No abstract available.
Vascular Access Devices*

No abstract available.
Open Access Publishing

No abstract available.
Fires ; Open Access Publishing

No abstract available.
Child ; Humans ; Vascular Access Devices

Introduction: Accurate and reliable glucose level measurements are essential for ensuring safe and effective glycemic control among diabetic patients undergoing hemodialysis (HD). Capillary blood glucose (CBG) monitoring is the standard of care of glycemic control assessment in patients with diabetes on maintenance HD. In the Philippines, glucose monitoring during HD involves either standard finger stick (CBG) or blood sample from the arterial line (AL) of extracorporeal circuit of HD machine. However, anecdotal observations noted over the years have shown discrepancies in the glucose values from the two sites. This study aimed to determine the accuracy of blood glucose measurements of capillary and AL of extracorporeal circuit of HD machine using point-of-care (POC) glucose meter in comparison to central laboratory venous plasma among diabetic patients undergoing outpatient HD in a private tertiary hospital in the Philippines. Determining the most accurate and reliable method of glucose level measurement is vital in helping patients attain glycemic control. To date, there is limited published data regarding the accuracy of blood glucose values obtained through CBG and AL of extracorporeal circuit of HD machine while patients are undergoing dialysis. Methods: This is a prospective, cross-sectional, analytical study involving thirty patients. Forty blood samples from 30 patients obtained through CBG, AL and the peripheral venous plasma of the opposite arm were simultaneously analyzed. Specifically, StatStrip was utilized as the POC glucose meter. Accuracy of AL of extracorporeal circuit and CBG were determined and assessed in accordance with International Organization for Standardization (ISO) 15197:2013 minimum accuracy criteria for glucose meters. Regression analysis was used to determine whether AL and CBG significantly predict peripheral venous blood glucose levels. Results: Analysis showed that there is a statistically significant difference in the glucose values obtained from AL and CBG (p-values 0.005 and <0.0001) when compared to venous plasma glucose. However, this may not pose clinical significance in routine practice. It is noteworthy that both AL (concordance rate (CR)=100%) and CBG (CR=96.5%) satisfied the revised ISO 15197:2013 accuracy criteria for glucose value greater than or equal to 100mg/dL. Conclusion Both CBG and AL blood glucose measurement significantly predict venous plasma blood glucose level. POC blood glucose value from both AL of extracorporeal circuit during HD and CBG satisfied the accuracy criteria set by ISO 15197: 2013 for glucose value greater than or equal to 100mg/dL. Thus, confirming the glucose level by CBG monitoring is not necessary in patients with arterial glucose value of greater than or equal to 100 mg/dL during HD.
Vascular Access Devices ; Renal Dialysis

A vascular access catheter has been widely used for hemodialysis patients in an emergency when an arteriovenous shunt get clogged and cannot be reopened or when patients have no arterio-venous fistula. However, it often causes deterioration in activities of daily living (ADLs) and other troubles. Therefore, we place the catheter into the internal jugular vein in the neck to minimize the risk of complications and patients' inconvenience. Nevertheless, free spaces tend to be created between the dressing agent and skin because the articular excursion is wide in the neck. Although the CDC (Centerfor Disease Control and Prevention) guidelines recommended that the dressing tapes should be changed once every seven days, we change the tapes every two or four days to avoid peeling-off. In this study, we examine the difference in fixation ability between two types of tapes;standard size (10×12 cm) and 1/4 cut-size (5×6 cm). Our results showed that there were significant differences in peeling-off area between the two tapes. The smaller-sized tape had better adhesion to the skin so that you could not peel it off easily. Furthermore, the smaller one stuck fast to the catheter and needed less replacement. Consequently, the skins seemed to be more protected.
Catheter ; Blood vascular ; SIZES ; Access ; Fixation - action

BACKGROUND/AIMS: Eight years have passed since Clinical and Molecular Hepatology changed its language policy to English-only in September 2010. The journal has been included in PubMed Central since September 2010. Present title continues the Korean Journal of Hepatology since June 2012. It has been indexed in the Web of Science Core Collection as an Emerging Sources Citation Index journal since 2015. I sought to determine whether the change in language policy was successful based on journal metrics. I also investigated whether the journal has become one of the top-ranked world journals in the category of gastroenterology and hepatology. METHODS: The following journal metrics were calculated or analyzed based on the journal’s bibliographic information from 2012 to 2017 and the Web of Science Core Collection database: citable and non-citable articles, country of authors, total cites, impact factor, the immediacy index, country of citing authors, citing journal titles, and the Hirsch index. RESULTS: From 2012 to 2017, there were 282 citable articles. Authors from 29 countries have published in the journal. The number of total citations in 2017 was 611. The impact factor increased from 2.1 in 2014 to 2.8 in 2017. The citing authors were from 85 countries, and their papers have been cited in 663 journals. The Hirsch index was 19. CONCLUSIONS: Based on journal metrics, Clinical and Molecular Hepatology has succeeded in becoming a top-ranked international journal 8 years after changing its language policy to English-only.
Bibliometrics ; Editorial Policies ; Gastroenterology* ; Open Access Publishing

BACKGROUND/AIMS: Fragmented care in nephrology can cause treatment delays. Nephrologists are qualified to perform vascular access-related procedures because they understand the pathophysiology of renal disease and perform physical examination for vascular access. We compared treatment delays associated with tunneled hemodialysis catheter (TDC) placement between interventional radiologists and nephrologists. METHODS: We collected data by radiologists from January 1, 2011 through December 31, 2011 and by nephrologists from since July 1, 2012 through June 30, 2013. We compared the duration from the hemodialysis decision to TDC placement (D-P duration) and hemodialysis initiation (D-H duration), catheter success and the complication rate, and the frequency and the usage time of non-tunneled hemodialysis catheters (NDCs) before TDC placement. RESULTS: The study analyzed 483 placed TDCs: 280 TDCs placed by radiologists and 203 by nephrologists. The D-P durations were 319 minutes (interquartile range [IQR], 180 to 1,057) in the radiologist group and 140 minutes (IQR, 0 to 792) in the nephrologist group. Additionally, the D-H durations were 415 minutes (IQR,260 to 1,091) and 275 minutes (IQR, 123 to 598), respectively. These differences were statistically significant (p = 0.00). The TDC success rate (95.3% vs. 94.5%, respectively; p = 0.32) and complication rate (16.2% vs. 11%, respectively; p = 0.11) did not differ between the groups. The frequency (24.5 vs. 26%, respectively; p = 0.72) and the usage time of NDC (8,451 vs. 8,416 minutes, respectively; p = 0.91) before TDC placement were not statistically significant. CONCLUSIONS: Trained interventional nephrologists could perform TDC placement safely, minimizing treatment delays.
Catheters* ; Nephrology ; Physical Examination ; Renal Dialysis* ; Vascular Access Devices

The pseudoaneurysms are resulted from complication of vascular catheterization, trauma, etc. and recently, the reports on pseudoaneurysms have been increasing. Successful treatment of pseudoaneurysms have been described usingdirect compression guided by color doppler ultrasound, instead of invasive surgical treatment. Authors experienced three cases of pseudoaneurysm ; two resulted from post-catheterization and one from trauma. We successfully treated two post-catheterization cases using C-clamp compression under the color doppler US-guidance. The traumatic case was treated by embolization instead of US-guided compression. We suggest that the compression of pseudoaneurysm using C-clamp under the US-guidance is more useful than hand or probe compression method.
Aneurysm, False* ; Arteries* ; Hand ; Ultrasonography ; Vascular Access Devices

Totally implanted vascular access devices are excellent for delivering chemotherapeutic agents and prolonged intravenous infusions in patients with cancer. Catheter disconnection and migration are rare but potentially serious complications of these widely used devices. Retrieval of the migrated fragment is generally indicated but may not be possible. We hereby report three cases of catheter disconnection and migration of totally implanted vascular access devices into the heart along with the review of literatures.
Catheters ; Heart ; Humans ; Infusions, Intravenous ; Vascular Access Devices*