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Cimino Fistula
A Cimino fistula, also Cimino-Brescia fistula, surgically created arteriovenous fistula and (less precisely) arteriovenous fistula (often abbreviated AV fistula or AVF), is a type of vascular access for hemodialysis. It is typically a surgically created connection between an artery and a vein in the arm, although there have been acquired arteriovenous fistulas which do not in fact demonstrate connection to an artery. Structure The radiocephalic arteriovenous fistula (RC-AVF) is a shortcut created between cephalic vein and radial artery at the wrist. It is the recommended first choice for hemodialysis access. However, after a period of usage, failures can occur. Possible causes for failure are stenosis and thrombosis especially in diabetics and those with low blood flow such as due to narrow vessels, arteriosclerosis and advanced age. Reported patency of fistulae after 1 year is about 60%, when primary failures were included. Juxa-anastomotic site (venous segment that is between ...
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James Cimino
James E. Cimino (1928-11 February 2010) was a physician who specialized in palliative care. He is best known for his invention of the Cimino fistula and for his work as an administrator at Calvary Hospital into the Palliative Care Center it is today. Dr. Cimino went to New York University School of Medicine and did his internal medicine residency at the University of Buffalo followed by a fellowship in physiology. He then moved back to the Bronx to work at the Bronx Veterans Administration Medical Center where he started a program on dialysis. He developed techniques for employing Arteriovenous fistula in patients with chronic kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ..., which led to a presentation in 1966 at the convention of the American Society for Artif ...
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Chronic Renal Failure
Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications can relate to hormonal dysfunction of the kidneys and include (in chronological order) high blood pressure (often related to activation of the renin–angiotensin system system), bone disease, and anemia. Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization. Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. Risk factors include a family history of chronic kidney disease. Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin. Ultrasound or kidney biopsy may be performed to ...
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Arteriovenous Fistula
An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arterial aneurysm. Clinical features Pathological Hereditary hemorrhagic telangiectasia is a condition where there is direct connection between arterioles and venules without intervening capillary beds, at the mucocutaneous region and internal bodily organs. Those who are affected by this conditions usually do not experience any symptoms. Difficulty in breathing is the most common symptom for those who experience symptoms. Just like berry aneurysm, a cerebral arteriovenous malformation can rupture causing subarachnoid hemorrhage. Causes The cause of this condition include * Congenital (developmental defect) * Rupture of arterial aneurysm into an adjacent vein * Penetrating injuries * Inflammatory necrosis of adjacent vessels * Complication of c ...
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Veteran
A veteran () is a person who has significant experience (and is usually adept and esteemed) and expertise in a particular occupation or field. A military veteran is a person who is no longer serving in a military. A military veteran that has served directly in combat in a war is further defined as a war veteran (although not all military conflicts, or areas in which armed combat took place, are necessarily referred to as ''wars''). Military veterans are unique as a group as their lived experience is so strongly connected to the conduct of war in general and application of professional violence in particular. Therefore, there are a large body of knowledge developed through centuries of scholarly studies that seek to describe, understand and explain their lived experience in and out of service. Griffith with colleagues provides an overview of this research field that addresses veterans general health, transition from military service to civilian life, homelessness, veteran empl ...
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Korean War
, date = {{Ubl, 25 June 1950 – 27 July 1953 (''de facto'')({{Age in years, months, weeks and days, month1=6, day1=25, year1=1950, month2=7, day2=27, year2=1953), 25 June 1950 – present (''de jure'')({{Age in years, months, weeks and days, month1=6, day1=25, year1=1950) , place = Korean Peninsula, Yellow Sea, Sea of Japan, Korea Strait, China–North Korea border , territory = Korean Demilitarized Zone established * North Korea gains the city of Kaesong, but loses a net total of {{Convert, 1506, sqmi, km2, abbr=on, order=flip, including the city of Sokcho, to South Korea. , result = Inconclusive , combatant1 = {{Flag, First Republic of Korea, name=South Korea, 1949, size=23px , combatant1a = {{Plainlist , * {{Flagicon, United Nations, size=23px United Nations Command, United Nations{{Refn , name = nbUNforces , group = lower-alpha , On 9 July 1951 troop constituents were: US: 70.4%, ROK: 23.3% other UNC: 6.3%{{Cite ...
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Bellevue Hospital
Bellevue Hospital (officially NYC Health + Hospitals/Bellevue and formerly known as Bellevue Hospital Center) is a hospital in New York City and the oldest public hospital in the United States. One of the largest hospitals in the United States by number of beds, it is located at 462 First Avenue in the Kips Bay neighborhood of Manhattan, New York City. Bellevue is also home to FDNY EMS Station 08, formerly NYC EMS Station 13. Historically, Bellevue was popularly associated with its treatment of mentally ill patients such that "Bellevue" became a local pejorative slang term for a psychiatric hospital. This is long past the case as the hospital since developed into a comprehensive major medical center over the years, including outpatient, specialty, and skilled nursing care, as well as emergency and inpatient services. The hospital contains a 25-story patient care facility and has an attending physician staff of 1,200 and an in-house staff of about 5,500. Bellevue is a safety n ...
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New York City
New York, often called New York City or NYC, is the List of United States cities by population, most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the List of United States cities by population density, most densely populated major city in the United States, and is more than twice as populous as second-place Los Angeles. New York City lies at the southern tip of New York (state), New York State, and constitutes the geographical and demographic center of both the Northeast megalopolis and the New York metropolitan area, the largest metropolitan area in the world by urban area, urban landmass. With over 20.1 million people in its metropolitan statistical area and 23.5 million in its combined statistical area as of 2020, New York is one of the world's most populous Megacity, megacities, and over 58 million people live within of the city. New York City is a global city, global Culture of New ...
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Phlebotomist
Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood. The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a phlebotomy is called a ''phlebotomist'', although most doctors, nurses, and other technicians can also carry out a phlebotomy. In contrast, phlebectomy is the removal of a vein. Phlebotomies that are carried out in the treatment of some blood disorders are known as '' therapeutic phlebotomies''. The average volume of whole blood drawn in a therapeutic phlebotomy to an adult is 1 unit (450-500 ml) weekly to once every several months, as needed. Etymology From grc, φλεβοτομία ( – 'blood vessel, vein' + 'cutting'), via fro, flebothomie (modern French ). Phlebotomies Phlebotomies are carried out by phlebotomists – people trained to draw blood mostly from veins for clinical or medical testing, transfusions, donations, or rese ...
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Teflon
Polytetrafluoroethylene (PTFE) is a synthetic fluoropolymer of tetrafluoroethylene that has numerous applications. It is one of the best-known and widely applied PFAS. The commonly known brand name of PTFE-based composition is Teflon by Chemours, a spin-off from DuPont, which originally discovered the compound in 1938. Polytetrafluoroethylene is a fluorocarbon solid, as it is a high-molecular-weight polymer consisting wholly of carbon and fluorine. PTFE is hydrophobic: neither water nor water-containing substances wet PTFE, as fluorocarbons exhibit only small London dispersion forces due to the low electric polarizability of fluorine. PTFE has one of the lowest coefficients of friction of any solid. Polytetrafluoroethylene is used as a non-stick coating for pans and other cookware. It is non-reactive, partly because of the strength of carbon–fluorine bonds, so it is often used in containers and pipework for reactive and corrosive chemicals. Where used as a lubricant, PT ...
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Scribner Shunt
Hemodialysis, American and British English spelling differences#ae and oe, also spelled haemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of Kidney dialysis, dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure. Hemodialysis is one of three renal replacement therapy, renal replacement therapies (the other two being kidney transplant and peritoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma or cells is apheresis. Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility, either a purpose-built room in a hospital or a dedicated, stand-alone clinic. Less frequently hemodialysis is done at home hemodialysis, home. Dialysis treatments in a clinic are initiated and mana ...
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Bronx Veterans Administration Hospital
The James J. Peters VA Medical Center, (also known as the Bronx Veterans Hospital), is a US Department of Veterans Affairs hospital complex located at 130 West Kingsbridge Road in West Fordham, Bronx, New York City. The hospital is the headquarters of the Veterans Integrated Service Networks New York/New Jersey VA Health Care Network. This network is also the parent network to VA New York Harbor Healthcare System. The campus falls under the jurisdiction of the United States Department of Veterans Affairs Police and the United States Department of Veterans Affairs, Office of Inspector General. History During the American Revolutionary War, the site of the medical center was the location of British '"Fort Number 6" (1777–1779). During the 19th century, the land was part of the estate of Nathaniel Platt Bailey. The site then became the property of the Sisters of Charity of New York who turned it into the Bronx Roman Catholic Orphan Asylum. The hospital opened as United Sta ...
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