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Indwelling devices

Joshua Brown, Jeffery Talbert, Ryan Pennington, Qiong Han, Driss Raissi
Background: Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a low-cost intervention and evaluation for quality improvement. The working hypothesis was that a simple, mailed letter intervention could increase retrieval rates by increasing patient and primary care provider knowledge of the need for retrieval. Methods: For all prospective patients who received a retrievable IVCF during the intervention period from January 1, 2014 to February 29, 2016, patients and their primary care providers were mailed letters encouraging contact with the clinic for evaluation of eligibility for retrieval...
2018: Patient Safety in Surgery
Carlo Pallotto, Gioele Simonte, Fabio Verzini, Massimo Lenti, Franco Baldelli, Daniela Francisci, Maurizio Fiorio
Propionibacterium acnes is a member of the human microbiota that has been recently associated with late-onset infections of indwelling devices, especially shoulder prosthesis. Aortic graft infection are rare events with significant morbidity and mortality. Here, we describe the case of an abdominal aortic graft infection due to P. acnes with an unusual early onset. A review of the recent English language literature has been added.
March 20, 2018: Journal of Chemotherapy
Sandra N Bulens, Sarah H Yi, Maroya S Walters, Jesse T Jacob, Chris Bower, Jessica Reno, Lucy Wilson, Elisabeth Vaeth, Wendy Bamberg, Sarah J Janelle, Ruth Lynfield, Paula Snippes Vagnone, Kristin Shaw, Marion Kainer, Daniel Muleta, Jacqueline Mounsey, Ghinwa Dumyati, Cathleen Concannon, Zintars Beldavs, P Maureen Cassidy, Erin C Phipps, Nicole Kenslow, Emily B Hancock, Alexander J Kallen
In healthcare settings, Acinetobacter spp. bacteria commonly demonstrate antimicrobial resistance, making them a major treatment challenge. Nearly half of Acinetobacter organisms from clinical cultures in the United States are nonsusceptible to carbapenem antimicrobial drugs. During 2012-2015, we conducted laboratory- and population-based surveillance in selected metropolitan areas in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee to determine the incidence of carbapenem-nonsusceptible A...
April 2018: Emerging Infectious Diseases
Ina Willemsen, Jan Kluytmans
Background: Infection control needs user-friendly standardized instruments to measure the compliance to guidelines and to implement targeted improvement actions. This abstract describes a tool to measure the quality of infection control and antimicrobial use, the Infection Risk Scan (IRIS). It has been applied in a hospital, several nursing homes and a rehabilitation clinic in the Netherlands. Method: The IRIS consists of a set of objective reproducible measurements, combining patient- and healthcare related variables, such as: hand hygiene compliance, environmental contamination using ATP measurements, prevalence of resistant microorganisms by active screening, availability of infection control preconditions, personal hygiene of healthcare workers, appropriate use of indwelling medical devices and appropriate use of antimicrobials...
2018: Antimicrobial Resistance and Infection Control
V Hoerr, M Franz, M W Pletz, M Diab, S Niemann, C Faber, T Doenst, P C Schulze, S Deinhardt-Emmer, B Löffler
Infective endocarditis (IE) is a life-threatening disease, caused by septic vegetations and inflammatory foci on the surface of the endothelium and the valves. Due to its complex and often indecisive presentation the mortality rate is still about 30%. Most frequently bacterial microorganisms entering the bloodstream are the underlying origin of the intracardiac infection. While the disease was primarily restricted to younger patients suffering from rheumatic heart streptococci infections, new at risk categories for Staphylococcus (S...
February 21, 2018: International Journal of Medical Microbiology: IJMM
Branimir Lodeta, Dino Lovrinic, Maja Lodeta, Tina Zavidic, Hrvoje Baric
INTRODUCTION: This study is aimed at assessing the use of various types of urinary catheters, appropriateness of catheter placement and factors associated with antibiotic use in a population of chronically catheterized patients in Istria County. MATERIALS AND METHODS: This cross-sectional study, conducted between March and June 2017 in Istria County, Croatia, was initiated through a network of general family medicine offices. Data were collected from general practitioners (GPs) and from medical managers in nursing homes...
March 2, 2018: Urologia Internationalis
Brian Y Chang, Steven P Keller, Sonya S Bhavsar, Noam Josephy, Elazer R Edelman
The full potential of mechanical circulatory systems in the treatment of cardiogenic shock is impeded by the lack of accurate measures of cardiac function to guide clinicians in determining when to initiate and how to optimally titrate support. The left ventricular end diastolic pressure (LVEDP) is an established metric of cardiac function that refers to the pressure in the left ventricle at the end of ventricular filling and immediately before ventricular contraction. In clinical practice, LVEDP is typically only inferred from, and poorly correlates with, the pulmonary capillary wedge pressure (PCWP)...
February 28, 2018: Science Translational Medicine
Smrithi Padmakumar, Neha Parayath, Fraser Leslie, Shantikumar V Nair, Deepthy Menon, Mansoor M Amiji
Epithelial ovarian cancer (EOC) remains to be the most lethal of all gynecological malignancies mainly due to its asymptomatic nature. The late stages of EOC are manifested with predominant metastases confined to the peritoneal cavity. Although there has been a substantial progress in the treatment avenue with different therapeutic interventions, the overall survival rate of EOC patients remain poor due to relapse and drug resistance. Areas covered: The pharmacokinetic advantages offered by intraperitoneal (IP) chemotherapy due to the peritoneal-plasma barrier can be potentially exploited for EOC relapse treatment...
February 28, 2018: Expert Opinion on Drug Delivery
Emeka C Anyanwu, Viktoriya Kagan, Ankit Bhatia, David M Tehrani, Sirtaz Adatya, Gene Kim, Nitasha Sarswat, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
There is little data outlining the use of outpatient inotropic medications in patients with existing left ventricular assist devices (LVADs). This case series explores this patient population and seeks to define the indications, complications, and safety of dual support. A retrospective chart review was conducted for all patients on LVAD and then subsequently started on home inotropes post device implant. Eight patients met inclusion criteria. The indications for inotropes were right ventricular failure, aortic insufficiency with biventricular failure, LVAD thrombosis with contraindication to device exchange, and cannula malposition with elevated pulmonary vascular resistance...
February 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Kee Scholten, Ellis Meng
Closed-loop drug delivery promises autonomous control of pharmacotherapy through the continuous monitoring of biomarker levels. For decades, researchers have strived for portable closed-loop systems, capable of treating ambulatory patients with chronic conditions such as diabetes mellitus. After years of development, the first of these systems have left the laboratory and entered commercial use. This long-awaited advance reflects recent development of chronically stable implantable biosensors, able to accurately measure biomarker levels in vivo...
February 16, 2018: International Journal of Pharmaceutics
Diego E Pissinis, Guillermo A Benítez, Patricia L Schilardi
The use of indwelling devices has emerged as a frequent and often life-saving medical procedure. However, infection in prosthetic surgery is one of the most important and devastating complications. Once the biofilm has been formed, its eradication is extremely difficult, due to an increased resistance to host defense and conventional antimicrobials. Thus, the design of novel strategies for inhibiting the bacterial adhesion on implantable devices is a key point for successful surgical procedures. In this work, the development of a simple two-step protocol to prepare surfaces able to prevent the bacterial growth was successfully achieved...
January 31, 2018: Colloids and Surfaces. B, Biointerfaces
Lidiane Patrícia Gonçalves, Alejandro Miñán, Guillermo Benítez, Mónica Fernández Lorenzo de Mele, María Elena Vela, Patricia L Schilardi, Elias Paiva Ferreira-Neto, Júlia Cristina Noveletto, Wagner Rafael Correr, Ubirajara Pereira Rodrigues-Filho
Medical device-related infections represent a major healthcare complication, resulting in potential risks for the patient. Antimicrobial materials comprise an attractive strategy against bacterial colonization and biofilm proliferation. However, in most cases these materials are only bacteriostatic or bactericidal, and consequently they must be used in combination with other antimicrobials in order to reach the eradication condition (no viable microorganisms). In this study, a straightforward and robust antibacterial coating based on Phosphotungstate Ormosil doped with core-shell (SiO2@TiO2) was developed using sol-gel process, chemical tempering, and Ag nanoparticle photoassisted synthesis (POrs-CS-Ag)...
December 26, 2017: Colloids and Surfaces. B, Biointerfaces
Christian Adlhart, Joanna Verran, Nuno F Azevedo, Hulya Olmez, Minna M Keinänen-Toivola, Isabel Gouveia, Luis F Melo, Francy Crijns
The spread of infections in health care environments is a persistent and growing problem in most countries, aggravated by the development of microbial resistance to antibiotics and disinfectants. In addition to indwelling medical devices (implants, catheters, etc.), such infections may also result from adhesion of microbes either to external solid-water interfaces such as shower caps, taps, drains, etc, or to external solid-gas interfaces such as door handles, clothes, curtains, computer keyboards, etc. The latter are the main focus of the present work, where an overview of antimicrobial coatings for such applications is presented...
February 1, 2018: Journal of Hospital Infection
Hasanain Alalwan, Christopher J Nile, Ranjith Rajendran, Robert McKerlie, Paul Reynolds, Nikolaj Gadegaard, Gordon Ramage
Management of fungal biofilms represents a significant challenge to healthcare. As a preventive approach, minimising adhesion between indwelling medical devices and microorganisms would be an important step forward. This study investigated the anti-fouling capacity of engineered nanoscale topographies to the pathogenic yeast Candida albicans. Highly ordered arrays of nano-pit topographies were shown to significantly reduce the physical adherence capacity of C. albicans. This study shows a potential of nanoscale patterns to inhibit and prevent pathogenic biofilm formation on biomedical substrates...
February 1, 2018: Nanomedicine: Nanotechnology, Biology, and Medicine
Balvinder Mohan, Amber Prasad, Harsimran Kaur, Vinaykumar Hallur, Neha Gautam, Neelam Taneja
PURPOSE: Carbapenem-resistant Enterobacteriaceae (CRE) have emerged and disseminated widely causing a variety of infections. In India, the carriage of CRE in hospitalised patients has not been well-studied. Therefore, we conducted the present study to observe gut carriage rate of CRE in patients admitted to our tertiary care hospital. METHODS: A total of 232 faecal swabs collected from consecutive stool samples from admitted patients were inoculated on ChromID extended spectrum β-lactamase plates and members of Enterobacteriaceae family were subjected to antibiotic susceptibility as per the Clinical Laboratory Standards Institute guidelines...
October 2017: Indian Journal of Medical Microbiology
Rahul A Sheth, Andrew Niekamp, Keith B Quencer, Fadi Shamoun, Martha-Gracia Knuttinen, Sailendra Naidu, Rahmi Oklu
Venous thromboembolism (VTE) is the second most common cause of mortality in cancer patients. The mechanisms of cancer-associated thrombosis (CAT), much like cancer itself, are multi-factorial and incompletely understood. Cancer type, stage, tumor-derived factors and genetics all affect CAT risk. Furthermore, cancer therapies as well as the indwelling vascular devices through which these therapies are delivered can increase the risk for CAT. In this review, we summarize mechanisms of hypercoagulability in cancer patients, patterns of thrombosis associated with cancer, current guidelines for the diagnosis and management of CAT, and important considerations regarding the placement of implantable vascular devices in the care of cancer patients with VTE...
December 2017: Cardiovascular Diagnosis and Therapy
Terrie Beeson, Carmen Davis
BACKGROUND: Strategies to decrease use of female indwelling urinary catheters and catheter-associated urinary tract infections are challenging due to the limited availability of proper fitting external collection devices. Female urinary incontinence predisposes the skin to potential pain, itching, burning, infection, or pressure injuries. CASE STUDIES: This article discusses 3 patients' trajectory of care with use of an external female urinary collection device...
February 1, 2018: Journal of Wound, Ostomy, and Continence Nursing
Marco Falcone, Giusy Tiseo, Emanuele Durante-Mangoni, Veronica Ravasio, Francesco Barbaro, Maria Paola Ursi, Maria Bruna Pasticci, Matteo Bassetti, Paolo Grossi, Mario Venditti, Marco Rizzi
Objective: To investigate predisposing factors and outcomes of non-HACEK Gram-negative bacilli (GNB) infective endocarditis (IE) in a multicenter, contemporary cohort. Patients and Methods: Patients with IE due to GNB prospectively observed in 26 Italian centers from 2004 to 2011 were analyzed. Using a case-control design, each case was compared to three controls with IE by other etiologies matched for age and sex. Logistic regression was performed to identify risk factors for GNB IE. Factors associated with early and late mortality were assessed by Cox regression analysis...
January 29, 2018: Antimicrobial Agents and Chemotherapy
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
January 24, 2018: Tuberculosis and Respiratory Diseases
Maya Korem, Sarah Kagan, Itzhack Polacheck
Biofilm formation by microorganisms depends on their communication by quorum sensing, which is mediated by small diffusible signaling molecules that accumulate in the extracellular environment. During human infection, the pathogenic yeast Cryptococcus neoformans can form biofilm on medical devices, which protects the organism and increases its resistance to antifungal agents. The aim of this study was to test two novel heterocyclic compounds, S-8 (thiazolidinedione derivative, TZD) and NA-8 (succinimide derivative, SI), for their anti-biofilm activity against strains of Cryptococcus neoformans and Cryptococcus gattii...
July 20, 2017: Journal of Fungi (Basel, Switzerland)
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