236 research outputs found
Oxalate clearance by haemodialysis - a comparison of seven dialysers
No full textBackground. In patients with primary hyperoxaluria (PH) and oliguric end-stage renal disease, oxalate removal is largely dependent on the clearance by dialysis. Data on the oxalate clearance of newer dialyser types are scarce or absent. Therefore, we measured oxalate clearances of seven dialysers in a single 52-year-old female patient with PH. Since haemodiafiltration (HDF) has been advocated to increase oxalate clearance, we also assessed the effect of different predilution flows. The goal of the study was to select the dialyser and pre-dilution flow combination with the highest oxalate clearance. Methods. Oxalate clearances were assessed by simultaneously taking afferent blood and efferent dialysate samples at 30, 60, 120 and 180 min after the start of haernodialysis. Blood flow and dialysate flow were 350 and 500 ml/min, respectively. All dialysers were tested at a pre-dilution flow of 2 I/h. Six dialysers were also tested at either a pre-dilution flow of 4.5 I/h or without HDF, depending on the ultrafiltration coefficient of the dialyser. Results. Oxalate clearances differed markedly between the tested dialysers, ranging from 144 +/- 10 to 220 +/- 12 ml/min. The highest oxalate clearances were achieved with HdF 100S (219 +/- 10 ml/min) and Sureflux FB-2 IOU (220 12 ml/min) at a pre-dilution flow of 2 I/h. Higher pre-dilution flows (2 l/h vs no HDF or 4.5 vs 2.0 l/h) yielded similar oxalate clearances. Conclusion. The highest oxalate clearances were achieved with a high-flux polysulfone and a cellulose triacetate dialyser with a large surface area. Higher pre-dilution flows did not augment oxalate clearance
Making use of historical case material – the problems of looking back and the implications for service development in relation to research and evaluation activities
Get PDFThis methodological paper details the process of embarking on a follow-up study of young people with sexual behaviour problems who were known to services in the 1990s and who are now young adults in their twenties or early thirties. In the context of the importance of such follow-up work, the overall aim and objectives of the funded research project are specified and the challenges presented in setting up research partnerships with service sites, including the negotiation of access and ethical approval, are the subject of overview and reflection. The practicalities of beginning the fieldwork which comprised an initial analysis of historical case material held in the research sites are then detailed and the solutions to the problems encountered are explained. The article concludes by identifying the kinds of questions services and researchers need to consider when wanting to engender or enhance a research culture which is facilitative of this kind of outcome research. These relate to the resources necessary to support a research culture, the requirements of data protection and ethical approval processes, obtaining service user consent to participate in future research, secure but accessible storage of records, staff development and researchers’ obligations to minimise disruption to already hard pressed services
Measurement of relative blood volume changes during haemodialysis: merits and limitations
No full textEffect of high and low ultrafiltration volume during hemodialysis on relative blood volume
No full textAchieving an optimal posthemodialysis hydration status may be difficult because objective criteria for dry weight are lacking. Both relative blood volume changes (Delta RBV) at the end of hemodialysis and Delta RBV normalized for ultrafiltration volume (Delta RBV/UF ratio) have been reported to indicate posthemodialysis volume status. A parameter for volume status should not be influenced by variations in ultrafiltration volume. However, if the volume that has to be ultrafiltrated to reach dry weight varies as a result of variations in prehemodialysis weight, either Delta RBV or the Delta RBV/UF ratio (or both) must change. To elucidate the relation between intradialytic ultrafiltration volume versus Delta RBV and its derivative, the Delta RBV/UF ratio, we studied the effect of a relatively high (mean +/- SD, 2.7 +/- 0.51) and low (1.5 +/- 0.31) intradialytic ultrafiltration volume on these parameters in eight patients. Posthemodialysis weight was comparable in low and high ultrafiltration volume sessions. The average end-hemodialysis Delta RBV did not differ between high (-6.7 +/- 2.5%) and low ultrafiltration volume sessions (-7.3 +/- 1.0%; NS), but the intraindividual variation was considerable. The Delta RBV/UF ratio differed markedly (p <0.001) between high (-2.4 +/- 0.8 %/l) and low (-4.9 +/- 1.3%/l) ultrafiltration volume sessions. In conclusion, the considerable random intraindividual variation of Delta RBV and the systematic change of the Delta RBV/UF ratio with variations in intradialytic ultrafiltration volume limit the use of these parameters as an aid to assess hydration status in hemodialysis patients
Renal survival and prognostic factors in patients with PR3-ANCA associated vasculitis with renal involvement
No full textBackground. Severe renal disease is a feature of anti-neutrophil cytoplasmic antibodies (ANCA)-associated small-vessel vasculitis. We evaluated patient and renal survival and prognostic factors in patients with PR3-ANCA associated vasculitis with renal involvement at diagnosis during long-term follow-up. Methods. Eighty-five patients were diagnosed between 1982 and 1996 and followed until 2001 allowing greater than or equal to5 years of follow-up. All patients were treated with prednisolone and cyclophosphamide. Univariate and multivariate analyses with patient and renal survival as dependent variables were performed. Results. Of the 85 patients in this study, 17 (20%) died within one year after diagnosis. Of the 25 patients (29%) who were dialysis dependent at diagnosis, two remained dependent and two again became dialysis dependent after less than one year; nine died early without renal recovery. Risk factors for death occurring within one year in univariate analysis (RR, 95% CI) were age >65 years (6.5, 1.6-13.7) and dialysis dependency at diagnosis (3.6, 1.0-13). Twenty patients died beyond one year during the long-term follow-up. Male gender (4.7, 1.6-10) and developing dialysis dependency during follow-up (4.1, 1.4-12) were associated with poor outcome. Risk factor for renal failure within one year was dialysis dependency at diagnosis (29, 3.6-229). Of 64 patients dialysis independent one year after diagnosis, 12 patients became dialysis dependent during follow-up. A renal relapse was strongly associated with development of renal failure in long-term follow-up (17, 3.5-81). Conclusions.Early death and failure to recover renal function in P R3-ANCA associated vasculitis is associated with age >65 years and dialysis dependency at diagnosis. Long-term renal survival is determined by renal relapses during follow-up only. Slow, progressive renal failure without relapses is rarely observed in this group
Author, Dr. Paul Wehr. c. 1980
No full textDr. Paul Wehr, as he appeared c. 1980. Dr. Wehr was a professor of history at UCF and the author of Like a Mustard Seed: the Slavia Settlement (1982 - Mickler Publishing House), a history of the early years of Slavia and St. Luke\u27s history.https://stars.library.ucf.edu/cfm-images/1413/thumbnail.jp
Inscription By Author of Like a Mustard Seed: The Slavia Settlement
No full textAn inscription from author, Paul Wehr, to Judy and Walter Duda, to celebrate the completion of his work on Like a Mustard Seed: the Slavia Settlement. c.https://stars.library.ucf.edu/cfm-images/1410/thumbnail.jp
Conner, Author
No full textAnna Conner - wifehttps://stars.library.ucf.edu/cfm-ch-memoranda-1915/1140/thumbnail.jp
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