Brachial vein transposition with consecutive skin incisions in a hemodialysis patient with absence of adequate superficial veins: A case report

The creation of an arteriovenous fistula instead of a synthetic vascular graft is a smart decision in hemodialysis patients who do not have a suitable superficial vein. Basilic vein transposition (BVT) is a viable option in most cases, except in patients who do not have a proper basilic vein. In patients with inadequate superficial veins, another source of the autogenous vein is the brachial vein, a deep vein of the upper arm. Most surgeons choose a full medial arm incision to perform brachial vein exploration. We describe a patient in whom BVT was not possible and so brachial vein transposition using skip incisions was performed, with good results. Copyright © 2020 The Korean Society for Vascular Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited

Magnetic resonance imaging in the evaluation of iron overload: A comparison of MRI, echocardiography and serum ferritin level in patients with β-thalassemia major

Purpose: This study aimed to evaluate iron levels in cardiac and hepatic tissues using magnetic resonance imaging (MRI) T2*. Methods: Cardiac and hepatic MRI was performed for 93 patients with β-thalassemia major. Results: Cardiac T2* was in the range of 2.9-56.6 ms. Myocardial siderosis was detected in 44 of patients; 25 patients had moderate and severe siderosis with serum ferritin level (SFL) of 576-10,284 ng/ml. There was a significant correlation between SFL and cardiac T2* (p<.001). Conclusions: The effective role of MRI as a noninvasive producible method in measurement of iron concentration in tissues is not accessible with conventional techniques. © 2012 Elsevier Inc

Stock enhancement and estimation of growth rate of green tiger prawn (Penaeus semisulcatus) and banana shrimp (Fenneropenaeus merguiensis) released in the Persian Gulf

Present study was conducted in the Persian Gulf (Iranian waters) from 2009 to 2012. The main objective of the research was economical evalution of the stock enhancement of banana prawn (Fenneropenaeus merguiensis) and green tiger shrimp (Penaeus semisulcatus) in the studied area. Also tagging effects on the growth and mortality of tagged shrimp were studied. In banana prawn, broodstock shrimps were hatched in June. In July 2010 and 2011some of the juvenile of this species were marked by red fluorescent liquid injection and released were made at night in the estuaries of Tiab, Kolahi and Koolgan in the Hormozgan province. 84000 juveniles of banana prawn in 2010 and about 50000 in 2011 were released in this area. In Bushehr province waters, adults shrimp were reared and when juveniles reached to optimum size, some of them were tagged by red and blue coloures and were released in the coastal waters of Bandargah and Delvar. Tagging and releasing program of green tiger prawn was performed in 2010 and 2012. A total number of 8000 prawn in 2010 and about 30000 juveniles prawn in 2010 were released. Activities for recaptured shrimps were informed by posters describing the tagging program that were distributed to local peoples, as well as local magazines, and a tagging program awareness film was broadcast on national television three times prior to the shrimp fishing season and during catch season. To encourage people to report recaptures a reward of two handered thousent riales was paid for the return of each marked shrimp accompanied by information. Economical evaluation of banana prawn was performed based on releasing and recaptured program in 2011. As it mentioned in this year 50000 of juvenile shrimp were tagged and released. At the same time 4700000 of unmarked shrimp were released in this area. In the shrimp season 11 (./022%) of tagged shrimp were recaptured. Movements of tagged shrimp were northwesterly to released area. Weight average of tagged prawns was 1.2 gram. Mean weight of the recaptured prawns was 22.06±4.9 gram. Body weight Growth of the recaptured prawns was between 16-26 grams with the growth speed of 0.88-1.41 per week. The number of recaptured prawn to the released prawn was 0.022 percent. Based on the released prawns (4700000) to the recaptured percent (./022%), about 103400 of released shrimp with mean weight of 2.5 tones were observed in the Hormozgan shrimp catch. The average price of shrimp in the studied year in the local market was 85000 Rials per kilogram. These results showed that the ratio of profit is 210 milion riales. In the taggiing program of green tiger prawn in the Bushehr waters only one recaptured shrimp was observed in the catch season (2012). Total weigth and total length of this prawn was 99 gram and 22 centimeter respectively .given the small percentage of the recaptured, economical analyses was not performed on this species. The effects of tagging on the growth and mortality of green tiger prawn were studied. The present study was carried out in the shrimp research station in Bandargah and Abzistan shrimp Hatchery Company in Delvar during 2010 and 2012. The accuracy of the study was more rialable in 2012. In this year growth and mortality of juveniles that was marked by red and blue coloures, were studied in both area Bandargah and Delvar. In Bandargah, three tanks of 300 l each with 30 specimens were used for untagged shrimp as a control group, and tagged with injected liquid fluorescent during 98 days. Length and weigh of 10 specimens were measured evenly in different times. ANOVA results (α = 0.1 and α = 0.5) showed no significant differences between length growth of tagged shrimp and control group. The mortality of two groups was evaluated by numbering of remained shrimps and the average of survival was 52 percent in the tagged and 44.5 percent in tagged shrimps. In the Delvar station, Abzistan Company, the specimens were kept in the 9 tanks each 300 l that included of 30 untagged shrimps, 30 blue tagged shrimps and 30 red florescent tagged shrimp. The growth and mortality of this station were evaluated during 110 days. The growth rate of the specimens were measured and recorded evenly. The results of ANOVA (α = 0.1 and α = 0.5) showed no difference significantly in the weight growth of tagged and control groups. The mortality rates among the control group, red tagged and blue tagged were 63 percent, 59 percent and 40 percent. The mortality of the groups was differences in the two stations and it seems the management and environmental conditions were more affected on the mortalities. The results of the study show that the ratio of profit to the coast is 0.46 that is covering half of the coasts, so that the expenditures are two times more than profit. This result is the minimum of economical value of stock enhancement of shrimp. The results of study showed that the injected tags into the body tissue of shrimp has no affected on the growth rate and mortality

A Review of Surgical Informed Consent: Past, Present, and Future. A Quest to Help Patients Make Better Decisions

Contains fulltext : 87422.pdf (publisher's version ) (Closed access)BACKGROUND: Informed consent (IC) is a process requiring a competent doctor, adequate transfer of information, and consent of the patient. It is not just a signature on a piece of paper. Current consent processes in surgery are probably outdated and may require major changes to adjust them to modern day legislation. A literature search may provide an opportunity for enhancing the quality of the surgical IC (SIC) process. METHODS: Relevant English literature obtained from PubMed, Picarta, PsycINFO, and Google between 1993 and 2009 was reviewed. RESULTS: The body of literature with respect to SIC is slim and of moderate quality. The SIC process is an underestimated part of surgery and neither surgeons nor patients sufficiently realize its importance. Surgeons are not specifically trained and lack the competence to guide patients through a legally correct SIC process. Computerized programs can support the SIC process significantly but are rarely used for this purpose. CONCLUSIONS: IC should be integrated into our surgical practice. Unfortunately, a big gap exists between the theoretical/legal best practice and the daily practice of IC. An optimally informed patient will have more realistic expectations regarding a surgical procedure and its associated risks. Well-informed patients will be more satisfied and file fewer legal claims. The use of interactive computer-based programs provides opportunities to improve the SIC process.1 juli 201

Prediction of HCV load using genotype, liver biomarkers, and clinical symptoms by a mathematical model in patients with HCV infection

Hepatitis C virus (HCV) infection is a major public health problem with about 1.75 million new HCV cases and 71 million chronic HCV infections worldwide. The study aimed to evaluate clinical, serological, molecular, and liver markers to develop a mathematical predictive model for the quantification of the HCV viral load in chronic HCV infected patients. In this cross-sectional study, blood samples were taken from 249 recently diagnosed HCV-infected subjects and were tested for liver condition, viral genotype, and HCV RNA load. Receiver operating characteristics (ROC) curves and multiple linear regression analysis were used to predict the HCV-RNA load. Genotype 3 followed by genotype 1 were the most prevalent genotypes in Mashhad, Northeastern Iran. The maximum levels of viral load were detected in the mixed genotype group, and the lowest levels in the undetectable genotype group. The log of the HCV viral load was significantly associated with thrombocytopenia and higher serum levels of alanine transaminase (ALT). In addition, the log HCV RNA was significantly higher in patients with arthralgia, fatigue, fever, vomiting, or dizziness. Moreover, genotype 3 was significantly associated with icterus. A ROC curve analysis revealed that the best cut-off points for serum levels of aspartate aminotransferase (AST), ALT, and alkaline phosphatase (ALP) were &gt;31, &gt;34, and ≤246 IU/L, respectively. Sensitivity, specificity, and positive predictive values for AST were 87.7%, 84.36%, and 44.6%, for ALT they were 83.51%, 81.11%, and 36%, and for ALP were 72.06%, 42.81%, and 8.3%, respectively. A mathematical regression model was developed that could estimate the HCV-RNA load. Regression model: log viral load = 7.69 − 1.01 × G3 − 0.7 × G1 + 0.002 × ALT − 0.86 × fatigue

Serum 25-hydroxyvitamin D Levels in Patients Referred to Clinical Laboratories in Various Parts of Mashhad- Northeastern Iran

Introduction: Vitamin D has an important role in maintaining human health. The main source of vitamin D production is skin exposure to sunlight. Accordingly with the spread of apartment life culture, growth of industrial cities and the increase of air pollution; vitamin D deficiency and its implications is an important factor in the appearance of debilitating diseases in different age categories (especially for children, adults and elderly people).   Materials and Methods: A retrospective cross-sectional study based on an objective was conducted on 1,110 patients who were selected randomly. These patients have been referred to “center of education culture and research” laboratories (2 laboratories) and 8 specialized laboratories for vitamin D test in the city of Mashhad. And after conducting the study, the collected data was analyzed using SPSS 13 software.   Results: The prevalence of vitamin D deficiency in the population under study was 68.8%. Vitamin D levels were significantly lower in males in comparison with females (