Skin ulcer due to hemodialysis access-induced distal ischemia treated with arteriovenous fistula banding and endovascular therapy

Publication date: Available online 18 August 2019Source: Journal of Cardiology CasesAuthor(s): Susumu Odajima, Takumi Inoue, Tomoyo Hamana, Ryota Masaki, Wataru Fujimoto, Koji Kuroda, Yutaka Hatani, Masamichi Iwasaki, Hiroshi Okamoto, Masanori Okuda, Takatoshi HayashiAbstractA 58-year-old woman with pallor on her left hand due to chronic hemodialysis presented with a recent intractable skin ulcer on her left 3rd finger; the skin perfusion pressure (SPP) was 19 mmHg. Preoperative angiography revealed an occluded proximal left radial artery, no communication between the ulnar and superficial palmar arteries, several collaterals from the left ulnar to the radial artery, and no visualization of the finger arteries. Successful endovascular therapy to the occluded radial artery increased flow to the arteriovenous fistula (AVF), but not to the fingertips. Slightly compressing the AVF augmented the flow and wound blush at the wound sites on the 3rd fingertip, leading to a diagnosis of hemodialysis access-induced distal ischemia (HAIDI). Surgical AVF banding with intra-operative SPP monitoring improved the SPP to 34 mmHg, leading to complete wound healing over 1 month with a preserved AVF. We performed a bilateral temporal artery biopsy and diagnosed giant cell arteritis. As the angiographic wound blush at wound sites is reportedly an important factor for wound healing, angiography with AVF manual compression is essential to diagnose HAIDI and evaluate the blood flow for...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research

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We presented a rare case of application of LI-ESWT in a 39-years old man with erectile dysfunction after penile trauma obtained during sexual intercourse.
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Publication date: Available online 21 February 2020Source: Urology Case ReportsAuthor(s): Irzi Mohamed, EL Houmaidi Amine, Mhanna Tarik, Ouraghi Abdelghani, Alaoui Mhammedi wassim, Barki AliAbstractUsual location of metastasis are in renal cell carcinoma (RCC) the lung, liver, bone, adrenal and brain. Here we report on an unusual case of a 76-year-old male with a solitary sternal metastasis as an initial presentation of clear-cell RCC.The management of metastatic kidney cancer has been disrupted over the last decade by the emergence of new treatments and the progress of surgery and ablative techniques.the Carmena study sug...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
ConclusionsOur data indicate a higher overall expression of MMP-2 and MMP-9 in the tumor area of the RP compared to the corresponding areas of the negative previous biopsy, which seems to be associated to the process of malignant transformation.ResumenLas metaloproteasas (MMPs) y el inhibidor tisular de metaloproteasas-3 (TIMP-3) se han relacionado con el riesgo de padecer cáncer y con la agresividad de varios tumores. En ocasiones, existen muchas dificultades para diagnosticar el cáncer de próstata (CaP), la expresión de MMPs y del TIMP-3 en biopsias negativas nos podría ayudar a realiza...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
Publication date: Available online 21 February 2020Source: Actas Urológicas Españolas (English Edition)Author(s): M. Hevia, J.E. Robles, S. Chiva, P. Doménech, A. García, F.J. Ancizu, J.M. Velis, D. Rosell, F. Diez-Caballero, F. Guillén, B. Miñana, J.I. PascualAbstractIntroductionDue to the absence of specific instruments to study the psychosocial sphere of patients undergoing extracorporeal shock wave lithotripsy (SWL), the objective of this study is to develop a satisfaction questionnaire regarding the SWL treatment from a health questionnaire which was already designed and had b...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
Publication date: Available online 21 February 2020Source: Actas Urológicas Españolas (English Edition)Author(s): C. Hernández Fernández
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
ConclusionThe inclusion of 2LPV to the classification according to VP1N improves the discriminating capacity of RRG classification.ResumenIntroducciónNo existe consenso sobre el seguimiento tras nefrectomía por cáncer renal (CCR), siendo necesario establecer grupos de riesgo de recurrencia(GRR).Material y métodoAnálisis retrospectivo de 696 pacientes con CCR intervenidos entre 1990-2010;568(81.6%)pacientes con nefrectomía radical y 128(18.4%) con nefrectomía parcial.Se clasificaron las variables patológicas como variables de 1ernivel(VP1N): estadio pTpN y grado de Fur...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
Publication date: Available online 21 February 2020Source: American Journal of Kidney DiseasesAuthor(s): Mala Sachdeva, Laurence H. Beck, Ilene Miller, Vanessa Bijol, Steven FishbaneRenal course and clinical outcomes in pregnant women with primary membranous nephropathy are not completely understood. In addition, the use of autoantibodies to M-type phospholipase A2 receptor (PLA2R) as a serologic marker throughout pregnancy and postpartum in the mother and baby is not yet fully elucidated. We followed up a pregnant woman with primary membranous nephropathy during pregnancy and postpartum and describe the clinical course an...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Authors: Matricardi S, Farello G, Operto FF, Coppola G, Verrotti A PMID: 32077772 [PubMed - as supplied by publisher]
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
BACKGROUND: Emerging research suggests technology-facilitated crisis services are a promising method to support young people during child maltreatment disclosure. Little is known about how employees/volunteers respond to child maltreatment disclosure in th...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
In this study, we examined the co-occurrence of multiple health-risk behaviors to determine whether there are any differences in the pattern of co-occurrence by sex. Methods: We conducted latent class analysis using the national 2...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
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