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Biomedical subjects

Martin Sedlacek

Publications and source records attributed to Martin Sedlacek.

7 recordsLinked to original sources
PubMed2003

IgA nephropathy.

Explore the source record for details and available documents.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2003

Venous access: women are equal.

BACKGROUND: Arteriovenous fistulae (AVFs) are the preferred method of vascular access for hemodialysis patients; however, the current rate of AVF placement is only 25% to 30% in the United States. This prevalence is even smaller among women and attributed to their perceived inadequate vasculature. This commonly held view that women have less adequate vasculature for AVF placement than men has not been shown objectively in the literature. METHODS: To determine a difference in vasculature between the sexes, we retrospectively analyzed data on preoperative vascular mapping in 192 patients. During a 2-year period, vascular mapping of the upper extremities was routinely performed using duplex ultrasound in all patients requiring vascular access in our institution. RESULTS: One hundred six of these 192 patients were women, and 86 were men. There was no significant difference in vein size between men and women at any of the sites measured. A total of 87 fistulae were placed in 140 patients, 49% in women and 51% in men (P = 0.16). Prevalences of AVFs were 57% and 68% (P = 0.2) in women and men, respectively. Percentages of fistulae used at the initiation of hemodialysis therapy were 72% in women and 77% in men (P = 0.57). CONCLUSION: These data support the view that women have adequate vasculature for the placement of AVFs compared with men. We cannot explain the different outcomes found in other studies; however, we suggest that the differences are caused by physician practice patterns, not anatomic differences between men and women.

Arteriovenous Shunt, Surgical↗
PubMedDate not supplied

Impact of the surgeon on the prevalence of arteriovenous fistulas.

Decreased use of native arteriovenous fistulas and an increased reliance on synthetic grafts as permanent dialysis access have accompanied the growth of the dialysis population in the United States, but not at our institution. Possible reasons for this difference were studied in a cross-sectional analysis in August of 2000. There were 51 chronic dialysis patients, all of whom had their access placed by the same surgeon; 75% of them were dialyzed through an arteriovenous fistula, which compares well with the 23% prevalence at the national level. Among our patients, 57% were diabetic, 98% had a history of hypertension, 35% had amputations or arterial bypass surgery, 37% had coronary artery disease, 12% had suffered a stroke, 35% were active smokers, and 22% had a history of intravenous drug use. The high prevalence of arteriovenous fistulas, despite so many comorbid conditions, suggests that the presence of a skilled and experienced surgeon may be more predictive of better dialysis access than other factors.

Aged↗
PubMedDate not supplied

Electrolyte disturbances in the intensive care unit.

The development of many electrolyte disturbances in the ICU can be prevented by attention to the use of intravenous fluids and nutrition. Hyponatremia is a relative contraindication to the use of hypotonic intravenous fluids and hypernatremia calls for the administration of water. Formulae have been devised to guide the therapy of severe hyponatremia and hypernatremia. All formulae regard the patient as a closed system, and none takes into account ongoing fluid losses that are highly variable between patients. Thus, therapy of severe hyponatremia and hypernatremia must be closely monitored with serial electrolyte measurements. The significance of hypocalcemia in the critically ill is controversial. Hypokalemia, hypophosphatemia, and hypomagnesemia should be corrected.

Humans↗