Timely thrombectomy can improve patency of hemodialysis arteriovenous fistulas.

OBJECTIVE: The urgency with which salvage of thrombosed vascular accesses for dialysis should be attempted remains unknown. We examined the effect of a timely thrombectomy approach on vascular access outcomes for dialysis. METHODS: A before-and-after study was conducted with patients on hemodialysis who had undergone endovascular thrombectomy. A timely thrombectomy initiative (ie, salvage within 24 hours of thrombosis diagnosis) was started in July 2015 at our institution. Data about thrombectomy procedures, performed within 1 year before and after the initiative was introduced, were abstracted from an electronic database. Immediate outcomes and patency outcomes were compared between the preinitiative (control) and postinitiative (intervention) groups. RESULTS: During the study period, 329 patients were enrolled, including 165 cases before and 164 cases after the initiative. The intervention group had more thrombectomy procedures performed within 24 hours (93% vs 55%; P < .01) and within 48 hours (97% vs 79%; P < .01) than the control group. No between-group differences in procedural success or clinical success rates were found. At 3 months, the intervention group had a higher postintervention primary patency rate than the control group, although this did not reach statistical significance (58% vs 48%; P = .06). After stratification into native or graft accesses, the patency benefit was observed in the native access group (68% vs 50%; P = .03) but not in the graft access group (50% vs 46%; P = .65). After adjusting for potential confounders, timely thrombectomy remained an independent predictor of postintervention primary patency (hazard ratio, 0.449; 95% confidence interval, 0.224-0.900; P = .02) for native dialysis accesses. CONCLUSIONS: Our results suggest that a timely thrombectomy approach, in which salvage is attempted within 24 hours of thrombosis diagnosis, improves postintervention primary patency of native but not graft accesses for dialysis.

[Molecular markers and its clone for salt tolerance gene in wheat].

Genetic and RAPD analysis were studied among [4] individuals in F2 segregated population originating from a cross between wheat cultivator Nongda 85021 (female parent, salt sensitive) and Chadian Red (male parent, salt tolerant). For genetic analysis and chi-square test gave a good fit of 1:2:1 ratio showing that one major gene was controlling the salt tolerant character in Chadian Red. DNA of F2 population was extracted to develop tolerant and sensitive gene pools, respectively, based the BSA (Bulked Segregate Analysis). By RAPD (Randomly Amplified Polymorphic DNAs), 520 random primers were used to amplify the two types of gene pools. Only primer OPZ09 was found to be polymorphic with a fragment of 590 bp in the two parents, F1 and F2 populations. So, the specific fragment OPZ09-590 was, a RAPD marker linked to salt tolerance gene in Chadian Red. By the software JOINMAP (Version 1.4), the recombination was 5.674% and the linking distance was 6.557 cM. OPZ09-590 was extracted from the agarose and mixed with pUCm-T vector, then the vector was transferred into JM109. The clone was determined 591 bp after being sequenced. It indicated that the RAPD marker of salt tolerance gene in Chadian Red was OPZ09-591.