Switching temporary hemodialysis catheters to long-term catheters: exchange versus de-novo placement, any difference in line infection? .

Background: Shifting from a short-term catheter to a long-term one is done either by removing the old catheter and placing a new long-term one via fresh new puncture site, or by replacing the old catheter with a long-term one over a guidewire.

Aim: We aimed to describe our technique in changing a temporary line to a long-term catheter (LTC) over a guidewire and to determine the incidence of line-related infections following this procedure.

Materials And Methods: A retrospective pilot study was conducted between 2005 and 2010 at the American University of Beirut Hospital.

Weight gain in gestational diabetes: the effect of treatment modality.

Objective: To evaluate treatment effectiveness (diet alone, insulin or glyburide) on maternal weight gain in gestational diabetes (GDM).

Methods: GDM patients were treated with diet alone, insulin or glyburide. Weight gain was stratified into: prior to GDM diagnosis, from diagnosis to delivery and total pregnancy weight gain.

Electrical pacemaker as a safe and feasible method for decreasing the uterine contractions of human preterm labor.

Aim: The aim of the study was to test the safety and feasibility of a system designed to decrease the uterine contractions of human preterm labor using a weak electrical current.

Methods: Patients in preterm labor had an electrode catheter placed in the posterior vaginal fornix and attached to an electrical pacemaker. Contraction intervals were determined during the 60-min study, in which minutes 0-20 was the preintervention control period (C1); 21-40 was the electrical intervention (EI), with a 10-s burst of current administered just before each expected contraction; and 41-60 was the postintervention control (C2).

Male-to-female gender ratio in fetuses with increased nuchal translucency.

Objective: To describe gender distribution in fetuses with increased nuchal translucency (NT) measurements.

Methods: All fetuses with mild (2.5-2.

Prevalence of peripheral vascular calcifications in patients on chronic hemodialysis at a tertiary care center in Beirut: a pilot study.

Background: Vascular calcifications are highly prevalent in patients maintained on chronic hemodialysis. They have been linked to numerous risk factors and have been associated with an increased risk of cardiovascular morbidity and mortality. The purpose of this pilot study is to assess the prevalence of vascular calcifications among dialysis patients in our tertiary care center and to identify the associated risk factors.

First-trimester crown-rump length as a predictor of fetal LGA and SGA at term.

Objective: To determine whether first-trimester crown-rump length (CRL) is associated with birthweight extremes at term.

Methods: Included in this study were all term, small for gestational age (SGA), and large for gestational age (LGA) neonates with no other obstetric complications and no abnormal outcomes of pregnancy. CRL at 12.

Hypoglycemia in glyburide-treated gestational diabetes: is it dose-dependent?

Objective: To estimate whether there is a relationship between glyburide dose and the rate of hypoglycemic episodes in women with gestational diabetes mellitus (GDM).

Methods: We studied 674 women with GDM who were treated with glyburide and diagnosed from 2000 to 2009. Glucose data were downloaded from memory-based meters at each visit and analyzed to estimate the incidence of recorded episodes of hypoglycemia and the association with concurrent dose of glyburide therapy (2.

High-output cardiac failure secondary to a large arteriovenous fistula: a persistent threat to the dialysis and kidney transplant patient.

High-output cardiac failure secondary to a surgically constructed arteriovenous fistula (AVF) is a rare entity that is usually under-diagnosed in the dialysis population. We herein present a case of a 35-year-old female who was diagnosed with high-output cardiac failure secondary to an AVF and later managed with surgical division of the fistula. Risk factors associated with this entity are discussed, and preventive screening strategies are recommended.

Influence of HLA disparity, immunosuppressive regimen used, and type of kidney allograft on production of anti-HLA class-I antibodies after transplant and occurrence of rejection.

We studied the effects of HLA disparity, immunosuppressive regimen used, and the type of kidney allograft on production of anti-HLA antibodies after transplant and the occurrence of rejection episodes. Five living-unrelated donors and 4 living-related donors kidney recipients received quadruple therapy (including sirolimus and mycophenolate mofetil). Fifteen living-unrelated donors and 19 living-related donors received triple therapy (excluding sirolimus).

Observations on quadruple immunosuppression maintenance therapy using rapamycin, low-dose cyclosporine, mycophenolate mofetil, and prednisone following ATG induction.

Introduction: We prospectively evaluated an immunosuppressive regimen consisting of rapamycin (Rapa), low-dose cyclosporine (CsA), low-dose mycophenolate mofetil (MMF), and prednisone (group 1) versus a regimen of CsA, MMF, and prednisone (group 2) in mismatched living related donor (LRD) and living unrelated donor (LUD) kidney transplantation.

Methods: Group 1 included 24 transplant recipients of eight mismatched LRD and 16 LUD, treated with Rapa, low-dose MMF, CsA, and prednisone. Group 2 included 53 transplant recipients (25 LRD, 27 LUD, and one cadaveric donor), treated with MMF, CsA, and prednisone.

A controlled sequential evaluation of open donor nephrectomy versus classical and modified laparoscopic donor nephrectomy: an update.

This study sought to determine the procedure of choice for kidney retrieval for transplantation by comparing open donor nephrectomy to laparoscopic donor nephrectomy and modified laparoscopic donor nephrectomy and by analyzing intraoperative donor and recipient graft function parameters. In this single-center, controlled, sequential analysis, 100 consecutive donor-recipient pairs were recruited, grouped according to surgical procedure, and operated upon between 1997 to 2004, as follows: group 1, open donor nephrectomy (n = 30), performed from 1997 to 2000; group 2, laparoscopic donor nephrectomy (n = 28), performed from 2000 to 2002; and group 3, modified laparoscopic donor nephrectomy (n = 42), performed from 2002 to 2004. Data were analyzed by type of operative procedure, graft function, length of hospital stay, and donor recovery time.

A controlled sequential evaluation of laparoscopic donor nephrectomy versus open donor nephrectomy: an update.

Introduction: In this study, we compared laparoscopic (lap Nx) to open donor nephrectomy (open Nx) with specific emphasis on outcomes in the donor and recipient.

Methods: This single-center sequential analysis recruited 100 consecutive donor-recipient pairs operated on from 1997 until 2003. The open Nx (n = 30), were performed between 1997 and 2000; the lap Nx (n = 70) were performed between 2000 and 2003.

Predictors of bone mineral density in patients on hemodialysis.

Renal osteodystrophy is a universal complication of uremia. Renal failure patients are at risk for low bone mineral density (BMD) and fractures. Parathyroid hormone (PTH) plays a pivotal role in the pathophysiology of uremic bone disease.

Hematologic parameters and iron stores in patients on hemodialysis for chronic renal failure.

Thirty-two patients on hemodialysis for chronic renal failure were investigated. A correlation was sought between bone marrow iron stores assessed on Prussian-blue stained smears, and some common hematological parameters such as red blood corpuscle indexes obtained by coulter counter, serum iron, iron-binding capacity and serum ferritin levels (measured by RIA). MCH and MCV were both found significantly depressed in patients with depleted iron stores, a situation not reflected by any of the other tested parameters.

Blood leukocyte contribution to serum ferritin levels in patients on chronic hemodialysis.

Serum ferritin level has been shown by many investigators to be a good indicator of bone marrow iron stores in normal subjects. Although this correlation may hold in some pathological situations, it is lost in others. In leukemia a dissociation has been observed between serum ferritin levels and bone marrow iron stores.

Monocyte ferritin as a possible index of bone marrow iron stores in patients on chronic hemodialysis.

It is well known that macrophages are the principle cells responsible for removal of senescent erythrocytes from circulation and are the major storage cell for body iron. Monitoring stored iron in patients with anemia secondary to renal failure and chronic hemodialysis is an important parameter used for gauging supplementing these patients with iron. We have proven that blood monocyte ferritin unlike serum ferritin reflects adequately bone marrow iron stores and thus replaces an undesirable procedure in such patients namely bone marrow punctures.

Efficacy and safety of lasilactone, a new combination diuretic, in essential hypertension.

1. Lasilactone, a new combination diuretic (furosemide 20 mg and spironolactone 50 mg) was evaluated in 30 patients with mild-to-moderate essential hypertension. Each patient received one capsule of lasilactone daily.