The effects of vascular access types on the survival and quality of life and depression in the incident hemodialysis patients.
The effects of vascular access types on the survival and quality of life and depression in the incident hemodialysis patients. Ren Fail. 2020 Nov;42(1):30-39 Authors: Kim DH, Park JI, Lee JP, Kim YL, Kang SW, Yang CW, Kim NH, Kim YS, Lim CS Abstract Background: Although arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD), the association between vascular access types and quality of life is not well-known. We investigated the relationships between HD vascular access types and all-cause mortality, health-related quality of life (HRQOL) and the degree of depression in a large prospective cohort.Methods: A total of 1461 patients who newly initiated HD were included. The initial vascular access types were classified into AVF, arteriovenous graft (AVG), and central venous catheter (CVC). The primary outcomes were all-cause mortality and HRQOL and depression. The secondary outcome was all-cause hospitalization. Kidney Disease Quality of Life Short Form 36 (KDQOL-36) and Beck's depression inventory (BDI) scores were measured to assess HRQOL and depression.Results: Among 1461 patients, we identified 314 patients who started HD via AVF, 76 via AVG, and 1071 via CVC. In the survival analysis, patients with AVF showed significantly better survival compared with patients with other accesses (p
ConclusionsThere is a correlation between traditional Chinese medicine syndrome type and intestinal flora. The control group, the spleen–kidney‐yang deficiency group, and the liver‐depression and spleen‐deficiency group have specific bacteria.
ConclusionA low-dose fentanyl citrate patch was effective in the management of cancer pain in opioid-na ïve patients and was well tolerated.Study RegistrationJPRN-JapicCTI-173717.
In their article recently published in the Journal, Omer and colleagues1 demonstrated that in patients subjected to isolated coronary artery bypass grafting (CABG), depressed left ventricular ejection fraction (LVEF) was strongly associated with incremental rates of some complications (ie, renal failure, prolonged ventilation, and mechanical support), leading to increased mortality. They also found that the risk of specific complications may vary by LVEF class according to other preoperative characteristics (ie, preexisting renal failure or lung disease).
DISCUSSION: ED utilization after outpatient hand surgery is low, with postoperative pain being the most common cause of an ED visit at all time points. Nearly 98% of patients presenting to the ED for postoperative pain are subsequently discharged home. LEVEL OF EVIDENCE: Level III, Retrospective Cohort. PMID: 32732657 [PubMed - in process]
This patient has a severe electrolyte abnormality. Can you tell from the ECG what it is?IMPRESSION by computer and physician overread:Heart Rate 120SINUS TACHYCARDIA WITH FIRST DEGREE AV BLOCKPOSSIBLE LEFT ATRIAL ENLARGEMENT [-0.1mV P WAVE IN V1/V2]MODERATE ST DEPRESSION [0.05+ mV ST DEPRESSION]Prolonged QTABNORMAL ECGP-R Interval 220 msQRS Interval 84 msQT Interval 349 ms QTC Interval 419 msP Axis 125QRS Axis 13T Wave Axis 2I think the computer got the QT wrong. It is at least 360 ms and possibly as high as 400 ms.Hodges Corrections using 360 ms: QTc = 465 msSmith Impression: The ECG shows ...
CONCLUSION: PPD intoxication is a life-threatening situation even in low doses. For this reason, even asymptomatic cases should undergo physical examination and should be followed closely in terms of respiratory tract obstruction. Ensuring hydration and diuresis in the early period, steroid and adrenalin therapy for prophylaxis in terms of respiratory tract obstruction are important and tracheostomy should not be abstained in necessary cases. It should not be forgotten that symptomatic treatment for organ systems and dialysis will decrease mortality and morbidity. PMID: 32558412 [PubMed - in process]
Conclusions Comorbidities, previous exacerbations and hospitalisation, and increased length of stay were significant risk factors for 30- and 90-day all-cause readmission after an index hospitalisation with an exacerbation of COPD.
ConclusionNAFLD is associated with a number of EHMs that increases its mortality and increased healthcare expenditure.
Conclusion: ART may reduce the risk of NCIs in HIV-infected patients in general. Further research to investigate NCIs on specific antiretroviral regimens and comorbidities may provide insights regarding the long-term clinical care of these patients.
CONCLUSIONS: Despite the high level of complexity of the studied population, RA turned out to be an effective procedure with a low rate of in-hospital complications and demonstrated good immediate and mid-term results. PMID: 32250249 [PubMed - as supplied by publisher]