Impact of eversion technique in carotid endarterectomy: Mansoura experience

To review our experience in eversion technique in carotid enclarterectomy in patients with carotid artery stenosis with particular attention to restenosis, occlusion, recurrent stroke or TIA. This prospective study included 12 patients with symptoms of unilateral carotid artery stenosis who were investigated, operated and followed up in Vascular Surgery Unit of Mansoura University Hospital during the period from July 2004 to January 2008. Eversion carotid endarterectomy [ECEA] was carried out for all patients. Carotid restenosis rate [>50%] during follow up was [0%] after eversion CEA at the end of the study. The cumulative stroke free survival rate was 85.7% at the end of the study. ECEA is a feasible and safe alternative technique for management of extracranial carotid stenosis, an excellent technique for handling of the kink, spiral or redundant internal carotid artery. It can be performed while patients under local or general anesthesia according to the general condition and cooperation of the patient

Assessment of iron status in hemodialysis patients

This study aims at reaching a parameter that can be used as an early predictor of iron deficiency in haemodialysedchronic renal failure patients caused by recent introduction or recent change of erythropoietin dose. Fouily two chronic renal failure patients on regular haemodialysisweresubjected to conventionalirondeficiencydetection profile, as well as soluble transferrin receptor estimation, zinc protoporphyrin estimation, and"eticulocyteparameters,mainly reticulocytic haemoglobin.From these fourty two patients only 34 were found to be iron nleted after a therapeutic trial of 1000 mg iron infusion . The markers that succeded u detect this stage were only serum ferritin, VK'V,MCH, and reticulocytic haemoglobin Ir][PO.05].Theseparameterswere further subjected to ROC curve analysis that reached the conclusion that only mature cell haemoglobin [area under the curve of 0.966], achieved a sensitivity of 100% and a specificity of 79% at a cut off of 26.85 , the seeond one [CHr] achieved a sensitivity of 0%, as well as a specificity of 84% at a cut off of 27.3.These two parameters were found to be highly correlated to each other [r =0.71 ,P<0.01].Anyhowtheywerehighly statisticallydifferentfromeach other[t=82,P=0.0000],that means that they could not be used interchangeably.After a follow up study [for one week,two weeks] CHr succeded to prove itself as an early predictor of iron deficiency anemia.We conclude therefore that retiuculocytic haemoglobin alone can be used as a sensitive and specific marker of iron deficiency. It can be used for early prediction of iron deficiency state specially the functional iron deficiency anemia that is produced iatrogenicaily after blinded Erythropoietin infusion