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Mohit Bajaj, Jon Wells, Anuja Liyanage, Stephen Evans, James Hamill
Permanent central venous access is essential for the management of many pediatric patients. Knowing the amount of ionizing radiation used during the insertion of these devices is important. Our aim was to identify the radiation used in percutaneous insertion of central venous access devices, and to correlate radiation exposure to patient weight. METHODS: Data was prospectively collected during a 12-month period from August 2015 to August 2016 on all ultrasound-guided percutaneous central venous access device insertions...
October 26, 2017: Journal of Pediatric Surgery
Alix Marhic, Jean-François Tremblay, Rachid Kaci, Thierry André, Clarisse Eveno, Marc Pocard
BACKGROUND: The interval between surgery and adjuvant chemotherapy (AC) is a predictive factor of survival in high-risk colon cancer (CC). This study aimed to evaluate the impact of intraoperative sentinel lymph node (SLN) analysis using the one-step nucleic acid amplification (OSNA) technique on the time interval between surgery and AC. METHODS: We performed a prospective study analyzing 56 consecutive patients who had surgery for CC between July 2012 and October 2014, including 20 patients needing AC...
August 2017: Digestive and Liver Disease
Lea-Valeska Blum, Ulf Abdel-Rahman, Thomas Klingebiel, Henning Fiegel, Stefan Gfroerer, Udo Rolle
PURPOSE: Tunneled central venous catheters (tCVCs) are routinely used for long-term venous access in children with cancer and chronic diseases. They may be inserted by surgical venous cut-down or percutaneously. The aim of this study was to compare the operative times and intraoperative complications of both techniques. METHODS: This study compared group A (surgical venous cut-down, years 2002-2006) with group B (percutaneous, years 2008-2012). Patient characteristics, operative times, and intraoperative complications were obtained from surgical reports...
May 2017: Journal of Pediatric Surgery
Maryam Nilforoshan, Ismael Matus
The implanted venous access catheter is commonly used in the treatment of oncology patients. Although common long-term complications of these devices, such as infection and thrombosis, have been widely reported, venous-airway fistula due to port placement is an extremely rare and poorly understood complication. We report a case of a 56-year-old woman with pancreatic adenocarcinoma whose implanted catheter was complicated by the development of an azygo-bronchial fistula with a concomitant aspergilloma. Herein is the first reported case of successful venous-airway fistula closure obtained through silicone stenting...
October 2017: Journal of Bronchology & Interventional Pulmonology
Omidreza Tabatabaie, Gyulnara G Kasumova, Mariam F Eskander, Jonathan F Critchlow, Nicholas E Tawa, Jennifer F Tseng
OBJECTIVE: Totally implantable venous access devices (portacaths, or "ports"), are widely used for intermittent central venous access especially for cancer patients. Although ports have a superior safety margin compared with other long-term venous access devices, there are a number of complications associated with their use. METHODS: This is a narrative review. We searched PubMed and Google Scholar for articles about complications related to the use of portacaths...
February 2017: American Journal of Clinical Oncology
Hagen Frickmann, Wibke Schmeja, Emil Reisinger, Thomas Mittlmeier, Karen Mitzner, Norbert Georg Schwarz, Philipp Warnke, Andreas Podbielski
This study assessed protective effects of a continuous introduction of safe instruments in terms of reduction of needle stick injuries. The retrospective study analyzed correlations between the increasing proportion of safe instruments and a reduction of the incidence of needle stick injuries linked to such instruments in a German university hospital over 5 years. Incidents declined about 17.6% from 80.3 incidents per 1000 employees to 66.2, associated with an increase in the proportions of injuries due to instruments without protective mechanisms such as scalpels or hypodermic needles by 12...
September 29, 2016: European Journal of Microbiology & Immunology
Joseph W Duncumb, Kana Miyagi, Parto Forouhi, Charles M Malata
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression...
2016: Case Reports in Surgery
Wala Ben Kridis, Mohamed Sahnoun, Hammadi Maraoui, Naceur Amari, Mounir Frikha
Totally implantable venous access port has become an essential prerequisite for many chemotherapy protocols in solid tumors and hematological malignancies. However, we should be aware of its complications such as: venous thrombosis, extravasations, dislocation, obstruction, catheter leakage, and local or systemic infections. Among those complications, a dislodged broken catheter is rare and dangerous. We report a new case with review of literature to make oncologists aware about this entity and the necessity of monitoring by chest radiography...
May 13, 2016: Acta Clinica Belgica
Bernhard Renger, Carina Brieskorn, Vivien Toth, Detlef Mentrup, Sascha Jockel, Fabian Lohöfer, Martin Schwarz, Ernst J Rummeny, Peter B Noël
Bedside chest X-rays (CXR) for catheter position control may add up to a considerable radiation dose for patients in the intensive care unit (ICU). In this study, image quality and dose reduction potentials of a novel X-ray scatter correction software (SkyFlow, Philips Healthcare, Hamburg, Germany) were evaluated. CXRs of a 'LUNGMAN' (Kyoto Kagaku Co., LTD, Kyoto, Japan) thoracic phantom with a portacath system, a central venous line and a dialysis catheter were performed in an experimental set-up with multiple tube voltage and tube current settings without and with an antiscatter grid...
June 2016: Radiation Protection Dosimetry
Élisabeth Barbier
The portacath reflects the cancer and its future treatments. Its insertion causes high levels of anxiety for patient. Thanks to medical hypnosis, he can use its internal resources to help them manage the situation and the symptoms he feels.
April 2015: Revue de L'infirmière
Lynne A McIntosh, Gregor M Walker
BACKGROUNDS AND AIMS: Portacaths are regularly used in children with cystic fibrosis (CF). We aimed to assess patient satisfaction with lateral chest wall portacaths in children with CF. METHODS: All children in a geographical region with CF and portacath in situ were identified. Site of chest wall placement was identified on X-ray; only children with lateral chest wall portacaths were sent questionnaires. Data collected included preoperative information, cosmesis and interference with activities...
July 2015: Archives of Disease in Childhood
Matteo Bassetti, Maria Merelli, Filippo Ansaldi, Daniela de Florentiis, Assunta Sartor, Claudio Scarparo, Astrid Callegari, Elda Righi
BACKGROUND: Candida is an important cause of bloodstream infections (BSI) in nosocomial settings causing significant mortality and morbidity. This study was performed to evaluate contemporary epidemiology, species distribution, antifungal susceptibility and outcome of candida BSI in an Italian hospital. METHODS: All consecutive patients who developed candidemia at Santa Maria della Misericordia University Hospital (Italy) between January 2009 and June 2014 were enrolled in the study...
2015: PloS One
Matthew H Andrews, Bruce D Chisholm
Subcutaneous venous port or 'portacath' devices are widely used, especially in oncology patients. Several potential complications of portacath devices have been well documented. We report a rare case of the spontaneous migration of the tip of a portacath into the azygos vein, with subsequent development of a tracheo-azygos fistula. This resulted in the patient receiving a dose of chemotherapy agent and saline directly into his lungs, which ultimately contributed to his death a few weeks later. To our knowledge, there have been only 10 previously reported cases of inadvertent intrathoracic (mediastinal, pleural or pulmonary) extravasation of chemotherapy agent as a result of central venous catheter malposition or perforation; this is the second reported case of extravasation of chemotherapy agent as a result of migration of a portacath device into the azygos vein...
April 2015: Journal of Medical Imaging and Radiation Oncology
Z A Nurgat, M Smythe, A Al-Jedai, S Ewing, W Rasheed, A Belgaumi, S O Ahmed, M Ashour, A Al Agil, K Siddiqui, M Aljurf
INTRODUCTION: Numerous international organisations have advocated the preparation of vincristine in small volume intravenous bags in order to eliminate inadvertent intrathecal administration. However, the risk of extravasation is a significant deterrent, and adoption of this practice has been variable and only hesitantly accepted in the clinical setting. PURPOSE: We carried out a study with the aims of establishing the incidence of reported extravasation of vincristine administration to paediatric and adult patients in mini-bags; here we describe motivating factors and barriers faced by clinical staff...
October 2015: Journal of Oncology Pharmacy Practice
Sohail Asghar Dogar, Muhammad Arif Mateen Khan
OBJECTIVE: To assess the frequency of infection of portacath in children having malignant tumours and undergoing chemotherapy, and to assess the association of the infection with already known risk factors. METHODS: The retrospective review was conducted at Aga Khan University Hospital, Karachi, and involved patient data related to the period between January 2005 to December 2010. A questionnaire was designed to collect the required data. A total of 67 children were included having portacath inserted for chemotherapy...
October 2013: JPMA. the Journal of the Pakistan Medical Association
Etan Orgel, Lingyun Ji, William Pastor, Reuven J Schore
BACKGROUND: Three central venous catheters types are commonly used in pediatric cancer: totally implantable catheters (ICs; eg, mediports, portacaths), tunneled externalized catheters (eg Broviac® or Hickman® catheters [Bard Medical]) and peripherally inserted central catheters. While previous studies have examined risks for catheter-related infections, this is the first large multicenter study to compare catheter-associated infectious morbidity through patient outcomes and hospital utilization...
March 2014: Pediatric Infectious Disease Journal
M Ussowicz, J Musiał, M Mielcarek, A Tomaszewska, B Nasiłowska-Adamska, K Kałwak, E Gorczyńska, B Mariańska, A Chybicka
INTRODUCTION: Steroid-refractory graft-versus-host disease (GVHD) remains a challenging therapeutic problem after allogeneic hematopoietic stem cell transplantation (HSCT). The aim of this study was to evaluate the clinical effect of extracorporeal photopheresis (ECP), and its impact on intensivity of immunosuppresive therapy in allogeneic HSCT patients. PATIENTS AND METHODS: In this study 443 Therakos ECP procedures were performed in 21 patients after allogeneic HSCT with acute (aGVHD, 8 patients) or chronic (cGVHD, 13 patients) therapy-refractory GVHD...
November 2013: Transplantation Proceedings
Nicolas Janus, Florian Scotte, Jean-Baptiste Rey, Sabine Amet, Laurence Rouillon, Lorraine Zakin, Lamine Mahi, Gilbert Deray, Vincent Launay-Vacher
PURPOSE: Implantable central venous access port (portacath) is used to provide long-term venous access and to deliver chemotherapy in cancer patients. Intravenous iron complexes are frequently prescribed in this setting, and some physicians use a portacath for their administration. The aim of this survey was to assess the frequency of this practice and the reasons supporting it. METHODS: This declarative survey was conducted in France; 497 oncologists/hematologists were contacted to answer a survey on their practices regarding the administration of intravenous iron via a portacath...
October 2013: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
M Sochor, Z Pelikánová, M Sercl, V Mellanová, P P Lazarov, D Fáčková
Long-term access devices (VAD) in oncology patients are the elemental procedure of contemporary treatment. Apart from their indisputable benefit they are linked with an increased risk of infectious complications, ranging between simple colonisation of a device to catheter related bloodstream infections. The decision to salvage or extract the VAD in case of bloodstream infection depends on patient's clinical state, localisation of infection (site of insertion, catheter or pocket), casual agent and complications (e...
2012: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Hüsnü Süslü, Gülten Arslan, Kemal Tural
OBJECTIVES: In the cancer therapy, the role of central venous access device has been increased because of factors; such as accessing to vein frequently, having long term therapy, using of sclerosan agents, giving much fluid. A chemoport is a thin, soft, plastic tube surgically implanted into a vein in chest or arm. Portacath doesn't have a huge size and it can generate numerous advantages. All the same, portacaths have risks such as infection, thrombosis, mechanical failure, pneumothorax, arterial injury...
2012: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
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