bluuebunny/crossref_metadata_2025 huggingface dataset:
Distal Ulnar-Basilic Fistula as the First Hemodialysis Access
Authors: Shintaku Sadanori , Kawanishi Hideki , Moriishi Misaki , Bansyodani Masataka , Tsuchiya Shinichiro
Published: May 2014

Purpose

A distal forearm ulnar-basilic (UB) arteriovenous fistula (AVF) can be chosen if a radial-cephalic (RC)-AVF is not suitable for a primary AVF. However, limited data are available on the feasibility of using a distal forearm UB-AVF as an option for primary AVF.

Methods

This retrospective analysis included 446 patients for whom AVFs (417 RC and 29 UB) had been newly created from January 2003 to December 2009, at our hospital. Patients in whom the arterial or venous anatomy precluded RC-AVF creation, UB-AVF was established as distally as possible on the forearm. Patency, defined as access survival after creation, was calculated using Kaplan-Meier analysis. The difference in patency between the two groups was examined using log-rank test.

Results

The primary patency of UB-AVFs was significantly lower than that of RC-AVFs (p=0.037, log-rank test). The primary patency rate at 1 year was 25.0% versus 44.7%, respectively. However, there was no significant difference in secondary patency between the two groups. The secondary patency rate at 1 year was 85.5% for UB-AVFs versus 82.9% for RC-AVFs. The incidence rate of percutaneous angioplasty until access abandonment per patient-years was 1.100 for UB-AVFs versus 0.671 for RC-AVFs. There was no difference in the time to maturation between the two groups.

Conclusions

The secondary patency rate of UB-AVF is similar to that of RC-AVF. We recommend the creation of an UB-AVF when an RC-AVF is not a suitable option for the primary AVF.
Efficacy of Normal Saline in the Maintenance of the Arterial Lines in Comparison to Heparin Flush: A Comprehensive Review of the Literature
Authors: Kordzadeh Ali , Austin Tomas , Panayiotopoulos Yiannis
Published: May 2014

Purpose

The aim of this study is to examine the efficacy of normal saline (0.9% sodium chloride) as a flush solution on patency of arterial lines in comparison to heparin flush. Data have been examined in various categories of specialty (medical, surgical, cardiac, burns, gynecology), frequency of flushes, strength and volume of flushes, continuous versus bolus, duration of each flush and patency incidence (range, ≤24 to ≥96 hours). The secondary aim focused on the incidences of reported heparin-induced thrombocytopenia (HIT type I and II).

Methods

A comprehensive review of the literature from 1951 to 2012. An electronic search of OVID, Medline, Embase, Cochrane, Scopus and CINAHL database in English language was conducted. The search was limited to adult subjects only. The following keywords were used: heparin flush, saline flush, 0.9% sodium chloride flush, arterial line and indwelling vascular line. A total of ten papers (n=10) were found eligible.

Results

The evidence suggests patency is feasible with both solutions but if longer duration of use (arterial line) is advocated, heparin is superior in the long term. Furthermore, heparin flush effects are dose dependent and require fewer numbers of flushes. In addition, no adverse effects were found with heparin flush solution.

Conclusion

There is level 1 evidence to support heparin as a flush solution once the time frame exceeds 48 hours. In addition, there is level 1 evidence to suggest that heparin at higher doses and in continuous infusion has better patency incidence with no reports of HIT type II or I.
Translesional Pressure Ratio Predicts Technical Outcome and Patency in Angioplasty on Outflow Stenosis of Hemodialysis Graft
Authors: Lai Chi-Cheng , Fang Hua-Chang , Tsai Han-Lin , Mar Guang-Yuan , Tseng Ching-Jiunn , Liu Chun-Peng , Liou Jau-Cheng
Published: May 2014

Purpose

Translesional pressure ratio (TLPR) indicating fractional flow reserve has been applied to physiological assessment of moderate coronary stenosis. The role of TLPR in hemodialysis (HD) patients with arteriovenous graft (AVG) outflow stenosis undergoing percutaneous transluminal angioplasty (PTA) is unclear. The purpose of the study was to assess the validation of TLPR in such patients undergoing PTA.

Methods

Patients with pure AVG outflow stenosis confirmed by angiography were prospectively enrolled. A TLPR defined as a ratio of the mean pressure downstream to the lesion(s) to the vein-sided intragraft pressure was measured using a catheter pullback method. Relationship among TLPR, angiographic result and clinical outcome within 6 months was detected.

Results

Of 65 PTAs, the post-PTA TLPR significantly increased (from 0.28±0.10 to 0.50±0.11; p<0.0001). A significantly greater pre-PTA TLPR was observed in the simple lesions at baseline compared with the complex lesions (0.32±0.09 vs. 0.20±0.06; p<0.0001). Post-PTA TLPR ≥0.5 was powerfully related to angiographic success (p<0.0001). The group with angiographic success plus post-PTA TLPR ≥0.5 had a longer PTA-free patency (208.7±188.7 vs. 109.8±67.7 days; p=0.013) compared with that with angiographic nonsuccess plus post-PTA TLPR <0.5.

Conclusions

Our data show that TLPR correlates well with lesion properties and angiographic results, and helps predict following unassisted patency. The study suggests TLPR as a hemodynamic indicator during PTA.
Arteriovenous Fistula Salvage Utilizing a Hybrid Vascular Graft
Authors: Jones Robert G. , Inston Nicholas G. , Brown Timothy
Published: May 2014

Introduction

Loss of arteriovenous fistula as access for hemodialysis leads to significant morbidity and increased mortality risk.

Methods

Maintenance of this access is of paramount importance and we describe a case of a patient with a functioning radiocephalic fistula with associated arm swelling due to poor narrow caliber venous drainage above the elbow but with normal central veins.

Results

A hybrid vascular graft was anastomosed to the upper extent of the fistula and the nitonol stent section introduced into the patent axillary vein.

Conclusion

The described method led to resolution of symptoms and arm swelling. The described method allowed the continued use of a mature fistula.
Satisfactory Reliability among Nursing Students using the Instrument PVC ASSESS to Evaluate Management of Peripheral Venous Catheters
Authors: Ahlqvist Margary , Berglund Britta , Nordström Gun , Klang Birgitta , Johansson Eva
Published: May 2014

Purpose

Nursing students should be given opportunities to participate in clinical audits during their education. However, audit tools are seldom tested for reliability among nursing students. The aim of this study was to present reliability among nursing students using the instrument PVC assess to assess management of peripheral venous catheters (PVCs) and PVC-related signs of thrombophlebitis.

Methods

PVC assess was used to assess 67 inserted PVCs in 60 patients at ten wards at a university hospital. One group of nursing students (n=4) assessed PVCs at the bedside (inter-rater reliability) and photographs of these PVCs were taken. Another group of students (n=3) assessed the PVCs in the photographs after 4 weeks (test-retest reliability). To determine reliability, proportion of agreement [P(A)] and Cohen's kappa coefficient (κ) were calculated.

Results

For bedside assessment of PVCs, P(A) ranged from good to excellent (0.80-1.0) in 55% of the 26 PVC assess items that were tested. P(A) was poor (<0.70) for two items: “adherence of inner dressing to the skin” and “PVC location.” In 81% of the items, κ was between moderate and almost perfect: moderate (n=5), substantial (n=3), almost perfect (n=5). For edema at insertion site and two items on PVC dressing, κ was fair (0.21-0.40). Regarding test-retest reliability, P(A) varied between good and excellent (0.81-1) in 85%-95% of the items, and the κ ranged between moderate and almost perfect (0.41-1) in 90%-95%.

Conclusions

PVC assess demonstrated satisfactory reliability among nursing students. However, students need training in how to use the instrument before assessing PVCs.
Surgical Treatment of Cephalic Arch Stenosis by Central Transposition of the Cephalic Vein
Authors: Sigala Fragiska , Saßen Regine , Kontis Elissaios , Kiefhaber Laura D. , Förster Rolf , Mickley Volker
Published: May 2014

Purpose

After creation of a brachiocephalic (BC) arteriovenous fistula (AVF), stenosis of the cephalic vein close to its junction with the axillary vein (cephalic arch stenosis, CAS) can develop. Flow impairment and access thrombosis are the consequences, sometimes complicated by prestenotic aneurysm of the cephalic vein. We here report our experience with cephalic vein transposition (CVT) for CAS.

Methods

From March 2007 through February 2012, symptomatic CAS was detected in 25 patients (13 female) with either dysfunction (n=14) or thrombosis (n=11) of their BC AVF. All were treated by CVT: the vein was ligated and cut distally to the stenotic segment, then tunneled subcutaneously to the medial aspect of the upper arm and anastomosed to the proximal brachial or basilic vein in an end-to-side fashion. Simultaneous thrombectomy of the cephalic vein was performed in 11 patients and aneurysmorrhaphy in 9. In addition, one patient had a proximal new AV anastomosis, another angioplasty of an in-stent restenosis of the access-draining subclavian vein.

Results

After CVT, two acute complications (8%) occurred: access thrombosis (one) and bleeding (one). During follow-up (1 to 54 months, median 13 months, 34.5 patient-years), six patients died with functioning AVF, three were successfully transplanted. Primary (secondary) 1-year patency was 79% (90%), with a reintervention rate of 0.1/patient/year.

Conclusions

Primary 1-year access patency rates after CVT compare favorably with those after interventional treatment, and reintervention rates are lower. Frequently occurring prestenotic aneurysms could be repaired simultaneously. CVT should therefore be regarded as the treatment of choice for CAS.
Endovascular Management of Iatrogenic Carotid-jugular Fistula Presenting as Congestive Heart Failure
Authors: Verma Himanshu , Meda Narendranadh , George Robbie K. , Tripathi Ramesh K.
Published: May 2014

Carotid-jugular arteriovenous fistula (C-J AVF) after inadvertent carotid puncture during internal jugular vein puncture is a rare entity. Previously, majority of reported cases of CJAVF were identified during inadvertent arterial puncture and managed as emergency. We report a delayed presentation of congestive cardiac failure following multiple attempts at securing an internal jugular venous access for dialysis 3 months prior to diagnosis. Carotid-jugular fistula was identified during workup and was successfully treated by endovascular technique with a covered stent.
Quantification of Fibrin in Blood Thrombi Formed in Hemodialysis Central Venous Catheters: A Pilot Study on 43 CVCs
Authors: Lucas Thabata Coaglio , Tessarolo Francesco , Veniero Patrizia , D'Amato Elvira , Caola Iole , Nollo Giandomenico , Huebner Rudolf , Brunori Giuliano
Published: May 2014

Purpose

Fibrin deposition and thrombotic occlusion represent a serious cause of access dysfunction in hemodialysis central venous catheters (CVCs). The aim of this work was to define and apply a method for imaging and quantifying fibrin in thrombi formed into the side holes of CVCs.

Methods

Forty-three CVCs removed from a cohort of dialyzed patients were analyzed in this pilot study. Hematoxylin and eosin and a modified Carstair's staining were applied on permanent thrombus sections. Fluorescence microscopy and image analysis were performed to quantify the fibrin amount.

Results

Highly fluorescent areas were invariably associated with fibrin by Carstair's method. The deposition of concentric layers of fibrin and erythrocytes was easily identified by fluorescence microscopy, showing growth features of the thrombus. Fibrin amount in diabetic patients was significantly higher than that in nondiabetic patients with median (interquartile range) values of 51% (47-68%) and 44% (30-54%), respectively (p=0.032). No significant difference in fibrin content was found by grouping data according to catheter type, permanence time, insertion site and dialysis vintage. Higher variability in fibrin values was found in thrombi from CVCs removed after 1-15 days compared with 16-60 days. A trend of an increase in fibrin amount in thrombi was noted according to blood platelet count at CVC insertion.

Conclusions

The analytical method presented here proved to be a rapid and effective way for quantifying fibrin content in thrombi formed on CVCs with potential application in future clinical studies.
Comparison of Tesio and LifeCath Twin Permanent Hemodialysis Catheters: The VyTes Randomized Trial
Authors: Power Albert , Hill Peter , Singh Seema K. , Ashby Damien , Taube David , Duncan Neill
Published: May 2014

Purpose

Central venous catheters for maintenance hemodialysis (HD) are designed to attain the required dialysis dose through sustained high blood flow rates (BFR). The authors studied the immediate and long-term performance and complications of two twin-catheter systems, the Tesio catheter (TC) and the LifeCath Twin (LC), to inform clinical practice.

Methods

This single-center randomized controlled parallel-group trial allocated 80 incident patients (1:1) to receive either a TC (MedComp) or LC (Vygon). Patients were dialyzed to target BFR 450 mL/min and followed up for 12 months. The primary outcome was achievement of target BFR during the first HD session. Secondary outcomes included thrombotic dysfunction, displacement and catheter-related infection. Catheter dysfunction was defined by a BFR ≤ 250 mL/min.

Results

More LCs reached the primary endpoint (44% vs. 10%, p=0.001) delivering a higher BFR (mean 383±82 vs. 277±79 mL/min, p<0.001). Significant differences in BFR persisted until the fourth dialysis session. Rates of catheter-related bacteremia (0.40 vs. 0.51/1,000 catheter days, p=0.7) and exit site infection were similar between groups (0.24 vs. 0.09/1,000 catheter days, p=0.4). Overall rates of catheter dysfunction were 2.8/1,000 catheter days (95% CI 2.1-3.5), with no differences in thrombolytic lock use although the LC group required more thrombolytic infusions (6 vs. 0, p=0.01).

Conclusions

The LC can deliver greater BFRs in the first three HD sessions following insertion although this did not translate into differences in performance, dialysis adequacy or complication rates with long-term use. Both catheter types can consistently deliver high BFRs over an extended period of time.
The use of Tunneled Central Venous Catheters: Inevitable or System Failure?
Authors: Aitken Emma L. , Stevenson Karen S. , Gingell-Littlejohn Marc , Aitken Margaret , Clancy Marc , Kingsmore David B.
Published: May 2014

Purpose

To evaluate reasons for tunneled central venous catheter (TCVC) usage in our prevalent hemodialysis population and assess the impact of a surgically aggressive approach to definitive access creation.

Methods

Clinical review of all patients in the West of Scotland dialyzing via a TCVC in November 2010 was performed. Reasons for TCVC usage and TCVC complications were evaluated. Over the subsequent year, aggressive intervention was undertaken to achieve definitive access in all suitable patients and outcomes re-evaluated a year later (November 2011).

Results

There was no significant difference in the proportion of patients dialyzing via a TCVC in 2010 compared to 2011 (30.3% (n=193) vs. 31.7% (n=201), respectively; p=0.56). All patients now have a “vascular access plan.” Of patients dialyzing via a TCVC in 2010, 37% had died by 2011, 22% remained on long-term line, 20% had successful arteriovenous fistula (AVF) creation, 1% had an arteriovenous graft and 2% were transplanted; 10.4% developed complications of vascular access and required ligation of a functioning AVF. A further 6.5% died within 28 days of surgery. The incidence of culture-positive Staphylococcus aureus bacteremia was 1.6 per 1,000 catheter days.

Conclusions

Aggressive strategies of AVF creation resulted in one-fifth of patients on a long-term TCVC having successful creation of an AVF. This was offset against high failure and significant complication rate from AVF creation in this population. One-third of patients dialyzing via a TCVC died in the subsequent year. Correct patient selection for AVF creation is essential and predialysis care must be optimized to avoid the need for TCVCs entirely.
Devices in Vascular Access: Is Technology Overtaking Evidence?
Authors: Inston Nicholas G. , Jones Robert
Published: May 2014

Advances in device technology have led to a rapid expansion in the number of available devices, which can be used for the formation and maintenance of vascular access. Whilst this may appear to be improving outcomes, there is little evidence to support the use of these devices over currently available methods. Most of the evidence that is available is from small studies with an absence of robust well-designed trials. The examples of “quick-stick” grafts and drug-eluting balloons serve to illustrate this. Whilst there is an enthusiasm for the potential benefits of novel devices there is also a risk - both economically and clinically - to adopting new practices without appropriate and valid comparisons to be made.
Accuracy of Early Postoperative Clinical and Ultrasound Examination of Arteriovenous Fistulae to Predict Dialysis Use
Authors: Ferring Martin , Henderson John , Wilmink Teun
Published: May 2014

Aim

The aim of this article is to assess the accuracy of early clinical and ultrasound (US) examination in terms of predicting arteriovenous fistula (AVF) dialysis use.

Methods

Physical and US examination of patent AVF was performed 4 weeks after fistula creation. AVF dialysis use was defined as subsequent use of an AVF for at least six consecutive dialysis sessions with two needles and a blood flow of more than 200 mL/min.

Results

Of 119 AVF patent at 4 weeks, 26 (22%) failed. Clinical examination was 96% sensitive for predicting successful dialysis, but only 21% specific for failure. Vein diameter above 5 mm and an arterial end-diastolic velocity above 110 cm/s were the best US predictors for dialysis use. Vein diameter was slightly better than arterial velocity in terms of predicting maturity (sensitivity: 83% vs 67%, specificity: 68% vs 65%). All assessments predicted AVF maturity (positive predictive value: clinical = 81%, US diameter = 90%, US velocity = 87%) much better than AVF failure (negative predictive value: clinical = 63%, US diameter = 53%, US velocity = 37%).

Conclusion

One month after surgery, a new AVF with a thrill or a vein diameter >5 mm is likely to be used for dialysis. An AVF not meeting these criteria has an increased risk of failure and further investigations may be required.
Natural History of Venous Morphologic Changes in Dialysis Access Stenosis
Authors: Lee Timmy , Somarathna Maheshika , Hura Arjan , Wang Yang , Campos Begona , Arend Lois , Munda Rino , Roy-Chaudhury Prabir
Published: May 2014

Purpose

Venous stenosis secondary to neointimal hyperplasia is a major etiology of early arteriovenous fistula (AVF) failure. The natural history of AVF failure is likely influenced by progressive vascular insults to the vein prior to and after AVF creation. The main objectives of this study were to ( 1 ) provide a histologic and morphometric description of non-chronic kidney disease (CKD), upper extremity vein specimens and ( 2 ) perform a morphometric analysis to study venous histology from non-CKD upper extremity veins, veins collected at the time of new vascular access surgery and veins collected from failed stenotic AVFs.

Methods

Vein samples from 11 non-CKD deceased donors, 29 subjects receiving new vascular access creation and 20 subjects with stenotic failed AVFs were collected for histologic and morphometric analysis.

Results

The mean values of average intima/media thickness ± S.E. from veins collected from non-CKD subjects, subjects receiving new vascular access and subjects with stenotic AVFs were 0.16±0.02, 0.43±0.07 and 3.84±0.55, respectively (p<0.0001). Among donor, non-CKD, vein samples, only diabetes (p=0.0007) was associated with increased average intima/media thickness.

Conclusions

Our results demonstrate a progressively increasing venous neointimal hyperplasia development from the non-CKD period through the period of AVF creation and failure. Vascular injuries from complications of progressive CKD prior to access placement and vascular injuries after vascular access placement may play important roles in these progressive vascular changes, and need to be further elucidated.
Safe Administration of Vancomycin through a Novel Midline Catheter: A Randomized, Prospective Clinical Trial
Authors: Caparas Jona V. , Hu Jian-Ping
Published: May 2014

Background

According to the 2011 Infusion Nursing Standards of Practice, the low pH of intravenous vancomycin requires that it be administered through a central line. However, a careful review of the literature and a retrospective analysis of the experience at New York Hospital Queens (NYHQ) did not support the position of the Standards.

Purpose

A prospective, controlled, randomized clinical trial was conducted to determine if intravenous vancomycin could be safely administered through a novel midline catheter (POWERWAND®, Access Scientific, San Diego, CA).

Methods

Patients scheduled to receive short-term (<6 days) intravenous vancomycin were randomly assigned to receive treatment through either a peripherally inserted central catheter (PICC) or the midline study device. Complications and the costs of insertion were recorded.

Results

The two groups did not differ significantly with respect to total complications (17.9% with PICCs vs. 19.9% with the midline), phlebitis (0% vs. 0%) or thrombosis (0% vs. 0%). One suspected catheter-associated bloodstream infection did occur in the PICC group. Insertion costs were $90.00 less per insertion in the midline group.

Conclusions

Short-term intravenous vancomycin can be safely and cost-efficiently administered in the deep vessels of the upper arm using the midline study device.
A New Model of Arteriovenous Fistula to Study Hemodialysis access Complications
Authors: Loveland-Jones Catherine E. , Jayarajan Senthil , Fang Jianhua , Monroy Alexandra , Zhang Hao Mike , Holt-Bright Lewis , Choi Eric T.
Published: May 2014

Purpose

This report presents a new animal model of arteriovenous fistula (AVF) with attention given to surgical techniques as well as hemodynamic and pathologic measurements. Of note, this model was created with a tunneled central catheter with the purpose of studying therapeutic interventions, including hemodialysis.

Methods

Side-common carotid artery to end-external jugular vein AVFs were created in eight minipigs. A tunneled central catheter was also placed in the internal jugular vein. After 28 days, hemodynamic measurements of AVF flow and stenosis were performed. The minipigs were then euthanized and the AVFs were harvested for pathologic measurements of neointimal hyperplasia and thrombus volumes. In order to account for variable size of the AVFs, percentage luminal stenosis and degree of intima–media thickening were calculated.

Results

After 28 days, all eight AVFs remained patent. On average, 19% of arterial blood flow that approached the AVF traveled through the anastomosis. The average luminal stenosis by angiogram was 61.1%. The average neointimal hyperplasia and thrombus volumes were 1.4×108 and 3.8×108 μm3, respectively. The average luminal stenosis and intima–media thickening were 65.2% and 430.4 μm, respectively.

Conclusions

This AVF model is ideal because of the relative ease of surgery and husbandry, lack of complications, as well as consistent and rapid development of the neointimal lesion which underlies AVF failure.
Autologous Surgical Reconstruction for True Venous Hemodialysis access Aneurysms–-Techniques and Results
Authors: Sigala Fragiska , Kontis Elissaios , Saßen Regine , Mickley Volker
Published: May 2014

Purpose

Due to their relatively low complication rates autogenous arteriovenous fistulas (AVFs) are the preferred access for hemodialysis. In long-standing AVF, however, aneurysmatic degeneration of the fistula vein can develop. Several treatment options have been published. We evaluated our experience with autologous surgical reconstruction in patients with AVF aneurysms in order to assess complication and patency rates.

Methods

Demographics and comorbidities of all patients operated on for true AVF aneurysms in our institution, during a 7-year period, were reviewed. Access function and surgical outcomes were evaluated with pre- and postoperative Doppler ultrasonography. Patient survival, primary and secondary access patency rates are presented.

Results

From April 2006 through March 2013, 31 patients presented with access-associated upper extremity venous aneurysms. The mean time from AVF creation to aneurysm formation was 4.9±3.6 years. The most frequent indication for surgery was aneurysm-associated stenosis (n=16) followed by high flow (n=9), complete thrombosis (n=3) and uncontrolled bleeding (n=3). All patients had autologous reconstructions: 5 resections with end-to-end anastomosis and 26 aneurysmorrhaphies. Overall patient survival at 1 and 2 years was 89% and 84%, respectively. The primary (secondary) patency rates at 6 mo, 1 and 2 years were 87%, 81% and 81% (96%, 96% and 90%), respectively.

Conclusions

Autologous surgical reconstruction is feasible in the majority of AVF aneurysms. It preserves fistula function and–-in contrast to graft interposition and endovascular repair–-keeps the advantages of an autogenous access: low complication and high patency rates.
Hemodialysis Tunneled Central Venous Catheters: Five-Year Outcome Analysis
Authors: Mandolfo Salvatore , Acconcia Pasqualina , Bucci Raffaella , Corradi Bruno , Farina Marco , Rizzo Maria Antonietta , Stucchi Andrea
Published: May 2014

Background

Tunneled central venous catheters (tCVCs) are considered inferior to arteriovenous fistulas (AVFs) and grafts in all nephrology guidelines. However, they are being increasingly used as hemodialysis vascular access. The purpose of this study was to document the natural history of tCVCs and determine the rate and type of catheter replacement.

Methods

This was a prospective study of 141 patients who underwent hemodialysis with tCVCs between January 2008 and December 2012. The patients used 154 tCVCs. Standard protocols about management of tCVCs, according to European Renal Best Practice, were well established. All catheters were inserted in the internal jugular vein. Criteria for catheter removal were persistent bloodstream infection, detection of an outbreak of catheter-related bloodstream (CRBS) infections, or catheter dysfunction. Event rates were calculated per 1,000 catheter days; tCVC cumulative survival was estimated by Kaplan-Meier analysis.

Results

Catheter replacement occurred in 15 patients (0.29 per 1,000 days); catheter dysfunction was the main cause of replacement (0.18 per 1,000 days), typically within 12 months of surgical insertion. A total of 53 CRBS events in 36 patients were identified (0.82 per 1,000 days); 17 organisms, most commonly Gram-positive pathogens, were isolated; 87% of CVC infections were treated by systemic antibiotics associated with lock therapy. tCVC cumulative survival was 91% at 1 year, 88% at 2 years and 85% at 4 years.

Conclusions

Our data show a high survival rate of tCVCs in hemodialysis patients, with low incidence of catheter dysfunction and CRBS events. These data justify tCVC use for hemodialysis vascular access, also as first choice, especially in patients with exhausted peripheral access and limited life expectancy.
Peripherally Inserted Central Catheter (PICC)-Related Thrombosis in Critically Ill Patients
Authors: Zochios Vasileios , Umar Imraan , Simpson Nicola , Jones Nicola
Published: May 2014

Background

Peripherally inserted central catheters (PICC) are being increasingly used in critical care setting. However, PICCs are associated with a number of complications, particularly upper extremity venous thrombosis (UEVT), leading to post-thrombotic syndrome, pulmonary embolism and increased risk of catheter-related infection.

Objective

To review the literature surrounding PICCs and highlight the epidemiology, pathophysiology, diagnosis and management of PICC-related thrombosis in critically ill patients.

Data sources and extraction

We performed an electronic literature search of the databases PubMed, EMBASE and Google scholar using set search terms, from their commencement date to the end of January 2014.

Summary of review

It has been shown that PICCs may double the risk of deep venous thrombosis compared with centrally inserted venous catheters, in critically ill patients. However, the incidence of PICC-related thrombosis in critically ill patients has not been quantified. Ultrasonography is the preferred diagnostic imaging modality. There are no randomized controlled trials (RCTs) on the best treatment of PICC-related thrombosis in the intensive care unit (ICU) setting and in most cohort studies, anticoagulation strategies with or without PICC removal have been used.

Conclusions

Decision to insert a PICC should be taken after careful risk stratification. There is lack of high-quality evidence assessing prevention strategies and management of PICC-related thrombosis in the ICU. Well-designed RCTs are required to estimate the prevalence of UEVT in ICU patients with PICCs and evaluate the efficacy and magnitude of clinical benefit and cost-effectiveness of therapeutic strategies.
“Am I That Name?” Feminism, Feminist Criticism, and Gender Studies
Authors: Filipowicz Halina
Published: May 2014

This article takes up three overlapping sets of issues. The first set brings into sharper relief current debates about work–family balance and persistent gender inequality. The second set traces the emergence of women’s studies as a scholarly discipline, examines a shift from women’s studies to gender studies, and considers the reception of Western feminist discourse in Poland. The final set builds on the first two by addressing assumptions about the history of Polish women and their supposedly benighted sisters in the West, by questioning the presupposition that archives are passive depositories, and by exploring prospects for future work.
Unique and Incomparable The Exceptional Life of the First Female Doctor in Poland, Regina Salomea Pilsztynowa
Authors: Lubamersky Lynn
Published: May 2014

The three waves of feminism and postfeminist analysis can be seen in the interpretation of Regina Salomea Pilsztynowa’s Life’s Travels and Adventures. Pilsztynowa’s eighteenth-century memoir was of great interest to first-wave feminists and antifeminists at the turn of the twentieth century because it included compelling narratives of female agency and emancipation. To antifeminists, it was evidence of a world turned upside down in which warped emancipated woman lost their way in the world, but feminists found evidence that the twentieth-century drive for women’s freedom had its roots in the struggle for freedom waged by eighteenth-century feminist foremothers. One of the clearest goals of second-wave feminism was to recover the lost voices of women of the past via the rediscovery of texts, and this memoir was rediscovered in the 1970s-1990s and reevaluated and translated. Third-wave feminists included this memoir in gender studies courses where students and scholars used digital media to publish their findings to cast a wider net and it captured a multiplicity of views including new discoveries regarding the author. Some third-wave feminists have labeled Pilsztynowa’s experience as exceptional and therefore unworthy of consideration or inclusion in any sort of canon of Polish female authors. But if we could go back in time to ask Pilszytynowa, in true Sarmatian fashion, she would insist that she was unique and incomparable, but nevertheless she was the first female doctor in Poland.
« L’âme est l’architecte de son propre corps »
Authors: Papapetros Spyros , Raiffé Alex
Published: May 2014

À une époque où l’on s’est efforcé de redéfinir la nature de la vie et de faire de l’âme (anima ou psyché) une autorité centrale dans l’organisation de tout processus matériel et immatériel, l’architecture sert non seulement de métaphore structurelle, mais aussi de schéma épistémologique capable de recadrer la formation tectonique de tout être vivant. Cet article retrace les manifestations externes et les processus méthodologiques internes de cette « âme architectonique » à travers les théories épistémologiques du philosophe Albert Lemoine et sa lecture des principes vitalistes et animistes de Georg Ernst Stahl; également dans les récits ethnographiques des forêts animées écrits par des anthropologues comparatistes tels Edward Burnett Tylor et James George Frazer; ou encore dans les rudiments du culte animiste des arbres que l’on trouve dans les écrits d’historiens et théoriciens de l’architecture tels James Fergusson, Karl Bötticher et Gottfried Semper; ou enfin dans les mémoires ethnographiques sur les rituels animistes contemporains de l’historien culturel Aby Warburg.
Dégel
Authors: Joubert-Laurencin Hervé
Published: May 2014

Après avoir fait le départ, chez André Bazin, de l’immobilité filmique et de l’intensité du plan, rattachable à l’idée qu’animer est une propriété du cinéma, sont présentés l’usage et les conséquences historiques de la nomination du cinéma « d’animation », qui débute au milieu des années 1950. L’importance de l’immobilité dans l’animation est ensuite interrogée à travers quatre exemples affirmant que l’art du cinéma consiste à créer une intensité plus mobile que le seul mouvement.
Animisme de l’image
Authors: Sierek Karl
Published: May 2014

Le cinéma n’est pas seulement un dispositif des représentations ou un système des signes. Souvent, surtout dans les théories des premières décennies, il était décrit dans un cadre anthropologique comme une machine d’une efficacité et d’une puissance propres. Le texte résume, d’après Aby Warburg, quatre fonctions de cette tendance animiste : l’image comme génératrice et ré-activatrice d’une certaine instantanéité et présence, comme indicatrice et amplificatrice d’une dynamique inhérente et temporalité autonome, comme instrument de pensée et accumulateur de savoir et enfin l’image comme force quasiment vivante d’intervention et d’agitation dans un sens directement politique.
Du mode d’existence des objets animés
Authors: Lamarre Thomas
Published: May 2014

Cet article présente une série d’analyses sur le mode d’existence des objets animés. Les dessins animés des années 1930 et 1940, ainsi que les théories des films d’animation (de Sergei Eisenstein et Taihei Imamura) de la même époque tiennent une place primordiale parce que nous y retrouvons les sources d’une spécification de la vie par le mouvement et donc une expérience de la « vie-mouvement ». Cette « vie-mouvement » dans les dessins animés n’implique pas une illusion à démystifier ou une difficulté de la perception à subordonner au symbolique. Nous voulons ici traiter de la vie-mouvement en tant qu’expérience réelle du mouvement non localisé et non séparé que nous allons rapprocher du concept de la vie inséparée de Muriel Combes.
Les images de synthèse peuvent-elles avoir une âme ?
Authors: Massuet Jean-Baptiste
Published: May 2014

Cet article se donne pour ambition de soulever une question théorique peu posée à l’ère des images de synthèse, celle du lien entre ces dernières et l’âme des figures qu’elles simulent. Le coeur de notre démonstration repose principalement sur l’émergence des dispositifs de capture de mouvement, à partir desquels la relation des images de synthèse à la notion d’anima pourrait faire l’objet d’une réévaluation théorique, au point de contribuer à expliquer la profonde remise en question de la notion même de cinéma d’animation à l’ère du numérique.
Cell-intrinsic mechanisms of temperature compensation in a grasshopper sensory receptor neuron
Authors: Roemschied Frederic A , Eberhard Monika JB , Schleimer Jan-Hendrik , Ronacher Bernhard , Schreiber Susanne
Published: May 2014

Changes in temperature affect biochemical reaction rates and, consequently, neural processing. The nervous systems of poikilothermic animals must have evolved mechanisms enabling them to retain their functionality under varying temperatures. Auditory receptor neurons of grasshoppers respond to sound in a surprisingly temperature-compensated manner: firing rates depend moderately on temperature, with average Q10 values around 1.5. Analysis of conductance-based neuron models reveals that temperature compensation of spike generation can be achieved solely relying on cell-intrinsic processes and despite a strong dependence of ion conductances on temperature. Remarkably, this type of temperature compensation need not come at an additional metabolic cost of spike generation. Firing rate-based information transfer is likely to increase with temperature and we derive predictions for an optimal temperature dependence of the tympanal transduction process fostering temperature compensation. The example of auditory receptor neurons demonstrates how neurons may exploit single-cell mechanisms to cope with multiple constraints in parallel.
Re-examining how complexin inhibits neurotransmitter release
Authors: Trimbuch Thorsten , Xu Junjie , Flaherty David , Tomchick Diana R , Rizo Josep , Rosenmund Christian
Published: May 2014

Complexins play activating and inhibitory functions in neurotransmitter release. The complexin accessory helix inhibits release and was proposed to insert into SNARE complexes to prevent their full assembly. This model was supported by ‘superclamp’ and ‘poor-clamp’ mutations that enhanced or decreased the complexin-I inhibitory activity in cell–cell fusion assays, and by the crystal structure of a superclamp mutant bound to a synaptobrevin-truncated SNARE complex. NMR studies now show that the complexin-I accessory helix does not insert into synaptobrevin-truncated SNARE complexes in solution, and electrophysiological data reveal that superclamp mutants have slightly stimulatory or no effects on neurotransmitter release, whereas a poor-clamp mutant inhibits release. Importantly, increasing or decreasing the negative charge of the complexin-I accessory helix inhibits or stimulates release, respectively. These results suggest a new model whereby the complexin accessory helix inhibits release through electrostatic (and perhaps steric) repulsion enabled by its location between the vesicle and plasma membranes.
Evolution of elastic wave speed during shear‐induced damage and healing within laboratory fault zones
Authors: Kaproth Bryan M. , Marone Chris
Published: May 2014

Earthquake faults fail and restrengthen repeatedly during the seismic cycle. Faults restrengthen via a set of processes known collectively as fault healing, which is well documented in the laboratory but less well understood in tectonic fault zones. Recent observations of fault zone wave speed following earthquakes suggest opportunities to connect laboratory and field observations of fault healing. However, existing laboratory data lack detail necessary to identify specific processes linking elastic wave speed to fault damage and healing. Here we document changes in elastic properties during laboratory seismic cycles, simulated via periods of nonshear and quasistatic fault slip. Experiments were conducted on brine‐saturated halite under conditions favoring pressure solution, analogous to healing processes within and at the base of the seismogenic zone. We find that elastic wave speed (V) and amplitude (A) correlate with porosity. For each percent of porosity lost during compaction, VP increases by ~3%, VS by ~2%, AP by ~10%, and AS by ~7%. Moreover, V and A decrease with granular dilation during fault slip. With increasing shear strain, fabric formation dominates the ultrasonic signals. We find that fault strength depends on fault porosity, making VP and VS potential proxies for fault strength evolution. Our data show that a 1% change in VP or VS results in a friction increase of 0.01 or 0.02, respectively. Within natural fault zones, advances in monitoring elastic wave speed may provide critical information on the evolution of fault strength and seismic hazard throughout the seismic cycle.
Twenty‐eight years after the complete ban on the physical punishment of children in Finland: Trends and psychosocial concomitants
Authors: Österman Karin , Björkqvist Kaj , Wahlbeck Kristian
Published: May 2014

In 1983 Finland became the second country in the world, after Sweden, to adopt a law prohibiting all kinds of physical punishment towards children, also by parents. The present investigation was carried out in 2011, 28 years after the law was adopted. Changes in exposure to various types of physical punishment towards respondents born between 1931 and 1996 are presented. A representative sample from Western Finland, consisting of 4,609 respondents (2,632 females, 1,977 males) between 15 and 80 years, filled in a paper‐and‐pencil questionnaire. A number of psychosocial concomitants were measured. The results showed a significant drop in reports of being slapped and beaten with an object among respondents who were born after the law was adopted. The decline in physical punishment was associated with a similar decline in the number of murdered children. Respondents who had been exposed to higher amounts of physical punishment than average scored significantly higher on alcohol abuse, depression, mental health problems, and schizotypal personality. Divorced respondents had been significantly more physically punished than others. Respondents who had attempted suicide during the last 12 months had been exposed to physical punishment during childhood significantly more often than those who had not attempted suicide. Aggr. Behav. 40:568–581, 2014. © 2014 Wiley Periodicals, Inc.
Occupational fatalities among driver/sales workers and truck drivers in the United States, 2003–2008
Authors: Chen Guang X. , Amandus Harlan E. , Wu Nan
Published: May 2014

Background

This study provides a national profile of occupational fatalities among truck drivers and driver‐sales workers.

Methods

Data from the 2003–2008 Census of Fatal Occupational Injuries were used. Cases were extracted specifically for occupational subcategories included in the Driver/Sales Workers and Truck Drivers occupational category: Driver/Sales Workers, Heavy and Tractor‐Trailer Truck Drivers, and Light Truck or Delivery Services Drivers.

Results

In 2003–2008, the group Driver/Sales Workers and Truck Drivers had 5,568 occupational fatalities, representing 17% of all occupational fatalities in the United States. The majority of these fatalities were in the subgroup Heavy and Tractor‐Trailer Truck Drivers (85%) and due to transportation incidents (80%). Older and male drivers had higher fatality rates than their counterparts.

Conclusions

Findings suggest a need for targeted interventions to reduce highway fatalities among heavy truck drivers. Better employment data are needed to separate the three occupational subcategories by worker characteristic and employment history for use in research and prevention efforts. Am. J. Ind. Med. 57:800–809, 2014. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
Work stress, sleep deficiency, and predicted 10‐year cardiometabolic risk in a female patient care worker population
Authors: Jacobsen Henrik B. , Reme Silje E. , Sembajwe Grace , Hopcia Karen , Stiles Tore C. , Sorensen Glorian , Porter James H. , Marino Miguel , Buxton Orfeu M.
Published: May 2014

Objectives

The aim of this study was to investigate the longitudinal effect of work‐related stress, sleep deficiency, and physical activity on 10‐year cardiometabolic risk among an all‐female worker population.

Methods

Data on patient care workers (n = 99) was collected 2 years apart. Baseline measures included: job stress, physical activity, night work, and sleep deficiency. Biomarkers and objective measurements were used to estimate 10‐year cardiometabolic risk at follow‐up. Significant associations (P < 0.05) from baseline analyses were used to build a multivariable linear regression model.

Results

The participants were mostly white nurses with a mean age of 41 years. Adjusted linear regression showed that having sleep maintenance problems, a different occupation than nurse, and/or not exercising at recommended levels at baseline increased the 10‐year cardiometabolic risk at follow‐up.

Conclusions

In female workers prone to work‐related stress and sleep deficiency, maintaining sleep and exercise patterns had a strong impact on modifiable 10‐year cardiometabolic risk. Am. J. Ind. Med. 57:940–949, 2014. © 2014 Wiley Periodicals, Inc.
Occupational handling of nickel nanoparticles: A case report
Authors: Journeay W. Shane , Goldman Rose H.
Published: May 2014

A 26‐year‐old female chemist formulated polymers and coatings usually using silver ink particles. When she later began working with nickel nanoparticle powder weighed out and handled on a lab bench with no protective measures, she developed throat irritation, nasal congestion, “post nasal drip,” facial flushing, and new skin reactions to her earrings and belt buckle which were temporally related to working with the nanoparticles. Subsequently she was found to have a positive reaction to nickel on the T.R.U.E. patch test, and a normal range FEV1 that increased by 16% post bronchodilator. It was difficult returning her to work even in other parts of the building due to recurrence of symptoms. This incident triggered the company to make plans for better control measures for working with nickel nanoparticles. In conclusion, a worker developed nickel sensitization when working with nanoparticle nickel powder in a setting without any special respiratory protection or control measures. Am. J. Ind. Med. 57:1073–1076, 2014. © 2014 Wiley Periodicals, Inc.
De novo microdeletion of BCL11A is associated with severe speech sound disorder
Authors: Peter Beate , Matsushita Mark , Oda Kaori , Raskind Wendy
Published: May 2014

In 10 cases of 2p15p16.1 microdeletions reported worldwide to date, shared phenotypes included growth retardation, craniofacial and skeletal dysmorphic traits, internal organ defects, intellectual disability, nonverbal or low verbal status, abnormal muscle tone, and gross motor delays. The size of the deletions ranged from 0.3 to 5.7 Mb, where the smallest deletion involved the BCL11A, PAPOLG, and REL genes. Here we report on an 11‐year‐old male with a heterozygous de novo 0.2 Mb deletion containing a single gene, BCL11A, and a phenotype characterized by childhood apraxia of speech and dysarthria in the presence of general oral and gross motor dyspraxia and hypotonia as well as expressive language and mild intellectual delays. BCL11A is situated within the dyslexia susceptibility candidate region 3 (DYX3) candidate region on chromosome 2. The present case is the first to involve a single gene within the microdeletion region and a phenotype restricted to a subset of the traits observed in other cases with more extensive deletions. © 2014 Wiley Periodicals, Inc.