LENUS Community:

Patients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access.

Thu, 01 Nov 2012 00:00:00 GMT

Title: Patients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access. Authors: Sultan, Sherif; Hynes, Niamh; Hamada, Nader; Tawfick, Wael Abstract: Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.

Natural history of fetal trisomy 18 after prenatal diagnosis.

Fri, 01 Mar 2013 00:00:00 GMT

Title: Natural history of fetal trisomy 18 after prenatal diagnosis. Authors: Burke, Annette L; Field, Katie; Morrison, John J Abstract: To evaluate the natural fetal and neonatal outcome for pregnancies with an established prenatal diagnosis of fetal trisomy 18, and a parental decision for continuation of the pregnancy.

Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

Wed, 01 Aug 2012 00:00:00 GMT

Title: Gastrointestinal stromal tumour presenting as gastroduodenal intussusception. Authors: Wilson, Mark H; Ayoub, Firas; McGreal, Paul; Collins, Chris Abstract: Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland.

Sat, 01 Dec 2012 00:00:00 GMT

Title: Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland. Authors: Mullen, J; McGaffin, J; Farvardin, N; Brightman, S; Haire, C; Freeman, R Abstract: Most of the Republic of Ireland's public water supplies have been fluoridated since the mid-1960s while Northern Ireland has never been fluoridated, apart from some small short-lived schemes in east Ulster.