ORCID Profile
0000-0001-7096-0144
Current Organisations
John Hunter Hospital
,
The University of Newcastle
,
University of Newcastle Faculty of Health
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Publisher: Wiley
Date: 02-02-2016
DOI: 10.1111/HDI.12401
Abstract: Introduction Heparin is commonly used after hemodialysis treatments as a locking solution to prevent catheter thrombosis. The comparative efficacy and safety of different heparin concentrations to maintain catheter patency has been previously reported in retrospective studies. We conducted a prospective, randomised, controlled study of 1000 U/mL heparin (low dose) versus 5000 U/mL heparin (high dose) locking solution to maintain patency of tunnelled catheters. Methods One hundred patients receiving chronic, unit-based hemodialysis with newly placed tunnelled hemodialysis catheters (less than 1 week) were randomly assigned to either a low dose (n = 48) or high dose heparin (n=52). The primary intention-to-treat analysis examined time to malfunction in both groups over a 90 day period. A secondary analysis compared baseline patient characteristics in relation to catheter malfunction. Findings Overall rate of catheter patency loss was 32% of catheters by 90 days. There was no significant difference in time to malfunction of catheters locked with low dose or high dose heparin (P = 0.5770). Time to catheter malfunction was not associated with diabetic, hypertensive or smoking status. There was no difference in mean delivered blood flow rate, venous and arterial pressure, and dialysis adequacy between low dose and high dose groups. No patient suffered a hemorrhagic complication requiring hospitalisation during the study period. Discussion Low dose heparin is adequate to maintain tunnelled hemodialysis catheter patency when compared with high dose heparin. The study also suggests that there is no relationship between catheter malfunction and diabetic, hypertensive or smoking status.
Publisher: Onati International Institute for the Sociology of Law
Date: 10-10-2023
Publisher: Public Library of Science (PLoS)
Date: 12-08-2019
Publisher: Wiley
Date: 13-06-2018
DOI: 10.1111/SDI.12617
Abstract: Sleep disturbance is one of the most common dialysis-related symptoms reported by hemodialysis patients. Poor sleep confers significant physical and psychological burden on patients with kidney disease and is associated with reduced quality of life and survival. More recent evidence also indicates that sleep-disordered breathing may be a risk factor for kidney injury.
Publisher: Wiley
Date: 27-07-2020
DOI: 10.1111/TID.13400
Publisher: Cambridge University Press (CUP)
Date: 28-05-2018
DOI: 10.1017/S0020589318000143
Abstract: In recent years there has been a trend towards independent and more transparent ethical regulation for sitting judges, which is said to promote public confidence in the judicial institution, and reflect a move towards accountability and transparency as judicial values. However, regimes governing sitting judges largely fall away when the judge retires from the bench. Increasing longevity and rising numbers of former judges raise complex ethical regulation questions. Drawing on judicial ethics regimes in England and Wales, Australia, the United States and New Zealand, and instances where the conduct of former judges has reflected poorly on the integrity of the judiciary, this article argues that there are strong reasons for extending ethics regulation beyond judicial retirement. By reference to the principles that inform the rules regulating the conduct of sitting judges, we investigate the extent to which misconduct and disciplining regimes should extend to former judges, and whether there is a stronger role for soft instruments and more formalized processes for regulating former judges. In doing so, we propose a model for the development of ethical regulation for former judges.
Publisher: Elsevier BV
Date: 07-2020
Publisher: S. Karger AG
Date: 2020
DOI: 10.1159/000505572
Abstract: b i Background: /i /b Sleep apnoea is prevalent in dialysis patients. Previous studies identified excessive inflammation in patients with sleep apnoea. Online haemodiafiltration (OL-HDF) may reduce systematic inflammation through better clearance of middle molecules. We aimed to determine the feasibility of OL-HDF in sleep apnoea management. b i Methods: /i /b Eligible dialysis patients were screened for risk of sleep apnoea by nocturnal oximetry followed by a diagnostic sleep study to assess apnoea-hypopnea index (AHI). Patients with AHI ≥15/h were invited to a randomized crossover trial. The intervention was 2-month high-flux haemodialysis (HF-HD) followed by 2-month OL-HDF or vice versa with 1-month washout via HF-HD. Feasibility was assessed by patient recruitment and the primary outcome, severity of sleep apnoea (AHI). Secondary outcomes were pro-inflammatory cytokines, patient-reported daytime sleepiness, quality of sleep and health-related quality of life. b i Results: /i /b Of 65 participants at risk of sleep apnoea, only 15 were consented and randomized (mean age 70 years, 80% male, mean AHI 42.2/h). AHI was not statistically different between OL-HDF versus HF-HD (55.6/h vs. 48.3/h, i /i = 0.134) however, when sleep apnoea was stratified into obstructive and central apnoea, patients had less obstructive episodes after treated by OL-HDF (23.2/h vs. 18.6/h, i /i = 0.178) a sensitivity analysis was performed excluding outliers, and the treatment effect for obstructive episodes was found to be statistically significant (11.1 vs. 18.2/h, i /i = 0.019). Pro-inflammatory biomarkers and patient-reported outcomes were similar between OL-HDF and HF-HD. b i Conclusion: /i /b Patient recruitment was a major challenge in this feasibility study. OL-HDF may reduce obstructive sleep apnoea however, the result needs to be confirmed by larger studies.
No related grants have been discovered for Ginger Chu.