Jugular vein-mammary artery fistula after catheterism for hemodialysis: case report

The demographic characteristics of hemodialysis (HD) patients increase the need for the tunneled cuffed permanent catheter (TCC) as a definitive vascular access (VA) for HD. The internal jugular vein is increasingly being used as a route for TCC or temporary catheter placement and can be associated with serious complications. Among them other authors have described arteriovenous fistula (AVF) creation between the common carotid artery and the right jugular vein. We describe a case of an AVF between the right internal jugular vein and the right internal mammary artery. The fistula was detected during the TCC placement in a patient who underwent several jugular and subclavian catheterisms for HD in her clinical history.The demographic characteristics of hemodialysis (HD) patients increase the need for the tunneled cuffed permanent catheter (TCC) as a definitive vascular access (VA) for HD. The internal jugular vein is increasingly being used as a route for TCC or temporary catheter placement and can be associated with serious complications. Among them other authors have described arteriovenous fistula (AVF) creation between the common carotid artery and the right jugular vein. We describe a case of an AVF between the right internal jugular vein and the right internal mammary artery. The fistula was detected during the TCC placement in a patient who underwent several jugular and subclavian catheterisms for HD in her clinical history

Anticoagulation therapy for the prevention of hemodialysis tunneled cuffed catheters (TCC) thrombosis

BACKGROUND: Chronic oral anticoagulation is currently used to avoid thrombosis and the malfunction of tunneled cuffed catheters (TCCs) for hemodialysis (HD). The aim of the study was to assess the efficacy of early warfarin administration, after TCC placement, in comparison to its administration after the first thrombosis or malfunction event of the TCC. PATIENTS AND METHODS: One hundred and forty-four chronic dialysis patients, who underwent TCC placement between June 2001 and June 2005, were randomized into two groups: 81 patients, group A, started oral anticoagulation 12 hr after the TCC placement (target international normalized ratio (INR) 1.8-2.5), in association with ticlopidine 250 mg/die; 63 patients, group B, started warfarin after the first thrombosis/malfunction episode (target INR 1.8-2.5) in association with ticlopidine 250 mg/die. The efficacy of oral anticoagulation therapy in preventing TCC thrombotic complications was evaluated in a 12-month follow-up period, after TCC placement, in terms of: a) the number of patients with thrombotic-malfunction events; b) the number of thrombotic-malfunction events with urokinase infusion (events/patient/year); c) intradialytic blood flow rate (BFR, ml/min); d) negative blood pressure (BP) from the arterial line of the TCC (AP, mmHg); e) positive BP, in the extracorporeal circuit from the venous line (VP, mmHg); and f) bleeding complications. RESULTS: Ten patients (12%) in group A showed TCC thrombosis/malfunction vs. 33 patients (52%) in group B (p < 0.01). In group A, 0.16 events of thrombosis/malfunction per patient/year vs. 1.65 in group B (p < 0.001) were ob-served. BFR was respectively 305 +/- 34 vs. 246 +/- 42 ml/min (p < 0.001). AP was -124 +/- 13 in group A vs. -174 +/- 21 mmHg in group B (p < 0.05). VP was 112 +/- 28 in group A vs. 168 +/- 41 mmHg in group B (p < 0.05). No patient showed any bleeding events. CONCLUSIONS: Early warfarin therapy allows a significant reduction in TCC thrombotic complications and an improvement in both arterial and venous fluxes in comparison with the same therapy administered after the first TCC thrombotic/malfunction event. This therapy did not induce any bleeding complications in the patients included in the study

Data acquisition electronics for NESTOR experiment: Project and tests

The NESTOR detector, at present under construction, is a telescope for high-energy neutrino astronomy. The apparatus, based on Cherenkov light detection, will be deployed in deep sea (about 4000m) near the S.W. Greek coast. We briefly describe the NESTOR detector, then we describe with more details the electronics for NESTOR data acquisition and transmission. The detector signals are sampled at 200MHz and all the resulting information are transmitted to the laboratory on 30km long electro-optical cable. The estimated Mean Time Between Failure of the full electronics system is greater than 20 years. Tests performed on the first prototypes confirm the main characteristics of these electronics: the dynamic range allowed for the signals is bigger than 1000, the pulse shape is reconstructed with an 8 bit ADC accuracy and the resolution in the measurement of the signal "threshold crossing time" is better than 200ps

A new mathematical model for profiled-HFR

none14noneColì L; Ursino M; Magosso E; Capriotti P; Donati G; Cianciolo G; Panicali L; Ruggeri G; Nastasi V; Piccari M; Di Nicolò P; Cannarile D; Bergamini C; Stefoni SColì L; Ursino M; Magosso E; Capriotti P; Donati G; Cianciolo G; Panicali L; Ruggeri G; Nastasi V; Piccari M; Di Nicolò P; Cannarile D; Bergamini C; Stefoni

Beyond geometrical overlap: a Dosimetrical Evaluation of automated volumes Adaptation (DEA) in head and neck replanning

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Hybrid Tri-Co-60 MRI radiotherapy for locally advanced rectal cancer: An in silico evaluation

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