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Your search term(s) "Thrombocytosis or thrombosis" returned 95 results.

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Increasing the Hematocrit Has a Beneficial Effect on Quality of Life and Is Safe in Selected Hemodialysis Patients. JASN. Journal of the American Society of Nephrology. 11(2): 335-342. February 2000.

Target hematocrit and hemoglobin values in dialysis patients are still controversial. This article reports on a 6 month prospective study conducted by the Spanish Cooperative Renal Patients Quality of Life Study Group (including 34 hemodialysis units) on the effect of patient functional status and quality of life using epoetin to achieve normal hematocrit in hemodialysis patients with anemia. The possible adverse effects of increased hematocrit, patient hospitalization, and epoetin requirements were also studied. The study included 156 patients (age range, 18 to 65 years). Quality of life was measured with the Sickness Impact Profile (SIP) and Karnofsky scale. Patients completed questionnaires at home at onset and conclusion of the 6 month study. Mean hematocrit increased from 30.9 to 38.4 percent and hemoglobin from 10.2 to 12.5 g per dl during the study. Health indicator scores improved significantly; functional status and quality of life improved with increased hematocrit. No deaths occurred. Three patients (2 percent) were censored for hypertension and nine (5.7 percent) for thrombosis of the vascular access. The number of patients hospitalized decreased and hospital lengths of stay were shorter during the study period than in the same patients in the 6 month period preceding the study. The authors conclude that normalization of hematocrit in selected hemodialysis patients, i.e. nondiabetic patients without severe cardiovascular or cerebrovascular comorbidities, improves quality of life and decreases morbidity without significant adverse effects. 2 figures. 5 tables. 37 references.

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Ischemic Nephropathy: Clinical Characteristics and Treatment. American Journal of Kidney Diseases. 36(5): 883-893. November 2000.

Ischemic nephropathy (kidney damage due to lack of adequate blood flow in the organ) is a long term cause of hypertension (high blood pressure) and renal (kidney) failure. Although its real incidence is unknown, ischemic nephropathy is growing because of the increased mean age of the population and the greater prevalence of populations with hypertension or diabetes mellitus. This review article describes the typical clinical profile of afflicted patients. The authors note that atherosclerosis in different vascular beds is common in these patients. The evolution of ischemic nephropathy is generally progressive, although some patients present with acute renal failure (ARF), either secondary to the administration of ACE inhibitors or caused by thrombosis of the renal arteries. Resvascularizing surgery may stabilize or improve renal function, even in patients with nonfunctioning kidneys. The results obtained with intraluminal angioplasty are worse, with a high percentage of re-stenosis. Placement of an endoprosthesis is recommended when the lesions affect the ostium or proximal third of the artery. The authors caution that this complex disease typically affects multiple organs, thus making individual patient assessment essential. 4 figures. 6 tables. 94 references.

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Levin and O'Neal's the Diabetic Foot. 6th ed. St. Louis, MO: Mosby, Inc. 2000. 828 p.

This book serves as a guide for the interdisciplinary team treating people who have diabetes, focusing on the medical, surgical, psychosocial, and medicolegal aspects of care. The first section explores the foundations of diabetic foot management. Chapters discuss old assumptions and new realities about diabetes, the epidemiology of foot ulcers and amputations, neuropathic problems of the lower extremities, atherosclerosis and thrombosis, the principles and concepts of hemorheology, the biomechanics of the foot in diabetes, cutaneous aspects of diabetes, nutritional issues, and the pathogenesis and management of foot lesions. The section concludes with an overview of diabetic foot care throughout the world. The next section deals with nonsurgical management of diabetic foot problems. Chapters focus on a method for staging and classifying foot lesions, diabetic foot ulcer care, total contact casting, alternative weight redistribution, imaging of the diabetic foot, and noninvasive vascular testing. Other chapter topics include radiologic intervention in diabetic peripheral vascular disease, wound healing, adjunctive hyperbaric oxygen therapy, footwear for injury prevention, Charcot neuroarthropathy of the foot, and infectious problems of the foot. The third section addresses the surgical aspects of diabetic foot care. Chapters discuss the surgical pathology of the foot and clinicopathologic correlations, medical management of diabetic patients during the perioperative period, vascular surgery, plastic surgical reconstruction of the foot, Charcot neuropathy of the foot, lower limb amputation, and rehabilitation of the amputee. The next section is devoted to the team approach to diabetic foot care. Topics include patient education, the role of the wound care nurse and the podiatrist, psychological aspects, and improvements in diabetic foot care. The final section addresses the medicolegal issues relevant to clinicians providing diabetic foot care. Numerous figures. Numerous tables. Numerous references.

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Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia. In: Narayan, P. Benign Prostatic Hyperplasia. London, England: Churchill Livingstone. 2000. p. 355-367.

Transurethral resection of the prostate (TURP) is a procedure used to prevent unnecessary damage to the bladder and kidneys of men with benign prostatic hyperplasia (BPH). This chapter on TURP in the clinical management of BPH is from a textbook that compiles data and commentary from the world's leading experts in this field. The author considers the indications for TURP; the need for informed consent, particularly addressing the potential problems of retrograde ejaculation and erectile dysfunction (impotence); contraindications to transurethral resection; patient preparation, including position on the operating table; equipment, including irrigating fluid, diathermy, avoiding deep venous thrombosis, and anesthesia; the techniques used for TURP, including preliminary cystourethroscopy, internal urethrotomy, preliminary diathermy of the prostatic arteries, finding the landmarks, resecting the left lateral lobe, the capsule, hemostasis, the second lateral lobe, completing the procedure, and catheterization; complications that may be encountered during the procedure, including hemorrhage, perforation, and erection; postoperative complications, including reactionary hemorrhage, secondary hemorrhage, the transurethral resection syndrome, and incontinence; and dealing with the long term aftermath of cardiac disease. Each step of the surgical procedure is illustrated with line drawings. 24 figures. 41 references.

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Vascular Access Procedures for American Indian Dialysis Patients. IHS Primary Care Provider. 25(10): 153-158. October 2000.

More than 300,000 patients are currently receiving treatment for chronic renal failure with chronic dialysis in the United States. Access complications are the leading cause for hospitalizations in this population. This article examines renal (kidney) failure and the complications of dialysis access in two groups of patients from two southwestern Native American tribes. As in the general population, comorbid conditions (illnesses in addition to the kidney disease) were common. In the group from Tribe A, 84 percent had diabetes and 97 percent had hypertension (high blood pressure). In the Tribe B group, 66 percent had diabetes and 80 percent had hypertension. Renal failure associated with diabetes mellitus and hypertension is largely preventable by maintaining strict control of serum glucose and blood pressure. There are three general treatment options for end stage renal disease (ESRD): no therapy (which results in death), peritoneal dialysis, and hemodialysis. In this article, the authors review results from 60 patients from Tribe A who had 81 primary dialysis access procedures over a 6 year period, and from 58 patients from Tribe B who had 94 primary dialysis access procedures over a three year period. The authors discuss the types of grafts and fistulas used, and the complications that can be encountered, including thrombosis (clotting), infection, and arterial insufficiency. In the groups covered in this paper, arteriovenous fistulas had a higher initial failure rate than PTFE (polytetrafluoroethylene) grafts in both patient populations, but those that last a year have longer patency than grafts. The primary and secondary patency rates for Tribe B are less than those for Tribe A patients for PTFE grafts. Radiologic thrombectomy with angioplasty has as good results as surgical revisions as a treatment for graft thrombosis. The authors conclude that early placement of access in patients with progressive ESRD reduces the need for temporary access procedures and may reduce the incidence of subclavian vein stenosis. 5 figures. 3 tables. 28 references.

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