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Peripheral IV infection

Ke Huang, Dun-Hua Zhou, Yang Li, Hong-Gui Xu, Li-Ping Que, Chun Chen, Hong-Man Xue, Hai-Xia Guo, Wen-Jun Weng, Shao-Liang Huang, Jian-Pei Fang
BACKGROUND: The objective of this study was to evaluate the feasibility of a modified conditioning regimen for the treatment of patients with β-thalassaemia major (TM), using unrelated donor peripheral blood stem cell transplantation (UD-PBSCT). METHODS: A modified conditioning regimen based on intravenous busulfan, cyclophosphamide, fludarabine, and antithymocyte globulin was performed in 50 consecutive childhood patients with β-TM and a median age of 4.6 years (range, 2-12 years)...
March 7, 2018: Pediatric Blood & Cancer
Nardhy Gomez-Lopez, Roberto Romero, Yi Xu, Derek Miller, Yaozhu Leng, Bogdan Panaitescu, Pablo Silva, Jonathan Faro, Ali Alhousseini, Navleen Gill, Sonia S Hassan, Chaur-Dong Hsu
PROBLEM: The immune cellular composition of amniotic fluid is poorly understood. Herein, we determined: 1) the immunophenotype of amniotic fluid immune cells during the second and third trimester in the absence of intra-amniotic infection/inflammation; 2) whether amniotic fluid T cells and ILCs display different phenotypical characteristics to that of peripheral cells; and 3) whether the amniotic fluid immune cells are altered in women with intra-amniotic infection/inflammation. METHOD OF STUDY: Amniotic fluid samples (n = 57) were collected from 15 to 40 weeks of gestation in women without intra-amniotic infection/inflammation...
March 3, 2018: American Journal of Reproductive Immunology: AJRI
Can Boga, Mahmut Yeral, Ciğdem Gereklioglu, Suheyl Asma, Erkan Maytalman, Pelin Aytan, Ilknur Kozanoglu, Cagla Sariturk, Hakan Ozdogu
OBJECTIVE/BACKGROUND: Anti-T lymphocyte globulin Fresenius (rATG-F; ATG-Fresenius) and antithymocyte globulin (thymoglobulin), which are included in transplant protocols, are used to reduce the risk of chronic graft-versus-host disease (cGVHD) or suppress allograft rejection. Available clinical studies have been conducted in heterogenous patient populations and with different administration protocols including stem cell sources. Additionally, the pharmacokinetics of ATG is variable, and the clinically effective dose of rATG-F, in particular, is not exactly known...
February 20, 2018: Hematology/oncology and Stem Cell Therapy
Benjamin R Williams, Dylan L McCreary, Michael Chau, Brian P Cunningham, Fernando Pena, Marc F Swiontkowski
BACKGROUND: Orthopedic implant removal following open reduction internal fixation of a fracture is a common procedure, especially in the foot and ankle. The purpose of this study was to evaluate functional change after the removal of symptomatic implants following ankle fracture open reduction internal fixation (ORIF) using the Short Musculoskeletal Function Assessment (SMFA) outcome score. We hypothesized that implant removal after ankle fracture would result in improved functional outcomes...
February 1, 2018: Foot & Ankle International
Katrine Kielsen, Christian Enevold, Carsten Heilmann, Henrik Sengeløv, Anders Elm Pedersen, Lars P Ryder, Klaus Müller
The efficacy of allogeneic hematopoietic stem cell transplantation (HSCT) is challenged by acute and chronic graft-versus-host disease (aGVHD and cGVHD) and viral infections due to long-lasting immunodeficiency. Interleukin-7 (IL-7) is a cytokine essential for de novo T cell generation in thymus and peripheral T cell homeostasis. In this study, we investigated the impact of the single nucleotide polymorphism rs6897932 in the IL-7 receptor α-chain (IL-7Rα) which has previously been associated with several autoimmune diseases...
2018: Frontiers in Immunology
Alex Chau, Jose Alberto Hernandez, Sheena Pimpalwar, Daniel Ashton, Kamlesh Kukreja
BACKGROUND: Femoral tunneled central line placement in the pediatric population offers an alternative means for intravenous (IV) access, but there is concern for higher complication and infection rates when placed at bedside. OBJECTIVE: To describe the complications and infection outcomes of primary femoral tunneled central venous catheter placement in the interventional radiology suite compared to the portable bedside location at a single tertiary pediatric institution...
February 8, 2018: Pediatric Radiology
Annick Smismans, Astrid Vantrappen, Freija Verbiest, Christophe Indevuyst, Bea Van den Poel, Sandrina von Winckelmann, Annelore Peeters, Sara Ombelet, Peter Lybeert, Andre Heremans, Eric Frans, Erwin Ho, Johan Frans
Since its introduction in the 1970s in the United States, outpatient parenteral antibiotic/antimicrobial therapy (OPAT) has been adopted internationally for long-term intravenous (IV) treatment of stable infectious diseases. The aim is to provide a safe and successful completion of IV antimicrobial treatment at the ambulatory care center or at home without complications and costs associated with hospitalization. OPAT implementation has been accelerated by progress in vascular access devices, newly available antibiotics, the emphasis on cost-savings, as well as an improved patient comfort and a reduced incidence of health care associated infections with a similar outcome...
January 31, 2018: Acta Clinica Belgica
Benjamin T Galen, William N Southern
PURPOSE: The traditional technique of placing a peripheral intravenous (IV) catheter is successful in most cases on inpatient wards. However, when the traditional method fails, a central venous catheter may be placed to maintain IV access. These catheters are associated with risks including central line-associated bloodstream infection. METHODS: We evaluated the effectiveness and acceptability of an ultrasound-guided peripheral IV service to reduce the number of newly placed central venous catheters on an inpatient ward...
January 2018: Quality Management in Health Care
Paul G Rubinstein, Page C Moore, Michelle A Rudek, David H Henry, Juan C Ramos, Lee Ratner, Erin Reid, Elad Sharon, Ariela Noy
OBJECTIVE: Brentuximab vedotin (BV) is an FDA approved anti-CD30 antibody drug conjugate potently active in Hodgkin lymphoma (HL). Trials of BV with doxorubicin, vinblastine, and dacarbazine (AVD-BV) excluded patients with HIV. We studied the safety of (AVD-BV) in newly diagnosed HIV-associated classical Hodgkin lymphoma (HIV-cHL). DESIGN AND METHODS: Patients diagnosed with Stage II-IV HIV-cHL received AVD-BV on days 1 and 15 every 28 days for 6 cycles. Anti-HIV medications with strong CYP3A4 inhibition were excluded...
December 26, 2017: AIDS
Turena Reeves, Dolores Morrison, Gerry Altmiller
: Insertion of peripheral iv catheters is a common practice in medical-surgical care settings. The frequency with which attempts are made to insert catheters causes rapid peripheral vessel depletion (a reduction in the number of usable veins), leading to the overuse of unnecessary central line catheters. Reducing central line-associated bloodstream infections is a national health care priority. In this quality improvement report, the authors describe the implementation of a nurse-led vascular access preservation program using ultrasound technology as a method to reduce the use of nonessential peripherally inserted central catheters...
December 2017: American Journal of Nursing
M R Dowling, S Li, B R Dey, S L McAfee, H R Hock, T R Spitzer, Y-B Chen, K K Ballen
Neurologic complications (NCs) may be a significant source of morbidity and mortality after hematopoietic cell transplantation (HCT). We performed a retrospective study of 263 consecutive patients undergoing allogeneic HCT for hematological malignancies to determine the incidence, risk factors and clinical impact of NCs in the first 5 years after HCT. We determined the incidence of central nervous system (CNS) infection, intracranial hemorrhage, ischemic stroke, metabolic encephalopathy, posterior reversal encephalopathy syndrome, seizure and peripheral neuropathy...
November 13, 2017: Bone Marrow Transplantation
Yoann Cazaubon, Nicolas Venisse, Olivier Mimoz, Pascal Maire, Michel Ducher, Laurent Bourguignon, Sylvain Goutelle
Objectives: To investigate the population pharmacokinetics of teicoplanin in patients treated by the subcutaneous (sc) and/or intravenous (iv) route. Patients and methods: Non-linear mixed-effects modelling described teicoplanin concentrations from 98 patients with infection caused by Gram-positive cocci. Monte Carlo simulations were performed to evaluate the probability of target attainment (PTA) of various dosage regimens. Results: Teicoplanin concentrations were best described by a two-compartment model with clearance predicted by estimated glomerular filtration rate...
October 1, 2017: Journal of Antimicrobial Chemotherapy
Andrew L Gilman, Wing Leung, Morton J Cowan, Mark Cannon, Stacy Epstein, Carrie Barnhart, Krishna Shah, Michelle Hyland, Tracy Fukes, Anastasia Ivanova
CD34+ cell selection minimizes graft-versus-host disease (GVHD) after haploidentical donor stem cell transplant but is associated with slow immune recovery and infections. We report a Phase I/II study of prophylactic donor lymphocyte infusion (DLI) followed by methotrexate (MTX) GVHD prophylaxis after CD34-selected haploidentical donor transplant. A prophylactic DLI was given between day +30 and +42. Rituximab was given with DLI for the last 10 patients. The goal of the study was to determine a DLI dose that would result in a CD4+ cell count > 100/µL at Day +120 in ≥ 66% of patients with ≤ 33% grade II-III, ≤ 17% grade III, and no grade IV acute GVHD by Day +180...
October 19, 2017: American Journal of Hematology
Xin Chen, Jialin Wei, Yong Huang, Yi He, Donglin Yang, Rongli Zhang, Erlie Jiang, Qiaoling Ma, Weihua Zhai, Jianfeng Yao, Guixin Zhang, Sizhou Feng, Mingzhe Han
We wanted to evaluate efficacy of porcine antithymocyte globulin (ATG) in HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (MSD-HSCT) for patients with severe aplastic anemia (SAA). The clinical data of 113 SAA patients who received MSD-HSCT from January 2005 to November 2016 were analyzed retrospectively. Of these, 58 patients received rabbit ATG as a part of conditioning regimen (R-ATG group), whereas the other 55 patients received porcine ATG (P-ATG group). Patient baseline characteristics and donor conditions of the 2 groups were similar, except patients were older and more received peripheral blood stem cell transplantation in the P-ATG group...
October 13, 2017: Biology of Blood and Marrow Transplantation
Raymond J Chan, Sarah Northfield, Emily Larsen, Gabor Mihala, Amanda Ullman, Peter Hancock, Nicole Marsh, Nicole Gavin, David Wyld, Anthony Allworth, Emily Russell, Md Abu Choudhury, Julie Flynn, Claire M Rickard
BACKGROUND: Peripherally inserted central catheters (PICCs) are commonly used for delivering intravenous therapy. PICC failure is unacceptably high (up to 40%) due to mechanical, infectious and thrombotic complications. Poor securement potentiates all complication types. This randomised controlled trial (RCT) aimed to examine the feasibility of a large RCT of four dressing and securement methods to prevent PICC failure. METHODS: This single-centre pilot RCT included 124 admitted medical/surgical/cancer patients aged ≥ 16 years with a PICC...
October 4, 2017: Trials
Katherine Yih-Jia Fu, Roxana Zamudio, Jo Henderson-Frost, Alex Almuedo, Hannah Steinberg, Steven Joseph Clipman, Gustavo Duran, Rachel Marcus, Thomas Crawford, Daniel Alyesh, Rony Colanzi, Jorge Flores, Robert Hugh Gilman, Caryn Bern
INTRODUCTION: Trypanosoma cruzi (Tc) infection is usually acquired in childhood in endemic areas, leading to Chagas disease, which progresses to Chagas cardiomyopathy in 20-30% of infected individuals over decades. The pathogenesis of Chagas cardiomyopathy involves the host inflammatory response to T. cruzi, in which upstream caspase-1 activation prompts the cascade of inflammatory chemokines/cytokines, cardiac remodeling, and myocardial dysfunction. The aim of the present study was to examine the association of two caspase-1 single nucleotide polymorphisms (SNPs) with cardiomyopathy...
July 2017: Revista da Sociedade Brasileira de Medicina Tropical
Lan Lin, Tingyan Lin, Bangwei Zeng
Advanced lung cancer is considered to exhibit a poor prognosis; however, the pulmonary lymphoepithelioma-like carcinoma (LELC), a rare subtype of non-small cell lung cancer (NSCLC), exhibits an improved prognosis, compared with non-LELC. The present study aimed at investigating the clinical manifestation, imaging characteristics, pathology, tumor markers, treatment and prognosis of primary LELC of the lung. A total of 14 patients with pulmonary LELC were confirmed by surgery and pathology. Clinical data of those patients were retrospectively reviewed including age, sex, smoking history, symptoms, computed tomography (CT) results, Epstein-Barr virus-encoded RNA (EBER) status, treatment and outcomes...
September 2017: Oncology Letters
Robin Atallah, Jiao Jiao Li, William Lu, Ruud Leijendekkers, Jan Paul Frölke, Munjed Al Muderis
BACKGROUND: Osseointegration is an alternative treatment for amputees who are unable to wear or have difficulty wearing a socket prosthesis. Although the majority of limb amputations are due to vascular disease, such amputations have been perceived as a contraindication to osseointegration surgery. We report the outcomes of osseointegrated reconstruction in a series of 5 patients with limb amputation due to peripheral vascular disease. METHODS: Five patients with transtibial amputation and a history of peripheral vascular disease who received an osseointegration implant from 2014 to 2015 were followed for 12 months...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
James D Stewart, Naomi Runnegar
BACKGROUND: Management of Staphylococcus aureus bacteraemia (SAB) includes prolonged intravenous antibiotics often administered through a peripherally inserted central catheter (PICC). Optimal timing of PICC insertion for SAB treatment is unknown. There are concerns that early insertion may increase the risk of subsequent line infection. AIMS: This retrospective audit aims to determine if early PICC insertion is safe. The outcomes considered included crude mortality, attributable mortality, PICC line infections, duration of bacteraemia and relapsed SAB...
January 2018: Internal Medicine Journal
Jamie Yao, Juliet Morgan, Joshua Brotman
Emphysematous gastritis is a rare infection of the gastric wall with 55%-60% mortality. A 44-year-old man with AIDS, hepatitis C, and intravenous drug use presented with a 1-day history of acute-onset abdominal pain, nausea, and nonbloody, nonbilious emesis. On examination, he was afebrile without other vital sign abnormalities. He had epigastric abdominal tenderness without rebound or guarding. The peripheral-blood leukocyte count was elevated to 12.8 with 93.8% neutrophils. The patient's clinical presentation markedly improved with IV fluids and broad-spectrum antibiotic therapy...
September 2017: Radiology Case Reports
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