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https://www.readbyqxmd.com/read/29650891/-fourteen-cases-of-implanted-central-venous-access-port-related-bloodstream-infection
#1
Toshihiko Sakai, Masakazu Kono, Chie Koumura, Yuri Oyano, Noriko Sakuma, Hirokazu Tojima
We conducted a clinical study involving cases of central venous(CV)port-related infection in Tokyo Rosai Hospital. Fourteen patients with suspected CV port-related infection at Tokyo Rosai Hospital between April 2015 and January 2017 were observed. Identical bacterial types were detected from 2 sets of blood cultures and cultures from the catheter tip, and a definitive diagnosis was made. Data on patient background, causative bacteria, quick sequentialorgan failure assessment (qSOFA)score, CV port placement period, presence or absence of local inflammatory findings, and prognosis were analysed...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29642728/tunnelling-a-midline-catheter-when-the-traffic-light-shifts-from-yellow-to-green
#2
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
INTRODUCTION: A safe, largely used practice for difficult venous access patients is positioning a catheter in deeper veins under ultrasound guide. However, the risk of complications is increased when there is a high catheter-to-vein ratio or when the insertion site is in a zone with particular anatomical/physiological characteristics. CASE DESCRIPTION: A 60-year-old woman admitted to a post-operative intensive care unit after cardiac surgery had a complicated post-operative course...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29627071/ultrasound-versus-anatomical-landmarks-immediate-complications-in-the-central-venous-catheterization-in-children-under-18-years-of-age
#3
D Rivera-Tocancipá, E Díaz-Sánchez, C A Montalvo-Arce
INTRODUCTION: The insertion of a central venous line in children and adolescents is technically more difficult, due to the smaller size of the structures. This can lead to an increase in immediate complications, which can be reduced when using ultrasound. In our institution, the percentage of these complications and the use of ultrasound are unknown. OBJECTIVE: To describe the frequency of immediate complications of central venous catheterisation guided by the ultrasound in a general university hospital, compared to the anatomical landmarks technique in children less than 18years of age...
April 4, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29626368/patient-centred-value-framework-for-haemophilia
#4
B O'Mahony, G Dolan, D Nugent, C Goodman
INTRODUCTION: Growing budgetary demands have led to increased scrutiny of healthcare spending for rare diseases, leading to a unified goal within the haemophilia community to define objectively patient-centred value in haemophilia care. AIM: To develop a patient-centred outcomes framework with global applicability for assessing value in haemophilia healthcare. METHODS: An international, multidisciplinary panel of experts convened to identify the range of patient impacts of haemophilia health care and organize these into a three-tiered, patient-centred outcomes framework based on Porter's model for assessing value...
April 6, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29605361/combined-nd-yag-laser-and-bleomycin-sclerotherapy-under-the-same-anesthesia-for-cervicofacial-venous-malformations-a-safe-and-effective-treatment-option
#5
Stacie Gregory, Patricia E Burrows, Herodotos Ellinas, Michael Stadler, Robert H Chun
INTRODUCTION: Extensive cervicofacial venous malformations (VM) pose significant challenges to a patient's quality of life (altered breathing, dysphagia, dysarthria). Treatment options include: 1) Surgical debulking; 2) Sclerotherapy; 3) laser therapy; or 4) Combined modalities. Recent studies have demonstrated the importance of multimodality and multidisciplinary management of these patients. However, no studies have described combined single anesthetic laser and sclerotherapy treatment...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29544387/a-case-series-of-favorable-vessel-dilatation-using-a-nitinol-scoring-element-equipped-helical-balloon-catheter-angiosculpt%C3%A2
#6
Ryo Sato, Tetsuhiko Sato, Yuichi Shirasawa, Chika Kondo, Masao Tadakoshi, Michio Fukuda, Nobuyuki Ohte, Kunio Morozumi
OBJECTIVE: Although percutaneous transluminal angioplasty is an effective therapy against vascular access failure in hemodialysis patients, recurrent stenosis imposes enormous burden for hemodialysis patients. A nitinol scoring element-equipped helical balloon catheter (AngioSculpt® ) has been altered the landscape for treating several vascular diseases. It is not, however, fully elucidated whether AngioSculpt for advanced vascular access stenosis, difficult to expand by conventional balloons, successfully provides bailout angioplasty...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29529966/ultrasound-guided-internal-jugular-vein-cannulation-in-the-obese-patient-in-a-forced-semi-sitting-position
#7
Anton A Kasatkin, Aleksandr L Urakov, Anna R Nigmatullina
INTRODUCTION: Central venous cannulation may be difficult in morbidly obese patients. We present a case of successful right internal jugular vein catheterization under real-time ultrasound guidance in an obese patient in a forced semi-sitting position. CASE REPORT: A 43-year-old male patient with body mass of 182 kg (body mass index, 52.2 kg/m2 ) was admitted to the clinic 48 h after the trauma. The patient was in a forced semi-sitting position (37° head elevation)...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29439080/risk-factors-for-difficult-peripheral-venous-cannulation-in-hospitalised-patients-protocol-for-a-multicentre-case-control-study-in-48-units-of-eight-public-hospitals-in-spain
#8
Miguel Angel Rodriguez-Calero, Ismael Fernandez-Fernandez, Luis Javier Molero-Ballester, Catalina Matamalas-Massanet, Luis Moreno-Mejias, Joan Ernest de Pedro-Gomez, Ian Blanco-Mavillard, Jose Miguel Morales-Asencio
INTRODUCTION: Patients with difficult venous access experience undesirable effects during healthcare, such as delayed diagnosis and initiation of treatment, stress and pain related to the technique and reduced satisfaction. This study aims to identify risk factors with which to model the appearance of difficulty in achieving peripheral venous puncture in hospital treatment. METHODS AND ANALYSIS: Case-control study. We will include adult patients requiring peripheral venous cannulation in eight public hospitals, excluding those in emergency situations and women in childbirth or during puerperium...
February 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#9
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29385869/the-use-of-ultrasound-as-an-adjunct-to-peripheral-venous-cannulation-by-junior-doctors-in-clinical-practice
#10
Ryan Breslin, Karen Collins, Jason Cupitt
PURPOSE: There is little consensus on the role of training in bedside ultrasound skills for medical students or junior doctors early in their careers. METHODS: We trained 20 Foundation Year 1 doctors in the use of ultrasound as an adjunct to peripheral venous cannulation and following an assessment of competence gave them access to an ultrasound machine to assist with difficult cannulations in their clinical practice. Self-reported confidence and competence were assessed using pre- and post-training questionnaires, with competence objectively assessed immediately post-training and at one and three months follow up...
January 31, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29377971/patterns-and-predictors-of-short-term-peripherally-inserted-central-catheter-use-a-multicenter-prospective-cohort-study
#11
David Paje, Anna Conlon, Scott Kaatz, Lakshmi Swaminathan, Tanya Boldenow, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: The guidelines for peripherally inserted central catheters (PICCs) recommend avoiding insertion if the anticipated duration of use is =5 days. However, short-term PICC use is common in hospitals. We sought to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term PICCs. METHODS: Between January 2014 and June 2016, trained abstractors at 52 Michigan Hospital Medicine Safety (HMS) Consortium sites collected data from medical records of adults that received PICCs during hospitalization...
February 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29238233/an-in-vivo-comparison-of-the-efficacy-of-hemostatic-powders-using-two-porcine-bleeding-models
#12
Melinda H MacDonald, Allen Y Wang, Jeffrey W Clymer, Richard W Hutchinson, Richard Kocharian
Background: Usage of topical hemostatic agents in surgery is increasing, including use during minimally invasive procedures, and even for surgeries that have a low risk of bleeding complications. A novel product, Surgicel® Powder - Absorbable Hemostatic Powder (SP), made from oxidized regenerated cellulose (ORC) fabric, has been developed for adjunctive use in surgical procedures to assist in control of oozing bleeding over broad areas and where access could be difficult with a fabric ORC product...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29200325/incidence-and-risk-factors-of-bacterial-and-fungal-infection-during-induction-chemotherapy-for-high-risk-neuroblastoma
#13
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
August 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29198897/the-idle-central-venous-catheter-in-the-nicu-when-should-it-be-removed
#14
Cristen N Litz, Jordan G Tropf, Paul D Danielson, Nicole M Chandler
PURPOSE: There is debate regarding the optimal timing of central line removal in the neonatal intensive care unit (NICU). The purpose was to evaluate outcomes of idle peripherally inserted central catheters (PICCs) and tunneled central venous catheters (TCVCs) and determine the incidence of line-related infections and replacements. METHODS: Patients in the NICU with T-CVCs placed between 11/2008 and 8/2015 (n=134) or PICCs placed between 7/2013 and 10/2015 (n=467) were included...
November 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29187109/modified-in-situ-pericardial-rerouting-technique-for-scimitar-syndrome-repair
#15
Ignacio Lugones, María Fernanda Biancolini, Victoria Eugenia Zerpa Pacheco, Inés Ana Martínez, Jesús María Maximiliano Damsky Barbosa, Ana María Susana de Dios
Scimitar syndrome repair represents a challenge due to the high incidence of postoperative pulmonary venous obstruction associated with classic surgical strategies. In situ pericardial rerouting technique has been considered a promising alternative approach due to its simplicity and excellent midterm results. Access to the left atrium can be difficult in young patients with severe dextrocardia and hypoplastic right lung. We describe a modification of the original rerouting technique in which the atrial septum is repositioned in order to create a wide opening in the lateral aspect of the left atrium and ensure an adequate size of the reconstructed pathway...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29176933/a-clinical-pathway-for-the-management-of-difficult-venous-access
#16
Vanno Sou, Craig McManus, Nicholas Mifflin, Steven A Frost, Julie Ale, Evan Alexandrou
Background: Many patients are admitted to hospital with non-visible or palpable veins, often resulting in multiple painful attempts at cannulation, anxiety and catheter failure. We developed a difficult intravenous pathway at our institution to reduce the burden of difficult access for patients by increasing first attempt success with ultrasound guidance. The emphasis was to provide a solution for hospitalised patients after business hours by training the after-hours clinical support team in ultrasound guided cannulation...
2017: BMC Nursing
https://www.readbyqxmd.com/read/29152470/fluoroscopy-guided-combined-surgical-endovascular-treatment-of-dural-arteriovenous-fistula
#17
So Hee Park, Jong-Hoon Kim, Chul-Hoon Chang, Young-Jin Jung
For dural arteriovenous fistula (DAVF), when the usual endovascular or neurosurgical approaches are difficult to treat, multi-modal treatment can be helpful. We present a case of a 71-year-old woman with DAVF, who presented with an intracerebral haemorrhage. Digital subtraction angiography revealed a DAVF of the transverse sinus, with cortical venous reflux. Transvenous and transarterial approaches for coil embolization failed. In the operating room, a small craniotomy was performed, and coil embolization was done under fluoroscopy...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29118844/ultrasound-probe-grip-the-afternoon-tea-technique
#18
Luke McMenamin, Stephen Wolstenhulme, Max Hunt, Stuart Nuttall, Asoka Weerasinghe
Background: Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings. Context: After reading Flood's paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique. Innovation: The purpose of this correspondence is to highlight the 'afternoon tea technique' as a potential teaching method for probe stabilisation...
August 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29112475/transjugular-venous-approach-for-endovascular-interventions-in-hemodialysis-grafts-and-fistulas-of-the-upper-extremities
#19
Hector Ferral, Marc J Alonzo
OBJECTIVE: This article describes the use of a transjugular venous access for interventions in upper extremity hemodialysis arteriovenous fistulas (AVFs) and grafts. This access is used in selected patients in whom direct puncture of the hemodialysis access is considered to be difficult or cumbersome. Technical success was achieved in 96.7% of patients. If an intervention is unsuccessful, the transjugular access offers the possibility of placement of a dialysis catheter for temporary or long-term hemodialysis...
February 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#20
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
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