“
“Objective: To report a
multi-center experience with the novel Hemodialysis Reliable Outflow (HeRO) vascular access graft.
Materials and methods: Four centers conducted a retrospective review of end stage renal disease CB-5083 cell line patients who received the HeRO device from implant to last available follow-up. Data is available on 164 patients with an accumulated 2092.1 HeRO implant months.
Results: At 6 months, HeRO primary and secondary patency is 60% and 90.8%, respectively and at 12 months, 48.8% and 90.8%, respectively. At 24 months, HeRO had a primary patency of 42.9% and secondary patency was 86.7%. Interventions to maintain or re-establish patency have been required in 71.3% of patients (117/164) resulting in an intervention rate of 1.5/year. Access IAP inhibitor related infections have been reported in 4.3% patients resulting in a rate of 0.14/1000 implant days.
Conclusions: In our experience the HeRO device has performed comparably to standard AVGs and has proven superior to TDCs in terms of ‘latency, intervention, and infection rates when compared to the peer-reviewed literature. As an alternative to catheter dependence as a means for hemodialysis access, this graft could reduce the morbidity and mortality associated with TDCs and have a profound impact on the costs associated with catheter related infections and interventions.
(C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.”
“A continuous feeling of hunger is the major cause of dietary treatment failure AZD1390 in obese patients, making dietary leave. The aim of this study was to
evaluate the effect of percutaneous electrical neurostimulation (PENS) of T6 dermatome on appetite, weight loss and dietary compliance.
A prospective, randomized study was performed. The patients were randomized into two groups: those undergoing PENS of dermatome T6 associated with the implementation of a 1,200-Kcal diet (group 1) and those following only a 1,200-Kcal diet (group 2). A third group of obese patients (BMI > 30 Kg/m(2)) with fecal incontinence undergoing PENS of posterior tibial nerve was evaluated.
One hundred five patients were included in the study, 45 in groups 1 and 2, and 15 in group 3. The median pain perception after PENS of dermatome T6 was 1. There were no complications. Only the patients in group 1 experienced significant reductions of weight, BMI, and appetite. All of the patients in group 1 experienced appetite reduction compared to 20 % of the patients in group 2 and 30 % of the patients in group 3 (p < 0.001). Weight loss a parts per thousand yen5 Kg was achieved in 76.7 % of the patients in group 1, 6.7 % of the patients in group 2, and 0 % of the patients in group 3 (p < 0.001). Dietary compliance after 12 weeks was 93.3 % in group 1, 56.7 % in group 2, and 50 % in group 3(p = 0.006).