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Portal venous thrombosis (PVT) is an uncommon complication in post-liver transplant recipients. The reported incidence is 1-4%. It may occur within a month, called early or after one month of transplantation, known as late PVT. Early PVT has a poor prognosis, leading to graft failure in most cases. Treatment of such cases is quite challenging because of difficult alternative portal inflow establishment. We performed successful thrombolysis of acute major PVT with a unique technique using ultrasound-guided percutaneous trans-splenic vein access in a post-liver transplant recipient. The per-cutaneous trans-splenic vein approach-based thrombolysis described here in this report might be very helpful in similar cases. This technique minimizes the potential risk of graft loss, avoids re-exploration, has a low risk of bleeding, and is cost-effective. [ABSTRACT FROM AUTHOR]

This paper discusses the major hazardous activities during the casing and cementing operation with potential associated hazards in the on and offshore oil and gas industries of Malaysia, Pakistan and Saudi Arabia. The researcher adopted the explanatory research approach for the quantitative (survey questionnaire) and qualitative research methods (semistructured interview) in the data collection process. Eighty drilling crew were randomly selected for quantitative research, while three safety officers were purposively selected for qualitative research from each targeted industry. According to the findings of this study, running casing to wells and circulation cementing activity is considered highly hazardous at the offshore site. At the Saudi Arabian onshore domain, running casing to holes is more hazardous, while at offshore domains, installation of casing and casing accessories is more hazardous than in Malaysia and Pakistan. The participants from the Pakistani offshore industry reported that installation of casing and circulation of cementing activity were highly hazardous. In the context of overall casing and cementing operation among the focus industries, the Malaysian on and offshore oil and gas industry considers the casing and cementing operation as more hazardous compared to that of other industries, with a total mean range of 3.37 for onshore and 3.45 for offshore sites that lie under a moderate level of the mean range.The dangers are associated with potential ergonomic, chemical and safety hazards during on and offshore operation. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic strained hospital resources in New York City, including those for providing dialysis. New York University Medical Center and affiliations, including New York City Health and Hospitals/Bellevue, developed a plan to offset the increased needs for KRT. We established acute peritoneal dialysis (PD) capability, as usual dialysis modalities were overwhelmed by COVID-19 AKI., Methods: Observational study of patients requiring KRT admitted to Bellevue Hospital during the COVID surge. Bellevue Hospital is one of the largest public hospitals in the United States, providing medical care to an underserved population. There were substantial staff, supplies, and equipment shortages. Adult patients admitted with AKI who required KRT were considered for PD. We rapidly established an acute PD program. A surgery team placed catheters at the bedside in the intensive care unit; a nephrology team delivered treatment. We provided an alternative to hemodialysis and continuous venovenous hemofiltration for treating patients in the intensive-care unit, demonstrating efficacy with outcomes comparable to standard care., Results: From April 8, 2020 to May 8, 2020, 39 catheters were placed into ten women and 29 men. By June 10, 39% of the patients started on PD recovered kidney function (average ages 56 years for men and 59.5 years for women); men and women who expired were an average 71.8 and 66.2 years old. No episodes of peritonitis were observed; there were nine incidents of minor leaking. Some patients were treated while ventilated in the prone position., Conclusions: Demand compelled us to utilize acute PD during the COVID-19 pandemic. Our experience is one of the largest recently reported in the United States of which we are aware. Acute PD provided lifesaving care to acutely ill patients when expanding current resources was impossible. Our experience may help other programs to avoid rationing dialysis treatments in health crises., Competing Interests: D. Charytan has consulted for Fresenius Medical Care and Medtronic, has received research support from Bioporto and Medtronic, and has received fees related to service on a trial committee from PLC Medical. D. Goldfarb has consulted for AstraZeneca. All remaining authors have nothing to disclose., (Copyright © 2020 by the American Society of Nephrology.)

Objective: To determine the number of hospitalized patients at risk for developing venous thromboembolism (VTE) / deep vein thrombosis (DVT), identifying the most common risk factor and to document the use of thromboprophylaxis., Study Design: Observational and cross-sectional study., Place and Duration of Study: Chandka Medical College Hospital, Larkana, from October to December 2011., Methodology: A total of 170 patients underwent this study and these included 51 (30%) from general medical, and 119 (70%) from surgical units. Inclusion and exclusion criteria were defined and data was collected on printed format. VTE risk assessment was done according to Caprini Model and criteria defined by the American College of Chest Physicians- ACCP., Results: Out of 170 patients, 91 were male and 79 female with mean age of 39 ± 16 years. According to ACCP criteria for VTE risk assessment, 20% (n=34) patients were identified to be at low risk, 20% (n=34) at moderate risk, 47.65% (n=81) at high risk and 12.35% (n=21) at very high risk of developing VTE. The commonest risk factor significantly identified was immobility (54.7%, p < 0.005), followed by advancing age (41.17%, p < 0.005) and obesity (18.23%). The most common risk factor in all types of surgical patients was anaesthesia for more than 45 minutes 82.35% (n=98/119) and in medical patients advancing age 45% (n=23/51). Only 6 (3.5%) patients received thromboprophylaxis, all were surgical patients of very high-risk category., Conclusion: Majority of studied hospitalized patients were at high risk of developing VTE. Immobility was the commonest risk factor for developing VTE, followed by advancing age and obesity. Very few hospitalized patients actually received thromboprophylaxis.