Nocturnal home hemodialysis associates with improvement of electrocardiographic features linked to sudden cardiac death.

Sudden cardiac death (SCD) remains the leading cause of death in hemodialysis patients. We performed a retrospective electrocardiograph (ECG) and chart review to determine whether hemodialysis modality, frequency, or duration could predict change in ECG parameters associated with SCD. Frequent nocturnal hemodialysis was associated with an improvement in Tpeak to Tend within 365 days (83.

Ventilator settings and monitoring parameter targets for initiation of continuous mandatory ventilation: a questionnaire study.

Purpose: To inform development of educational tools, we sought to identify initial ventilator settings and monitoring targets for 3 scenarios.

Method: A survey was e-mailed to Canadian Society of Respiratory Therapists members with 2 reminders in March/April 2011.

Results: Total evaluable surveys were 363.

Alexithymia and eating disorders: a critical review of the literature.

Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.

The diagnosis of tuberculosis in dialysis patients.

Tuberculosis is an important issue for nephrologists caring for dialysis patients. Because dialysis patients are immunocompromised, they are at higher risk for reactivation of latent tuberculosis, and they frequently have atypical presentation. Furthermore, hemodialysis units may foster rapid spread of active pulmonary tuberculosis.

Lung protective strategies in anaesthesia.

Patients are at risk for several types of lung injury in the perioperative period including atelectasis, pneumonia, pneumothorax, acute lung injury, and acute respiratory distress syndrome. Anaesthetic management can cause, exacerbate, or ameliorate these injuries. This review examines the effects of perioperative mechanical ventilation and its role in ventilator-induced lung injury.

In patients with HIV-infection, chromium supplementation improves insulin resistance and other metabolic abnormalities: a randomized, double-blind, placebo controlled trial.

Chromium is an essential micronutrient; chromium deficiency has been reported to cause insulin resistance, hyperglycemia and hyperlipidemia. The aim was to investigate the effect of chromium supplementation on insulin-resistance, other metabolic abnormalities, and body composition in people living with HIV. This was a randomized, double-blind, placebo-controlled trial.

The use of Cytokeratin 19 (CK19) immunohistochemistry in lesions of the pancreas, gastrointestinal tract, and liver.

Cytokeratin immunostaining forms the bedrock of the immunohistochemical evaluation of tumors. Cytokeratin 19 (CK19) belongs to a family of keratins, which are normally expressed in the lining of the gastroenteropancreatic and hepatobiliary tracts. CK19 immunohistochemistry has been used successfully in thyroid tumors to recognize papillary carcinomas for some time.

Intraductal pancreatic neuroendocrine tumor.

Intraductal lesions of the pancreas are usually due to intraductal papillary mucinous neoplasms and the less common intraductal tubular adenoma. Cases of acinar cell carcinoma within intraductal location have also been encountered recently. Pancreatic neuroendocrine tumors are rarely encountered within the main pancreatic duct.

Intraductal tubular adenoma (pyloric gland-type) of the pancreas: a reappraisal and possible relationship with gastric-type intraductal papillary mucinous neoplasm.

Aims: Intraductal tubular adenoma (ITA) is an uncommon intraluminal polypoid lesion that occurs in the main pancreatic duct and involves the main pancreatic duct in the region of head or body. Three cases of ITA are presented, the literature reviewed and their association with intraductal papillary mucinous neoplasm (IPMN) is postulated.

Methods And Results: ITA is composed of tightly packed tubular structures with focal cystic dilation and papillary areas lined by gastric/pyloric epithelium showing minimal to mild cytological atypia.

Bioenergetic provision of energy for muscular activity.

A complex series of metabolic pathways are present in human muscle that break down substrates from nutritional sources to produce energy for different types of muscular activity. However, depending on the activity in which an individual is engaged, the body will make use of different energy systems that have been adapted for the particular activity. More specifically, utilization of bioenergetic substrates depends on the type, intensity, and duration of the exercise.

Mitral valve repair for advanced myxomatous degeneration with posterior displacement of the mitral annulus.

Objective: This study examines the outcomes of mitral valve repair in a defined group of patients with mitral regurgitation caused by advanced myxomatous degeneration.

Methods: Advanced myxomatous degeneration of the mitral valve was defined as a degenerative process whereby both leaflets are voluminous and aneurysmal and the mitral annulus diameter exceeds 40 mm and has posterior displacement, as determined by means of echocardiographic analysis. Over a 16-year period, we identified 183 patients who underwent valve repair in this subgroup of myxomatous degeneration.

Predicting prognosis in gastroentero-pancreatic neuroendocrine tumors: an overview and the value of Ki-67 immunostaining.

Gastroenteropancreatic neuroendocrine tumors (GEP-NETS) are unusual and rare neoplasms for which prognostic assessment and the diagnosis of malignancy, on the basis of histology alone, represent considerable challenges for the pathologist. To date, many molecular markers have been identified with a view to providing accurate and timely prediction of response to treatment and long-term survival. Proliferation remains a key feature of tumor progression, which has been widely estimated by the immunohistochemical use of the Ki-67 nuclear antigen.

Reduction in cardiovascular related hospitalization with nocturnal home hemodialysis.

Background: Cardiovascular disease remains the leading cause of death among patients with end-stage renal disease (ESRD). Nocturnal home hemodialysis (NHD) (5 - 6 sessions per week; 6 - 8 hours per session) is a novel form of home-based renal replacement therapy, which has been shown to improve several cardiovascular risk factors. The impact of NHD on hospitalization rate has remained unclear.

Nutritional assessment and hepatic fatty acid composition in non-alcoholic fatty liver disease (NAFLD): a cross-sectional study.

Background/aims: Low hepatic n-6 and n-3 polyunsaturated fatty acid (PUFA) may contribute to steatosis and steatohepatitis and can be affected by diet and oxidative stress.

Methods: Seventy-three patients referred for elevated liver enzymes and suspected NAFLD were assessed. Nutritional assessment, hepatic FA composition and oxidative stress were compared between these groups: simple steatosis (SS, n=18), steatohepatitis (NASH, n=38) and minimal findings on liver biopsy (MF, n=17).

Up-regulation of leukocyte CXCR4 expression by sulfatide: an L-selectin-dependent pathway on CD4+ T cells.

CXCR4 plays significant roles in immune and inflammatory responses and is important for selective recruitment of leukocytes. We previously showed that CXCR4 surface expression of human lymphocytes was affected by sulfatide, an in vivo ligand for L-selectin. Increased CXCR4 expression was shown to promote biologically relevant functions such as integrin-dependent adhesion and transmigration.

Cytokeratins 7 and 20 immunoexpression profile in goblet cell and classical carcinoids of appendix.

Goblet cell carcinoid (GCC) of the vermiform appendix is an uncommon neoplasm and its histogenesis is controversial. Whether GCC represents a morphological variant of classical appendiceal carcinoid or a mucin-producing adenocarcinoma is still conjectural. Little is known about the immunohistochemical expression of cytokeratins 7 (CK7) and 20 (CK20) in appendiceal neuroendocrine tumors.

Dietary intake of elderly living in Toronto long-term care facilities: comparison to the dietary reference intake.

Objective: To compare the dietary intake of elderly living in 11 long-term care facilities (LTCFs) to the Estimated Average Requirement set as part of the Dietary Reference Intake for older adults.

Design: A cross-sectional assessment of dietary intake using a 3 days food record among 407 elderly with mean age of 85.2 +/- 7.

Influence of obstructive sleep apnea on mortality in patients with heart failure.

Objectives: This study sought to determine, in patients with heart failure (HF), whether untreated moderate to severe obstructive sleep apnea (OSA) is associated with a higher mortality rate than in patients with mild to no sleep apnea (M-NSA).

Background: Obstructive sleep apnea is common in patients with HF and exposes the heart and circulation to adverse mechanical and autonomic effects. However, its effect on mortality rates of patients with HF has not been reported.

Trisodium citrate 4%--an alternative to heparin capping of haemodialysis catheters.

Background: Central venous catheters (CVCs) continue to be used at a high rate for dialysis access and are frequently complicated by thrombus-related malfunction. Prophylactic locking with an anticoagulant, such as heparin, has become standard practice despite its associated risks. Trisodium citrate (citrate) 4% is an alternative catheter locking anticoagulant.