Liver histology in hepatitis B and C co-infection on hemodialysis patients

Non-A, non-B hepatitis accounts for a substantial proportion of both acute and chronic liver disease in chronic renal failure patients. Hepatitis C virus has been documented to be the major cause of non-A. non-B hepatitis [2], contributing for long-term morbidity in these patients

Fine needle aspirative biopsy of the liver in HBsAG-positive patients with end-stage renal failure

HBsAg-positive patients with end-stage renal failure have a high prevalence of asymptomatic chronic hepatitis. In order to determine the usefulness of hepatic cytology in the diagnosis of liver disease, the findings of hepatic needle core biopsy (NCB) and fine needle aspirative biopsy (FNAB) were compared in 75 HBsAg-positive uremic patients. The patients, aged 42 ± 12 years, 14 males, were on hemodialysis for periods ranging from 13 to 105 months. The NCB was processed by standard histologic and immunohis-tochemical techniques and FNAB by the conventional technique, using the total corrected increment score (TCI). Plasma samples were collected for evaluation of hepatic function and for viral serologic tests. In 15 patients a diagnosis was made by NCB: normal, 7 cases; chronic persistent hepatitis, 4 cases', and chronic active hepatitis, 4 cases. When the patients were allocated into two groups according to the severity of the liver histologic findings [group I-minor changes (normal + chronic persistent hepatitis), 11 patients; group II-major changes (chronic active hepatitis), 4 patients], statistically higher values were found in the major changes group for alanine aminotransferase (49 ± 33 vs. 24 ± 11, p = 0.04), γglutamyl transpeptidase [148 ± 53 vs. 38 ± 28, p<minor) 0.02] and TCI (3.7 ± 1.2 vs. 2.5 ± 0.8, p = 0.04). In conclusion, liver FNAB can be useful as a screening procedure for the identification of liver histologic changes (minor or major) in uremic HBsAG-positive patients

The comparative performance of three screening questionnaires for psoriatic arthritis in a primary care surveillance study.

Objectives To compare the performance of three psoriatic arthritis (PsA) screening questionnaires in a primary care psoriasis surveillance study. Methods Participants with psoriasis, and not known to have psoriatic arthritis (PsA), were identified from general practice databases and invited to attend a secondary care centre for a clinical assessment. The three patient-completed screening questionnaires (PEST, CONTEST, and CONTESTjt) were administered along with other patient reported measures and a clinical examination of skin and joints was performed. Participants who demonstrated signs of inflammatory arthritis suggestive of PsA were referred, via their GP, for a further assessment in a secondary care rheumatology clinic. Results A total of 791 participants attended the screening visit and 165 participants were judged to have signs and symptoms of inflammatory arthritis, of which 150 were referred for assessment. Of these 126 were seen and 48 were diagnosed with PsA. The results for each questionnaire were as follows: PEST: Sensitivity 0.625 (95% CI 0.482–0.749), specificity 0.757 (0.724–0.787). CONTEST: Sensitivity 0.604 (0.461–0.731), specificity 0.768 (0.736–0.798). CONTESTjt: Sensitivity 0.542 (0.401–0.676), specificity 0.834 (0.805–0.859). CONTESTjt demonstrated marginally superior specificity to PEST though the area under the ROC curve was similar for all three instruments. Conclusions Minimal differences between the three screening questionnaires were found in this study and no preference can be made based on these results. The choice of which instrument to choose will depend on other factors, such as simplicity and low patient burden

Budd-Chiari syndrome secondary to catheter-associated inferior vena cava thrombosis

Abstract Introduction: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. Case report: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days. She had a tunneled dialysis catheter placed at the left jugular vein. The diagnosis of BCS was established by abdominal computed tomography that showed a partial thrombus within the inferior vena cava which extended from the right atrium to medium hepatic vein, and continuing along the left hepatic vein. Patient was treated with anticoagulants and discharged asymptomatic. Discussion: Budd-Chiari syndrome is a rare medical condition caused by hepatic veins thrombosis. It can involve one, two, or all three of the major hepatic veins. It is usually related to myeloproliferative disorders, malignancy and hypercoagulable states. This case calls attention for inadvertent catheter tip placement into hepatic vein leading to this rare complication. Conclusion: Assessment of catheter dialysis tip location with radiological image seems to be a prudent measure after each procedure even if the tunneled dialysis catheter has been introduced with fluoroscopy image

Room temperature mechanical behavior of two refractory castables

4th International Symposium on Advances in Refractories for the Metallurgical Industries held at the 43rd Annual Conference of Metallurgists of CIM, Hamilton, CANADA, AUG 22-25, 2004International audienceThe present work is achieved in the framework of a French national program on modeling and experimental characterization of the thermo-mechanical properties of refractory materials (PROMETHEREF). This research program is aimed to establish fair models and experimental database and to make it available to industrial partners for numerical simulation of industrial structures made of these materials. The present paper focuses on two silico-alumina refractory castables, an andalusite based one and a bauxite based one. We will present the first rheological characterization results achieved at room on normal and preheated samples of these two refractory castables. Refractory castables are characterized with the help of four points bending tests, compression tests and tensile tests

Room temperature mechanical behavior of two refractory castables

4th International Symposium on Advances in Refractories for the Metallurgical Industries held at the 43rd Annual Conference of Metallurgists of CIM, Hamilton, CANADA, AUG 22-25, 2004International audienceThe present work is achieved in the framework of a French national program on modeling and experimental characterization of the thermo-mechanical properties of refractory materials (PROMETHEREF). This research program is aimed to establish fair models and experimental database and to make it available to industrial partners for numerical simulation of industrial structures made of these materials. The present paper focuses on two silico-alumina refractory castables, an andalusite based one and a bauxite based one. We will present the first rheological characterization results achieved at room on normal and preheated samples of these two refractory castables. Refractory castables are characterized with the help of four points bending tests, compression tests and tensile tests

Microstructural changes and high temperature mechanical behavior of an andalusite based low cement refractory castable

4th International Symposium on Advances in Refractories for the Metallurgical Industries held at the 43rd Annual Conference of Metallurgists of CIM, Hamilton, CANADA, AUG 22-25, 2004International audienceThis paper deals with studies made in the field of the French research network PROMETHEREF. Several refractory castables are considered in this program. In the present paper, one of these materials is considered, it is a low cement castable based on andalusite aggregates. A particular attention is paid to microstructural changes during the first heating and on their effects on the high temperature mechanical behavior. Microstructural evolutions have been characterized by the way of dilatometry, scanning electron microcopy and X-ray diffraction. In-situ observations by environmental scanning electron microscopy gave complementary results on these high temperature microstructural changes. They deal with microcrack formation, phase changes, crystallization, liquid phase formation and sintering. By propagation of ultrasonic waves, high temperature continuous measurements of the Young's modulus have been made. Results confirm the. existence of microstructural changes and allow to quantify the Young's modulus variations all along specific thermal cycles. High temperature four point bending tests and room temperature tensile tests were made in the same temperature range. Behavior evolutions could be found and interpreted with the help of previously mentioned results

Budd-Chiari syndrome secondary to catheter-associated inferior vena cava thrombosis

Abstract Introduction: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. Case report: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days. She had a tunneled dialysis catheter placed at the left jugular vein. The diagnosis of BCS was established by abdominal computed tomography that showed a partial thrombus within the inferior vena cava which extended from the right atrium to medium hepatic vein, and continuing along the left hepatic vein. Patient was treated with anticoagulants and discharged asymptomatic. Discussion: Budd-Chiari syndrome is a rare medical condition caused by hepatic veins thrombosis. It can involve one, two, or all three of the major hepatic veins. It is usually related to myeloproliferative disorders, malignancy and hypercoagulable states. This case calls attention for inadvertent catheter tip placement into hepatic vein leading to this rare complication. Conclusion: Assessment of catheter dialysis tip location with radiological image seems to be a prudent measure after each procedure even if the tunneled dialysis catheter has been introduced with fluoroscopy image

Microstructural changes and high temperature mechanical behavior of an andalusite based low cement refractory castable

4th International Symposium on Advances in Refractories for the Metallurgical Industries held at the 43rd Annual Conference of Metallurgists of CIM, Hamilton, CANADA, AUG 22-25, 2004International audienceThis paper deals with studies made in the field of the French research network PROMETHEREF. Several refractory castables are considered in this program. In the present paper, one of these materials is considered, it is a low cement castable based on andalusite aggregates. A particular attention is paid to microstructural changes during the first heating and on their effects on the high temperature mechanical behavior. Microstructural evolutions have been characterized by the way of dilatometry, scanning electron microcopy and X-ray diffraction. In-situ observations by environmental scanning electron microscopy gave complementary results on these high temperature microstructural changes. They deal with microcrack formation, phase changes, crystallization, liquid phase formation and sintering. By propagation of ultrasonic waves, high temperature continuous measurements of the Young's modulus have been made. Results confirm the. existence of microstructural changes and allow to quantify the Young's modulus variations all along specific thermal cycles. High temperature four point bending tests and room temperature tensile tests were made in the same temperature range. Behavior evolutions could be found and interpreted with the help of previously mentioned results

Budd-Chiari syndrome secondary to catheter-associated inferior vena cava thrombosis

Abstract Introduction: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. Case report: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days. She had a tunneled dialysis catheter placed at the left jugular vein. The diagnosis of BCS was established by abdominal computed tomography that showed a partial thrombus within the inferior vena cava which extended from the right atrium to medium hepatic vein, and continuing along the left hepatic vein. Patient was treated with anticoagulants and discharged asymptomatic. Discussion: Budd-Chiari syndrome is a rare medical condition caused by hepatic veins thrombosis. It can involve one, two, or all three of the major hepatic veins. It is usually related to myeloproliferative disorders, malignancy and hypercoagulable states. This case calls attention for inadvertent catheter tip placement into hepatic vein leading to this rare complication. Conclusion: Assessment of catheter dialysis tip location with radiological image seems to be a prudent measure after each procedure even if the tunneled dialysis catheter has been introduced with fluoroscopy image.</div