Native arteriovenous fistula is considered the best type of access for dialysis. Its function is affected by multiple factors.The aim of the study was to identify risk factors of the loss of fistula patency.Material and methods. Between 1990-2004, 218 patients underwent 276 surgical procedures involving vascular access creation. In 245 (89%) of cases, a fistula was created using only patient's own blood vessels; in 31 (11%) of cases a vascular graft was implanted. 158 (64%) radio-cephalic fistulae were created, 15 (6%) radiobasilic fistulae, 33 (14%) brachiocephalic and 39 (16%) brachiobasilic fistulae. Duration of primary patency was identified for 217 native fistulae. Age, gender, diabetes mellitus, type, mode of creation and fistula location, vein translocation, type of anastomosis and time of initial cannulation were analyzed as potential factors affecting the fistula patency. Cox proportional hazards model was used in the analysis.Results. Probability of fistula patency loss in patients above 46 years of age was 2.12-fold higher than in younger patients and 1.62-fold higher for end-to-side anastomosis versus end-to-end anastomosis. Risk of loss of patency in fistulae cannulated for the first time within the first 14 days, 15-21 days and 22-35 days from their creation was 31-, 19- and 7-fold higher than when they were cannulated after the first 35 days.Conclusions. Type of vascular anastomosis, age above 46 years and time of the first cannulation are independent risk factors of the loss of patency of vascular access. First cannulation should not take place earlier than 7 weeks after its creation.
2
Dostęp do pełnego tekstu na zewnętrznej witrynie WWW
Introduction March Training (MT) is one of the ways to improve the results of treatment in patients with peripheral artery disease (PAD). The aim of this study was to investigate the effect of 12 weeks of march training on the claudication distance in patients with PAD who underwent endovascular surgery. Material and methods The study included 30 patients with peripheral arterial disease (PAD) and evaluated the claudication distance on a treadmill: before endovascular surgery, 3 days and 3 months after the surgery. The maximum claudication distance (MCD) was measured during each test on a treadmill. Patients were randomly divided into 2 groups of 15: group A consisted of patients who were not recommended to march after endovascular surgery and group B consisted of patients to whom training was recommended. Patients in group B were recommended march training at home for 3 months according to the following schedule: walking at a regular walking pace of 60-120 feet’s per minute for at least 30 minutes, 3 times a day, 3 days a week, supervised by a physiotherapist. Results Group A - MCD before surgery: 103,23m , MCD 3 days after surgery: 179m, MCD 3 months after treatment: 136,67m , p <0.001. Conclusions MCD carried out for 3 months after endovascular treatment of patients with PAD is better in group of patient systematically doing march training compared to patients without such training.
4
Dostęp do pełnego tekstu na zewnętrznej witrynie WWW
The aim of the study was to compare the quality of life of patients with cardiovascular diseases after surgical treatment of cholecystolithiasis by means of laparoscopy as compared to open surgery.Material and methods. The study group comprised 111 patients burdened with cardiovascular diseases who underwent surgical treatment for symptomatic cholecystolithiasis, at the Department of General and Vascular Surgery, Międzyleski Specialistic Hospital in Warsaw, during the period between 2002 and 2005. Patients were divided in two groups: those managed by means of laparoscopic surgery, and those who underwent open surgery. The study was interpreted by means of a questionnaire form created by the authors, entitled SATISFACTION AND GENERAL CONDITION AFTER TREATMENT OF CHOLECYSTOLITHIASIS, in combination with the SF-36 questionnaire. The mean observation period for group I patients totaled 22.06 ± 10.98 months, while that of group II patients totaled 22.12 ± 3.41 months after cholecystectomy.Results. Based on the analysis of both questionnaires, it was determined that a better postoperative quality of life was experienced by the patients who underwent laparoscopic surgery.Conclusion. Laparoscopic cholecystectomy is highly recommended for the treatment of patients with concomitant cardiovascular disease, due to the quality of life experienced postoperatively.
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.