RESUMO
INTRODUCTION: Use of chronic intermittent hemodialysis is recent in Chad, where it remains underdeveloped. Vascular access is most commonly by catheter. The objective of our study was to demonstrate the feasibility of arteriovenous fistula (AVF) surgery for hemodialysis during deployments as part of the medical civic action program (MEDCAP). METHODS: We prospectively included all patients admitted for AVF creation at Camp Kossei forward surgical unit in N'Djamena (Chad) between December 2016 and February 2017. Surgery was performed by an experienced vascular surgeon. The data collected included age, sex, cause of kidney failure, type of anesthesia, AVF location, and the duration of the intervention and hospitalization. Patients were examined one month after the procedure to evaluate the functionality, morbidity, and mortality of the AVF. RESULTS: We performed 17 AVF in 3 months. Male to female ratio was 3. High blood pressure was the main cause of chronic kidney failure (55%). All interventions were conducted under locoregional anesthesia. Overall, 35% of fistulae were radiocephalic, 41% brachiocephalic, and 24% brachiobasilic. The mean duration of intervention was 58 minutes and that of hospitalization one day. No deaths occurred. Global morbidity, including non-functioning AVF, was 25%. CONCLUSION: Our study showed that AVF surgery is feasible during deployment, especially in Chad, and meets the needs of the local healthcare facilities. It should be developed and taught to local surgeons.
Assuntos
Derivação Arteriovenosa Cirúrgica , Falência Renal Crônica/terapia , Diálise Renal/métodos , Adulto , Idoso , Chade , Estudos de Viabilidade , Feminino , França , Cirurgia Geral , Humanos , Cooperação Internacional , Masculino , Pessoa de Meia-Idade , Medicina Militar , Estudos Prospectivos , Adulto JovemAssuntos
Hospedeiro Imunocomprometido , Infarto/etiologia , Intestinos/irrigação sanguínea , Mucormicose/complicações , Enterite/complicações , Enterite/diagnóstico , Enterite/microbiologia , Humanos , Infarto/diagnóstico , Infarto/imunologia , Infarto/microbiologia , Intestinos/microbiologia , Intestinos/patologia , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/imunologia , Leucemia Mieloide Aguda/microbiologia , Masculino , Pessoa de Meia-Idade , Mucormicose/diagnóstico , Mucormicose/imunologiaRESUMO
INTRODUCTION: Adenoviral infection is a classic cause of lymphohistiocytic hemophagocytosis (LH) in bone marrow transplantation but is rare outside this setting. CASE REPORT: A 31-year-old female, with a history of treated mesencephalic astrocytoma, was hospitalized for fever, pancytopenia, elevated liver enzymes, hyperferritinemia and hypertriglyceridemia. Adenovirus viral load in blood was 7.3×10(9) copies/mL. Bone marrow aspirate examination confirmed LH. The patient recovered without specific LH or adenovirus-directed treatment. CONCLUSION: Adenovirus-related LH, common in bone marrow transplant recipients, should also be considered in patients with chemotherapy in solid tumors.