Experience with continuous venovenous hemodiafiltration in four newborns: A case series and review of the literature

When conventional methods for treating complicated problems such as acute and chronic renal failure or metabolic diseases fail, the therapy of choice is peritoneal dialysis (PD) in neonatal period. However, in cases that involve technical difficulties, such as bulky lesions in the abdomen or complications from previous abdominal surgeries, it is not always possible to place a peritoneal catheter. In such situations, continuous venovenous hemodiafiltration (CVVHDF) can be effective. This case series presents our experience in 2013 with the administration of CVVHDF to four patients in our neonatal intensive care unit who could not undergo PD for various reasons.     

Dilator venotomy technique for placement of hemodialysis catheter following recanalization of occluded central vein

Recanalization of occluded central veins for insertion of hemodialysis catheter is a particular attractive option in patients who are catheter dependent for hemodialysis, as it delays exhaustion of conventional venous accesses. Literature detailing techniques for catheter placement in recanalized veins remain sparse. We hereby describe a safe and economical technique of using dilator venotomy to allow catheter placement following successful recanalization.     

Iliopsoas abscess as a complication of tunneled jugular vein catheterization in a hemodialysis patient

Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47‐year‐old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter‐related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin‐resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess. Following surgical intervention and intravenous daptomycin, the patient experienced full recovery and a return to usual activities. This case indicates that an iliopsoas abscess can be related to a jugular vein catheter, which is apparently facilitated by infective endocarditis. The possibility of iliopsoas abscess should be considered when a hemodialysis patient presents with severe low back pain, even when there is no history of adjacent mechanical intervention.     

Model predictive control for tendon‐driven balloon actuator on simulation

Many pneumatic actuators have been developed to be lightweight with high output for decreasing the impact force. However, for pneumatic actuators it is difficult to maintain exact control because these actuators have constraints. In this study, we developed model predictive control (MPC) that can accommodate these constraints when applied to the pneumatic actuator we developed. As described here, we compared and evaluated the control performance using MPC and proportional–integral–derivative (PID) control with an anti‐windup control system. © 2016 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.     

GFE（L）1型高空气象探测雷达假定向抓球的识别与处理

GFE（L）1型高空气象探测雷达假定向抓球在实际工作中经常发生,从而造成探测数据错误、缺测,严重影响天气预报、特别是灾害性天气预报的准确率。本文详细分析了假定向抓球产生的原因,并提出了相应的识别方法及处理措施。     

电阻式汽车预爆胎在线传感器的设计

爆胎是车辆行进中的重大危害。鉴于目前轮胎压力检测系统的不足,选用应变式电阻传感器,从结构和电路两个方面进行了汽车预爆胎电阻式在线传感器的设计;同时开发了相应的程序。现场实验结果表明该设计达到了预期的效果,这也为完善汽车智能控制系统的可靠性提供了一定的参考价值。     

Right intra-atrial catheter placement for hemodialysis in patients with multiple venous failure

The purpose of this study is to evaluate the efficacy and safety of direct right atrial catheter insertion for hemodialysis in patients with multiple venous access failure. We retrospectively evaluated the charts of 27 patients with multiple venous access failure who had intra-atrial dialysis catheter placement between October 2005 and October 2010 in our clinic. Permanent right atrial dialysis catheters were placed through a right anterior mini-thoracotomy under intratracheal general anesthesia in all patients. Demographics of the cases, the patency rates of hemodialysis via atrial catheterization, existence of any catheter thrombosis, and catheter-related infections were documented and used in statistical analysis. Seventeen women (63%) and 10 men (37%) with the mean age of 59.0 ± 7.1 years (47-71) were enrolled in this study. Chronic renal failure was diagnosed for the mean of 78.9 ± 24.3 months (33-130). Five patients (18.5%) died. Ventricular fibrillation and myocardial infarction were the causes of death in the early postoperative period in two patients. Two of the remaining three patients died because of cerebrovascular events, and one patient died because of an unknown cause. Ten patients (37%) had been using anticoagulate agents (warfarin) because of concomitant disorders such as deep vein thrombosis, operated valve disease, and arrhythmias. Catheter thrombosis and malfunction was determined in three cases (11.1%). Intra-atrial hemodialysis catheterization is a safe and effective life-saving measure for the patients with multiple venous failure and without any possibility of peritoneal dialysis or renal transplantation.     

Efficacy of preventing hemodialysis catheter infections with citrate lock

Prevalent use of tunneled dialysis catheters can reach 30%. Infection remains the most serious catheter‐related problem. Catheter locks are increasingly used for prevention, but are not yet recommended either by the Food and Drug Association or European Medicines Agency, on the basis of increasing bacterial resistance or lock toxicity. The aim was to test safety and effectiveness of citrate. A prospective, interventional study was conducted to assess the safety and efficacy of a 30% citrate lock in preventing catheter‐related bacteremia (CRB). A total of 157 prevalent tunneled catheters were locked with citrate and prospectively followed during a 1‐year period. The primary endpoint was first CRB diagnosed according to two of the diagnostic criteria for Catheter Infection of Centers for Disease Control and Prevention (CDC), namely definite and probable infection. The CDC criterion of possible but not proved infection was not considered. This citrate lock cohort (n = 157) had 10 episodes of CRB. We observed 0.49 CRB episodes/1000 patient‐days and the mean infection‐free catheter day was 130.6 ± 100.9. No clinically relevant adverse events were observed. No proved tunnel or exit site infection was observed and no patients died because of CRB. Catheter obstruction episodes were reported on 69 occasions out of 14 catheters. These results were compared with an historical cohort from a previous study of catheter locking with low‐dose gentamicin and did not show significant difference in efficacy. Citrate lock is effective in preventing CRB. No toxicity was observed. The use of citrate lock may have advantages over antibiotic locks: No reported bacterial resistance, lower industrial cost, and less manipulation.     

Energy from solar balloons

Solar balloons are hot air balloons in which the air is heated directly by the sun, by means of a black absorber. The lift force of a tethered solar balloon can be used to produce energy by activating a generator during the ascending motion of the balloon. The hot air is then discharged when the balloon reaches a predefined maximum height. A preliminary study is presented, along with an efficiency estimation and some considerations on possible realistic configurations.