Preserving function and long-term patency of dialysis access

Of the 283, 932 patients with end stage renal disease (ESRD) receiving replacement therapy in the US in 1996, 62% were being treated with haemodialysis. Improved survival of haemodialysis patients coupled with the inability to provide enough renal transplants for the growing ESRD population has resulted in an increase in the average length of time patients spend on dialysis. Vascular accesses are, therefore, required to function for longer periods of time. Maintenance of a reliable access to the circulation has been described as the Achilles' heel of modern haemodialysis. Preserving access function and long-term patency are essential for efficient dialysis delivery.     

Sonographic appearance of oxidised cellulose (Surgicel): pitfall in the diagnosis of renal vein thrombosis in a transplant kidney

We report the misleading sonographic appearance of Surgicel in the diagnosis of renal vein thrombosis in a case of kidney transplant and a review of the literature. Removal of the Surgicel before closure is advisable to avoid misdiagnosis.     

Post‐COVID‐19 splenic infarction in a patient with chronic atrial fibrillation: A case report

We describe splenic infarction (SI), an infrequent condition, in an 82‐year‐old COVID‐19 patient with chronic atrial fibrillation (AF). COVID‐19 may cause thrombosis, and AF is a predisposing factor for splenic infarction. Suspicion of SI may be warranted in COVID‐19 patients with abdominal pain, especially if a predisposing factor exists.     

A nucleic acid amplification test‐based strategy does not help inform return to work for healthcare workers with COVID‐19

ObjectiveThe objective of this study is to assess the utility of a nucleic acid amplification test‐based approach to shorten isolation of healthcare workers (HCWs) with COVID‐19 in the setting of the highly transmissible omicron variant.MethodsBetween December 24, 2021, and January 5, 2022, HCWs who tested positive for SARS‐CoV‐2 were retested with PCR at least 5 days since onset of symptoms.ResultsForty‐six sequential fully COVID‐19 vaccinated HCWs who had tested positive for SARS‐CoV‐2 underwent follow‐up testing. All the samples were confirmed as omicron variants and only four (8.7%) were negative in the follow‐up test performed at a median of 6 (range 5–12) since onset of symptoms.ConclusionsImplementation of a test‐based strategy is logistically challenging, increases costs, and did not lead to shorter isolation in our institution.     

Impact of zoledronic acid on control of metastatic spinal cord compression

BACKGROUND: Zoledronic acid was demonstrated to reduce the rate of skeletal-related events, a hypernym including various outcomes, in patients with bone metastases. In contrast to other studies, this matched-pair analysis focused solely on the impact of zoledronic acid on metastatic spinal cord compression (MSCC). PATIENTS AND METHODS: Data from 98?patients with MSCC receiving radiotherapy plus zoledronic acid were matched 1:2 to 196?patients receiving radiotherapy alone for ten potential prognostic factors. Both groups were compared for local control of MSCC within the irradiated region, overall control of MSCC (local and distant MSCC control), and survival. RESULTS: The 1-year local control rates were 90% after radiotherapy plus zoledronic acid and 81%, after radiotherapy alone (p?=?0.042). The 1-year overall control rates were 87% and 75%, respectively (p =?0.016), and the 1-year survival rates were 60% and 52%, respectively (p?=?0.17). Results were significant in the Cox proportional hazards model regarding local control (p?=?0.024) and overall control (p =?0.008). CONCLUSION: According to the results of this study, zoledronic acid was associated with improved control of MSCC in irradiated patients.     

Small bowel transplantation

Many patients die each year lacking only a functional small bowel to survive. The minimum amount of small intestinal absorptive surface required to sustain life varies from patient to patient. Prolonged survival with oral alimentation alone has been reported in a few patients with an intact duodenum and as little as 15-45 cm of residual jejunum. However, without long-term total parenteral nutrition (TPN), prolonged patient survival is the exception rather than the rule. Chronic parenteral nutrition is associated with complications, including sepsis, venous thrombosis, metabolic disorders and liver dysfunction. From studies of patients currently on long-term TPN, it would appear that there are between two and three patients per million of population per year who develop irreversible small bowel failure. It is estimated that 20 new patients/year in the UK receiving home TPN would be potential candidates for small bowel transplantation.     

Epidemiology of football injuries in Asia: A prospective study in Qatar

ObjectivesTo investigate the incidence, characteristics and patterns of football injuries at club level in Qatar.DesignProspective cohort study.MethodsData were prospectively collected from the first division football league clubs in Qatar, in accordance with the international consensus statement on football injury epidemiology. An injury was defined as any physical complaint sustained during football activity resulting in the inability to participate fully in the next training or match. Individual injuries and exposure of each player were recorded by the medical staff of each team over one season.ResultsA total of 217 injuries were recorded, with an injury rate during matches of 14.5/1000 h (95% CI: 11.6–18.0) compared with 4.4/1000 h during training sessions (95% CI: 3.7–5.2). More than one third of all injuries were muscle strains (36.4%). Hamstring strains (54.4% of all muscle strains) exhibited a higher incidence than all other injury types (p < 0.001). The thigh was the most frequent injury location (41.9%, p < 0.001). Reinjuries (15% of total injuries) were mainly comprised of muscle strains associated with a higher severity compared with new injuries.ConclusionsDespite the different environmental, social and cultural setting, our findings are comparable with previous data from European club football, confirming the previous finding at national team level that there are no regional peculiarities of football injuries in this part of the Asiatic continent.The relatively high overuse injury incidence rate and the high recurrence rate for (severe) thigh muscle strains, especially during games, warrants prevention strategies.