Brachial vein transposition arteriovenous fistulas for hemodialysis access

BackgroundAn arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis, offering lower morbidity, mortality, and cost compared with grafts or catheters. Patients with a difficult access extremity have often lost all superficial veins, and even basilic veins may be obliterated. We have used brachial vein transposition AVFs (BVT-AVFs) in these challenging patients and review our experience in this report.MethodsThe study reviewed consecutive patients in whom BVT-AVFs were created from September 2006 to March 2009. Most BVT-AVFs were created in staged procedures, with the second-stage transposition operations completed 4 to 6 weeks after the first-stage AVF operation. A single-stage BVT-AVF was created when the brachial vein diameter was ≥6 mm.ResultsWe identified 58 BVT-AVF procedures, comprising 41 women (71.0%), 28 diabetic patients (48.3%), and 29 (50.0%) had previous access surgery. The operation was completed in two stages in 45 operations (77.6%) and was a primary transposition in 13 patients. However, five of these were secondary AVFs with previous distal AV grafts or AVFs placed elsewhere; effectively, late staged procedures. Follow-up was a mean of 11 months (range, 2.0-31.7 months). Primary patency, primary-assisted patency, and cumulative (secondary) patency were 52.0%, 84.9%, and 92.4% at 12 months and 46.2%, 75.5%, and 92.4% at 24 months, respectively. Harvesting the brachial vein was tedious and more difficult than harvesting other superficial veins. No prosthetic grafts were used.ConclusionBVT-AVFs provide a suitable option for autogenous access when the basilic vein is absent in patients with difficult access extremities. Most patients required intervention for access maturation or maintenance. Most BVT-AVFs were created with staged procedures. Cumulative (secondary) patency was 92.4% at 24 months

Research Report: High tunnel eggplant varieties, pruning, and postharvest storage, 2018

Recently, parthenocarpic varieties of eggplant (ones that set fruit without pollination) have been developed specifically for greenhouse and tunnel production. In other parts of the world where greenhouse eggplant is more frequently grown, various pruning systems are used to enhance productivity and growth. Our primary objective was to compare yields of eggplant varieties in high tunnel production conditions. We specifically chose to focus on elongated types and to include new parthenocarpic varieties selected for high tunnel and greenhouse conditions. We had two additional objectives: 1) to determine whether pruning to 2- or 4-leader systems would affect yields compared to no pruning, and 2) to compare quality of different varieties in post-harvest storage