One-Year Efficacy of Expanded Polytetrafluoroethylene Vascular Graft in Eighty-Three Hemodialysis Patients

<p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Purpose:</span></strong><span style="mso-bidi-language: FA;"> To evaluate the patency and efficacy of expanded Polytetrafluoroethylene (ePTFE) vascular graft in hemodialysis patients.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Materials and Methods:</span></strong><span style="mso-bidi-language: FA;"> In a prospective study from January 1999 to January 2001 at Sina hospital 41 patients underwent implantation of 6-mm vascular grafts and 42 underwent implantation of 8-mm grafts in order to make vascular assess for hemodialysis. They were followed up to 12 months, observing the complications. </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Results:</span></strong><span style="mso-bidi-language: FA;"> Mean patients’ age was 52.2 years. Thirty-seven of them were females and 46 were males. Over a 12 months period of follow-up, 12 cases of graft infection (14.5%), 21 cases of thrombosis (25.3%), 7 cases with both complications (8.4%), and 1 case of pseudoaneurism (1.2%) were observed. One-year patency rate was 34.9%. Diabetes was the only factor associated with lower patency rate (27% versus 57%, p<0.05).</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Conclusion:</span></strong><span style="mso-bidi-language: FA;"> ePTFE vascular graft seems to be an appropriate substitute for arteriovenous fistula as a vascular assess in hemodialysis patients. Educating patients and good care can decrease the rate of infection, thrombosis, and other complications, resulting in a better patency and lower morbidity rate.</span></span></span></p&gt

Barriers and facilitators to provide effective pre-hospital trauma care for road traffic injury victims in Iran: a grounded theory approach

BACKGROUND: Road traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs) worldwide, particularly in low- and middle-income countries (LMICs) with a high rate of RTIs such as Iran. The current study aimed to explore pre-hospital trauma care process for RTI victims in Iran and to identify potential areas for improvements based on the experience and perception of pre-hospital trauma care professionals. METHODS: A qualitative study design using a grounded theory approach was selected. The data, collected via in-depth interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative method. RESULTS: Seven categories emerged to describe the factors that hinder or facilitate an effective pre-hospital trauma care process: (1) administration and organization, (2) staff qualifications and competences, (3) availability and distribution of resources, (4) communication and transportation, (5) involved organizations, (6) laypeople and (7) infrastructure. The core category that emerged from the other categories was defined as "interaction and common understanding". Moreover, a conceptual model was developed based on the categories. CONCLUSIONS: Improving the interaction within the current pre-hospital trauma care system and building a common understanding of the role of the Emergency Medical Services (EMS) emerged as key issues in the development of an effective pre-hospital trauma care process

The Comparison Of Characteristics Among Injured Pedestrians And Car Occupants (Tehran, 1996-97)

This article is to verify mortality rate, cause of death, severity of injury (ISS),GCS, patient fate in hospital, pattern of specific organ injuries and some other characteristics among injured pedestrians and car occupants referred to three trauma centers in Tehran (Sina hospital, Shohada Tajrich hospital, Fayazbakhsh hospital) from May 1996 until May 1997."nMaterials and Methods: 57367 patients were admitted to emergency department of these centers among which, 6027 victims of motor-vehicle accidents were included in this study."nResults: 71% of cases were pedestrians and rest was car occupants. M/F ratio was 1.8/5. Mean age was 29y. Motor vehicle accidents occurred most commonly during nights. The patients' GCS at arrival in emergency department had similar distribution in both groups. The most commonly injured organs in both groups were: integument, head and neck, extremities and bony pelvis. Thoracic and spinal injuries were more common among car occupants. Extremities and boney pelvis injuries were more common among pedestrians. The mortality rate was the same between both groups. Mortality rate was affected by GCS at arrival and severity of injury. Mortality rate among the old was 4 times the rate among the children. The accidents most commonly occurred on metropolitan roads and streets. The most common cause of death between both groups was head injury. Surprisingly head injury was a more common cause of death among the car occupants."nConclusion: Pattern of specific organ injuries was different form the pattern in previous studies as the pattern was virtually the same between both groups except for spinal and thoracic injuries were more common among the car occupants