Switch from conventional to every other day hemodialysis: a comparison pilot study.

Fluid and solute fluctuations during the week are the main drawbacks of conventional hemodialysis (cHD) in patients' outcomes. The aim of our study was to evaluate the influence of every other day hemodialysis (eodHD) on clinical and laboratory parameters and to compare to that of cHD. Eighteen patients on cHD were included in the study. Nine patients (group I) were randomly switched to eodHD, while the rest (group II) remained on their regular cHD. By the end of the study (12 months) we observed a reduction in body weight followed by a parallel reduction in predialysis mean blood pressure by 7 mm Hg in group I (p<0.05) and the number of antihypertensives. Moreover, a reduction in left ventricular mass and an increment of ejection fraction was observed in group I. Hemoglobin levels remained stable in both groups, but erythropoietin dose was reduced in eodHD group. Dialysis delivered dose (dpKt/V) was higher and urea rebound phenomenon was less in group I. Finally, an improvement in uremia related and postdialysis symptoms was observed in the same group of patients. Our results showed that eodHD improved patients' clinical and biochemical status and therefore might have advantages in patients' outcomes compared with cHD.

Smoking cessation is associated with reduced long-term mortality and the need for repeat interventions after coronary artery bypass grafting.

DESIGN: A prospective study. METHODS: We estimated the impact of smoking cessation on long-term mortality and the need for a revascularization procedure in 1027 patients undergoing a first-ever coronary artery bypass-grafting. RESULTS AND DISCUSSION: Of the 640 active smokers, 44.7% continued smoking after CABG ('current smokers'), and 55.3% quit. During a 5310 patient-years follow-up, with never smokers as the reference group, current smokers (but not quitters) experienced a significant increase in total mortality (hazard ratio 2.6, 95% confidence interval 1.0-6.6) mainly owing to increased cardiovascular mortality (hazard ratio 4.8, 95% confidence interval 1.1-21.4), as well as increased need for a repeat revascularization procedure (hazard ratio 1.7, 95% confidence interval 1.0-2.9).

Health information on the internet: evaluating greek health portals and depicting users' attitudes in West Macedonia, Greece.

The increasing use of communication networks help individuals, organizations and governments to access this information as an every day practice to support their decision-making procedures. Information seekers use the web to get hold of information that exists on the Internet. A lot of times this information has to do health. The existence of health portals has made life easier for the people that need this information. However, the quality of portal interfaces as well as the portal content has many times been in doubt. Many surveys have obtained results that are negative as far as health portal quality is concerned. The purpose of this paper is to evaluate a representative selection of Greek health portals from the actual users' point of view. The evaluation takes place at a small town of North-West Greece called Ptolemais. Questionnaires and interviews as well as interface evaluation techniques are used. The outcome seems positive for the Greek health portals. The study is extended to get some estimate of simple and professional users' attitudes upon seeking health related information on the internet in Greek. The conclusions of this study regarding information preferences of health information seekers are compared to international surveys.

Usefulness of predischarge exercise electrocardiographic testing in detecting the late patency status of the infarct-related artery.

Predischarge exercise electrocardiographic testing (PEET) represents a widely accepted clinical tool for prognostic and functional assessment of patients who experience an uncomplicated acute myocardial infarction (AMI). However, there are no data suggesting any relation between PEET results and patency status of the infarct-related artery (IRA). The aim of this study was to investigate whether ST and/or QT-dispersion (QTD) changes induced by a low-level PEET, after uncomplicated ST-elevation AMI, are related to the late patency status of the IRA. We prospectively evaluated 61 consecutive patients who had suffered a first uncomplicated ST-elevation AMI. All of them successfully carried out four stages of the modified Bruce protocol exercise testing before discharge, and thereafter were subjected to coronary angiography. Exercise-induced ST elevation and QTD shortening were found significantly more frequently in patients with persistently occluded IRA, as compared to patients with patent IRA (ST elevation 65% vs 27%, P = 0.006; QTD shortening 80% vs 29%, P < 0.0001). The coexistence of the two variables predicted the presence of occluded IRA with a positive predictive value of 75%, whereas the absence of both predicted the patency of IRA with a negative predictive value of 100%. These results indicate that ST-elevation and QT-dispersion changes induced by a predischarge exercise testing after a first ST-elevation AMI may effectively predict the late patency status of the infarct-related artery.

Empty follicle syndrome associated with ovarian torsion in an in vitro fertilization program.

We report a very rare case of ovarian torsion following controlled ovarian stimulation for in vitro fertilization in which no oocytes were obtained at the time of ovum retrieval from the left torsed ovary. The patient was a 33-year-old nulligravida female undergoing controlled ovarian stimulation. On day 14, the patient complained of lower left abdominal pain with nausea. Transvaginal oocyte retrieval from the right ovary was performed. The patient subsequently underwent laparoscopy 6 hours following oocyte retrieval. A portion of the left ovary was observed. The ovary was detorsed at the time of laparoscopy followed by peritoneal lavage.