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https://www.readbyqxmd.com/read/28821891/an-audit-of-829-paediatric-epidurals-in-a-tertiary-singapore-hospital-complications-and-conundrums
#1
Jolin Wong, Serene St Lim
INTRODUCTION: The incidence of complications related to epidural analgesia remains less well defined in the paediatric population as compared to adults. A retrospective review of prospectively collected data was performed to review and quantify risks of both adverse events and complications related to epidural analgesia in our Singaporean paediatric population. MATERIALS AND METHODS: Data from the Acute Pain Service (APS) was prospectively collected over 19 years...
July 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#2
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820309/advanced-cone-beam-ct-venous-angiographic-imaging
#3
Visish M Srinivasan, Gouthami Chintalapani, Edward A M Duckworth, Peter Kan
OBJECTIVE The evaluation of the venous neurovasculature, especially the dural venous sinuses, is most often performed using MR or CT venography. For further assessment, diagnostic cerebral angiography may be performed. Three-dimensional rotational angiography (3D-RA) can be applied to the venous system, producing 3D rotational venography (3D-RV) and cross-sectional reconstructions, which function as an adjunct to traditional 2D digital subtraction angiography. METHODS After querying the database of Baylor St...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28818226/percutaneous-ultrasound-guided-sclerotherapy-with-polidocanol-microfoam-for-lymphatic-malformations
#4
Takashi Yamaki, Yumiko Sasaki, Yuki Hasegawa, Atsuyoshi Osada, Hisato Konoeda, Atsumori Hamahata, Motohiro Nozaki, Hiroyuki Sakurai
BACKGROUND: Lymphatic malformations (LMs) are low-flow congenital lesions that consist of cysts of varying size. Sclerotherapy with intralesional bleomycin and OK-432 has been reported to yield dramatically beneficial results for this disorder. However, inflammation-related symptoms are often seen after treatment with these sclerosing agents. On the other hand, polidocanol (POL) is reportedly associated with fewer allergic and inflammatory reactions. Up to now, however, very few reports have documented the use of POL microfoam for treatment of LMs...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818213/the-natural-history-and-outcomes-of-line-associated-upper-extremity-deep-venous-thromboses-in-critically-ill-patients
#5
Joshua Underhill, Matthew A Sherman, Ryan Howard, Anthony Hage, Andrea Obi, Lena Napolitano, Dawn M Coleman
OBJECTIVE: Anticoagulation remains the standard of care for line-associated upper extremity deep venous thrombosis (UEDVT). This treatment carries the risk of hemorrhagic complications, possibly more so in surgical patients. Considering the low-risk profile of UEDVT-which is associated with fewer, less severe pulmonary emboli than lower extremity deep venous thrombosis-current UEDVT treatment guidelines may be overly aggressive. The goal of this study was to review outcomes of line-associated UEDVT in critically ill patients and to define the efficacy of current treatment protocols in pulmonary embolism (PE) prevention while avoiding hemorrhagic complications...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818212/national-trends-in-hospitalizations-for-venous-thromboembolism
#6
Anand Brahmandam, Marwan S Abougergi, Cassius Iyad Ochoa Chaar
OBJECTIVE: The management of venous thromboembolism (VTE) has evolved during the last decade. This study sheds light on the national trends in hospital admissions, outcomes, and economic burden for VTE. METHODS: The National Inpatient Sample (NIS) was reviewed between 2003 and 2013 for hospitalizations for VTE, defined as admissions with a principal diagnosis of deep venous thrombosis (DVT) or pulmonary embolism (PE). Outcomes measured were incidence, inpatient mortality, rates of interventions, hospital length of stay (LOS), and charges...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818211/evaluation-of-thrombolysis-using-tissue-plasminogen-activator-in-lower-extremity-deep-venous-thrombosis-with%C3%A2-concomitant-femoral-popliteal-venous-segment%C3%A2-involvement
#7
Mayin Lin, John C F Hsieh, Mian Hanif, Alan McDaniel, David K Chew
OBJECTIVE: Current guidelines recommend thrombolytic therapy for iliofemoral deep venous thrombosis (DVT). Anticoagulation is the standard treatment for femoral-popliteal and tibial-level DVT. The objective of this study was to evaluate the efficacy of catheter-directed thrombolysis (CDT) using tissue plasminogen activator vs standard anticoagulation alone in patients with lower extremity DVT involving the femoral-popliteal segment. METHODS: A retrospective review was performed of patients referred to the vascular surgery service with lower extremity DVT from 2006 to 2015...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28811943/reviewing-the-emergence-of-lactococcus-garvieae-a-case-of-catheter-associated-urinary-tract-infection-caused-by-lactococcus-garvieae-and-escherichia-coli-coinfection
#8
Tatvam T Choksi, Farhan Dadani
Lactococcus garvieae is considered a low virulence organism which is rarely associated with human infections. Most of the reported cases have been associated with bacteremia with or without endocarditis. We report a rare case of catheter associated urinary tract infection (CAUTI) caused by Lactococcus garvieae and Escherichia coli coinfection without any bacteremia in a patient with indwelling urinary catheter placed for benign prostatic hyperplasia (BPH). The patient also had a history of gastroesophageal reflux disease (GERD) with long standing famotidine treatment...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28811806/comparison-of-right-and-left-trans-radial-catheterization-for-coronary-angiography-and-intervention-in-patients-with-acute-myocardial-infarction
#9
Hongying Wang, Shijin Song
OBJECTIVE: To compare the clinical characteristics between the right and left radial approach in treating acute myocardial infarction, helping physicians make treatment strategies correctly. METHODS: The patients admitted at our institution and undergoing percutaneous coronary angiography and interventional procedures by left or right radial approach between November 2013 and July 2016 were retrospectively reviewed. The access time, compression time, ambulation time, the amount of contrast material used, fluoroscopy time, interventional procedural time, the number of catheters used, the percentage of procedures completed using the assigned approach and the major vascular complications were recorded and compared between the two groups...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28810961/resuscitation-of-hypotensive-traumatic-brain-injured-animals-with-spray-dried-plasma-does-not-adversely-alter-physiology-and-improves-blood-brain-barrier-function
#10
Steven McDaniel, Stephanie Golla, Anthony N Moore, Joe DaCorta, Arthur Bode, Shibani Pati, Pramod K Dash, Jing Zhao
INTRODUCTION: According to the Defense and Veterans Brain Injury Center and the Armed Forces Health Surveillance Center, the number of soldiers who have sustained a traumatic brain injury (TBI) has risen dramatically over the past decade. Studies have shown that brain damage can be exacerbated if blood loss occurs (often occurring in polytrauma). As blood supply is critical for brain function and survival, TBI patients must be properly resuscitated to maintain blood volume, blood pressure, and cerebral perfusion...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810636/necessity-of-heparin-for-maintaining-peripheral-venous-catheters-a-systematic-review-and-meta-analysis
#11
Tao You, Jianliang Jiang, Jianchang Chen, Weiting Xu, Li Xiang, Yang Jiao
Heparin has typically been used as a flushing or infusion solution for vascular lines in daily practice. However, several clinical trials have yielded controversial results about the benefits of heparin in maintaining peripheral venous catheters. The present meta-analysis was conducted to evaluate the efficacy of heparin on the patency profiles and complications in peripheral intravenous catheters. PubMed, Embase and Cochrane Central Register of Controlled Trials were searched up to February 2016 for randomized controlled trials comparing heparin with placebo in maintaining peripheral intravenous catheters...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28807625/role-of-urodynamics-in-management-of-urethral-diverticulum-in-females
#12
Kuan-Jung Lin, Yu-Hua Fan, Alex Tong-Long Lin
BACKGROUND: Few studies have focused on the urodynamic findings of urethral diverticula (UD). We characterized the symptoms and urodynamic findings in women with UD. METHODS: A retrospective review of all women in a single center having surgical treatment for symptomatic UD between May 2004 and September 2014 was done. Lower urinary tract symptoms were evaluated with International Prostate Symptom Score and Overactive Bladder Symptom Score questionnaires. All patients underwent magnetic resonance imaging and videourodynamic study (VUDS) prior to surgery, and postoperative evaluation with VUDS...
August 11, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28807449/non-invasive-intra-cardiac-pressure-measurements-using-subharmonic-aided-pressure-estimation-proof-of-concept-in-humans
#13
Jaydev K Dave, Sushmita V Kulkarni, Purva P Pangaonkar, Maria Stanczak, Maureen E McDonald, Ira S Cohen, Praveen Mehrotra, Michael P Savage, Paul Walinsky, Nicholas J Ruggiero, David L Fischman, David Ogilby, Carolyn VanWhy, Matthew Lombardi, Flemming Forsberg
This study evaluated the feasibility of employing non-invasive intra-cardiac pressure estimation using subharmonic signals from ultrasound contrast agents in humans. This institutional review board-approved proof-of-concept study included 15 consenting patients scheduled for left and right heart catheterization. During the catheterization procedure, Definity was infused intra-venously at 4-10 mL/min. Ultrasound scanning was performed with a Sonix RP using pulse inversion, three incident acoustic output levels and 2...
August 11, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28807426/clinical-usefulness-of-catheter-drawn-blood-samples-and-catheter-tip-cultures-for-the-diagnosis-of-catheter-related-bloodstream-infections-in-neonatology-a-systematic-review
#14
REVIEW
Janita Ferreira, Paulo Augusto Moreira Camargos, Wanessa Trindade Clemente, Roberta Maia de Castro Romanelli
OBJECTIVES: Neonatal sepsis is the most frequent health care-associated infection in neonatal units. This study aimed to analyze articles on the clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of intravascular catheter-related bloodstream infection (CRBSI) in neonates. METHODS: A systematic search was performed for studies published from 1987-2017, without language restriction. Observational studies carried out in neonates with CRBSI diagnosed using catheter-drawn blood samples or catheter tip cultures were included...
August 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#15
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
July 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28806628/complete-step-section-microscopic-study-of-a-swan-ganz-catheter-related-pulmonary-artery-rupture-a-frequently-lethal-complication-that-to-our-knowledge-has-not-had-a-comprehensive-microscopic-examination-case-report-and-literature-review
#16
Ya Xu, L Clarke Stout
BACKGROUND: Introduced in 1970, the Swan-Ganz catheter (SGC) soon became widely used because of its unique usefulness in managing intensive care patients. Unfortunately, SGC usage was complicated by pulmonary artery rupture (PAR) with a 50% mortality rate that led to a near banning of the SCG in the late 1980s. Increasing knowledge and decreasing incidence of SGC-related PARs (SGPARs) led to the current feeling that the present SGPAR incidence is now low enough to tolerate given the lives saved by SGC usage...
July 4, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28806148/atrial-fibrillation-ablation
#17
Rakesh Latchamsetty, Fred Morady
The prevalence of atrial fibrillation (AF) has risen significantly over the past two decades. Catheter ablation is an increasingly utilized treatment strategy and has evolved significantly over the same time period. Successful ablation improves patient symptoms, reduces stroke risk, and can preserve or improve cardiac function. Recurrences following ablation can occur, particularly in patients with persistent AF. Procedural efficacy can best be improved through continued advancements in ablation technology and strategy, better understanding of the mechanisms of AF initiation and perpetuation, and rigorous integration of ablation into a multidisciplinary AF management approach...
August 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28805343/rest-and-exercise-hemodynamic-and-metabolic-findings-in-active-duty-soldiers-referred-for-cardiac-catheterization-to-exclude-heart-disease-insights-from-past-invasive-cardiopulmonary-exercise-testing-using-multisensor-high-fidelity-catheters
#18
James A Watts, Faith R Kelly, Terry D Bauch, Joseph P Murgo, Bernard J Rubal
OBJECTIVE: This study describes results of iCPET from the past, which used submaximal stress and multisensor high-fidelity catheters to exclude heart disease in a unique population of young adults. BACKGROUND: There has been resurgence in comprehensive hemodynamic evaluation of complex cardiovascular patients. Although dynamic assessments during cardiac catheterization have become commonplace, there remains limited information regarding left and right heart hemodynamic changes during supine exercise in young adults...
May 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28805341/treatment-options-for-severe-pulmonary-embolism-during-pregnancy-and-the-postpartum-period-a-systematic-review
#19
G Martillotti, F Boehlen, H Robert-Ebadi, N Jastrow, M Righini, M Blondon
BACKGROUND: Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but dramatic event. Our aim was to systematically review the evidence to guide its management. METHODS: We searched Pubmed, Embase, conference proceedings and the RIETE registry for published cases of severe (submassive/massive) PE treated with thrombolysis, percutaneous or surgical thrombectomy and/or with ECMO, occurring during pregnancy or within 6 weeks of delivery...
August 14, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#20
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
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