Autologous arteriovenous access is the key to long-term success with hemodialysis and is strongly supported by the National Kidney Foundation's Dialysis Outcomes Quality Initiative guidelines. Basilic vein transposition (BVT) fulfills the need for a durable conduit with high patency and maturation rates. This retrospective review examines a single group's experience with this procedure. All patients undergoing BVT for hemodialysis with available follow-up data were reviewed. Telephone interviews were used to supplement clinical data where needed. Functional assisted patency was used as the end point for this procedure, and if the access was never used for dialysis, then the patency was considered zero. Secondary interventions performed while the access remained patent and in use were not considered detrimental to the patency reported. One hundred seventy BVTs in 162 patients were performed between November 1992 and October 2001. There were 87 women (53.7%) and 112 black patients (69.1%); hypertension was present in 138 patients (85.2%) and diabetes in 89 patients (54.9%). Each year, an increasing incidence of BVT was performed in our dialysis population. The BVT was performed as the first access in that extremity in 73 of the procedures (42.9%). Functional patency (primary assisted) was achieved in 40.0% at 2 years and 15.2% at 5 years. The mean assisted patency was 14.6 months. To maintain BVT patency, 40 percutaneous secondary interventions (69.0%) and 18 surgical revisions (31.0%) occurred in 32 patients (19.0%). Ligation for swelling was necessary in 4 patients (2.5%), and steal syndrome occurred in 3 patients (1.9%). BVT is a useful autologous procedure for hemodialysis and the preferred access alternative in patients without an adequate cephalic vein. Although patencies remain poor relative to other conventional arterial vascular procedures, BVT is our most durable hemodialysis access procedure and is often the only available autologous conduit for hemodialysis.

Honeymoon palsy from another individual sleeping on and compressing one's arm overnight. Saturday night palsy from falling asleep with one's arm hanging over the arm rest of a chair, compressing the radial nerve

Myocardial rupture occurs in the setting of acute myocardial infarction (AMI), blunt and penetrating cardiac trauma, primary cardiac infection, primary and secondary cardiac tumors, infiltrative diseases of the heart, and aortic dissection. Myocardial rupture (or perforation) may also occur iatrogenically during percutaneous cardiac procedures (including device implantation) or open heart surgery (particularly valve replacement). Recently, myocardial rupture has been reported in the setting of stress cardiomyopathy (Takotsubo or regional ventricular ballooning syndrome). The clinical presentation of myocardial rupture depends on the mechanism and site of injury and the hemodynamic effects of the rupture. Mortality is extremely high unless early diagnosis is made and urgent surgical intervention is provided.

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In an autologous transplant, a patient's own blood-forming stem cells are collected. He or she is then treated with high doses of chemotherapy, or a combination of chemotherapy and radiation. The high-dose treatment kills cancer cells, but also eliminates the blood-producing cells that are left in the bone marrow.

Carbon monoxide poisoning occurs after too much inhalation of carbon monoxide (CO). Carbon monoxide is a toxic gas, but, being colorless, odorless, tasteless, and initially non-irritating, it is very difficult for people to detect.

Rhinoplasty enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose. Rhinoplasty surgery can change: Nose size in relation to facial balance Nose width at the bridge or in the size and position of the nostrils Nose profile with visible humps or depressions on the bridge Nasal tip that is enlarged or bulbous, drooping, upturned or hooked Nostrils that are large, wide, or upturned Nasal asymmetry

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The temporomandibular joint (TMJ), located just in front of the lower part of the ear, allows the lower jaw to move. The TMJ is a ball-and-socket joint, just like the hip or shoulder. When the mouth opens wide, the ball (called the condyle) comes out of the socket and moves forward, going back into place when the mouth closes. TMJ becomes dislocated when the condyle moves too far and gets stuck in front of a bony prominence called the articular eminence. The condyle can't move back into place. This happens most often when the ligaments that normally keep the condyle in place are somewhat loose, allowing the condyle to move beyond the articular eminence. The surrounding muscles often go into spasm and hold the condyle in the dislocated position.

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If levels of both vitamins are extremely high, there is more than a 17-fold greater risk that a child will develop autism, the researchers said. Most of the women in the study said they took multivitamins — which would include folic acid and vitamin B12 — throughout their pregnancy.

If you or someone you love has atrial fibrillation, learn more about what AFib is, why treatment can save lives, and what you can do to reach your goals, lower your risks and live a healthy life.

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Take regular breaks. If you are in a prolonged standing position or a prolonged sitting position, take regular breaks and move your arms or legs. Take a short walk, do some leg or arm exercises, on the spot walking/running, or take a walk outside the workplace. Get your circulation moving to your extremities.

To identify an UTI, keep an eye out for the following symptoms: A burning feeling when you urinate. A frequent or intense urge to urinate, even though little comes out when you do. Pain or pressure in your back or lower abdomen. Cloudy, dark, bloody, or strange-smelling urine. Feeling tired or shaky.

Minimally invasive open thyroidectomy (MIT) is similar to conventional thyroidectomy in its surgical approach. The major difference is the length of the neck incision. A smaller incision improves cosmesis and reduces discomfort. Typically, a skin incision less than 6 cm is considered minimally invasive. The remainder of the procedure is exactly the same as is used in conventional thyroidectomy. Adaptations to this technique include transection rather than lateral retraction of the strap muscles (the Sofferman technique). [1]

Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum—the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile—a liquid produced in the liver and stored in the gallbladder—to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy. Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them. Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur.

The two biggest considerations when choosing a suture are the location and tension of the wound. Other important considerations are tensile strength, knot strength, handling, and tissue reactivity. Sutures are divided into two major groups: Absorbable – lose the majority of their tensile strength in less than 60 days. They are generally used for buried sutures and do not require removal. Non-absorbable – maintain the majority of their tensile strength for more than 60 days. They are generally used for skin surface sutures and do require removal postoperatively. Suture needles also come in a variety of shapes and sizes. Curved needles are almost exclusively used in dermatological surgery. Cutting needles move through the tissue more easily and may have their primary cutting edge on the inside of the curve (conventional cutting) or outside of the curve (reverse cutting). The benefit of reverse cutting is that the tapered puncture left by the suture is directed away from the wound edge and therefore tissue tearing is less common. Non-cutting round needles cause even less tissue tearing and may be especially useful in delicate areas and fascia.

The majority of epileptic seizures are controlled by medication, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors, including the frequency and severity of the seizures and the person's age, overall health, and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment. Drug Therapy Many drugs are available to treat epilepsy. Although generic drugs are safely used for most medications, anticonvulsants are one category where doctors proceed with caution. Most doctors prefer to use brand-name anticonvulsants, but realize that many insurance companies will not cover the cost. As a result, it is acceptable to start taking a generic anticonvulsant medication, but if the desired control is not achieved, the patient should be switched to the brand-name drug.