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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
Sandra Roehrig, Axel Wein, Heinz Albrecht, Gudrun Maennlein, Kerstin Wolff, Dane Muskoski, Kerstin Amann, Rolf Janka, Werner Hohenberger, Eckhart G Hahn, Jürgen Siebler, Markus F Neurath, Frank Boxberger
INTRODUCTION: The prognostic outlook for patients suffering from pancreatic cancer is generally poor. Particularly in cases of advanced and metastatic disease, long-term relapse-free survival may be achieved only in a few cases. CASE REPORT: A 45-year-old patient presented with metastatic pancreatic cancer. Liver metastases had been intra-operatively confirmed by histology. Prior to initiating treatment, a portacath was surgically implanted. Subsequently, the patient received a weekly dose of 1,000 mg/m(2) gemcitabine combined with 2,000 mg/m(2) high-dose 5-fluorouracil as a 24-hour infusion for palliative treatment...
May 2011: Case Reports in Oncology
Ganapathy Ananthakrishnan, Richard McDonald, Jon Moss, Ram Kasthuri
Portacaths are tunnelled and totally implanted central venous access port devices (CVAPD). They are commonly used for intravenous antibiotic delivery in patients with cystic fibrosis. More recently, they are being used in oncology to deliver chemotherapy and apheresis. It is therefore important to be aware of portacath associated complications and their imaging features. This pictorial review illustrates and discusses common complications associated with Portacath devices.
January 2012: Journal of Vascular Access
A Ricci, A Majbar
No abstract text is available yet for this article.
April 2011: Journal of Visceral Surgery
C R M Hay, A Hellmann, A Dmoszynska, T Baglin, D O'Shaunessey, M Makris, R Shaikh-Zaidi, C H Dash
The efficacy and safety of Optivate(®) was assessed in 23 surgical operations, orthopaedic (12) including 5 revision arthroplasties, ophthalmic (1), ENT (1), dental (6), liver biopsy (2), and removal of portacath (1) on 15 teenagers and adults with severe haemophilia A. The preoperative dose was calculated to raise the FVIII concentration to 100 IU dL(-1). Subsequent doses were targeted to maintain at least 50 IU dL(-1). There were 11 major and 12 minor operations categorized as receiving intensive replacement therapy for ≥ 5 days or < 5 days respectively...
May 2011: Haemophilia: the Official Journal of the World Federation of Hemophilia
Wasek Faisal, Georgina Burnton, Louise Imlay-Gillespie, John Robilliard
Percutaneous intravenous devices are an essential component of modern health care. Although they are generally associated with a low incidence of vascular access device-related sepsis, the events following a vascular catheter-related sepsis can be clinically significant and difficult to treat. Here we report a case of Portacath-related sepsis with Serratia marcescens resulting in cerebral and pulmonary emboli, which in our knowledge, has not been reported before. Definitive identification and prolonged antimicrobial treatment according to culture sensitivities can lead to resolution of septic and pulmonary emboli...
December 2010: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
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