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https://www.readbyqxmd.com/read/28495535/endoluminal-dilation-technique-to-remove-stuck-port-a-cath-a-case-report
#1
Paolo Cerini, Giuseppe Guzzardi, Andrea Galbiati, Carmelo Stanca, Bruno Del Sette, Alessandro Carriero
Port-a-cath is a type of central venous catheter (CVC) designed to allow repeated access to the venous system for parenteral delivery of medications, fluids, and nutritional solutions and for sampling venous blood. After years of use or in case of damage, CVC must be removed and eventually replaced: the recovery of the device should normally be easy, with a small surgical incision of the skin and tissues surrounding the device and pulling the catheter. Sometimes scar tissue can develop around the device, making it resistant to removal even after application of forceful traction...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28489757/ultrasound-guided-catheterization-of-the-left-subclavian-vein-without-recognition-of-persistent-left-superior-vena-cava-a-case-report
#2
Sun Young Park, Jae Hwa Yoo, Mun Gyu Kim, Sang Ho Kim, Byoung-Won Park, Hong Chul Oh, Hojoon Kim
RATIONALE: A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach. PATIENT CONCERNS: A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage. Before the operation, a central venous catheter (CVC) was placed into the left subclavian vein...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28473028/-consequences-of-a-misplaced-central-venous-catheter
#3
Daniel Meier Gleesborg, Svend Erik Heiselberg, Ole Brink
Central venous catheter (CVC) is useful for prolonged intravenous treatment, but not without risk. This is a case report of a 21-year-old male with a rare incident of CVC misplacement from the right subclavian vein to the left. The misplacement caused severe discomfort and possibly secondary thrombosis (VT) of deep cervical veins. The CVK was removed, and the patient was treated with rivaroxaban for three months, which made him recover without sequelae. VT, due to CVC, can cause a potentially life-threatening pulmonary embolism...
April 24, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28469899/reducing-central-venous-catheter-use-in-peripheral-blood-stem-cell-donation-quality-improvement-report
#4
Samer Ghazi, Ahmed Alaskar, Mohsen Alzahrani, Moussab Damlaj, Khadega A Abuelgasim, Giamal Gmati, Mona Alshami, Salman Alshammary, Khaled Al-Surimi, Hind Salama, Ayman Alhejazi, Abdul-Rahman Jazieh
Peripheral blood stem cell (PBSC) collection from donors through apheresis has become the main source of stem cells for hematopoietic stem cell transplantation. This procedure requires a high blood flow venous access. A peripheral venous catheter (PVC), compared to a central venous catheter (CVC), is considered to provide safer venous access. However, initially at our institution, King Abdul-Aziz Medical City - Riyadh, a CVC was frequently used (72%). A quality improvement multidisciplinary team has been formed to conduct a systematic quality performance analysis to evaluate the current process of collecting donor PBSCs with the aim to reduce CVC use to less than the international benchmark (20%)...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28440110/in-parallel-connected-intermittent-hemodialysis-through-ecmo-does-not-affect-hemodynamic-parameters-derived-from-transpulmonary-thermodilution
#5
Tobias Lahmer, Ulrich Mayr, Sebastian Rasch, Gonzalo Batres Baires, Roland M Schmid, Wolfgang Huber
INTRODUCTION: We report a case of renal replacement therapy (RRT) during extracorporeal membrane oxygenation (ECMO) via a single venous access and analyze the feasibility of transpulmonary thermodilution (TPTD) for hemodynamic monitoring. CASE REPORT: ECMO and RRT connected into the ECMO-extracorporeal circuit were performed via a single venous access because of multiple venous thromboses. An indicator for TPTD and pulse contour analysis (PCA) was applied into the central venous catheter (CVC) placed in the right vena jugularis...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28427990/neuropeptide-y-not-involved-in-cutaneous-vascular-control-in-young-human-females-taking-oral-contraceptive-hormones
#6
Gary J Hodges, Zachary T Martin, Andrew T Del Pozzi
We previously reported that the cutaneous vasodilator response to local warming in males required noradrenaline (NA) and neuropeptide-Y (NPY). Animal work has shown no role for NPY in female vascular control. We investigated the contribution of NA and NPY in human female cutaneous vascular control. Nine female and nine male participants volunteered. To elucidate whether synthetic oestrogen and progesterone altered cutaneous vascular responses, females were tested in high-hormone (HH) and low-hormone (LH) phases of oral contraceptive pill (OCP)...
April 18, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28389093/risk-factors-for-kpc-producing-enterobacteriaceae-acquisition-and-infection-in-a-healthcare-setting-with-possible-local-transmission-a-case-control-study
#7
K M Cronin, Y S Poy Lorenzo, M E Olenski, A E Bloch, K Visvanathan, M J Waters, K L Buising
BACKGROUND: Reports of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kp) in Australia were previously uncommon, with cases imported sporadically by travellers from higher prevalence countries. AIM: The study institution reported the first outbreak of KPC-Kp in Australia. The aim of this study was to identify risk factors for KPC-Kp colonization and infection using a matched case-control study. METHODS: The study included all hospitalized patients with KPC-Kp colonization or infection from January 2012 to September 2015...
February 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28353459/first-report-of-kocuria-marina-bloodstream-infection-unrelated-to-a-central-venous-catheter-a-mini-review-on-an-emerging-and-under-recognized-opportunistic-pathogen
#8
Giovanna Pulcrano, Michela Balzaretti, Alessia Grosini, Vincenzo Piacentini, Dimitri Poddighe
We report a case of sepsis by Kocuria marina in a 45-year-old woman carrying a midline venous catheter to provide total parenteral nutrition. Despite the finding of K. marina bacteraemia, no bacteria grew from the culture of the catheter tip. As the patient was affected with severe leg ulcers, K. marina bloodstream infection from a skin breakage other than CVC was supposed. K. marina is an emerging opportunistic agent deserving attention and probably under-recognized, as it can be misdiagnosed as Staphylococcus if only conventional microbiological analyses are performed for bacterial identification...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28280852/tantigen-a-comprehensive-database-of-tumor-t-cell-antigens
#9
Lars Rønn Olsen, Songsak Tongchusak, Honghuang Lin, Ellis L Reinherz, Vladimir Brusic, Guang Lan Zhang
Tumor T cell antigens are both diagnostically and therapeutically valuable molecules. A large number of new peptides are examined as potential tumor epitopes each year, yet there is no infrastructure for storing and accessing the results of these experiments. We have retroactively cataloged more than 1000 tumor peptides from 368 different proteins, and implemented a web-accessible infrastructure for storing and accessing these experimental results. All peptides in TANTIGEN are labeled as one of the four categories: (1) peptides measured in vitro to bind the HLA, but not reported to elicit either in vivo or in vitro T cell response, (2) peptides found to bind the HLA and to elicit an in vitro T cell response, (3) peptides shown to elicit in vivo tumor rejection, and (4) peptides processed and naturally presented as defined by physical detection...
March 9, 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/28271565/prostacyclin-does-not-affect-sweating-but-induces-skin-vasodilatation-to-a-greater-extent-in-older-versus-younger-women-roles-of-no-and-kca-channels
#10
Naoto Fujii, Brendan D McNeely, Takeshi Nishiyasu, Glen P Kenny
What is the central question of this study? It remains unknown whether ageing modulates prostacyclin-induced cutaneous vasodilatation in women. What is the main finding and its importance? Prostacyclin induced cutaneous vasodilatation, albeit the magnitude of increase at lower concentrations of prostacyclin was greater in older relative to young women. This response was associated with greater contributions of nitric oxide synthase and calcium-activated potassium channels. Our results suggest that administration of prostacyclin might be an effective therapy to reverse microvascular hypoperfusion, especially in older women...
March 7, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28261815/the-practice-of-platelet-transfusion-prior-to-central-venous-catheterization-in-presence-of-coagulopathy-a-national-survey-among-clinicians
#11
E K van de Weerdt, A L Peters, E J Goudswaard, J M Binnekade, K P van Lienden, B J Biemond, A P J Vlaar
BACKGROUND: Correction of coagulopathy prior to central venous catheter (CVC) placement is advocated by guidelines, while retrospective studies support restrictive use of transfusion products. STUDY DESIGN AND METHODS: We conducted a mixed vignette and questionnaire web survey to investigate current practice and preferences for CVC placement. Clinical vignettes were used to quantify the tendency to administer platelet concentrate. A positive ß-coefficient is in favour of administering platelet concentrate...
March 5, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#12
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
March 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28181240/cytochrome-p450-genetic-variations-can-predict-mrna-expression-cyclophosphamide-4-hydroxylation-and-treatment-outcomes-in-chinese-patients-with-non-hodgkin-s-lymphoma
#13
Wenying Shu, Lingyan Chen, Xiaoye Hu, Meimei Zhang, Wensheng Chen, Lei Ma, Xiaoyan Liu, Jianing Huang, Tingyuan Pang, Jia Li, Yu Zhang
To investigate the impact of cytochrome P450 (CYP) genetic polymorphisms CYP2B6, CYP2C19, and CYP3A5 on mRNA expression, cyclophosphamide/4-hydroxycyclophosphamide pharmacokinetics, and treatment outcomes of the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) in Chinese patients with non-Hodgkin's lymphoma, 567 cases were investigated. Plasma concentrations of cyclophosphamide/4-hydroxycyclophosphamide were determined using liquid chromatography-tandem mass spectrometry and pharmacokinetic parameters calculated...
February 9, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#14
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28104952/pitfalls-in-interpretation-of-fdg-pet-ct-septic-pulmonary-emboli-mimicking-metastases-in-a-case-of-gastric-carcinoma
#15
Harkirat Singh, Aftab Alam, T V S V G K Tilak, Prateek Kinra, Brijesh K Soni
Inflammatory lesions may sometimes show intense tracer uptake and mimic neoplastic lesions on (18) F-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). We report one such false positive case on FDG PET/CT, where septic pulmonary emboli (SPE) mimicked pulmonary metastases. A 45-year-old man with stomach cancer had an indwelling central venous catheter (CVC) in situ while on neoadjuvant chemotherapy. He underwent FDG PET/CT scan for response assessment and the images revealed multiple, intensely FDG avid, peripheral, lung nodules with feeding vessels, which were suspicious for pulmonary metastases...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#16
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28063456/normal-saline-versus-heparin-for-patency-of-central-venous-catheters-in-adult-patients-a-systematic-review-and-meta-analysis
#17
Lei Zhong, Hai-Li Wang, Bo Xu, Yao Yuan, Xin Wang, Ying-Ying Zhang, Li Ji, Zi-Mu Pan, Zhan-Sheng Hu
BACKGROUND: Heparin saline (HS) is theoretically superior to normal saline (NS) for maintaining the patency of central venous catheters (CVCs), but the comparative efficacy of them remains controversial. The aim of this systematic review and meta-analysis was to assess the efficacy of NS versus HS in the maintenance of the patency of CVCs in adult patients. METHODS: We searched PubMed, Embase and the Cochrane library databases. Randomized controlled trials (RCTs) evaluating the use of NS vs...
January 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27965360/screening-guidelines-for-venous-thromboembolism-risk-in-hospitalized-children-have-low-sensitivity-for-central-venous-catheter-associated-thrombosis
#18
Asfawossen B Asfaw, Rowena C Punzalan, Ke Yan, Raymond G Hoffmann, Sheila J Hanson
OBJECTIVES: Local pediatric screening guidelines for venous thromboembolism (VTE) are developed from incomplete pediatric data and extrapolated from adult data in which immobility is a major risk factor. We hypothesized that screening guidelines centered on immobility are inadequate for identifying children at risk of central venous catheter (CVC)-associated VTE. METHODS: This retrospective case-control (4:1) study at an academic, quaternary-level, free-standing children's hospital applied screening guidelines for VTE risk to all cases of VTE from July 2012 to April 2014...
January 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#19
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
April 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27878131/extra-luminal-entrapment-of-guide-wire-a-rare-complication-of-central-venous-catheter-placement-in-right-internal-jugular-vein
#20
Md Abu Masud Ansari, Naveen Kumar, Shailesh Kumar, Sarita Kumari
Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels...
October 2016: Bulletin of Emergency and Trauma
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