Radiation Monitoring Using Personal Dosimeter Devices in Terms of Long-Term Compliance and Creating a Culture of Safety.

Introduction Radiation-emitting devices are commonplace in the hospital with their ability to produce imaging for diagnoses, However, they hold a risk for device operators due to radiation exposure. Hospital systems have programs where physicians exposed to radiation are required to wear dosimeters to help record total radiation over time. Dosimetry readings over standardized recommendations can lead to hospital image issues and disciplinary action for physicians.

Case report: Unilateral conduction hearing loss due to central venous occlusion.

Central venous stenosis is a well-known complication in patients with vascular access for hemodialysis. We report two cases involving patients on hemodialysis with arteriovenous fistulas who developed reversible unilateral conductive hearing loss secondary to critical stenosis of central veins draining the arteriovenous dialysis access. A proposed mechanism for the patients' reversible unilateral hearing loss is pterygoid venous plexus congestion leading to decreased Eustachian tube patency.

Percutaneous creation of an arteriovenous fistula for hemodialysis access.

Purpose: Arteriovenous fistulae (AVFs) created by conventional surgical techniques are associated with suboptimal short- and long-term patency. This study investigated the feasibility of creating fistulae with a percutaneous system and evaluated the utility of percutaneous AVFs (pAVFs) in providing hemodialysis access.

Materials And Methods: From August 2012 to September 2013, a percutaneous system was used to attempt pAVF creation between the proximal ulnar artery and a closely associated ulnar vein in 33 patients.

Minimally invasive outpatient centers.

Minimally-invasive medicine has continually progressed from its beginning in the 1960's. Evolution of technology and techniques have led to treatment of new disease states in minimally-invasive therapies. Now the venue of those therapies is shifting outpatient procedures from the hospital and into outpatient centers.

Systemic barriers to improving vascular access outcomes.

Vascular access dysfunction is the most frequent cause of hospitalization for end-stage renal disease (ESRD) patients. Our system of vascular access care and industry standards developed for historic reasons have resulted in a haphazard approach to access management. The Dialysis Outcome Quality Initiative has provided a road map for improving vascular access management.

The role of color flow Doppler ultrasound in dialysis access.

Color flow Doppler provides accurate imaging and access flow volume measurement of the hemodialysis vascular access. It can readily identify subsets of patients at high risk for future thrombosis. It is noninvasive, mobile, and allows convenient clinical evaluation at the dialysis facility.