Etiological Factors Affecting Single Versus Multiple Tunneled Hemodialysis Catheter Cuff Extrusions in the Saudi Population.

OBJECTIVE: To identify underlying factors associated with single versus multiple expulsions of tunneled hemodialysis catheter cuffs and their associated complications. MATERIALS AND METHODS: A multicenter, five-year retrospective data analysis was conducted on hemodialysis patients with tunneled catheters. Patient data included age, gender, BMI, and associated comorbidities. The type of procedure (new tunnel insertion vs. exchange), exit site infection, and catheter-related bloodstream infection (CRBSI) were also included. RESULTS: The data of 122 patients was analyzed. Seventy-eight patients had diabetes mellitus, 102 patients had hypertension, and 24 had ischemic heart disease. Fifty-one patients were on antiplatelet therapy, and nine patients were on oral steroids. The access site for 98 patients was the right internal jugular; for 19 patients, it was the left internal jugular; five patients had a femoral dialysis catheter. Patients were grouped into two categories: those with single cuff extrusion episodes and those with multiple cuff-out episodes. Sixty-three patients had one cuff extrusion, and 59 had multiple cuff-out episodes during the study period. Patients who had CRBSI and hypertension and were aged between 61 and 95 had multiple episodes of cuff extrusion and reached statistical significance. Exit-site infection, diabetes mellitus, antiplatelet therapy, gender, catheter site, and BMI had no statistical significance between the two groups. CONCLUSION: Tunneled catheter cuff extrusion is a frequent phenomenon. Catheter-related bloodstream infection, hypertension, and age of 61 to 95 years are high-risk factors for multiple episodes of cuff extrusion.

Charge transfer in TiO2-based photocatalysis: fundamental mechanisms to material strategies.

Semiconductor-based photocatalysis has attracted significant interest due to its capacity to directly exploit solar energy and generate solar fuels, including water splitting, CO2 reduction, pollutant degradation, and bacterial inactivation. However, achieving the maximum efficiency in photocatalytic processes remains a challenge owing to the speedy recombination of electron-hole pairs and the limited use of light. Therefore, significant endeavours have been devoted to addressing these issues. Specifically, well-designed heterojunction photocatalysts have been demonstrated to exhibit enhanced photocatalytic activity through the physical distancing of electron-hole pairs generated during the photocatalytic process. In this review, we provide a systematic discussion ranging from fundamental mechanisms to material strategies, focusing on TiO2-based heterojunction photocatalysts. Current efforts are focused on developing heterojunction photocatalysts based on TiO2 for a variety of photocatalytic applications, and these projects are explained and assessed. Finally, we offer a concise summary of the main insights and challenges in the utilization of TiO2-based heterojunction photocatalysts for photocatalysis. We expect that this review will serve as a valuable resource to improve the efficiency of TiO2-based heterojunctions for energy generation and environmental remediation.