ABSTRACT
Arteriovenous fistula failure represents a major cause of hospitalization and a significant economic burden for end-stage renal disease patients on hemodialysis. The Optiflow (Bioconnect Systems Inc., Ambler, PA) is a new device developed to improve arteriovenous fistula outcomes and decrease failure rates by reducing the risk of stenosis and improving maturation rates. This case report describes a 50-year-old male with hypertensive nephropathy on dialysis who had multiple arteriovenous fistula failures in the past. He was scheduled to undergo brachiocephalic fistula construction using the Optiflow device. After 8 months of use, the new fistula developed a peri-anastomotic venous stenosis, just distal to the Optiflow device. To our knowledge, this is the first time such a complication has been reported.
ABSTRACT
Cardiac complications of high-dose cytosine arabinoside (HiDAC), although rare, predominantly include pericarditis, pericardial effusion and cardiomyopathy (with concurrent use of cyclophosphamide). Clinically significant arrhythmias associated with HiDAC, although reported in the literature, are rare. The following case report has for the first time used the Naranjo Scale to document a high-probability association (definite adverse drug reaction) of cytarabine with symptomatic sinus bradycardia.
Subject(s)
Antimetabolites, Antineoplastic/adverse effects , Bradycardia/chemically induced , Bradycardia/diagnosis , Cytarabine/adverse effects , Electrocardiography , Bradycardia/physiopathology , Cytarabine/administration & dosage , Dose-Response Relationship, Drug , Female , Humans , Middle AgedABSTRACT
Clinically, retroperitoneal abscesses present insidiously and the diagnosis may be delayed. This, with inadequate drainage, may result in increased morbidity and mortality. Most cases result from a renal or gastrointestinal process, but in a small number of patients there is no identifiable source and the abscess is designated as "primary." Most retroperitoneal abscesses are polymicrobial, and cultures often reveal organisms such as Proteus mirabilis, Staphylococcus species, Peptostreptococcus, Enterococcus, Enterobacter, Escherichia coli and Bacteroides species. Fungal causes appear to be very rare, and in this study, a case of a patient with primary Candida glabrata retroperitoneal abscess is reported.
Subject(s)
Abdominal Abscess/microbiology , Candida glabrata , Candidiasis/complications , Abdominal Abscess/therapy , Drainage , Humans , Male , Middle Aged , Retroperitoneal SpaceABSTRACT
Elevated peripheral (brachial) blood pressure (PBP) is related to hard cardiovascular outcomes and remains the main target for antihypertensive therapy. However, central aortic blood pressure (CABP) can be measured noninvasively and could potentially prove to be a more important marker of cardiovascular diseases in future. Several studies have shown association of CABP with cardiovascular mortality, coronary artery disease, left-ventricular hypertrophy and atherosclerosis. Furthermore, the impact of various classes of antihypertensive agents on CABP is different from their impact on PBP. We review the significance of CABP in cardiovascular outcomes and the differential impact of antihypertensive therapy on CABP.
