C.; Ståhl Nilsson, A.; Mauritz, N.-J.; Schirdewan, S.; Stelin, G.; Ottosson, P.; Stefansson, B.; Ramsauer, B.; Hultström, D.; Hadimeri, H.; Andersson, P.-O.; Al Magdasi, H.; Weiss, L.; Welander, G.; Gröntoft, K. C.; Zezina, L.; Svensson, L.; Fagerström, A.; Lund, U.; Tidman, M.; Lundin, C.; Sjöström, P.; Wessén, P.; Halvarsson, P.; Wrege, U.; Linder, M.; Ekspong, A.; Jensen, G.; Alfredsson, A.; Löfberg, E.; Almroth, G.; Haarhaus, M.; Gisslén, K.; Mathillas, O.; Bock, A.; Burnier, M.; Binet, I.; Tsinalis, D.; Wüthrich, R.; Basci, A.; Turgan, C.; Duranay, M.; Nergizoglu, G.; Gullulu, M.; Turkmen, F.

    2009-01-01

    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

  10. Carpal Tunnel Syndrome in Patient on long Term Hemodialysis - a ...

    African Journals Online (AJOL)

    Pain in hands is a common complaint in patients of end-stage renal disease on long term hemodialysis. This pain can arise from various different etiological factors. We present one such case of 56 years old lady who suffered from pain in the hand due to carpal tunnel syndrome on the side with angioaccess. Carpal tunnel ...

  11. Hypercalcemia, inappropriate calcitriol levels, and tuberculosis on hemodialysis.

    Science.gov (United States)

    Peces, R; Pobes, A; Díaz-Corte, C; Gago, E

    2000-08-01

    We describe a female patient undergoing hemodialysis who developed tuberculosis, hypercalcemia, and inappropriately elevated calcitriol levels. These findings suggest ectopic production of calcitriol by tuberculous granulomas. Successful treatment of tuberculosis led to a substantial decrease in the levels of calcium and calcitriol.

  12. Left atrial calcification in a hemodialysis patient with cor triatriatum.

    Science.gov (United States)

    Peces, R; Pobes, A; Rodriguez, M; Simarro, C; Iglesias, G; Simarro, E

    2000-05-01

    Myocardial calcification is a rare manifestation of abnormal calcium metabolism seen in some patients with chronic renal failure. This report describes the transesophageal echocardiographic and spiral computed tomography (CT) findings in a young hemodialysis female with severe secondary hyperparathyroidism. These findings included calcification of the multiperforated membrane of a cor triatriatum and the wall of the left atrium.

  13. Management of dabigatran-induced bleeding with continuous venovenous hemodialysis.

    Science.gov (United States)

    Paul, Suman; Hamouda, Danae; Prashar, Rohini; Mbaso, Chiamaka; Khan, Abdur; Ali, Abdulmonam; Shah, Sarthi; Assaly, Ragheb

    2015-06-01

    Dabigatran, a direct thrombin inhibitor, is increasingly used for stroke prevention in patients with non-valvular atrial fibrillation. Dabigatran has a stable pharmacokinetic profile with minimum drug interactions, and requires no routine laboratory evaluation to measure level of anticoagulation. This provides a huge advantage over warfarin, and has the potential to improve patient compliance. The disadvantages of dabigatran are the lack of a reversal agent to counter dabigatran-related bleeding and the absence of a widely available laboratory test that can quantify the extent of coagulopathy in dabigatran overdose. Hemodialysis can rapidly lower dabigatran levels and assist in controlling bleeding secondary to dabigatran overdose. However, in cases in which hemodynamic instability precludes the use of hemodialysis, alternative methods have to be utilized to control dabigatran-associated bleeding. Here we document a case of massive gastrointestinal bleeding secondary to dabigatran use that was successfully managed by continuous venovenous hemodialysis (CVVHD), along with supportive care with blood product transfusions. CVVHD reduces thrombin time and activated partial thrombin time, and causes a parallel decrease in amount of active bleeding. Finally, we show that compared to the rapid lowering of elevated thrombin time observed in hemodialysis, CVVHD requires several days to reduce thrombin time to normal range.

  14. Measurement of body composition changes during hemodialysis by bioimpedance analysis.

    Science.gov (United States)

    Morais, A A; Costa, R A; Grilo, M G; Bezerra, M E; Vieira, M M; Alves, R F; Carmo, S C; Faintuch, J

    1996-01-01

    Monitoring of fluid exchanges during hemodialysis is essential for the safety and efficacy of the procedure. Bioimpedance analysis has been used for the measurement of body compartments in many settings, but experience during hemodialysis is relatively scare. In a prospective study of 28 cases of chronic renal failure treated by long-term hemodialysis on an outpatient basis, body composition studies were done immediately before and after the dialysis session. Methods included body weight, serum albumin, hematocrit, hemoglobin, sodium and osmolality. These variables were compared with impedance (BIA) findings, namely lean body mass, body fat, total water, extra and intra-cellular water, third space, and exchangeable sodium/potassium ratio. Patients lost weight and improved hematocrit, hemoglobin, osmolality and serum sodium during the therapy, and BIA measurements were consistent with these changes. Lean body mass and body fat markedly changed along the dialysis session (respectively -24.5% and + 7.5%), and these results were out of proportion regarding known gains and losses in that period. It is concluded that BIA was useful for monitoring water fluxes during hemodialysis, but provided unreliable information about body fat and lean body mass.

  15. Bacterial contamination of hemodialysis water in three randomly ...

    African Journals Online (AJOL)

    2015-11-05

    Nov 5, 2015 ... E-mail: yok8t@yahoo.com. Bacterial contamination of hemodialysis water in ... processed, patients can develop septicemia or endotoxemia either directly or indirectly. Consequence of microbial .... conducted in six centers in Lagos,[16] Escherichia coli was the commonly isolated bacteria perhaps due to the ...

  16. 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

  17. Assessment of the pharmacokinetics, removal rate of hemodialysis, and safety of lactulose in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Cheng-Jui Lin

    2016-10-01

    Full Text Available Lactulose is often used to treat hepatic encephalopathy or constipation, and also exhibits benefits to chronic renal insufficiency due to reduce nitrogen-related products in serum. The present study investigated the pharmacokinetics of lactulose, its removal rate through dialysis, and safety by administering lactulose 6.5 g (Lagnos Jelly Divided Pack 16.05 g orally to six hemodialysis patients who resided in Taiwan. As a result, the means of maximum plasma concentrations (Cmax and Time to reach Cmax (Tmax were 3090 ± 970 ng/mL and 6.5 ± 2.3 hours, respectively. The mean plasma concentration was 2220 ± 986 ng/mL after administration for 24 hours. Sequentially, the mean plasma concentration reduced to 307 ± 117 ng/mL after the application of 4-hour dialysis. Area under the plasma concentration-time curve from zero to 24 h post-dose (AUC0–24h were 56,200 ± 21,300 ng h/mL and the AUC0–28h was 61,200 ± 23,300 ng h/mL. The rate of lactulose removal by dialysis was 83.6 ± 8.9%. In addition, the multiple doses of lactulose using a simulated model suggested that no plasma accumulation would be expected while coordinating with dialysis. Good tolerability was confirmed, while the mild adverse effect of diarrhea was observed in one case during the study period. No death or serious adverse effect was reported. Based on the present study, we demonstrated the pharmacokinetic transition with respect to plasma levels of lactulose in patients with impaired renal excretion treated with hemodialysis.

  18. Effects of salinity stress on seedlings growth, mineral nutrients and ...

    African Journals Online (AJOL)

    USER

    2010-08-16

    Aug 16, 2010 ... The supply of mineral nutrient solution with NaCl did not affect significantly leaf total chlorophyll content and plant organs dry ... plant growth, development and proteins synthesis (Alam et al., 2004; Le Rudulier, ..... wheat genotypes to long term salinity stress in relation to oxidative stress, antioxidant activity ...

  19. 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 ...

  20. 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.

  1. PHYSIOLOGICAL AND BIOCHEMICAL MARKERS OF SALINITY TOLERANCE IN PLANTS

    OpenAIRE

    Yildiz, Mustafa; Hakan TERZİ; CENKCİ, Süleyman; E. Suna ARIKAN TERZİ; Uruşak, Behiye

    2011-01-01

    Salt stress limits plant productivity in arid and semi arid regions. Salt stress causes decrease in plant growth by adversely affecting physiological processes, especially photosynthesis. Salinity tolerance is defined as the ability of plant to maintain normal rowth and development under salt conditions. Salt stress results in accumulation of low molecular weight compounds, termed compatible solutes, which do not interfere with the normal biochemical reactions. These compatible solutes such ...

  2. High salinity wastewater treatment.

    Science.gov (United States)

    Linarić, M; Markić, M; Sipos, L

    2013-01-01

    The shock effect, survival and ability of activated sludge to acclimatize to wastewater containing different concentrations of NaCl and Na2SO4 were investigated under laboratory conditions. To accomplish this, the potential penetration of a sewage system by seawater as a consequence of storm surge flooding was simulated. The experiments were conducted using activated sludge taken from the aeration tank of a communal wastewater treatment plant and adding different concentrations up to 40 g/L of NaCl and 4.33 g/L of Na2SO4. The effects of salinity on the activated sludge were monitored for 5 weeks based on the values of pH, dissolved oxygen, total suspended solids, volatile suspended solids, sludge volume, sludge volume index, electrokinetic potential, respirometric measurements and enzymatic activity. The addition of salt sharply reduced or completely inhibited the microbial activity in activated sludge. When salt concentrations were below 10 g/L NaCl, microorganisms were able to acclimatize in several weeks and achieve the same initial activity as in raw sludge samples. When the salt concentration was above 30 g/L NaCl, the acclimatization process was very slow or impossible.

  3. Performance of the Framingham risk score in patients receiving hemodialysis.

    Science.gov (United States)

    Huang, Jiun-Chi; Chen, Szu-Chia; Su, Ho-Ming; Chang, Jer-Ming; Hwang, Shang-Jyh; Chen, Hung-Chun

    2013-07-01

    The Framingham Risk Score (FRS), calculated by considering conventional risk factors of cardiovascular diseases, was developed to predict coronary heart disease in various populations. However, reverse epidemiology has been raised concerning these risk factors in predicting high cardiovascular mortality in hemodialysis patients. Our objectives are to determine whether FRS is associated with overall and cardiovascular mortality and the role of new risk markers when they were added to a FRS model in hemodialysis patients. This study enrolled 201 hemodialysis patients aged 20-80 years old. The FRS is used to identify individuals categorized as low (20% risk). Medical records were reviewed to collect clinical information. Data of ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were obtained by an ABI-form device. The mean follow-up period was 4.4 ± 1.5 years. Intermediate risk predicted overall hazard ratio (HR) (2.157, P = 0.039) and cardiovascular mortality (HR= 5.023; P = 0.004) versus low risk, but 'high' risk did not. High risk (vs low risk) predicted cardiovascular events (HR = 2.458, P = 0.05). Besides, the addition of ABI hemodialysis patients, intermediate risk but not high risk categorization by FRS predicted overall and cardiovascular mortality, and high risk predicted cardiovascular events. ABI hemodialysis-specific equations and assess whether risk refinement using ABI < 0.9 and baPWV leads to a meaningful change in clinical outcomes. © 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.

  4. Free triiodothyronine in hemodialysis patients: link with malnutrition and inflammation.

    Science.gov (United States)

    Yavuz, Demet; Sezer, Siren; Yavuz, Rahman; Canoz, Mujdat Batur; Altunoglu, Alpaslan; Altinoglu, Alpaslan; Elsürer, Rengin; Arat, Zubeyde; Ozdemir, Fatma Nurhan

    2014-05-01

    Free triiodothyronine (FT3) is a marker of comorbidity in end-stage renal disease and in many acute and chronic diseases. There is lack of data about the link between FT3 levels and malnutrition and inflammation in hemodialysis patients. The objective of the present study was to investigate the link between FT3 and malnutrition and inflammation in hemodialysis patients. A total of 84 patients were included in the study (38 men and 46 women; mean age, 56.2 +/- 14.8 years; hemodialysis duration, 95.72 +/- 10.35 months). Serum FT3, free thyroxin, and thyroid-stimulating hormone concentrations were determined. Demographic data and laboratory values were evaluated. Patients' comorbidity status was determined using the Charlson Comorbidity Index (CCI), and malnutrition-inflammation status was determined by Malnutrition-Inflammation Score (MIS). Serum FT3 concentration inversely correlated with age (r = -0.328, P = .002), CCI (r = -0.591, P = .001), C-reactive protein (r = -0.299, P = .01), and MIS (r = -0.671, P = .001), and positively correlated with serum albumin (r = 0.389, P = .001). In multivariate linear regression analysis, FT3 was independently associated with MIS (beta;, -0.14; 95% confidence interval, -0.175 to 0.063, P = .003), adjusted for CCI, C-reactive protein level, serum albumin level, and MIS. The results of this study indicate that FT3 is negatively correlated with inflammatory markers, namely C-reactive protein, and it is independently related with MIS in hemodialysis patients. Therefore, we suggest that FT3 can be accepted as an inflammatory marker in hemodialysis patients.

  5. Tinzaparin reduces health care resource use for anticoagulation in hemodialysis.

    Science.gov (United States)

    Pettigrew, Martine; Soltys, George I M; Bell, Robert Z; Daniel, Nicole; Davis, Joanne R; Senecal, Lynne; Leblanc, Martine

    2011-04-01

    Anticoagulation is required during hemodialysis to prevent thrombus formation within the extracorporeal circuit. The low-molecular-weight heparin tinzaparin is more expensive than unfractionated heparin (UFH) in Canada but more convenient to administer. We conducted a time-and-motion study to test the hypothesis that tinzaparin may reduce nursing time and total health care costs compared with UFH. Data on health care resource use associated with anticoagulation during hemodialysis for chronic renal failure were collected at an academic hospital in Quebec. Nursing time was recorded for 8 nurses performing 16 dialysis sessions for 4 patients receiving tinzaparin and 4 receiving UFH (2 dialysis sessions per patient). Nurses had ≥ 1 year of experience supervising hemodialysis. We estimated total annual costs of nursing time and health care resources (anticoagulants, medical supplies, and laboratory testing) associated with anticoagulation. In sensitivity analyses, drug costs were varied ± 30% of their base-case values. Estimated annual nursing times per patient were 0.8 vs. 11.5 hours in the first year and 0.6 vs. 10.2 hours in subsequent years for tinzaparin vs. UFH, respectively. Annual drug costs per patient were CAD 898.56 for tinzaparin and 546.75 for UFH. Estimated total annual costs were CAD 1061.03 vs. 1012.71 in the first year and CAD 917.75 vs. 895.23 in subsequent years for tinzaparin vs. UFH, respectively. Use of tinzaparin was cost saving relative to UFH if tinzaparin price was reduced 30%. Most of the price differential between tinzaparin and UFH is offset by substantial time savings to nephrology nurses. © 2011 The Authors. Hemodialysis International © 2011 International Society for Hemodialysis.

  6. Measurement of tumor markers in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Tzitzikos G

    2010-01-01

    Full Text Available Tumor markers are widely used for screening certain tumors, however, their use in chronic hemodialysis (HD patients in hemodialysis has been a controversial issue. To determine the reliability of the tumor markers, CA 15-3, CA 19-9, CA 125, Alpha-Fetoprotein and Carcinoem-bryonic antigen (CEA, in chronic HD patients, and the impact of active hepatitis C on the variation of tumor markers values, we studied 30 patients (16 men and 14 women aged from 40 to 78 years old (mean age: 54 ± 5 years, on intermittent hemodialysis (with a mean duration of 10.5 years, and clinically free from neoplastic disease. The control group included 30 healthy volunteers. All subjects were of Greek origin and residents of the Korinthos region. The tumor markers were measured once in the control group and before and afterwards the hemodialysis, in the study group. Alpha fetopro-tein was within normal limits in all the study patients, CA 125 was slightly increased in one (3.3% patient, CA 15-3 levels were twice normal in 4 (13% patients, CA 19-9 levels were twice normal in 5 (16% patients, and CEA levels were twice normal in 4(13% patients. More than half (7/13 of anti HCV positive and all Australian antigen positive patients had abnormal serum levels of CA 15-3 and CA 125 after hemodialysis treatment. We conclude that measurement of some tumor markers such as alfa-fetoprotein may be beneficial in HD patients. However, the elevated levels of other markers including CA 15-3 and CA 125 are not specific for neoplasms and related to active hepatitis C.

  7. Saline Sinus Rinse Recipe

    Science.gov (United States)

    ... of iodide-free salt with 1 teaspoon of baking soda and store in a small airtight container . Add 1 teaspoon of the mixture to 8 ounces (1 cup) of lukewarm distilled or boiled water. Use less dry ingredients to make a weaker solution ...

  8. NOAA Average Annual Salinity (3-Zone)

    Data.gov (United States)

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

  9. 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.

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

    Science.gov (United States)

    Dong, Fang; Chen, Wei; Xu, Liang; Wang, Huabing; Lu, Huizhi

    2014-01-01

    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. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Fang Dong

    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.

  12. Modelling salinity inhibition effects during biodegradation of perchlorate.

    Science.gov (United States)

    Park, C; Marchand, E A

    2006-07-01

    To determine the mathematical kinetic rates and mechanisms of acclimated perchlorate (ClO)-reducing microbial cultures by incorporating a term to relate the inhibitory effect of high salinity during biological reduction of concentrated perchlorate solutions. Salt toxicity associated with the biodegradation of concentrated perchlorate (200, 500, 1100, 1700 and 2400 mg l(-1) as ClO) was investigated using two microbial cultures isolated from a domestic wastewater treatment plant [return activated sludge (RAS) and anaerobic digester sludge (ADS)]. Experiments were performed in wastewaters containing various sodium chloride concentrations, ranging from 0% to 4.0% (w/v) NaCl (ionic strength: 0.14-0.82 mol l(-1), total dissolved solids: 5.3-42.6 g l(-1)) at near-neutral values of pH (6.7-7.8). Perchlorate biodegradation was stimulated through stepwise acclimation to high salinity. The ADS culture was capable of reducing perchlorate at salinities up to 4% NaCl, while the RAS culture exhibited complete inhibition of perchlorate degradation at 4% NaCl, probably resulting from either a toxic effect or enzyme inactivation of the perchlorate-reducing microbes. Further, a kinetic growth model was developed based on experimental data in order to express an inhibition function to relate specific growth rate and salinity. Biological reduction of concentrated perchlorate wastewaters using either acclimated RAS or ADS cultures is feasible up to 3% or 4% NaCl, respectively. In addition, the kinetic model including a salinity inhibition term should be effective in many practical applications such as improving reactor design and management, furthering the understanding of high salinity inhibition, and enhancing bioremediation under high salinity loading conditions. Applications of these findings in water treatment practice where ion exchange or membrane technologies are used to remove perchlorate from water can have the potential to increase the overall attractiveness of these

  13. Yield of cherry tomatoes as a function of water salinity and irrigation frequency

    National Research Council Canada - National Science Library

    Santos, Alexandre N; Silva, Ênio F. de F. e; Silva, Gerônimo F. da; Barnabé, Janice M. C; Rolim, Mario M; Dantas, Daniel da C

    2016-01-01

    .... This problem can be minimized by hydroponic cultivation, which improves plant development. The aim of this study was to evaluate the yield of cherry tomatoes grown in hydroponic system with substrate under salinity levels of the nutrient solution (NS...

  14. 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.

  15. 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.

  16. Tailor-made anion exchange membranes for salinity gradient power generation using reverse electrodialysis

    NARCIS (Netherlands)

    Güler, E.; Zhang, Y.; Zhang, Yali; Saakes, Michel; Nijmeijer, Dorothea C.

    2012-01-01

    Reverse electrodialysis (RED) or blue energy is a non-polluting, sustainable technology for generating power from the mixing of solutions with different salinity, that is, seawater and river water. A concentrated salt solution (e.g., seawater) and a diluted salt solution (e.g., river water) are

  17. 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...

  18. Optical sensor for seawater salinity.

    Science.gov (United States)

    Huber, C; Klimant, I; Krause, C; Werner, T; Mayr, T; Wolfbeis, O S

    2000-01-01

    An optical sensor for the measurement of salinity in seawater has been developed. It is based on a chloride-quenchable fluorescent probe (lucigenin) immobilized on a Nafion film. Two approaches for measuring salinity via chloride concentration are presented. In the first, a change in salinity corresponds to a change in the fluorescence intensity of lucigenin. In the second, the fluorescence intensity information is converted into a phase angle information by adding an inert phosphorescent reference luminophore (a ruthenium complex entrapped in poly(acrylonitrile) beads). Under these conditions, the chloride-dependent fluorescence intensity of lucigenin can be converted into a chloride-dependent fluorescence phase shift which serves as the analytical information. This scheme is referred to as dual lifetime referencing (DLR). The sensor was used to determine the salinity in seawater and brackish water of the North Sea.

  19. NOAA NOS SOS, EXPERIMENTAL - Salinity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA NOS SOS server is part of the IOOS DIF SOS Project. The stations in this dataset have salinity data. *These services are for testing and evaluation use...

  20. Effect of Salinity on Growth, Xylem Structure and Anatomical Characteristics of Soybean

    Directory of Open Access Journals (Sweden)

    Aria DOLATABADIAN

    2011-03-01

    Full Text Available This research was conducted in order to evaluation the salinity stress effect on growth parameters and stem anatomical changes of soybean grown under controlled conditions. Soybean seeds were surface sterilized and then sown into plastic pots filled up with perlite and vermiculite. Seeds were irrigated with Broughton and Dilworth solution daily. At full folded cotyledons stage (5 day after sowing, salinity stress was induced by adding NaCl into nutrition solution with final concentration of 0, 25, 50 and 100 mM. Thirty days after sowing plants were harvested and growth parameters and anatomical changes were evaluated. The results showed that, salinity stress was significantly decreased shoot and root weight either fresh weight or dry weight, in addition, total plant weight, plant height and leaf number were decreased due to salinity stress. Interestingly, leaf area was not affected by salinity stress. Stem microscopic study demonstrated that, salinity stress significantly increased cutin mass and trichome density on epidermal cells. On the other hand, cortex thickness was decreased because of salinity stress while xylem thickness had upward increase when soybean plants were grown under salinity stress especially high level of salinity. Additionally, there were changed in xylem formation and arrangement in stressed plants.

  1. Lipid profile and lipoprotein(a) in chronic renal failure patients with and without hemodialysis

    OpenAIRE

    Hariom Sharma; Tejas J Shah; Jignesh H Gorasia; Dipika P Baria

    2012-01-01

    Objectives: Chronic renal failure (CRF) is complicated by characteristic dyslipidemias. CRF patients on hemodialysis have abnormalities in lipid profile and have a high incidence of cardiovascular diseases. Lipoprotein(a) [Lp(a)] is now considered as a novel cardiovascular risk factor and its level is increased in CRF patients with and without hemodialysis. We sought to evaluate the pattern of lipid profile including Lp(a) level in CRF patients with and without hemodialysis. Methodol...

  2. Association between daily hemodialysis, access to renal transplantation and patients' survival in France.

    Science.gov (United States)

    Pladys, Adélaïde; Vigneau, Cécile; Hourmant, Maryvonne; Duneau, Gabrielle; Couchoud, Cécile; Bayat, Sahar

    2016-12-01

    Daily hemodialysis improves patients' quality of life and blood purification, but its effect on survival remains controversial. The aim of this study was to analyze the association between daily hemodialysis and renal transplantation and survival in France. This was an observational cohort study based on the French REIN registry. All incident patients ≥18 y/o who started daily hemodialysis in France between 2003 and 2012 were included. Using a propensity score, 575 patients on daily hemodialysis were matched with 1696 patients receiving thrice-weekly hemodialysis. Survival analysis was performed using the Cox model. Access to the renal transplant waiting list and renal transplantation were analyzed using the Fine and Gray model. Daily hemodialysis was not independently associated with reduced access to transplant waiting list, whereas, major comorbidities remained associated with restricted waitlisting after multivariate analysis adjusted for confounding factors. After being waitlisted, the cumulative incidence of renal transplantation was lower for the daily hemodialysis than for the thrice-weekly hemodialysis group (SHR = 0.72, 95%CI: 0.56-0.91). The risk of death was significantly higher in the daily hemodialysis group (HRadjusted  = 1.58, 95%CI: 1.4-1.8). Major comorbidities were associated with higher risk of death and lower likelihood of receiving a renal transplant during the follow-up period. Our study showed that in France, the likelihood of undergoing renal transplantation after being waitlisted was lower for patients on daily hemodialysis than those on thrice-weekly hemodialysis. Moreover, daily hemodialysis was associated with higher risk of death, even after taking into account age and all major comorbidities. This article is protected by copyright. All rights reserved.

  3. Incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients

    OpenAIRE

    ASGARI, Mohammad Reza; Asghari, Fatemeh; Ghods, Ali asghar; Ghorbani, Raheb; Hoshmand Motlagh, Nahid; Rahaei, Fatemeh

    2016-01-01

    Introduction: Chronic kidney disease (CKD) is a rising problem across the world, including Iran. Most of the patients will require hemodialysis for survival. Despite the great progress has been made in the hemodialysis equipment, but it is still associated with complications. Nausea and vomiting are common complication of during hemodialysis, which leads to unpleasant feeling in patients. Objectives: This study aimed to determine incidence and severity of nausea and vomiting in a group of mai...

  4. The Relationship between Self-Esteem and Coping Styles in Patients Undergoing Hemodialysis

    OpenAIRE

    Leila Rezaei; Shayesteh Salehi

    2016-01-01

    This paper is a report of a study of The Relationship between Self-Esteem and Coping Styles in patients undergoing hemodialysis in Iran. Hemodialysis patients face with multiple physical and psychological stressful factors; they use coping styles in order to cope with the challenges. A descriptive-correlation study was conducted based on the data collected from patients undergoing hemodialysis by census method in the city of Kerman using the Endler and Parker coping style, Self-es...

  5. Differences in quality of life of hemodialysis patients between dialysis centers

    OpenAIRE

    Mazairac, Albert; Grooteman, Muriel; Blankestijn, Peter; Lars Penne, E.; Weerd, Neelke; Hoedt, Claire; Dorpel, Marinus; Buskens, Erik; Nubé, Menso; Wee, Piet; Wit, Ardine; Bots, Michiel

    2012-01-01

    textabstractPurpose: Hemodialysis patients undergo frequent and long visits to the clinic to receive adequate dialysis treatment, medical guidance, and support. This may affect health-related quality of life (HRQOL). Although HRQOL is a very important management aspect in hemodialysis patients, there is a paucity of information on the differences in HRQOL between centers. We set out to assess the differences in HRQOL of hemodialysis patients between dialysis centers and explore which modifiab...

  6. Effect of Salinity on Growth, Xylem Structure and Anatomical Characteristics of Soybean

    OpenAIRE

    Aria DOLATABADIAN; Seyed Ali Mohammad MODARRES SANAVY; Faezeh GHANATI

    2011-01-01

    This research was conducted in order to evaluation the salinity stress effect on growth parameters and stem anatomical changes of soybean grown under controlled conditions. Soybean seeds were surface sterilized and then sown into plastic pots filled up with perlite and vermiculite. Seeds were irrigated with Broughton and Dilworth solution daily. At full folded cotyledons stage (5 day after sowing), salinity stress was induced by adding NaCl into nutrition solution with final concentration of ...

  7. Consequences of diurnal variation in salinity on water relations and yield of tomato

    OpenAIRE

    Ieperen, van, W.

    1996-01-01

    In soilless culture the EC (Electric Conductivity; mS cm -1) is an important measure for the total solute concentration (salinity level) of the nutrient solution in the root environment. This study concentrates on the possibilities of short-term control of the total nutrient concentration (salinity level) in the root environment in relation to the greenhouse climate. A general assumption in this study is that the EC mainly influences p...

  8. Saline waters and soil quality

    Directory of Open Access Journals (Sweden)

    Carmelo Dazzi

    Full Text Available The processes of secondary salinization due to anthropic actions are considered one of the most important environmental emergencies owing to their level of dangerousness. The soils of the dry areas of the Mediterranean basin are particularly prone to these processes. In such environments, it is imperative to resort to irrigation that allow for the reduction of risks due to soil moisture deficit and for the stabilization of yields. Frequently, saline waters are used that cause a lowering of the soil quality. If on one hand the presence of salts can benefit the soils mainly improving soil structure, on the other high levels of salts produce negative effects on soils and crops.When sodium prevails problems of soil quality can rise such as structure degradation, low hydraulic conductivity, soil sealing. The processes of secondary soil salinization due to the use of saline waters for irrigation are particularly evident in our Country among others. In Italy, saline soils are mainly distributed in long strips of the coastal belt of the Tyrrhenian sea and Adriatic sea, in the coastal belt of Apulia, Basilicata and Sardinia and in wide areas of Sicily. It is not possible to suggest general actions to combat soil salinization because we must take into consideration that in the relationship soil-water two different quality concept interact: one linked to the soils, the other to the waters.

  9. Saline waters and soil quality

    Directory of Open Access Journals (Sweden)

    Carmelo Dazzi

    2011-02-01

    Full Text Available The processes of secondary salinization due to anthropic actions are considered one of the most important environmental emergencies owing to their level of dangerousness. The soils of the dry areas of the Mediterranean basin are particularly prone to these processes. In such environments, it is imperative to resort to irrigation that allow for the reduction of risks due to soil moisture deficit and for the stabilization of yields. Frequently, saline waters are used that cause a lowering of the soil quality. If on one hand the presence of salts can benefit the soils mainly improving soil structure, on the other high levels of salts produce negative effects on soils and crops.When sodium prevails problems of soil quality can rise such as structure degradation, low hydraulic conductivity, soil sealing. The processes of secondary soil salinization due to the use of saline waters for irrigation are particularly evident in our Country among others. In Italy, saline soils are mainly distributed in long strips of the coastal belt of the Tyrrhenian sea and Adriatic sea, in the coastal belt of Apulia, Basilicata and Sardinia and in wide areas of Sicily. It is not possible to suggest general actions to combat soil salinization because we must take into consideration that in the relationship soil-water two different quality concept interact: one linked to the soils, the other to the waters.

  10. Incremental and infrequent hemodialysis: a new paradigm for both dialysis initiation and conservative management.

    Science.gov (United States)

    Rhee, Connie M; Ghahremani-Ghajar, Mehrdad; Obi, Yoshitsugu; Kalantar-Zadeh, Kamyar

    2017-06-01

    Registry or national dialysis data show that a sizeable proportion of contemporary dialysis patients have substantial levels of residual kidney function especially upon transitioning to dialysis therapy. However, among incident hemodialysis patients, the prevailing paradigm has been to initiate "full-dose" triweekly treatment schedules irrespective of native kidney function in most developed countries. Recognizing the benefits of residual kidney function upon the health and survival of dialysis patients, there has been growing interest in incremental hemodialysis, in which dialysis frequency and dose are tailored according to the degree of patients' residual kidney function. Infrequent hemodialysis can also be used for those who prefer a more conservative approach in managing uremia. Clinical practice guidelines support the use of twice-weekly hemodialysis among patients with adequate residual kidney function (renal urea clearance >3 mL/min/1.73 m2), and a growing body of evidence indicates that incremental hemodialysis is associated with better preservation of residual kidney function without adversely impacting survival. Nonetheless, incremental hemodialysis remains an underutilized approach in this population. In this review, we will discuss the history of the twice- versus triweekly hemodialysis schedules; current clinical practice guidelines regarding infrequent hemodialysis; emerging data on incremental treatment regimens and outcomes; and guidelines for the practical implementation of incremental and infrequent hemodialysis in the clinical setting.

  11. Incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients

    Science.gov (United States)

    Asgari, Mohammad Reza; Asghari, Fatemeh; Ghods, Ali Asghar; Ghorbani, Raheb; Hoshmand Motlagh, Nahid; Rahaei, Fatemeh

    2017-01-01

    Introduction: Chronic kidney disease (CKD) is a rising problem across the world, including Iran. Most of the patients will require hemodialysis for survival. Despite the great progress has been made in the hemodialysis equipment, but it is still associated with complications. Nausea and vomiting are common complication of during hemodialysis, which leads to unpleasant feeling in patients. Objectives: This study aimed to determine incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients. Patients and Methods: This is a descriptive and analytical study on 60 hemodialysis patients of dialysis wards in Semnan University of Medical Sciences. Verbal Numeric Rating Scale (VNRS) and Korttila vomiting severity scale were used to measure the severity of nausea and vomiting during hemodialysis respectively. Results: In this study, the incidence of nausea and vomiting during hemodialysis were 28.3% and 11.7%, respectively. Meanwhile, the mean severity of nausea was 1.15 and the mean rank of vomiting was 2.08. Conclusion: The results of the study showed a relatively high incidence of nausea and vomiting in patients undergoing hemodialysis, hence nurses must consider these problems by suitable measures to prevent the occurrence of the these unpleasant feelings in the patients during hemodialysis. PMID:28487872

  12. Neurologic and ophthalmologic complications of vascular access in a hemodialysis patient.

    Science.gov (United States)

    Cleper, Roxana; Goldenberg-Cohen, Nitza; Kornreich, Liora; Krause, Irit; Davidovits, Miriam

    2007-09-01

    Patients on long-term hemodialysis undergo multiple interventions, including insertion of central catheters and arteriovenous anastomoses for creation of vascular access. The need for high-flow vessels to maintain hemodialysis efficiency leads to wear on the central veins and consequent stenosis and occlusion. In addition to local signs of impaired venous drainage, abnormal venous flow patterns involving the upper chest, face, and central nervous system might develop. We describe the first pediatric case of devastating intracranial hypertension presenting with visual loss in the eye contralateral to a high-flow vascular access in a patient on long-term hemodialysis. The literature on this rare complication of hemodialysis is reviewed.

  13. 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... Physical and Chemical Characteristics of the Aquatic Ecosystem § 230.25 Salinity gradients. (a) Salinity... fresh or salt water may change existing salinity gradients. For example, partial blocking of the...

  14. 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...

  15. Correlation between ankle brachial index, carotid intima media thickness and left ventricular hypertrophy in patients on maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Hayam A. Hebah

    2012-09-01

    Conclusion: Both ABI and carotid IMT are equally effective to predict cardiovascular risk as regard to LVH in hemodialysis population and ABI should be included as a bed side cheap and reliable way to assess cardiovascular risk in hemodialysis patients.

  16. Treatment of high salinity brines by direct contact membrane distillation: Effect of membrane characteristics and salinity.

    Science.gov (United States)

    Li, Jianfeng; Guan, Yunshan; Cheng, Fangqin; Liu, Yu

    2015-12-01

    Direct contact membrane distillation (DCMD) is one of the attractive technologies for high salinity brine treatment. In this study, four polytetrafluoroethylene (PTFE) membranes were examined in treating highly concentrated salt solutions. Results showed that non-supported membranes generally have a higher overall mass transfer coefficient but porosity seems to be the most important parameter controlling membrane flux and thermal efficiency. Supported membranes with large thickness had relatively higher thermal efficiency than small thickness. This can be attributed to their reduced heat loss through heat condition. In addition, KCl, NaCl and MgCl2 solutions showed distinct trends over flux decline at high salt concentrations (⩾2.0M). The difference in flux was largely due to the discrepancy in water activities of these solutions (KCl>NaCl>MgCl2). However, the effect of viscosity on permeate flux could not be neglected for MgCl2 at high salt concentrations as the suddenly increased viscosity could lead to serious temperature polarization. This study indicates that membrane distillation is a promising technology for high salinity brine treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Saline nasal irrigation for upper respiratory conditions.

    Science.gov (United States)

    Rabago, David; Zgierska, Aleksandra

    2009-11-15

    Saline nasal irrigation is an adjunctive therapy for upper respiratory conditions that bathes the nasal cavity with spray or liquid saline. Nasal irrigation with liquid saline is used to manage symptoms associated with chronic rhinosinusitis. Less conclusive evidence supports the use of spray and liquid saline nasal irrigation to manage symptoms of mild to moderate allergic rhinitis and acute upper respiratory tract infections. Consensus guidelines recommend saline nasal irrigation as a treatment for a variety of other conditions, including rhinitis of pregnancy and acute rhinosinusitis. Saline nasal irrigation appears safe, with no reported serious adverse events. Minor adverse effects can be avoided with technique modification and salinity adjustment.

  18. Efficacy of stepwise sodium profile versus individualized dialysate sodium in blood pressure control among hemodialysis patients.

    Science.gov (United States)

    Shahgholian, Nahid; Hashemi, Maryam Sadat; Shahidi, Shahrzade

    2015-01-01

    Hypertension is very common in patients with end-stage renal disease and accelerates cardiovascular morbidity and mortality. The most important factor in achieving normal blood pressure in these patients is reaching dry weight. Sodium and extracellular fluid balance play a vital role in this regard. Considering the lack of consensus about the efficacy of stepwise sodium profile and individualized dialysate sodium, this study aimed to determine the superior method for blood pressure control in hemodialysis patients. In a quasi-experimental study, patients satisfying the inclusion criteria were enrolled through convenience sampling. The patients were randomly assigned to two groups of stepwise sodium profile and individualized dialysate sodium. Information record form was used for data collection. Data were analyzed with paired and independent t-test and descriptive statistics using SPSS for Windows 20.0. Patients in the two groups were similar in qualitative and quantitative background variables. While systolic blood pressure significantly decreased following hemodialysis with individualized dialysate sodium (P profile (P = 0.060). Individualized dialysate sodium caused greater change in the mean systolic blood pressure than stepwise sodium profile did (P = 0.040). Pre- and post-dialysis diastolic blood pressure values showed significant differences in both groups (P profile). However, the mean changes in diastolic blood pressure of the two groups were not significantly different (P = 0.295). We found no significant difference in interdialytic weight gain and blood pressure control by the two methods. The change in systolic blood pressure was lower in the stepwise profile method than in the individualized dialysate sodium method, and this method did not cause interdialytic hypertension. So, by adjusting the dialysis solution with regard to plasma sodium levels, lead to more blood pressure control. Meanwhile, the two groups were not significantly different in the

  19. [Renal replacement therapy by hemodialysis: an overview].

    Science.gov (United States)

    Jacobs, Claude

    2009-07-01

    The replacement of renal function by hemodialysis (HD) demonstrated for the first time that at least the most vital functions of a complex organ could be replaced by a man-made device. The Founding Father of dialysis is the Scottish chemist Thomas Graham who in 1861 found that colloid and crystalloid substances contained in fluids could be separated by diffusion of crystalloids through vegetable parchment acting as a semipermeable membrane. He coined this phenomenon as "dialysis". Fifty years later, using collodion as dialysis membrane and hirudin as anticoagulant (ATG), Abel et al. in Baltimore performed the first dialysis in dogs with a "vivi-diffusion" apparatus shortly after named "artificial kidney"(AK). In 1924, Haas in Germany treated for the first time uremia in man with dialysis using a collodion membrane and a new ATG: "heparin". Disappointed by unsuccessful results achieved with HD, Haas gave up his trials in 1928. HD revived in the early forties when Willem Kolff in the Netherlands built a "rotating drum kidney" using cellophane as dialysis membrane. The first recovery of a patient undergoing HD for acute renal failure (ARF) was reported by Kolff in 1945, paving the way for a rapidly worldwide expanding treatment of ARF with dialysis. The concept of applying HD to patients with end-stage chronic renal failure (ESRF), first pioneered by Alwall in Sweden as far back as 1948, became reality in 1960 when Scribner, Quinton et al. designed an external arteriovenous by pass made of Teflon tubing which allowed a permanent access to the bloodstream without requirement of permanent anticoagulation. The Teflon AV shunt, later improved with the use of a silicone rubber material (Silastic) has been the cornerstone for implementing the long-term treatment of ESRF patients with maintenance HD. The next major breakthrough in this area consisted in the surgically created AV fistula performed in 1966 by Cimino, Brescia et al. which considerably reduced the complications

  20. Correlates of ADL difficulty in a large hemodialysis cohort.

    Science.gov (United States)

    Kutner, Nancy G; Zhang, Rebecca; Allman, Richard M; Bowling, C Barrett

    2014-01-01

    Needing assistance with activities of daily living (ADL) is an early indicator of functional decline and has important implications for individuals' quality of life. However, correlates of need for ADL assistance have received limited attention among patients undergoing maintenance hemodialysis (HD). A multicenter cohort of 742 prevalent HD patients was assessed in 2009-2011 and classified as frail, prefrail and nonfrail by the Fried frailty index (recent unintentional weight loss, reported exhaustion, low grip strength, slow walk speed, low physical activity). Patients reported need for assistance with 4 ADL tasks and identified contributing symptoms/conditions (pain, balance, endurance, weakness, others). Nearly 1 in 5 patients needed assistance with 1 or more ADL. Multivariable analysis showed increased odds for needing ADL assistance among frail (odds ratio [OR] 11.35; 95% confidence interval [CI] 5.50-23.41; P Hemodialysis.

  1. Steal in hemodialysis patients depends on type of vascular access.

    Science.gov (United States)

    van Hoek, F; Scheltinga, M R; Kouwenberg, I; Moret, K E M; Beerenhout, C H; Tordoir, J H M

    2006-12-01

    To study incidence and severity of steal phenomena in hemodialysis patients and to investigate possible methods for its detection. A questionnaire was composed based on a literature search. A subgroup of patients having steal as identified by the questionnaire was studied using physical examination, arterial blood pressure, skin temperature, digital oxygenation, grip strength and plethysmography. Contralateral arms served as controls. A cold hand was present in 50% of the patients with a brachiocephalic (BC) arteriovenous fistula (AVF, n = 28) compared to 25% of prosthetic forearm loops (loop, n = 27) and 12% of the radiocephalic (RC, n = 65, p grip strength were lower in steal hands (p hemodialysis patient. Individuals with a BC are at a higher risk for developing complaints associated with reduced hand circulation compared to patients with a RC or loop. Low finger pressures in the presence of steal symptoms are usually reversible.

  2. Hypoalbuminemia and oxidative stress in patients on renal hemodialysis program.

    Science.gov (United States)

    de Castro, Laís Lima; de Carvalho e Martins, Maria do Carmo; Garcez, Anderson Mendes; Pacheco, James Frederico Rocha; Cunha, Francisco Valmor Macedo; Moita Neto, José Machado; de Freitas, Manoela Carine Lima; de Melo Cunha, Luan Arnon

    2014-10-01

    Albumin is considered an important extracellular antioxidant molecule. hypoalbuminemia is a strong and independent predictor of mortality in patients on hemodialysis. The present study evaluated the relation between hypoalbuminemia and oxidative stress by comparing superoxide dismutase activity, lipid peroxidation and antioxidant micronutrient consumption in chronic renal failure patients. A case-control study was carried out with 64 patients of both sexes aged 18 to 59 years. The patients with hypoalbuminemia (ALB profile and micronutrient antioxidants intake were performed. For comparisons between groups,the Student t test was used. Possible associations between variables were tested using the chi-square test and Pearson correlation test. Consumption of copper was significantly lower(p patients. Additionally, patients with chronic renal disease undergoing hemodialysis evaluated in this study had reduced consumption of cooper. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  3. MR angiography of hemodialysis access fistula. Evaluation before PTA procedure

    Energy Technology Data Exchange (ETDEWEB)

    Morimoto, Atsuko; Yoshimura, Hirohide; Hosokawa, Chisa; Yoshida, Toshiko [Yodogawa Christian Hospital, Osaka (Japan)

    2000-08-01

    We evaluated the feasibility of MR angiography for hemodialysis fistula. Eleven patients with suspected stenosis or occlusion of an autogenous hemodialysis fistula in the forearm underwent MRA. MRA was obtained using both the 3D-PC method and 3D gadolinium contrast-enhanced (CE) method with a knee coil. The two methods were compared with DSA in seven patients. CE-MRA clearly demonstrated the entire dialysis fistula. However, signals of the stenotic area are effaced in PC-MRA. The diameter of the vessels evaluated in the CE-MRA was well correlated with angiography. CE-MRA demonstrated smaller collateral vessels more clearly than PC-MRA. CE-MRA provided useful information before the PTA procedure. (author)

  4. 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.

  5. [Monitoring the nutritional status in patients on hemodialysis].

    Science.gov (United States)

    Stosović, M; Dragojlović, Z; Ostrić, V; Djukanović, Lj; Stanojević, M; Ristić, S; Naumović, R

    1996-01-01

    In order to monitor changes of the nutritive status of hemodialyzed patients, antropometric and laboratory parameters of the population of hemodialyzed patients in 1988 vs. 1994 have been compared. Antropometric parameters were measured by the same investigator. The results show absence of significant difference between antropometric parameters (body weight after hemodialysis, body mass index, triceps fold, circumference of upper arm and percentage of fat) in the patients hemodialyzed in 1988. The laboratory parameters (albumin and transferrin), however, show significant increase in the 1994 group. In the group of patients subjected to hemodialysis in 1988 as well, albumin was significantly elevated. Nevertheless, no differences in laboratory parameters in healthy populations of 1988 and 1994 were noted (controls). It was concluded that no significant changes in the nutritive status were present among either the population or the same patients, while elevation of laboratory parameters necessitate further investigation.

  6. Current practice of conventional intermittent hemodialysis for acute kidney injury

    Directory of Open Access Journals (Sweden)

    H Schiffl

    2013-01-01

    Full Text Available The use of conventional intermittent hemodialysis (IHD represents a mainstay of supportive care of patients with acute kidney injury (AKI. However, a number of fundamental questions regarding the optimal management of IHD remain unanswered after more than six decades of renal replacement therapy (RRT. This review summarizes current evidence regarding the timing of initiation of intermittent hemodialysis, the comparative outcomes (mortality and recovery of renal function, the prescription of the intensity of this therapy and discontinuation of dialysis. The way conventional IHD is performed has an impact on the outcome of sick patients with AKI. The value of regular education and training of those who provide IHD cannot be emphasized enough. However, we must be realistic in our expectations that no mode of RRT per se will substantially alter the excessive mortality of critically ill-patients with AKI.

  7. [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.

  8. Opportunistic intestinal parasites in hemodialysis patients - a systematic literature review

    Directory of Open Access Journals (Sweden)

    Solimar Almeida de Oliveira

    2013-12-01

    Full Text Available The objective of this systematic literature review was to identify the occurrence of opportunistic enteric parasites in chronic kidney patient undergoing hemodialysis. The review consisted on searching articles published on MEDLINE, LILACS, SciELO, and PubMed databases between 1991 and 2013. A total 178 articles were identified, ten of which were considered relevant for the present study. In the referred studies, the researchers demonstrated that immunosuppressed patients undergoing hemodialysis are potentially infected by opportunistic enteric agents. Further studies are needed on this topic, as there is a growing global concern with chronic kidney diseases and the potential for these patients contracting opportunistic diseases, which, inclusively, could contaminate hospital environments with opportunistic enteric protozoa. Descriptors: Renal Dialysis; Blastocystis hominis; Cryptosporidium; Cyclospora; Isospora.

  9. Negotiating living with an arteriovenous fistula for hemodialysis.

    Science.gov (United States)

    Richard, Cleo J; Engebretson, Joan

    2010-01-01

    The purpose of this study was to examine how clients with end stage renal disease on hemodialysis negotiate living with an arteriovenous fistula. A fistula is the preferred access for hemodialysis, and clients must continually monitor and protect their fistula. In this qualitative, ethnographic study, data were collected during fieldwork and semistructured interviews. Constructivism and a cultural negotiation model provided frameworks for the study. Fourteen clients were interviewed; interviews lasted 1.5 to 4 hours. Results revealed new insights into informants'perspectives and experiences with a vascular access. The overarching theme was vulnerability, and underlying themes were body awareness, dependency, mistrust, and stigma. The response to vulnerability was to be continually vigilant and assertive to protect the holistic self Stigma of the vascular access was an important issue for informants and evoked the greatest emotional responses.

  10. Immersing lungs in hydrogen-rich saline attenuates lung ischaemia-reperfusion injury.

    Science.gov (United States)

    Takahashi, Mamoru; Chen-Yoshikawa, Toyofumi F; Saito, Masao; Tanaka, Satona; Miyamoto, Ei; Ohata, Keiji; Kondo, Takeshi; Motoyama, Hideki; Hijiya, Kyoko; Aoyama, Akihiro; Date, Hiroshi

    2017-03-01

    Anti-oxidant effects of hydrogen have been reported in studies examining ischaemia-reperfusion injury (IRI). In this study, we evaluated the therapeutic efficacy of immersing lungs in hydrogen-rich saline on lung IRI. Lewis rats were divided into three groups: (i) sham, (ii) normal saline and (iii) hydrogen-rich saline. In the first experiment, the left thoracic cavity was filled with either normal saline or hydrogen-rich saline for 1 h. Then, we measured the hydrogen concentration in the left lung using a sensor gas chromatograph ( N = 3 per group). In the second experiment, lung IRI was induced by occlusion of the left pulmonary hilum for 1 h, followed by reperfusion for 3 h. During the ischaemic period, the left thoracic cavity was filled with either normal saline or hydrogen-rich saline. After reperfusion, we assessed lung function, histological changes and cytokine production ( N = 5-7 per group). Immersing lungs in hydrogen-rich saline resulted in an elevated hydrogen concentration in the lung (6.9 ± 2.9 μmol/1 g lung). After IRI, pulmonary function (pulmonary compliance and oxygenation levels) was significantly higher in the hydrogen-rich saline group than in the normal saline group ( P  hydrogen-rich saline group than in the normal saline group ( P  hydrogen-rich saline delivered hydrogen into the lung and consequently attenuated lung IRI. Hydrogen-rich solution appears to be a promising approach to managing lung IRI.

  11. 1-year course of fatigue in patients on chronic hemodialysis.

    Science.gov (United States)

    Bossola, Maurizio; Di Stasio, Enrico; Antocicco, Manuela; Pepe, Gilda; Marzetti, Emanuele; Vulpio, Carlo

    2017-04-01

    Fatigue is common in end-stage renal disease patients receiving hemodialysis, reduces significantly their quality of life and is associated with all-cause and cardiac-related mortality. Unfortunately, little is known about the course of fatigue in patients on chronic hemodialysis. The Vitality Subscale of the SF-36 (SF-36 VS), Short-Form Health Survey, was administered to 45 patients in January (T1), June (T2) and November (T3) 2015. The score of the SF-36 VS did not differ significantly among T1, T2 and T3. Similarly, the 1-year course of the SF-36 Vitality Subscale score did not differ significantly among T1, T2 and T3 after stratification of patients for sex, age, BMI, IADL and Charlson. Between T1 and T2, 21 out of 45 patients (46.6%) changed their fatigue status: 8 fatigued patients became not-fatigued and 13 not-fatigued patients became fatigued. Between T2 and T3, 12 out of 45 (26.6%) patients changed their fatigue status: 5 fatigued patients became not-fatigued and 7 not-fatigued patients became fatigued. Between T1 and T3, 19 out of 45 patients (42.2%) changed their fatigue status: 6 fatigued patients became not-fatigued and 13 not-fatigued became fatigued. The present study is the first to identify variations in fatigue status among patients on chronic hemodialysis during 1-year course. These findings suggest to frequently assess the presence and severity of fatigue in patients on chronic hemodialysis.

  12. Correlates of ADL difficulty in a large hemodialysis cohort

    OpenAIRE

    Kutner, Nancy G.; Zhang, Rebecca; Allman, Richard M.; Bowling, C. Barrett

    2013-01-01

    Needing assistance with activities of daily living (ADL) is an early indicator of functional decline and has important implications for individuals’ quality of life. However, correlates of need for ADL assistance have received limited attention among patients undergoing maintenance hemodialysis (HD). A multi-center cohort of 742 prevalent HD patients was assessed 2009–2011 and classified as frail, pre-frail and non-frail by the Fried frailty index (recent unintentional weight loss, reported e...

  13. Hemodialysis tunneled central venous catheters: five-year outcome analysis.

    Science.gov (United States)

    Mandolfo, Salvatore; Acconcia, Pasqualina; Bucci, Raffaella; Corradi, Bruno; Farina, Marco; Rizzo, Maria Antonietta; Stucchi, Andrea

    2014-01-01

    Tunneled central venous catheters (tCVCs) are considered inferior to arteriovenous fistulas (AVFs) and grafts in all nephrology guidelines. However, they are being increasingly used as hemodialysis vascular access. The purpose of this study was to document the natural history of tCVCs and determine the rate and type of catheter replacement. This was a prospective study of 141 patients who underwent hemodialysis with tCVCs between January 2008 and December 2012. The patients used 154 tCVCs. Standard protocols about management of tCVCs, according to European Renal Best Practice, were well established. All catheters were inserted in the internal jugular vein. Criteria for catheter removal were persistent bloodstream infection, detection of an outbreak of catheter-related bloodstream (CRBS) infections, or catheter dysfunction. Event rates were calculated per 1,000 catheter days; tCVC cumulative survival was estimated by Kaplan-Meier analysis. Catheter replacement occurred in 15 patients (0.29 per 1,000 days); catheter dysfunction was the main cause of replacement (0.18 per 1,000 days), typically within 12 months of surgical insertion. A total of 53 CRBS events in 36 patients were identified (0.82 per 1,000 days); 17 organisms, most commonly Gram-positive pathogens, were isolated; 87% of CVC infections were treated by systemic antibiotics associated with lock therapy. tCVC cumulative survival was 91% at 1 year, 88% at 2 years and 85% at 4 years. Our data show a high survival rate of tCVCs in hemodialysis patients, with low incidence of catheter dysfunction and CRBS events. These data justify tCVC use for hemodialysis vascular access, also as first choice, especially in patients with exhausted peripheral access and limited life expectancy.

  14. Psychosocial status of hemodialysis patients one year after Hurricane Katrina.

    Science.gov (United States)

    Hyre, Amanda D; Cohen, Andrew J; Kutner, Nancy; Alper, Arnold B; Dreisbach, Albert W; Kimmel, Paul L; Muntner, Paul

    2008-08-01

    Hemodialysis patients experience a high degree of psychosocial impairment. The psychosocial status of hemodialysis patients after Hurricane Katrina was evaluated using the Hurricane Coping Self-Efficacy (HCSE) measure, the Short Form-12 Health Survey (physical component summary [PCS] and mental component summary [MCS]), and the Center for Epidemiologic Studies Short Depression Scale (CES-D). These scales were administered to 391 hemodialysis patients (86% participation rate), 7 to 14 months after Hurricane Katrina. The mean score (standard deviation) was 36.2 (9.6) for the HCSE scale, 37.1 (10.9) and 46.7 (12.7) for the PCS and MCS, respectively, and 10.0 (6.5) on the CES-D. Symptoms of depression (CES-D scores > or =10) were present in 45.5% of patients. After age, race, and gender adjustment, evacuating less than 2 days before Hurricane Katrina making landfall and more fear of dying were associated with less favorable scores on the HCSE, MCS, and CES-D scales. Patients placed in a shelter and with a longer displacement had significantly lower MCS scores and more depressive symptoms. More depressive symptoms were observed among patients hospitalized in the month after the storm. Those who evacuated to a hotel, with more fear of dying and who were hospitalized in the month after Hurricane Katrina had lower scores on the PCS. Impaired psychosocial status was common among dialysis patients surviving Hurricane Katrina and associated with reduced coping. These data demonstrate the need for screening and management of psychosocial issues in hemodialysis patients after disasters.

  15. Inadequate doses of hemodialysis. Predisposing factors, causes and prevention

    Directory of Open Access Journals (Sweden)

    Pehuén Fernández

    2017-04-01

    Full Text Available Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V greater than 40 l (72 kg body weight approximately are 11 times more likely (OR = 11.6; CI 95% = 3.2 to 51.7, p < 0.0001 to receive an inadequate dose of hemodialysis, than those with a smaller V. This situation is more frequent in men (OR = 3.5; 95% CI 1.01-15.8; p = 0.0292. V greater than 40 l was the only independent predictor of sub-dialysis in the multivariate analysis (OR = 10.3; 95% CI 2.8-37; p < 0.0004. The main cause of suboptimal dialysis was receiving a lower blood flow (Qb than the prescribed (336.4 ± 45.8 ml/min vs. 402.3 ± 28.8 ml/min respectively, p < 0.0001 (n = 18. Other causes were identified: shorter duration of the session (n = 2, vascular access recirculation (n = 1, and error in the samples (n = 1. In conclusion, the only independent predisposing factor found in this study for sub-optimal dialysis is V greater than 40 l. The main cause was receiving a slower Qb than prescribed. From these findings, an algorithm for the management of these patients was developed

  16. Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco.

    Science.gov (United States)

    Diawara, Idrissa; Bekhti, Khadija; Elhabchi, Driss; Saile, Rachid; Elmdaghri, Naima; Timinouni, Mohammed; Elazhari, Mohamed

    2014-06-01

    Staphylococcus aureus (S. aureus) nasal carriage may be responsible for some serious infections in hemodialyzed patients. The main target of this study was to estimate the prevalence of S. aureus nasal carriage in hemodialysis outpatients and medical staff in hemodialysis centers specifically in Fez region. The second target is to identify the risks of colonization, resistance pattern of isolates and their virulence toxin genes. Nasal swab specimens were obtained from 143 hemodialyzed outpatients and 32 medical staff from January to June 2012. Each participant completed a short questionnaire. Nasal carriage of S. aureus was demographically related (age, gender, hemodialysis duration), comorbidity (diabetes, malignancy) and exposure to health care (dialysis staff, hospitalization). PCR (Polymerase Chain Reaction) were used on all the isolates in the research of twelve staphylococcal enterotoxins genes. Also the PCR was used to investigate on the three factors epidermal cell differentiation inhibitors; three exfoliatin toxins; two leukotoxins; the toxic shock syndrome toxin-1 and the hemolysin beta genes. Nasal screening revealed 38.16%, 50% and 18.75% S. aureus carries in chronic, acute hemodialysis patients and medical staff, respectively. Only young participants were likely to be S. aureus carries (p = 0.002). But there were no gender differences between the isolate carriers and non-carriers or some comorbidity factors such as viral hepatitis B and C, HIV (Human Immunodeficiency Virus) infections, diabetes, chronic smoking, recent hospitalization or antibiotic therapy. Out of all isolates, only one (1.61%) was methicillin-resistant and Twenty-one (33.87%) had at least two virulence toxin genes. Knowledge and monitoring of antibiotic resistance profile and virulence of S. aureus carriage are essential in the treatment of infections generated by this pathogen, as well as in the control of clonal dissemination and prevent the spread of S. aureus resistance.

  17. Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System.

    Science.gov (United States)

    Chen, Lihua; Zhu, Xuan; Zhang, Menglu; Wang, Yuxin; Lv, Tianyu; Zhang, Shenghua; Yu, Xin

    2017-05-28

    Culture-dependent methods, such as heterotrophic plate counting (HPC), are usually applied to evaluate the bacteriological quality of hemodialysis water. However, these methods cannot detect the uncultured or viable but non-culturable (VBNC) bacteria, both of which may be quantitatively predominant throughout the hemodialysis water treatment system. Therefore, propidium monoazide (PMA)-qPCR associated with HPC was used together to profile the distribution of the total viable bacteria in such a system. Moreover, high-throughput sequencing of 16S rRNA gene amplicons was utilized to analyze the microbial community structure and diversity. The HPC results indicated that the total bacterial counts conformed to the standards, yet the bacteria amounts were abruptly enhanced after carbon filter treatment. Nevertheless, the bacterial counts detected by PMA-qPCR, with the highest levels of 2.14 × 10 7 copies/100 ml in softener water, were much higher than the corresponding HPC results, which demonstrated the occurrence of numerous uncultured or VBNC bacteria among the entire system before reverse osmosis (RO). In addition, the microbial community structure was very different and the diversity was enhanced after the carbon filter. Although the diversity was minimized after RO treatment, pathogens such as Escherichia could still be detected in the RO effluent. In general, both the amounts of bacteria and the complexity of microbial community in the hemodialysis water treatment system revealed by molecular approaches were much higher than by traditional method. These results suggested the higher health risk potential for hemodialysis patients from the up-to-standard water. The treatment process could also be optimized, based on the results of this study.

  18. Factors associated with treatment adherence of Brazilian patients undergoing hemodialysis

    OpenAIRE

    Nakao, Renata Tamie; Gorayeb, Ricardo; da Costa, José Abrão Cardeal

    2016-01-01

    Objective: To evaluate patients’ adherence to hemodialysis (HD) and its relationship to psychosocial variables. Methods: Participated in the study 64 adult patients undergoing HD, assessed in regard to depression, anxiety, social support, disease and treatment knowledge, and adherence. Results: It was found association between sex and adherence to HD, to diet and to medication, as well as between schooling and overall adherence. There is association between disease knowledge and depression, w...

  19. Anti-ENA antibody profile in hepatitis C patients undergoing hemodialysis.

    Science.gov (United States)

    Batchoun, Raymond G; Al-Najdawi, Malek A; Al-Taamary, Sameh

    2011-07-01

    Infection with hepatitis C virus (HCV) is increasing all over the world, especially among hemodialysis patients. HCV is one of the major autoantibody inducing viruses, where anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), anti-liver kidney microsome antibodies (LKM-1), and rheumatoid factor (RF) have been related to HCV. Few studies have investigated the presence of anti-extractable nuclear antigens (ENA) antibodies in chronic liver diseases, especially in chronic hepatitis C cases, but none investigated its immunostimulation role in hemodialysis units. The aim of the study was to assess the prevalence of HCV among chronic kidney disease- Stage 5 (CKD5) patients undergoing hemodialysis and the prevalence of ENA antibodies among them. Sera of 134 patients with chronic kidney disease undergoing hemodialysis, were screened for HCV antibodies and ENA antibodies profile, using ELISA and Immunoblot technique. 41 HCV-positive blood bank donors were used as controls. Sixty-four (47.7%) of 134 patients undergoing hemodialysis were infected with HCV. Thirty-three (51.6%) of 64 patients with HCV infection undergoing hemodialysis had anti-ENA antibodies: 9 (27.3%) showed anti-SSA antibodies and 22 (66.7%) had anti-SSB antibodies. The prevalence of anti-ENA antibodies was significantly higher in the patients with HCV infection, undergoing hemodialysis, compared with both control groups (hepatitis C-positive blood bank donors and hepatitis C-negative patients undergoing hemodialysis). Seventeen of 33 HCV antibodies-positive males undergoing hemodialysis had anti-ENA antibodies, compared with 16 of 31 females, indicating no sex related difference. This study emphasizes the high prevalence of HCV infection in our hemodialysis patients, comparable to that of other Middle Eastern countries, but higher than Western ones. A strong association was observed between anti-HCV positivity and hemodialysis duration, as well as anti-ENA antibody profile. However, these

  20. Anti-ENA antibody profile in hepatitis C patients undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Raymond G Batchoun

    2011-01-01

    Full Text Available Infection with hepatitis C virus (HCV is increasing all over the world, especially among hemodialysis patients. HCV is one of the major autoantibody inducing viruses, where anti-nuclear antibodies (ANA, anti-smooth muscle antibodies (ASMA, anti-liver kidney microsome antibodies (LKM-1, and rheumatoid factor (RF have been related to HCV. Few studies have investigated the presence of anti-extractable nuclear antigens (ENA antibodies in chronic liver diseases, especially in chronic hepatitis C cases, but none investigated its immunostimulation role in hemodialysis units. The aim of the study was to assess the prevalence of HCV among chronic kidney disease- Stage 5 (CKD5 patients undergoing hemodialysis and the prevalence of ENA antibodies among them. Sera of 134 patients with chronic kidney disease undergoing hemodialysis, were screened for HCV antibodies and ENA antibodies profile, using ELISA and Immunoblot technique. 41 HCV-positive blood bank donors were used as controls. Sixty-four (47.7% of 134 patients undergoing hemodialysis were infected with HCV. Thirty-three (51.6% of 64 patients with HCV infection undergoing hemodialysis had anti-ENA antibodies: 9 (27.3% showed anti-SSA antibodies and 22 (66.7% had anti-SSB antibodies. The prevalence of anti-ENA antibodies was significantly higher in the patients with HCV infection, undergoing hemodialysis, compared with both control groups (hepatitis C-positive blood bank donors and hepatitis C-negative patients undergoing hemodialysis. Seventeen of 33 HCV antibodies-positive males undergoing hemodialysis had anti-ENA antibodies, compared with 16 of 31 females, indicating no sex related difference. This study emphasizes the high prevalence of HCV infection in our hemodialysis patients, comparable to that of other Middle Eastern countries, but higher than Western ones. A strong association was observed between anti-HCV positivity and hemodialysis duration, as well as anti-ENA antibody profile. However

  1. 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.

  2. 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 Pupil diameter was also significantly different before (4.28 ± 0.81 mm) and after (4.44 ± 0.79 mm) HD with ICCs > 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.

  3. Hypoglycemia in Hospitalized Hemodialysis Patients With Diabetes: An Observational Study.

    Science.gov (United States)

    Gianchandani, Roma Y; Neupane, Shristi; Heung, Michael

    2018-01-01

    Hypoglycemia and hyperglycemia affect outcomes in hospitalized patient. Patients with diabetes and end stage renal disease are prone to hypoglycemia and few studies have evaluated glucometrics to identify the incidence and risk factors for hypoglycemia in this population. We designed an observational retrospective review of 150 insulin requiring inpatients with diabetes receiving hemodialysis. We collected demographics, baseline characteristics, and glucometric data focusing on episodes of hypoglycemia with glucose cutoffs TDD) of insulin by weight (0.34 units/kg vs 0.23 units/kg, P = .003). We observed a linear increasing risk for hypoglycemia with increasing TDD, with nearly 65% of hypoglycemic episodes occurring with TDD >0.20 units/kg. A majority (61%) of all hypoglycemic episodes occurred in the 24 hours prior to a hemodialysis session. Type 1 diabetes was independently associated with hypoglycemia. Hospitalized diabetes patients undergoing hemodialysis were found to have high rates of hypoglycemia. Our results support using a lower TDD of insulin in this population (<0.23 units/kg/day) and recommend special caution in those with type 1 diabetes.

  4. Thoracic CT findings in long-term hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Coskun, M.; Boyvat, F.; Bozkurt, B.; Agildere, A.M.; Niron, E.A. [Baskent University School of Medicine, Ankara (Turkey). Department of Radiology

    1999-03-01

    Purpose: To evaluate thoracic CT findings of long-term hemodialysis patients. Material and methods: Thoracic CT findings of 117 umremic patients (61 men, 56 women) with complaints of cough, dyspnea, low-grade pyrexia, malaise, weight loss, and profuse perspiration were retrospectively documented. Results: Atelectasis (60%), cardiomegaly (60%), pleural effusion (51%), vascular congestion (44%), parenchymal consolidation (38%), parenchymal scarring-fibrosis (31%), and lymphadenopathy (29%) were the most common CT findings in the thoraces of the long-term hemodialysis patients. Staphylococcus aureus was detected in 13 patients (11%) who had parenchymal infiltration. Thoracid tuberculosis was identified in 15 patients (13%), 11 of these cases being confined to the lung parenchyma, 3 to the pleura, and 1 involving the pleura and pericardium. Conclusion: In patients under long-term hemodialysis treatment, parenchymal consolidation, secondary to infectious agents such as S. aureus and Mycobacterium tuberculosis, is the most important CT finding since these lesions can be detected and treated successfully if they are considered as etiologic factors early on. (orig.)

  5. 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

  6. Hemodialysis Clinic Social Networks, Sex Differences, and Renal Transplantation.

    Science.gov (United States)

    Gillespie, A; Fink, E L; Traino, H M; Uversky, A; Bass, S B; Greener, J; Hunt, J; Browne, T; Hammer, H; Reese, P P; Obradovic, Z

    2017-09-01

    This study describes patient social networks within a new hemodialysis clinic and models the association between social network participation and kidney transplantation. Survey and observational data collected between August 2012 and February 2015 were used to observe the formation of a social network of 46 hemodialysis patients in a newly opened clinic. Thirty-two (70%) patients formed a social network, discussing health (59%) and transplantation (44%) with other patients. While transplant-eligible women participated in the network less often than men (56% vs. 90%, p = 0.02), women who participated discussed their health more often than men (90% vs. 45.5%, p = 0.02). Patients in the social network completed a median of two steps toward transplantation compared with a median of 0 for socially isolated patients (p = 0.003). Patients also completed more steps if network members were closely connected (β = 2.23, 95% confidence interval [CI] 0.16-4.29, p = 0.03) and if network members themselves completed more steps (β = 2.84, 95% CI 0.11-5.57, p = 0.04). The hemodialysis clinic patient social network had a net positive effect on completion of transplant steps, and patients who interacted with each other completed a similar number of steps. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  7. 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.

  8. Personality types and coping style in hemodialysis patients.

    Science.gov (United States)

    Kidachi, Ruriko; Kikuchi, Atsuhiro; Nishizawa, Yoshiko; Hiruma, Tomiharu; Kaneko, Sunao

    2007-08-01

    The aim of this study was to obtain information that would enable caregivers to provide the necessary psychological care for hemodialysis patients. A total of 608 hemodialysis patients completed the questionnaire of the Neuroticism, Extroversion, Openness-Five Factor Inventory and were subsequently classified by personality types using cluster analysis. In comparison to the norms for the general Japanese adult population, the four-dimensional average of extroversion, openness, agreeableness, and conscientiousness among hemodialysis patients was significantly lower (P personality types were defined based on these dimensions. High scores for agreeableness, extroversion and conscientiousness characterized the agreeable type (22.6%). The patients in this type will likely accept their own experiences in a positive manner. Submissive types (22.0%) received the lowest scores for conscientiousness, though extroversion, openness, and agreeableness were also low. It is necessary to enhance a sense of independence and responsibility in patients with submissive type personalities. Sensitive types (21.5%) were characterized by the highest neuroticism scores and low scores for the other four dimensions. The patients in this type were likely to be persistent with changes in conditions. The last type was the balanced type (33.9%), which was defined by scores within mean range. In clinical practice, it is particularly important that the submissive and sensitive types should receive appropriate mental health care.

  9. The economics of hemodialysis catheter-related infection prophylaxis.

    Science.gov (United States)

    Kosa, S Daisy; Lok, Charmaine E

    2013-01-01

    Hemodialysis central venous catheter (CVC) use is associated with the highest morbidity, mortality, and cost of all types of hemodialysis vascular access. CVC-related infection drives much of the cost associated with CVC use. The magnitude of the cost associated with CVC-related infection varies depending on the type and severity of that infection; however, estimates of the total direct and indirect costs associated with hospitalizations due to hemodialysis CVC-related infections range from 17,000 USD to 32,000 USD per episode. Thus, it is critically important, to not only have effective strategies to limit CVC-related infection but also evaluate whether these strategies are an efficient use of resources. Prophylactic strategies can be considered economically efficient only if the value of its implementation and the corresponding drop in infection rate offer greater value than standard care. The optimal CVC-related infection prophylaxis strategy should work to limit infection risk with minimal risk, inconvenience, and discomfort to the patient, and at minimal cost. The aim of this review was to examine the clinical and economic impact of some commonly described interventions used for CVC infection prophylaxis. © 2013 Wiley Periodicals, Inc.

  10. 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.

  11. 78 FR 38994 - Implanted Blood Access Devices for Hemodialysis; Draft Guidance for Industry and Food and Drug...

    Science.gov (United States)

    2013-06-28

    ... HUMAN SERVICES Food and Drug Administration Implanted Blood Access Devices for Hemodialysis; Draft... availability of the draft guidance entitled ``Implanted Blood Access Devices for Hemodialysis.'' This guidance was developed to support the reclassification of the Implanted Blood Access Devices for Hemodialysis...

  12. Impact of hepcidin, interleukin 6, and other inflammatory markers with respect to erythropoietin on anemia in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ihab A. Ibrahim

    2014-01-01

    Conclusion Serum hepcidin levels were associated with iron status and inflammation in maintenance hemodialysis patients, and the high hepcidin serum levels, found in hemodialysis (HD patients, are dependent on the magnitude of the inflammatory process and on recombinant human erythropoietin doses. Hepcidin and its regulatory pathways are potential therapeutic targets, which could lead to effective treatment of anemia in chronic hemodialysis.

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

    African Journals Online (AJOL)

    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 immediately after being infused with 7.5% HSS. Of patients with a single injury, 96.6% recovered from shock whereas ...

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

    African Journals Online (AJOL)

    2013-03-27

    Mar 27, 2013 ... Árvores brasileiras: manual de identificação e cultivo de plantas arbóreas do Brasil. 3.ed. Instituto Plantarum, Nova. Odessa, Brasil. Meloni DA, Gulotta MR, Martinéz CA, Oliva MA (2004). The effects of salt stress on growth, nitrate reduction and proline and glycinebetaine accumulation in Prosopis alba.

  15. 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

    at the water-membrane interface to differ qualitatively. Cl(-) ions have well-defined characteristic residence times of nanosecond scale. In contrast, the binding of Na(+) ions to the carbonyl region appears to lack a characteristic time scale, as the residence time distributions displayed power-law features...

  16. Solução salina hipertônica para prevenção de insuficiência renal em pacientes com insuficiência cardíaca descompensada e hiponatremia Hypertonic saline solution for renal failure prevention in patients with decompensated heart failure

    Directory of Open Access Journals (Sweden)

    Victor Sarli Issa

    2007-10-01

    insuficiência renal.BACKGROUND: Hyponatremia and congestive phenomena indicate a bad prognosis in decompensated heart failure. The occurrence of renal failure is associated to an increased death risk. OBJECTIVE: To evaluate the safety and efficacy of the hypertonic saline solution in patients with decompensated heart failure for renal failure prevention. METHODS: Patients with decompensated heart failure, congestion and hyponatremia participated in the study. In addition to the standard treatment, the patients received hypertonic saline solution and were submitted to clinical as well as laboratory assessment. RESULTS: Nine patients were enrolled in the study. Mean age was 55 + 14.2 years, being 5 male (55.5% and 4 (44.5% female patients. All of them presented functional class III-IV of the New York Heart Association (NYHA, and 5 (55.5% received dobutamine. All of them presented initial creatinine > 1.4 mg/dl. The mean tonicity of the solution was 4.39% + 0.018% (2.5% to 7.5% and the duration of treatment was 4.9 days + 4.1 days (1-15 days. There were no severe adverse effects; none of the patients presented clinical worsening or neurologic disorders; hypokalemia occurred in 4 cases (44.5%. The comparison of the variables before and after treatment showed a decrease in urea (105 mg/dl + 74.8 mg/dl vs. 88 mg/dl + 79.4 mg/dl; p = 0.03 and increase in the urinary volume (1,183 ml/day vs. 1,778 ml/day; p = 0.03; there was no tendency to creatinine decrease (2.0 mg/dl + 0.8 mg/dl vs. 1.7 mg/dl + 1.0 mg/dl; p = 0.08. Despite the elevation in sodium levels (131 mEq/l + 2.8 mEq/l vs. 134 mEq/l + 4.9 mEq/l and weight decrease (69.5 kg + 18.6 kg vs. 68.2 kg + 17.1 kg, there was no statistically significant difference. CONCLUSION: The use of hypertonic saline solution in patients with decompensated heart failure can be a safe therapeutic method and potentially related to clinical improvement and renal failure prevention.

  17. Hypertonic saline plus i.v. furosemide improve renal safety profile and clinical outcomes in acute decompensated heart failure: A meta-analysis of the literature.

    Science.gov (United States)

    De Vecchis, R; Esposito, C; Ariano, C; Cantatrione, S

    2015-05-01

    In advanced congestive heart failure (CHF), intravenous (i.v.) inotropic agents, i.v. diuretics, ultrafiltration, and hemodialysis have been shown to not yield better clinical outcomes. In this scenario, the simultaneous administration of hypertonic saline solution (HSS) and furosemide may offer a more effective therapeutic option with a good safety profile. Therefore, a meta-analysis was performed to compare combined therapy, consisting of i.v. furosemide plus concomitant administration of HSS, with i.v. furosemide alone for acute decompensated heart failure (ADHF). The outcomes we chose were all-cause mortality, risk of re-hospitalization for ADHF, length of hospital stay, weight loss, and variation of serum creatinine. Based on five randomized controlled trials (RCTs) involving 1,032 patients treated with i.v. HSS plus furosemide vs. 1,032 patients treated with i.v. furosemide alone, a decrease in all-cause mortality in patients treated with HSS plus furosemide was proven [RR = 0.57; 95 % confidence interval (CI) = 0.44-0.74, p = 0.0003]. Likewise, combined therapy with HSS plus furosemide was shown to be associated with a reduced risk of ADHF-related re-hospitalization (RR = 0.51; 95 % CI = 0.35-0.75, p = 0.001). Besides, combined therapy with HSS plus furosemide was found to be associated with a reduced length of hospital stay (p = 0.0002), greater weight loss (p furosemide for diuretic-resistant CHF patients led to a better renal safety profile and improved clinical endpoints such as mortality and heart failure-related hospitalizations.

  18. Renal transplantation vs hemodialysis: Cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Perović Saša

    2009-01-01

    Full Text Available Background/Aim. Chronic renal insufficiency (CRI, diabetes, hypertension, autosomal dominant polycystic kidney disease (ADPKD are the main reasons for starting dialysis treatment in patients having kidney function failure. At present, dialysis treatments are performed in about 4,100 patients at 46 institutions in Serbia, out of which 90% are hemodialyses. At end-stage renal disease (ESRD the only correct selection is kidney transplatation. The basic aim of the planned research was to compare ratio of costs and effects (Cost Effectiveness Analysis - CEA of hemodialysis and kidney transplantation in patients at ESRD. Methods. As the main issue of treatment in patients from both groups the life quality measured by the validated McGill Questionary, was used. The study included 150 patients totally, divided into two groups. The study group consisted of 50 patients with kidney transplantation performed at the Clinical Center of Serbia and the control group consisted of 100 patients on hemodialysis at Clinical Center of Serbia, Clinical Hospital Center Zemun, Clinical Hospital Center 'Zvezdara', Clinical Center Kragujevac and Health Center 'Studenica', Kraljevo, comparable with respect to sex, age and length of treatment with the study group. Results. Effect of kidney transplantation in relation to hemodialysis being selection of treatment is expressed in the form of incremental ratio of costs and effects (Incremental Cost-Effectiveness Ratio - ICER. It is clear from the enclosed tables that the strategy of kidney transplantation is far more profitable considering the fact that it represents saving of EUR 132,256.25 per one year of contribution Quality Adjusted Life Years (QALY within the period of 10 years. According to all aspects of live quality (physical symptoms and problems, physical well-being, psychological symptoms, existential well-being and support, difference is statistically important in favor of transplant patents. Conclusion. The costs

  19. Validity and reliability of short form-12 questionnaire in Iranian hemodialysis patients

    DEFF Research Database (Denmark)

    Pakpour, Amir H; Nourozi, Saeedeh; Molsted, Stig

    2011-01-01

    The aim of the study was to assess the validity and reliability of the SF-12 questionnaire in a sample of Iranian patients undergoing hemodialysis.......The aim of the study was to assess the validity and reliability of the SF-12 questionnaire in a sample of Iranian patients undergoing hemodialysis....

  20. Frequency of and risk factors for poor cognitive performance in hemodialysis patients

    Science.gov (United States)

    There are few detailed data on cognition in patients undergoing dialysis. We evaluated the frequency of and risk factors for poor cognitive performance using detailed neurocognitive testing. In this cross-sectional cohort study, 314 hemodialysis patients from 6 Boston-area hemodialysis units underwe...

  1. Low expression of thiosulfate sulfurtransferase (rhodanese) predicts mortality in hemodialysis patients

    DEFF Research Database (Denmark)

    Krueger, Katharina; Koch, Kathrin; Jühling, Anja

    2010-01-01

    To test the hypothesis that impaired expression of the thiosulfate sulfurtransferase rhodanese is associated with oxidative stress and may predict mortality in hemodialysis patients.......To test the hypothesis that impaired expression of the thiosulfate sulfurtransferase rhodanese is associated with oxidative stress and may predict mortality in hemodialysis patients....

  2. Anatomic brain disease in hemodialysis patients: a cross-sectional study

    Science.gov (United States)

    Although dialysis patients are at high risk of stroke and have a high burden of cognitive impairment, there are few reports of anatomic brain findings in the hemodialysis population. Using magnetic resonance imaging of the brain, we compared the prevalence of brain abnormalities in hemodialysis pati...

  3. A case of chylothorax in a hemodialysis patient with left innominate venous stenosis

    Directory of Open Access Journals (Sweden)

    M Limesh

    2017-01-01

    Full Text Available Chylothorax is defined as accumulation of chyle-containing lymphatic fluid within the pleural space. Chylothorax is very rarely seen in hemodialysis patients. We report a case of a patient on hemodialysis who developed chylothorax secondary to left innominate vein stenosis, with other features of venous hypertension such as arm edema successfully treated with angioplasty and pigtail drainage.

  4. Validity and reliability of short form-12 questionnaire in Iranian hemodialysis patients

    DEFF Research Database (Denmark)

    Pakpour, Amir H.; Nourozi, Saeedeh; Molsted, Stig

    2011-01-01

    INTRODUCTION: The aim of the study was to assess the validity and reliability of the SF-12 questionnaire in a sample of Iranian patients undergoing hemodialysis. MATERIALS AND METHODS: One hundred and forty-four hemodialysis patients were included from dialysis centers in Zanjan, Iran, and were a...

  5. 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

    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 hemodialysi...

  6. Differences in quality of life of hemodialysis patients between dialysis centers.

    NARCIS (Netherlands)

    Mazairac, A.H.; Grooteman, M.P.C.; Blankestijn, P.J.; Lars Penne, E.; Weerd, N.C. van der; Hoedt, C.H. den; Dorpel, M.A. van den; Buskens, E.; Nube, M.J.; Wee, P.M. ter; Wit, G.A. de; Bots, M.L.; Hamersvelt, H.W. van

    2012-01-01

    PURPOSE: Hemodialysis patients undergo frequent and long visits to the clinic to receive adequate dialysis treatment, medical guidance, and support. This may affect health-related quality of life (HRQOL). Although HRQOL is a very important management aspect in hemodialysis patients, there is a

  7. Differences in quality of life of hemodialysis patients between dialysis centers

    NARCIS (Netherlands)

    Mazairac, Albert H. A.; Grooteman, Muriel P. C.; Blankestijn, Peter J.; Penne, E. Lars; van der Weerd, Neelke C.; den Hoedt, Claire H.; van den Dorpel, Marinus A.; Buskens, Erik; Nube, Menso J.; ter Wee, Piet M.; de Wit, G. Ardine; Bots, Michiel L.

    Purpose Hemodialysis patients undergo frequent and long visits to the clinic to receive adequate dialysis treatment, medical guidance, and support. This may affect health-related quality of life (HRQOL). Although HRQOL is a very important management aspect in hemodialysis patients, there is a

  8. Differences in quality of life of hemodialysis patients between dialysis centers

    NARCIS (Netherlands)

    A.H.A. Mazairac (Albert); M.P.C. Grooteman (Muriel); P.J. Blankestijn (Peter); E. Lars Penne; N.C. van der Weerd (Neelke); C.H. den Hoedt (Claire); M.A. van den Dorpel (Marinus); E. Buskens (Erik); M.J. Nubé (Menso); P.M. ter Wee (Piet); G.A. de Wit (Ardine); M.L. Bots (Michiel)

    2012-01-01

    textabstractPurpose: Hemodialysis patients undergo frequent and long visits to the clinic to receive adequate dialysis treatment, medical guidance, and support. This may affect health-related quality of life (HRQOL). Although HRQOL is a very important management aspect in hemodialysis patients,

  9. Differences in quality of life of hemodialysis patients between dialysis centers

    NARCIS (Netherlands)

    Mazairac, Albert H. A.; Grooteman, Muriel P. C.; Blankestijn, Peter J.; Penne, E. Lars; Lars Penne, E.; van der Weerd, Neelke C.; den Hoedt, Claire H.; van den Dorpel, Marinus A.; Buskens, Erik; Nubé, Menso J.; ter Wee, Piet M.; de Wit, G. Ardine; Bots, Michiel L.; Koopman, M. G.; Konings, C. J. A. M.; Haanstra, W. P.; Kooistra, M.; Noordzij, T.; Feith, G. W.; van Buren, M.; Offerman, J. J. G.; Hoogeveen, E. K.; de Heer, F.; van de Ven, P. J.; Hovinga, T. K. Kremer; Bax, W. A.; Groeneveld, J. O.; Lavrijssen, A. T. J.; Schrander-van der Meer, A. M.; Reichert, L. J. M.; Huussen, J.; Rensma, P. L.; Schrama, Y.; van Hamersvelt, H. W.; Boer, W. H.; van Kuijk, W. H.; Vervloet, M. G.; Wauters, I. M. P. M. J.

    2012-01-01

    Hemodialysis patients undergo frequent and long visits to the clinic to receive adequate dialysis treatment, medical guidance, and support. This may affect health-related quality of life (HRQOL). Although HRQOL is a very important management aspect in hemodialysis patients, there is a paucity of

  10. Short-term effects of hypertonic saline solution in acute heart failure and long-term effects of a moderate sodium restriction in patients with compensated heart failure with New York Heart Association class III (Class C) (SMAC-HF Study).

    Science.gov (United States)

    Paterna, Salvatore; Fasullo, Sergio; Parrinello, Gaspare; Cannizzaro, Sergio; Basile, Ivana; Vitrano, Gabriella; Terrazzino, Gabriella; Maringhini, Giorgio; Ganci, Filippo; Scalzo, Sebastiano; Sarullo, Filippo M; Cice, Gennaro; Di Pasquale, Pietro

    2011-07-01

    Hypertonic saline solution (HSS) and a moderate Na restriction plus high furosemide dose showed beneficial effects in compensated heart failure (HF), in short and long terms. The study was aimed to verify the effects of this combination on hospitalization time, readmissions and mortality in patients in New York Heart Association (NYHA) class III. Chronic ischemic or nonischemic cardiomyopathy uncompensated patients with HF in NYHA III functional class with ejection fraction <40%, serum creatinine <2.5 mg/dL, blood urea nitrogen <60 mg/dL and reduced urinary volume were single-blind randomized in 2 groups: the first group received a 30-minute intravenous infusion of furosemide (250 mg) plus HSS (150 mL) twice daily and a moderate Na restriction (120 mmol); the second group received furosemide intravenous bolus (250 mg) twice a day, without HSS and a low Na diet (80 mmol); both groups received a fluid intake of 1000 mL/d. After discharge, the HSS group continued with 120 mmol Na/d; the second group continued with 80 mmol Na/d. A total of 1771 patients (881 HSS group and 890 without HSS group) met inclusion criteria: the first group (881 patients), compared with the second (890 patients), showed an increase in diuresis and serum Na levels, a reduction in hospitalization time (3.5 + 1 versus 5.5 + 1 days, P < 0.0001) and, during follow-up (57 + 15 months), a lower rate in readmissions (18.5% versus 34.2%, P < 0.0001) and mortality (12.9% versus 23.8%, P < 0.0001); the second group also showed a significant increase in blood urea nitrogen and serum creatinine. This study suggests that in-hospital HSS administration, combined with moderate Na restriction, reduces hospitalization time and that a moderate sodium diet restriction determines long-term benefit in patients with NYHA class III HF.

  11. Factors affecting response to hepatitis B vaccine among hemodialysis patients in a large Saudi Hemodialysis Center.

    Science.gov (United States)

    Al Saran, Khalid; Sabry, Alaa; Al Halawany, Zakaria; Ismail, Mahmoud

    2014-01-01

    The aim of this study is to determine the response to hepatitis B virus (HBV) vaccination in patients on hemodialysis (HD) and to identify the factors that could affect this response. This retrospective study was carried out during the period from January 2009 to December 2009 in the Prince Salman Center for Kidney Diseases (PSCKD), Riyadh, and included 144 patients (78 males and 66 females) on regular HD, all of whom received hepatitis B vacci-nation. Patients were divided into two groups according to the level of hepatitis B surface antibodies (HBsAb): Responders group (>10 IU/L) and non-responders group (vaccination, like gender, age, co-existence of hepatitis C virus (HCV) infection, dialysis adequacy that was evaluated by urea reduction ratio (URR) and Kt/V, hemoglobin level, albumin level, protein catabolic rate (PCR), body mass index (BMI), subjective global nutritional status (SGA) and HbA1c. There were 129 patients (89.6%) in the responders group including 69 males and 60 females and 15 patients (10.4%) in the non-responders group including nine males and six females. The mean age in the responders group and the non-responders group was 50.56 ± 15.35 and 56.87 ± 12.52 years, respectively (P = 0.128). The mean value of the PCR was 1.03 ± 0.17 and 0.88 ± 0.17 g/kg/day in the responders group and non-responders group, respectively (P = 0.002). There was no statically significant difference between the two groups regarding the presence or absence of HCV infection, age, gender, diabetes mellitus, URR, Kt/V, hemoglobin level and albumin level. We report a high response rate (89%) for HBV vaccination in our HD patients. The PCR was the only factor that affected the response to HBV vaccination in these patients.

  12. Broncoprovocação com solução salina hipertônica em crianças asmáticas Brocoprovocación con solución salina hipertónica en niños asmáticos Bronchoprovocation with hypertonic saline solution in asthmatic children

    Directory of Open Access Journals (Sweden)

    Cínthia Maria X. Costa

    2012-09-01

    ,5%, considerándose el resultado positivo como la reducción del volumen espiratorio forzado en el primer segundo (VEF1 ≥20%. RESULTADOS: Sesenta individuos eran atópicos. La frecuencia de positividad de la prueba de broncoprovocación fue mayor en el Grupo MG que en el IL (93 versus 65%. El tiempo necesario para la reducción de 20% del VEF1 para el grupo de atópicos fue menor en el MG cuando comparado al IL, 90 (30 a 330 versus 210 (30 a 690 segundos, con pOBJECTIVE: To verify if the bronchoprovocation test with 4.5% hypertonic saline solution allows to detect the gradient of response in asthmatic children and adolescents, according to asthma severity. METHODS: 75 asthmatic patients aged six to 18 years-old were evaluated in this cross-sectional study. They were classified according to asthma severity in: intermittent or mild persistent (IM and moderate or severe persistent (MS. They were also classified according to sensitization to inhaled allergens in atopics: positive skin prick test to Dermatophagoides pteronyssinus, D. farinae and Blomia tropicalis; or non- atopic with negative skin prick tests. All patients underwent a bronchoprovocation test with 4.5% hypertonic saline solution. The result of the bronchoprovocation test was considerd positive if at least a reduction of 20% in the forced expiratory volume in one second (FEV1 was noted. RESULTS: 60 individuals were atopic. The bronchoprovocation test was positive more frequently in the MS group than in the IM one (93 versus 65%. Less time was needed for a 20% fall of FEV1 in the MG compared to the IL group [90 (30 - 330 versus 210 (30 - 690 seconds; p<0.05]. The percentage of FEV1 fall was higher in the MG group than in the IL one [26,4% (14 - 63 versus 20% (0 - 60; p<0.05]. CONCLUSIONS: The 4.5% hypertonic saline solution bronchoprovocation test is safe and easy to perform. It detects a gradient of response in asthmatic children and adolescents regarding asthma severity. Higher frequency of positive tests, shorter

  13. Hypertonic saline solution increases cerebral perfusion pressure during clinical orthotopic liver transplantation for fulminant hepatic failure: preliminary results Solução salina hipertônica aumenta a pressão de perfusão cerebral no transplante do fígado para hepatite fulminante: resultados preliminares

    Directory of Open Access Journals (Sweden)

    Joel Avancini Rocha Filho

    2006-06-01

    Full Text Available During orthotopic liver transplantation for fulminant hepatic failure, some patients may develop sudden deterioration of cerebral perfusion and oxygenation, mainly due to increased intracranial pressure and hypotension, which are likely responsible for postoperative neurological morbidity and mortality. In the present study, we hypothesized that the favorable effects of hypertonic saline solution (NaCl 7.5%, 4 mL/kg infusion on both systemic and cerebral hemodynamics, demonstrated in laboratory and clinical settings of intracranial hypertension and hemorrhagic shock resuscitation, may attenuate the decrease in cerebral perfusion pressure that often occurs during orthotopic liver transplantation for fulminant hepatic failure. METHODS: 10 patients with fulminant hepatic failure in grade IV encephalopathy undergoing orthotopic liver transplantation with intracranial pressure monitoring were included in this study. The effect on cerebral and systemic hemodynamics in 3 patients who received hypertonic saline solution during anhepatic phase (HSS group was examined, comparing their data with historical controls obtained from surgical procedure recordings in 7 patients (Control group. The maximal intracranial pressure and the corresponding mean arterial pressure values were collected in 4 time periods: (T1 the last 10 min of the dissection phase, (T2 the first 10 minutes at the beginning of anhepatic phase, (T3 at the end of the anhepatic phase, and (T4 the first 5 minutes after graft reperfusion. RESULTS: Immediately after hypertonic saline solution infusion, intracranial pressure decreased 50.4%. During the first 5 min of reperfusion, the intracranial pressure remained stable in the HSS group, and all these patients presented an intracranial pressure lower than 20 mm Hg, while in the Control group, the intracranial pressure increased 46.5% (P Neste estudo testamos a hipótese de que os efeitos benéficos decorrentes da administração da solu

  14. A crossover study of the acrylonitrile-co-methallyl sulfonate and polysulfone membranes for elderly hemodialysis patients: the effect on hemodynamic, nutritional, and inflammatory conditions.

    Science.gov (United States)

    Furuta, Minoru; Kuragano, Takahiro; Kida, Aritoshi; Kitamura, Rie; Nanami, Masayoshi; Otaki, Yoshinaga; Nonoguchi, Hiroshi; Matsumoto, Akihide; Nakanishi, Takeshi

    2011-01-01

    Many maintenance hemodialysis (MHD) patients have recently been treated with high flux (HF) dialysis membranes such as polysulfone (PSu) membranes. However, the appropriateness of HF for elderly MHD remains to be elucidated. In order to estimate hemodialysis (HD) efficiency, the hemodynamic condition during HD, and the nutritional status, 28 elderly MHD patients were treated with PSu for 3 months. After this, the patients were switched to acrylonitrile-co-methallyl sulfonate (AN69) membranes for the next 3 months and then returned to PSu for another 3 months. Reduction ratio of inflammatory cytokines (interleukin [IL]-6) by AN69 was significantly higher than the reduction ratio by PSu. After 3 months with AN69, the serum total protein, albumin, and cholesterol levels significantly increased, and after switching back to PSu, the levels returned to baseline. Furthermore, the frequency of saline used to treat episodes of hypotension during HD significantly decreased in the AN69 period. In elderly MHD patients, it was possible to achieve improvements in both malnutrition and chronic inflammatory conditions with AN69. This suggests that AN69 may be the preferred membrane for elderly MHD, because it stabilizes the hemodynamic condition and demonstrates a higher removal of inflammatory cytokines during HD.

  15. Determining Salinity by Simple Means.

    Science.gov (United States)

    Schlenker, Richard M.

    This paper describes the construction and use of a simple salinometer. The salinometer is composed, mainly, of a milliammeter and a battery and uses the measurement of current flow to determine the salinity of water. A complete list of materials is given, as are details of construction and operation of the equipment. The use of the salinometer in…

  16. 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...

  17. Response of tomato plants to a step-change in root zone salinity, under two different transpiration regimes

    NARCIS (Netherlands)

    Li, Y.; Stanghellini, C.; Challa, H.

    2002-01-01

    The response of a tomato crop to a step-change in salinity was investigated under different potential transpiration conditions. A crop growing for 5 months under saline irrigation water (EC 9 dS m−1) was given thereafter a standard nutrient solution with an EC of 2 dS m−1. The previous effects of

  18. Massive acetaminophen overdose: effect of hemodialysis on acetaminophen and acetylcysteine kinetics.

    Science.gov (United States)

    Ghannoum, Marc; Kazim, Sara; Grunbaum, Ami M; Villeneuve, Eric; Gosselin, Sophie

    2016-07-01

    Early onset acidosis from mitochondrial toxicity can be observed in massive acetaminophen poisoning prior to the development of hepatotoxicity. In this context, the efficacy of acetylcysteine to reverse mitochondrial toxicity remains unclear and hemodialysis may offer prompt correction of acidosis. Unfortunately, toxicokinetics of acetaminophen and acetylcysteine during extracorporeal treatments hemodialysis have seldom been described. An 18-year-old woman presented to the emergency department 60 minutes after ingestion of 100 g of acetaminophen, and unknown amounts of ibuprofen and ethanol. Initial assessment revealed an agitated patient. Her mental status worsened and she required intubation for airway protection. Investigations showed metabolic acidosis with lactate peaking at 8.6 mmol/L. Liver and coagulation profiles remained normal. Acetaminophen concentration peaked at 981 μg/ml (6496 μmol/L). Pending hemodialysis, the patient received 100 g of activated charcoal and an acetylcysteine infusion at 150 mg/kg over 1 hour, followed by 12.5 mg/kg/h for 4 hours. During hemodialysis, the infusion was maintained at 12.5 mg/kg/h to compensate for expected removal before it was decreased to 6.25 mg/kg for 20 hours after hemodialysis. The patient rapidly improved during hemodialysis and was discharged 48 hours post-admission. The acetaminophen elimination half-life was 5.2 hours prior to hemodialysis, 1.9-hours during hemodialysis and 3.6 hours post hemodialysis. The acetaminophen and acetylcysteine clearances by A-V gradient during hemodialysis were 160.4 ml/min and 190.3 ml/min, respectively. Hemodialysis removed a total of 20.6 g of acetaminophen and 17.9 g of acetylcysteine. This study confirms the high dialyzability of both acetaminophen and acetylcysteine. Hemodialysis appears to be a beneficial therapeutic option in cases of massive acetaminophen ingestion with coma and lactic acidosis. Additionally, these results

  19. Consequences of diurnal variation in salinity on water relations and yield of tomato

    NARCIS (Netherlands)

    Ieperen, van W.

    1996-01-01

    In soilless culture the EC (Electric Conductivity; mS cm -1) is an important measure for the total solute concentration (salinity level) of the nutrient solution in the root environment. This study concentrates on the possibilities of

  20. Mutual Charge Transfer for Estimating Salinity Ratio for Offshore Icing Sensors

    Directory of Open Access Journals (Sweden)

    Umair N. Mughal

    2015-11-01

    Full Text Available For offshore measurements in Cold Regions, salinity of ice is also a critical parameter (together with many other parameters such as icing type, load, icing rate and melting rate to be identified in order to optimize the performance of anti/de icing systems. Although there are some available sensory solutions in the market to measure real time salinity levels of water, however there are still not many real time techniques or solutions to measure the salinity of ice. In this research task, mutual charge transfer technique is utilized to measure the zero crossover values of different samples of ice and water with varying salt ratios. An analytical relation between percentage salinity ratio of ice and zero crossover values is established. The aim of this paper is therefore a feasibility study to discuss the testing methodology and testing results.