novel method for salvage of malfunctioning peritoneal dialysis catheter

Continuous ambulatory peritoneal dialysis [CAPD] has been widely used as an effective therapy in the management of patients with end-stage renal disease. Long-term use of CAPD needs methods with low incidence of catheter-related complications. Moreover, some complications may cause failure of fluid drainage and treatment interruption. We have innovated and studied a new minimal-invasive method of malfunctioning peritoneal catheter repair. Thirty-five patients agreed to undergo catheter rescue operation by this new method during 2004 and 2012. Under local anesthesia and light sedation, access to the abdominal cavity was made, the catheter and wrapped omentum grasped and the tip of catheter was released, debris were removed and the catheter was directed toward the pelvic floor with a finger guide. The patients were followed after catheter salvage up to the end of study [April 2012]. PD catheter function restored to the normal level in 28 [80%] of patients, and PD was started 1-2 days after the procedure. All patients had an uneventful recovery. PD catheter function was restored to the normal level in 28 [80%] patients, and PD was started 1-2 days after the procedure. Of these patients, 10 [35%] died of reasons unrelated to catheter or catheter complications; 7 [25%] were ultimately referred for kidney transplant; 8 [29%] continued PD up to the end of this study with no problem, and only 3 [11%] due to catheter complications. Catheter function did not restore to the normal level in seven patients [20%]; however, six patients continued PD for 1-18 months with the catheter. Comparing the advantages and disadvantages of this method to the previous laparoscopically repaired catheter, we concluded that this new method is efficient, and is a suitable way for malfunctioning PD catheter salvage

Antibody responses to trivalent influenza vaccine in Iranian adults infected with human immunodeficiency virus

The serious influenza-associated complications among immunodeficient individuals such as those who are infected with human immunodeficiency virus [HIV], highlights the importance of influenza vaccination in these people. Therefore, the current study aimed to investigate the antibody responses to influenza vaccine in this group. Two hundred subjects were recruited, during autumn 2010 and 2011, to receive, trivalent inactivated influenza vaccine consisting of A [H1N1], A [H3N2], and B strains. Hemagglutination inhibition assay was used to measure the antibody titer against all strains of the vaccine prior and one month post vaccination. Seroconversion rate for A [H1N1], A [H3N2], and B were found to be 58.5%, 67% and 64.5%, respectively. No correlation was found between antibody titer and demographics factors such as age and gender; however, we found a significant correlation between antibody titer and CD4 cell count. Checking the local and systemic reactions after vaccination, the pain on the injection site and myalgia were the most common local and systemic reactions with 20% and 6.5%, respectively. As vaccination with influenza mount considerable antibody responses in HIV-infected patients, annul influenza vaccination seems to be rational in order to prevent or reduce the severe clinical complications induced by influenza virus