Barriers and facilitators for people with severe mental illness accessing cancer screening: A systematic review.

Objective: Evidence suggests that people with severe mental illness (PwSMI) are 2.1 times more likely to die from cancer before the age of 75, compared to people without Severe mental illness (SMI). Yet, cancer screening uptake is low among PwSMI.

A protocol to identify the barriers and facilitators for people with severe mental illness and/or learning disabilities for PErson Centred Cancer Screening Services (PECCS).

Objectives: To identify the barriers and facilitators that people with severe mental illness and people with learning disabilities may encounter when accessing cancer screening and make recommendations for implementing reasonable adjustments throughout cancer screening services.

Methods And Analysis: An 18-month sequential, mixed-methods study comprising of two phases of work and underpinned by Normalisation Process Theory, recruiting from across the North-East and North Cumbria. The first phase aims to identify the barriers and facilitators for people with severe mental illness in accessing cervical, breast and colorectal cancer screening.

Time to symptomatic vascular stenosis at different locations in patients with arteriovenous grafts.

Most arteriovenous grafts fail due to irreversible thrombosis, superimposed on hemodynamically significant vascular stenosis. Previous studies observed the highest frequency of stenosis at the venous anastomosis, without addressing the timing of stenosis. The present study quantified time to symptomatic stenosis at different vascular locations, and related it to permanent graft failure.

Disparities in fistula maturation persist despite preoperative vascular mapping.

Background And Objectives: Failure to mature (primary failure) of new fistulas remains a major obstacle to increasing the proportion of dialysis patients with fistulas. This failure rate is higher in women than in men, higher in older than in younger patients, and higher in forearm than in upper arm fistulas. These disparities in the frequency of failure to mature may be due in part to marginal vessels in the high-risk groups and should be reduced by routine preoperative vascular mapping.

Increased risk of infection associated with polyurethane dialysis grafts.

Conventional polytetrafluoroethylene (PTFE) dialysis grafts cannot be cannulated for 2-3 weeks following their creation. Polyurethane grafts, made of a self-sealing material, can be cannulated within 24 hours of implantation, representing a potential advantage in patients with limited catheter options. However, early cannulation may increase the risk of graft infection.

Percutaneous renal biopsy: comparison of blind and real-time ultrasound-guided technique.

The use of real-time ultrasound-guided renal biopsy is believed to be superior to blind biopsy, but there are few reports comparing the two techniques. The goal of the present study was to compare the outcomes of ultrasound-guided and blind renal biopsies at a single teaching institution, in terms of adequacy of tissue yield and frequency of hemorrhagic complications. We reviewed retrospectively the outcomes of all patients undergoing a percutaneous native kidney biopsy during a 2-year period (January 1, 2004 to December 31, 2005).

Comparison of survival of upper arm arteriovenous fistulas and grafts after failed forearm fistula.

Although arteriovenous fistulas are considered superior to grafts, it is unknown whether that is true in the subset of patients with a previous failed fistula. For investigation of this question, a prospective vascular access database was queried retrospectively to compare the outcomes of 59 fistulas and 51 grafts that were placed in the upper arm after primary failure of an initial forearm fistula. Primary access failure was higher for subsequent fistulas than for subsequent grafts (44 versus 20%; P = 0.

Aneurysm formation in arteriovenous grafts: associations and clinical significance.

Aneurysms are a common complication of arteriovenous grafts in hemodialysis patients, resulting from repetitive needle sticks in the graft material. Although aneurysms are thought to contribute to graft failure, there are no prospective studies evaluating their risk factors or impact on graft survival. The present study evaluated aneurysms in 117 hemodialysis outpatients with upper extremity grafts at a university-affiliated dialysis center.

Needle infiltration of arteriovenous fistulae in hemodialysis: risk factors and consequences.

Background: Needle infiltration of arteriovenous fistulae is a common problem in US hemodialysis units. This study evaluated the frequency of fistula infiltration, its risk factors, and clinical consequences of this complication.

Methods: Using a prospective computerized vascular access database, we identified all patients with a major fistula infiltration sufficiently severe to prolong catheter dependence for dialysis.

Tunneled catheters in hemodialysis patients: reasons and subsequent outcomes.

Background: Reducing the use of tunneled catheters in hemodialysis patients requires concerted efforts to convert them to a usable permanent vascular access. The goal of this study is to evaluate the reasons for tunneled catheter use in our prevalent hemodialysis population and the success in converting them to a permanent vascular access.

Methods: We identified all catheter-dependent hemodialysis patients at our center on a single date.

Vascular access stenosis: comparison of arteriovenous grafts and fistulas.

Background: Vascular access stenosis is a frequent problem in hemodialysis patients. There is little published literature comparing the features of stenosis between arteriovenous fistulas and grafts, relative outcomes of elective angioplasty, and clinical factors predictive of access patency after angioplasty.

Methods: Prospective data were collected for all patients referred for a fistulogram during a 2-year period because of suspected access stenosis.

Associations with predialysis vascular access management.

Background: The Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines encourage increasing the proportion of arteriovenous fistulae among incident hemodialysis patients. Achieving optimal outcomes requires predialysis out-patient follow-up by a nephrologist, predialysis placement of a vascular access, and adequate maturation of the vascular access.

Methods: We assessed the effect of clinical factors on predialysis vascular access management in all incident hemodialysis patients at a single institution during a 2-year period.

Comparison of arteriovenous grafts in the thigh and upper extremities in hemodialysis patients.

Placement of a thigh graft is an option in hemodialysis patients who have exhausted all upper extremity sites for permanent vascular access. The outcome of thigh grafts has been reported only in retrospective studies. The outcomes of 409 grafts placed at a single institution during a 3.

Management of hemodialysis catheter-related bacteremia with an adjunctive antibiotic lock solution.

Background: Tunneled dialysis catheters are complicated by frequent systemic infections. Standard therapy of catheter-associated bacteremia involves both systemic antibiotics and catheter replacement. Recent data suggest that biofilms in the catheter lumen are responsible for the bacteremia, and that instillation of an antibiotic lock (highly concentrated antibiotic solution) into the catheter lumen after dialysis sessions can eradicate the biofilm.