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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.
Most women have between 11 and 13 menstrual periods each year. You may be different: You may have more or fewer. Missed or irregular periods must be looked at in terms of what is normal for you. Menstrual periods are often irregular during the first few years after menstruation starts. It may take several years for the hormones that control menstruation to reach a balance. Menstrual periods also may be very irregular at the other end of the menstrual years. Many women realize that they are approaching perimenopause and menopause when their otherwise regular periods become irregular. Menopause occurs when it has been 12 months since you had a menstrual period. Pregnancy is the most common cause of a missed period. If you might be pregnant, treat yourself as if you are pregnant until you know for sure. Use a home pregnancy test as the first step to finding out whether you are pregnant.
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.
Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include: Nausea Vomiting Loss of appetite Fatigue and weakness Sleep problems Changes in how much you urinate Decreased mental sharpness Muscle twitches and cramps Swelling of feet and ankles Persistent itching Chest pain, if fluid builds up around the lining of the heart Shortness of breath, if fluid builds up in the lungs High blood pressure (hypertension) that's difficult to control Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.
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.
If you and your partner are struggling to have a baby, you're not alone. Ten to 15 percent of couples in the United States are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples. Infertility may result from an issue with either you or your partner, or a combination of factors that interfere with pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant
Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins. Sclerotherapy involves an injection of a solution (generally a salt solution) directly into the vein. The solution irritates the lining of the blood vessel, causing it to collapse and stick together and the blood to clot.
Doctors have many options to choose from, including interferon (Avonex, Betaseron, Extavia, and Rebif ), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), teriflunomide (Aubagio), fingolimod (Gilenya), dimethyl fumarate (Tecfidera), and natalizumab (Tysabri).
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.
Thyroiditis is a general term that refers to “inflammation of the thyroid gland”. Thyroiditis includes a group of individual disorders causing thyroidal inflammation but presenting in different ways. For example, Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States. Postpartum thyroiditis, which causes temporary thyrotoxicosis (high thyroid hormone levels in the blood) followed by temporary hypothyroidism, is a common cause of thyroid problems after the delivery of a baby. Subacute thyroiditis is the major cause of pain in the thyroid. Thyroiditis can also be seen in patients taking the drugs interferon and amiodarone.
Blood clots form in an already-narrowed artery and block the flow of oxygen-rich blood to the heart muscle. When taken during a heart attack, aspirin slows clotting and decreases the size of the blood clot that is forming. After a heart attack. Aspirin can help prevent a second heart attack.
Adult stem cells are cells from your own body that can renew themselves and turn into other cells (differentiate). They live inside all of us in various tissues, poised to leap into action to repair damage as it occurs. As we age or have big injuries, we may not be able to recruit enough of these cells to the site to fully repair the area. Regenexx Stem Cell Procedures help overcome this problem by extracting stem cells from an area of high volume, then concentrating the cells and reinjecting them into the damaged area to help the body heal naturally.
Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.
Most people have general anesthesia right before surgery. This means you will be asleep and pain-free. Other kinds of anesthesia, like regional anesthesia or a block, may also be used for this surgery. The tissue to replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and chose to give all or part of his or her body to help others. Tissue taken from your own body is called an autograft. The two most common places to take tissue from are the knee cap tendon or the hamstring tendon. Your hamstring is the muscle behind your knee. Tissue taken from a donor is called an allograft. The procedure is usually performed with the help of knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small surgical cut. The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee. Your surgeon will make other small cuts around your knee and insert other medical instruments. Your surgeon will fix any other damage found, and then will replace your ACL by following these steps: The torn ligament will be removed with a shaver or other instruments. If your own tissue is being used to make your new ACL, your surgeon will make a larger cut. Then, the autograft will be removed through this cut. Your surgeon will make tunnels in your bone to bring the new tissue through. This new tissue will be in the same place as your old ACL. Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place. As it heals, the bone tunnels fill in. This holds the new ligament in place. At the end of the surgery, your surgeon will close your cuts with sutures (stitches) and cover the area with a dressing. You may be able to view pictures after the procedure of what the doctor saw and what was done during the surgery.
Possible complications include: Cardiovascular disease. ... Nerve damage (neuropathy). ... Kidney damage (nephropathy). ... Eye damage (retinopathy). ... Foot damage. ... Skin conditions. ... Hearing impairment. ... Alzheimer's disease.