Control and coping for individuals with end stage renal disease on hemodialysis: a position paper.

The hemodialysis regimen required to treat end stage renal disease (ESRD) can be extremely rigid, requiring individuals to adapt to and cope with multiple acute and chronic stressors. Stressors for individuals on hemodialysis can be treatment-related such as dietary and fluid restrictions and ingesting handfuls of medications, or psychosocial in nature such as alterations in sexual function, changes in self-perception, and fear of death. Coping for individuals with ESRD can be adaptive or maladaptive.

Quality of life among bipolar disorder patients misdiagnosed with major depressive disorder.

Objective: Bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD). We aim to quantify the prevalence of misdiagnosed bipolar disorder among the depression population and evaluate the quality-of-life (QOL) impact of misdiagnoses.

Method: Data were collected from 2 self-administered, cross-sectional studies in 2003.

The International Quotidian Dialysis Registry: annual report 2007.

In view of the need to study both intermediate and definitive outcomes associated with daily and extended-hours hemodialysis (HD), our group has undertaken the design and implementation of an international registry to collect data describing the treatments and outcomes of patients treated with these regimens. The International Quotidian Dialysis Registry began recruiting patients in June 2004. There are currently 229 patients enrolled in the registry, up from 199 last year.

A skeptical view of assisted home peritoneal dialysis.

While assisted PD may prove helpful for a subset of new patients, its overall effect will be small. A trend towards a small increase in incident PD rate will not translate directly into an equivalent rise in PD prevalence. Important questions about cost effectiveness and about long-term impact of home PD assistance on modality distribution remain unanswered.

Sodium citrate 4% locking solution for central venous dialysis catheters--an effective, more cost-efficient alternative to heparin.

Background: Thrombosis of the central venous haemodialysis catheter compromises dialysis adequacy and catheter survival. Heparin containing catheter-locking solution has been associated with bleeding, interferes with INR (prothrombin time/international normalized ratio) measurements and is costly. Sodium citrate has been used successfully as a catheter-locking solution, but long-term experience with its use as the exclusive locking solution has not been published.

Subjective and behavioural consequences of striatal dopamine depletion in schizophrenia--findings from an in vivo SPECT study.

Dysphoria is an integral part of the symptomatology of a variety of clinical states, though there is little empirical data available on the qualitative and quantitative aspects of this phenomenon. The purpose of the study was to administer alphamethyl paratyrosine (AMPT), a catecholamine depleting agent as a chemical probe to induce dysphoria, and document the ensuing changes in mental status. AMPT (4-5 g/day) was administered to a group of medication-free schizophrenic patients (n=13) over a 48 hour period, and changes in their mental status were monitored at 12 hour intervals with the Profile of Mood States (POMS), Addiction Research Center Inventory (ARCI), Drug Attitude Inventory (DAI) and other standardized rating scales.

The International Quotidian Dialysis Registry: annual report 2006.

Interest in short daily and nocturnal hemodialysis (HD) regimens continues to grow worldwide. Despite growing optimism that these therapies will afford better patient outcomes over conventional HD, the current literature has not been viewed as sufficiently compelling to affect widespread implementation in most jurisdictions. Before these therapies can gain wider acceptance, larger and more rigorous studies will likely be needed.

Daily hemodialysis 2006. State of the art.

The need to improve the dialysis outcomes, the negative results from the HEMO and ADEMEX studies as well reports of clinical benefits have rekindled the interest in daily hemodialysis. Although no randomized controlled studies have been published, a large number of manuscripts have described significant benefits from both the short or nocturnal forms of daily (quotidian) dialysis or hemo(dia)filtration. They include improved quality of life, hemodynamic stability, blood pressure control with minimal number of medications, anemia control, regression of cardiac hypertrophy and improved nutrition.

Modified SST-USST for tamsulosin-associated intraoperative [corrected] floppy-iris syndrome.

I describe a technique using ophthalmic viscosurgical devices to perform cataract surgery in patients taking tamsulosin (Flomax). The 6-step method uses a combination variant of the soft-shell and ultimate soft-shell techniques and involves adjustments to flow parameters. It achieves satisfactory iris stability and permits uneventful surgery.

Modality options for renal replacement therapy: the integrated care concept revisited.

As the End-stage renal disease population continues to grow, innovative strategies that optimize patient outcomes while capitalizing on the relative strengths of the existing modalities must be sought. Renal transplantation remains the preferred form of renal replacement therapy, but given the limited supply of donor organs, dialytic therapies will continue to constitute a large part of the modality mix. Matching patients to the most suitable modalities requires that a number of factors be considered.

Attitudes of Canadian nephrologists toward multidisciplinary team-based CKD clinic care.

Background: Although evidence supporting the advantages of multidisciplinary team-based chronic kidney disease (CKD) care is not well developed, many groups are advocating increased availability of this model.

Methods: The research design is a mailed survey sent to 523 members of the Canadian and Quebec Societies of Nephrology.

Results: After excluding 113 respondents who declared themselves to be ineligible, the response rate was 54%.

Diagnosis and management of insomnia in dialysis patients.

Sleep-related complaints affect 50-80% of patients on dialysis. Sleep disorders impair quality of life significantly. Increasing evidence suggests that sleep disruption has a profound impact both on an individual and on a societal level.

New classification of ophthalmic viscosurgical devices--2005.

Purpose: To revise the generally accepted classification of ophthalmic viscosurgical devices (OVDs) to include cohesion data and the new class of viscous dispersive OVDs.

Setting: York Finch Eye Associates, Toronto, Ontario, Canada, and Alcon Research Limited, Fort Worth, Texas, USA.

Methods: Pseudoplasticity and cohesion-dispersion (CDI) data of DisCoVisc (hyaluronic acid 1.

Deficiencies of cross-training between pediatrics and otolaryngology: a survey of specialists in Canada.

Objective: Conditions relating to the ear, nose and throat are very frequent problems encountered by general pediatricians. Similarly, a major percentage of patients seen and operated on by the general otolaryngologist are of the pediatric age group. The pilot study demonstrated that pediatric program directors of both specialties in Canada have identified a deficiency of cross-training and desire the need for more cross-training.

The phenomenon of chemo brain.

During and following chemotherapy, some patients experience difficulties with memory, attention, and other aspects of cognitive function. This constellation of deficits commonly is referred to as chemo brain. Although the phenomenon is not understood completely, it is assuming greater significance as cancer survival improves.

Haemodialysis vascular access problems in Canada: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS II).

Background: The optimal vascular access for chronic maintenance haemodialysis (HD) is the native arteriovenous fistula (AVF). Vascular access practice patterns are reported for a Canadian cohort of patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS II).

Methods: DOPPS II is a prospective, observational study in 12 countries, including Canada.

The International Quotidian Dialysis Registry: annual report 2005.

The International Quotidian Dialysis Registry was designed to collect data describing treatments, characteristics, and outcomes of patients treated with quotidian hemodialysis (HD) worldwide. In July 2004, North American centers were first invited to enroll patients. By March 1, 2005, a total of 70 nocturnal and 8 short-daily HD patients from three Canadian and two US centers were enrolled.

Corticosteroid injections for painful shoulders.

The painful shoulder is a common clinical entity with a broad array of possible causes. A caregiver for an affected patient needs to determine the aetiology for the pain, often relying primarily on the history and physical examination and supplemented with laboratory testing and imaging when needed. However, initial treatment decisions are often made before ordering these tests in situations not involving trauma.