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https://www.readbyqxmd.com/read/27742320/organ-donation-and-transplantation-from-donors-with-systemic-infection-a-single-center-experience
#1
X Yuan, C Chen, J Zhou, M Han, X Wang, C Wang, X He
OBJECTIVES: Donors with bacteremia and sepsis are often considered to be controversial for organ retrieval due to potential transmission of an infectious agent to the recipient. Herein we report our initial experience of organ donation and transplantation results from donors with systemic infection. MATERIALS AND METHODS: From January 2013 to December 2014, 125 cases of donation were completed in our organ procurement organization including 90 cases of donation after brain death (DBD) and 35 cases of donation after circulatory death (DCD)...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27516143/finding-the-right-hemodialysis-vascular-access-in-the-elderly-a-patient-centered-approach
#2
Mariana Murea, John Burkart
Vascular access preparation in the elderly with advanced kidney disease needs a nuanced approach. Recent studies indicate that age, along with comorbidity, modify the outcomes associated with the type of access placed or used for hemodialysis (HD). Options ranging from permanent vascular access (arteriovenous fistula [AVF] or graft [AVG]) to tunneled central venous catheter (TCVC) or conservative medical care must be weighed on an individual basis and reassessed longitudinally. The potential benefits derived from AVF compared with AVG and TCVC are not always seen in this population...
September 21, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27032450/are-early-cannulation-arteriovenous-grafts-ecavg-a-viable-alternative-to-tunnelled-central-venous-catheters-tcvcs-an-observational-virtual-study-and-budget-impact-analysis
#3
Emma Aitken, Kashfa Iqbal, Peter Thomson, Ram Kasthuri, David Kingsmore
BACKGROUND: Early cannulation arteriovenous grafts (ecAVGs) are advocated as an alternative to tunnelled central venous catheters (TCVCs). A real-time observational "virtual study" and budget impact model was performed to evaluate a strategy of ecAVG as a replacement to TCVC as a bridge to definitive access creation. METHODOLOGY: Data on complications and access-related bed days was collected prospectively for all TCVCs inserted over a six-month period (n = 101)...
May 7, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/26931575/looking-beyond-fistula-first-in-the-elderly-on-hemodialysis
#4
REVIEW
Mariana Murea, Scott Satko
Vascular access preparation, a pervasive challenge in hemodialysis (HD), is emerging as a multidimensional subject in geriatric nephrology. Previously published guidelines declared arteriovenous fistulas (AVF) as the preferred vascular access for all patients on HD. In this article, the benefit-risk evidence for using AVF versus an alternative access (arteriovenous graft [AVG] or tunneled central venous catheter [TCVC]) in the elderly is pondered. Compared to their younger counterparts, the elderly have significantly lower survival rates independent of the vascular access used for HD...
September 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/25885054/immediate-access-arteriovenous-grafts-versus-tunnelled-central-venous-catheters-study-protocol-for-a-randomised-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Emma Aitken, Colin Geddes, Pete Thomson, Ram Kasthuri, Mohan Chandramohan, Colin Berry, David Kingsmore
BACKGROUND: Autologous arteriovenous fistulae (AVF) are the optimal form of vascular access for haemodialysis. AVFs typically require 6 to 8 weeks to "mature" from the time of surgery before they can be cannulated. Patients with end-stage renal disease needing urgent vascular access therefore traditionally require insertion of a tunnelled central venous catheter (TCVC). TCVCs are associated with high infection rates and central venous stenosis. Early cannulation synthetic arteriovenous grafts (ecAVG) provide a novel alternative to TCVCs, permitting rapid access to the bloodstream and immediate needling for haemodialysis...
2015: Trials
https://www.readbyqxmd.com/read/25778560/immediate-access-arteriovenous-grafts-versus-tunnelled-central-venous-catheters-study-protocol-for-a-randomised-controlled-trial
#6
Emma Aitken, Colin Geddes, Pete Thomson, Ram Kasthuri, Mohan Chandramohan, Colin Berry, David Kingsmore
BACKGROUND: Autologous arteriovenous fistulae (AVF) are the optimal form of vascular access for haemodialysis. AVFs typically require 6 to 8 weeks to "mature" from the time of surgery before they can be cannulated. Patients with end-stage renal disease needing urgent vascular access therefore traditionally require insertion of a tunnelled central venous catheter (TCVC). TCVCs are associated with high infection rates and central venous stenosis. Early cannulation synthetic arteriovenous grafts (ecAVG) provide a novel alternative to TCVCs, permitting rapid access to the bloodstream and immediate needling for haemodialysis...
December 2015: Trials
https://www.readbyqxmd.com/read/25751550/is-there-an-association-between-central-vein-stenosis-and-line-infection-in-patients-with-tunnelled-central-venous-catheters-tcvcs
#7
Emma Aitken, Patrick Honour, Natalie Johnson, David Kingsmore
PURPOSE: Central vein stenosis (CVS) and line infection are well-recognized complications of tunnelled central venous catheters (TCVCs) in patients on haemodialysis. The aim of this study was to evaluate any relationship between CVS and line infection. METHODS: Analysis of 500 consecutive patients undergoing TCVC insertion was undertaken. Data were collected on patient demographics, details of line insertion and duration, culture-proven bacteraemia and presence of symptomatic CVS...
2015: Journal of Vascular Access
https://www.readbyqxmd.com/read/24939191/taurolidine-citrate-heparin-catheter-lock-solution-reduces-staphylococcal-bacteraemia-rates-in-haemodialysis-patients
#8
E C Murray, C Deighan, C Geddes, P C Thomson
BACKGROUND: Infection is second only to cardiovascular disease as a cause of death in the haemodialysis (HD) population. AIM: : To assess the effect of introducing catheter lock solution taurolidine-citrate-heparin to all tunnelled central venous catheters (TCVCs) on staphylococcal bloodstream infection rates in patients on chronic HD. DESIGN: Observational, prospective analysis of the incidence rates of staphylococcal bacteraemic events in National Health Service (NHS) Greater Glasgow & Clyde and NHS Forth Valley between April 2011 and June 2013, with taurolidine-citrate-heparin catheter lock solution introduced July 2012...
December 2014: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/24811590/hemodialysis-tunneled-central-venous-catheters-five-year-outcome-analysis
#9
Salvatore Mandolfo, Pasqualina Acconcia, Raffaella Bucci, Bruno Corradi, Marco Farina, Maria Antonietta Rizzo, Andrea Stucchi
BACKGROUND: Tunneled central venous catheters (tCVCs) are considered inferior to arteriovenous fistulas (AVFs) and grafts in all nephrology guidelines. However, they are being increasingly used as hemodialysis vascular access. The purpose of this study was to document the natural history of tCVCs and determine the rate and type of catheter replacement. METHODS: This was a prospective study of 141 patients who underwent hemodialysis with tCVCs between January 2008 and December 2012...
November 2014: Journal of Vascular Access
https://www.readbyqxmd.com/read/24532000/the-use-of-tunneled-central-venous-catheters-inevitable-or-system-failure
#10
COMPARATIVE STUDY
Emma L Aitken, Karen S Stevenson, Marc Gingell-Littlejohn, Margaret Aitken, Marc Clancy, David B Kingsmore
PURPOSE: To evaluate reasons for tunneled central venous catheter (TCVC) usage in our prevalent hemodialysis population and assess the impact of a surgically aggressive approach to definitive access creation. METHODS: Clinical review of all patients in the West of Scotland dialyzing via a TCVC in November 2010 was performed. Reasons for TCVC usage and TCVC complications were evaluated. Over the subsequent year, aggressive intervention was undertaken to achieve definitive access in all suitable patients and outcomes re-evaluated a year later (November 2011)...
September 2014: Journal of Vascular Access
https://www.readbyqxmd.com/read/24403202/-project-work-formation-of-health-care-personnel-for-self-care-of-tunnelled-central-venous-catheters-in-hemodialysis-patients-of-the-territory
#11
Walter Morale, D Patanè, C Incardona, G Seminara, P Malfa, G L'Anfusa, G Calcara, P Bisceglie, D Puliatti, D Di Landro
BACKGROUND: Scientific data from current literature demonstrate an incidence of bacteraemia due to tunnelled central venous catheter (tCVC) use accounting for 1.6 / 1000 days per tCVC, with a range of 1.5 to 1.8. In Sicily no data on the incidence of tCVC- related bacteraemia are available. In our hospital, tCVC infection occurs 2.4 times in 1000 days during CVC use. A retrospective analysis carried out from 2006 to 2012 was performed on 650 patients with tunnelled catheters. Of the subjects who received tCVC in our hospital, 90% were destined to undergo haemodialysis in a private health care environment outside our hospital...
July 2013: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/23959916/medication-assessment-tool-to-detect-care-issues-from-routine-data-a-pilot-study-in-primary-care
#12
Tobias Dreischulte, Julienne Johnson, John McAnaw, Marlies Geurts, Han de Gier, Steve Hudson
BACKGROUND: Medication assessment tools (MATs) may be implemented in routine electronic data sources in order to identify patients with opportunities for optimisation of medication therapy management (MTM) and follow-up by a multi-disciplinary team. OBJECTIVE: (1) To demonstrate the use of a MAT for cardiovascular conditions (MAT CVC) as a means of profiling potential opportunities for MTM optimisation in primary care and (2) to assess the performance of MAT CVC in identifying actual opportunities for better care...
December 2013: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/23416178/mutagenicity-of-the-cysteine-s-conjugate-sulfoxides-of-trichloroethylene-and-tetrachloroethylene-in-the-ames-test
#13
COMPARATIVE STUDY
Roy M Irving, Adnan A Elfarra
The nephrotoxicity and nephrocarcinogenicity of trichloroethylene (TCE) and tetrachloroethylene (PCE) are believed to be mediated primarily through the cysteine S-conjugate β-lyase-dependent bioactivation of the corresponding cysteine S-conjugate metabolites S-(1,2-dichlorovinyl)-l-cysteine (DCVC) and S-(1,2,2-trichlorovinyl)-l-cysteine (TCVC), respectively. DCVC and TCVC have previously been demonstrated to be mutagenic by the Ames Salmonella mutagenicity assay, and reduction in mutagenicity was observed upon treatment with the β-lyase inhibitor aminooxyacetic acid (AOAA)...
April 5, 2013: Toxicology
https://www.readbyqxmd.com/read/23258586/report-of-a-transient-increase-in-tunneled-catheter-infections-following-dialysis-facility-transfer-to-a-prefabricated-structure
#14
Andreana De Mauri, Doriana Chiarinotti, Martino De Leo
PURPOSE: Despite the efforts to promote the native artero-venous fistula as dialysis access, the use of tunneled central venous catheters (tCVC) is increasing. Main complications remain infections of the access, and the environment plays an important role in determining them; however, no studies are available that report dialysis provided in prefabricated temporary buildings. The aim of our study was to assess the incidence of tCVC infections in a container building. METHODS: Since May 2009 our Dialysis Center has been located in a container building...
April 2013: Journal of Vascular Access
https://www.readbyqxmd.com/read/22526869/self-administration-of-outpatient-parenteral-antibiotic-therapy-and-risk-of-catheter-related-adverse-events-a-retrospective-cohort-study
#15
D A Barr, L Semple, R A Seaton
Despite increasing use, limited data has been published comparing safety of different outpatient parenteral antimicrobial therapy (OPAT) models. Potential risks of self-administration at home include venous access device infection and other line complications. This study aims to investigate rates and predictors of intravenous access device complications in a large OPAT cohort. This is a retrospective cohort study of all uses of midlines, peripherally inserted central catheters (PICCs) and tunnelled central venous catheters (TCVCs) with univariate and multivariate (logistic regression) analysis of factors associated with line infections (LIs) and with other line events (OLEs)...
October 2012: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/20123206/large-bore-tunneled-central-venous-catheter-insertion-in-patients-with-coagulopathy
#16
Brian Haas, Jesse L Chittams, Scott O Trerotola
PURPOSE: To evaluate the safety of tunneled central venous catheter (TCVC) insertion in patients with an International Normalized Ratio (INR) of greater than or equal to 1.5 or a platelet count lower than 50,000/dL. MATERIALS AND METHODS: Our division's criteria for acceptable coagulation parameters in patients undergoing TCVC insertion is INR no greater than 2 and platelet count of at least 25,000/dL. Three-thousand one-hundred and eighty-eight TCVCs (8-14.5 F) placed between July 2001 and July 2008 were identified...
February 2010: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/19210271/the-influence-of-comorbidity-on-the-risk-of-access-related-bacteremia-in-chronic-hemodialysis-patients
#17
Emmanouil Mazonakis, Catherine Stirling, Karen L Booth, Jenny McClenahan, Neil Heron, Colin C Geddes
Access-related bacteremia is an important cause of morbidity in chronic hemodialysis patients. The incidence of bacteremia is higher in patients dialyzing through a tunneled central venous catheter (TCVC) compared with an arteriovenous fistula (AVF). Our aim was to explore if this is explained by patient comorbidity. Two groups of chronic hemodialysis outpatients were compared: all patients who dialyzed through a TCVC at any time during 2003 and were fit enough to subsequently have a functioning AVF or renal transplant even if it was after 2003 (Group 1; n=93); and all patients who dialyzed through a TCVC in 2003 and were not fit enough to have a functioning AVF or renal transplant (Group 2; n=119)...
January 2009: Hemodialysis International
https://www.readbyqxmd.com/read/19090869/infective-spondylodiscitis-in-patients-on-high-flux-hemodialysis-and-on-line-hemodiafiltration
#18
Saima Abid, Shamila DE Silva, Paul Warwicker, Ken Farrington
Infective spondylodiscitis (ISD) is a rare but potentially devastating condition in hemodialysis (HD) patients. Reports are limited especially in patients receiving high-flux HD and hemodiafiltration (HDF). In a retrospective analysis, 13 patients on our maintenance high-flux HD/HDF program were identified as having has infective spondylodiscitis over a 10-year period (1997-2006), an incidence of approximately 1 episode every 215 patient-years. The incidence was around 3 times higher in patients dialyzing with tunnelled central venous catheters (TCVC) than in those with arteriovenous fistulae...
October 2008: Hemodialysis International
https://www.readbyqxmd.com/read/17347324/s-1-2-2-trichlorovinyl-l-cysteine-sulfoxide-a-reactive-metabolite-of-s-1-2-2-trichlorovinyl-l-cysteine-formed-in-rat-liver-and-kidney-microsomes-is-a-potent-nephrotoxicant
#19
Adnan A Elfarra, Renee J Krause
Previously, we have provided evidence that cytochromes P450 (P450s) and flavin-containing monooxygenases (FMOs) are involved in the oxidation of S-(1,2,2-trichlorovinyl)-L-cysteine (TCVC) in rabbit liver microsomes to yield the reactive metabolite TCVC sulfoxide (TCVCS). Because TCVC is a known nephrotoxic metabolite of tetrachloroethylene, the nephrotoxic potential of TCVCS in rats and TCVCS formation in rat liver and kidney microsomes were investigated. At 5 mM TCVC, rat liver microsomes formed TCVCS at a rate nearly 5 times higher than the rate measured with rat kidney microsomes, whereas at 1 mM TCVC only the liver activity was detectable...
June 2007: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/17253487/prophylactic-antibiotics-for-preventing-early-central-venous-catheter-gram-positive-infections-in-oncology-patients
#20
REVIEW
M D van de Wetering, J B M van Woensel
BACKGROUND: Long-term tunnelled central venous catheters (TCVCs) are increasingly used when treating oncology patients. Despite international guidelines on sterile insertion, appropriate catheter maintenance and use, infections still a complication of TCVC. These infections are mainly caused by Gram-positive bacteria. Antimicrobial prevention strategies aimed at these micro-organisms could potentially decrease the majority of TCVC infections. The aim of this review was to evaluate the efficacy of antibiotics in the prevention of early TCVC infections...
2007: Cochrane Database of Systematic Reviews
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