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https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#1
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28320026/-alcohol-withdrawal-and-its-major-complications
#2
Klaus Junghanns, Tilman Wetterling
Delirium tremens is one of the most common complications of alcohol withdrawal. It is potentially lethal and therefore should be detected as early as possible and be monitored and treated intensively. The assessment of risk factors with the Luebeck Alcohol-Withdrawal Risk Scale short form (LARS-11) can help to predict the risk of severe withdrawal adequately. As delirium cannot be differentiated from Wernicke-Encephalopathy with sufficient certainty high parenteral doses of Vitamin B1 and Magnesium orally should be given in case of any severe withdrawal symptoms...
March 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28318647/prospective-evaluation-of-peripherally-inserted-central-catheter-complications-in-both-inpatient-and-outpatient-settings
#3
Christina Liscynesky, Jessica Johnston, Kelci E Haydocy, Kurt B Stevenson
We describe a prospective observational cohort (N = 187) to evaluate peripherally inserted central catheter line complications concurrently from the time of placement until removal. A significantly higher percentage of patients who experienced intraluminal thrombosis were receiving total parenteral nutrition (P ≤ .001) and had a dual lumen catheter (P = .01). Among patients with a confirmed or suspected infection, a significantly higher proportion received total parenteral nutrition (P = .01), had dual-lumen catheters (P = ...
March 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28314653/assessment-of-risk-factors-for-candidemia-in-non-neutropenic-patients-hospitalized-in-internal-medicine-wards-a-multicenter-study
#4
M Falcone, G Tiseo, C Tascini, A Russo, E Sozio, G Raponi, C Rosin, P Pignatelli, P Carfagna, A Farcomeni, R Luzzati, F Violi, F Menichetti, M Venditti
BACKGROUND: An increasing prevalence of candidemia has been reported in Internal Medicine wards (IMWs). The aim of our study was to identify risk factors for candidemia among non-neutropenic patients hospitalized in IMWs. METHODS: A multicenter case-control study was performed in three hospitals in Italy. Patients developing candidemia (cases) were compared to patients without candidemia (controls) matched by age, time of admission and duration of hospitalization...
March 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28306567/use-of-parenteral-nutrition-in-the-pediatric-icu-should-we-panic-because-of-pepanic
#5
Berthold Koletzko, Olivier Goulet, Frank Jochum, Raanan Shamir
No abstract text is available yet for this article.
March 16, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28304321/calcium-chloride-in-neonatal-parenteral-nutrition-a-15-year-experience
#6
R K Huston, J W Kaempf, M Wang, L Wang, Gary L Grunkemeier, Howard S Cohen
OBJECTIVE: The objective of this study was to determine if outcomes at our neonatal intensive care units (NICUs) since we began using calcium chloride (CaCl2) as our preferred calcium additive in order to reduce aluminum (Al) exposure are within expected outcome ranges for NICUs in the U.S. where calcium gluconate in glass vials (CaGlu-Gl) has been the preferred additive. STUDY DESIGN: A retrospective study of very low birth weight infants born between January 1, 2000 and December 31, 2014...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28303548/long-acting-antiretrovirals-where-are-we-now
#7
REVIEW
Amesika N Nyaku, Sean G Kelly, Babafemi O Taiwo
PURPOSE OF REVIEW: Current HIV treatment options require daily use of combination antiretroviral drugs. Many persons living with HIV experience treatment fatigue and suboptimal adherence as a result. Long-acting antiretroviral drugs are being developed to expand options for HIV treatment. Here, we review the agents in development, and evaluate data from recent clinical trials. In addition, we anticipate challenges to successful widespread use of long-acting antiretrovirals. RECENT FINDINGS: Parenteral nanosuspensions of cabotegravir and rilpivirine, and dapivirine vaginal ring are the farthest in clinical development...
March 16, 2017: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/28301915/emerging-role-of-direct-oral-anticoagulants-in-the-management-of-heparin-induced-thrombocytopenia
#8
Phu Ngoc Tran, Minh-Ha Tran
Heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia with thrombosis (HITT) are rare but potentially limb- and life-threatening complications of heparin therapy. Continuation of heparin or low-molecular-weight heparin is contraindicated due to platelet activation in the presence of (heparin-dependent) HIT antibodies. Primary treatment options currently include argatroban, fondaparinux, or bivalirudin. However, the parenteral administration routes and interference of argatroban with traditional coagulation markers complicate management...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28301628/recurrent-herpes-labialis-in-adults-new-tricks-for-an-old-dog
#9
Ted Rosen
<p>Herpes labialis remains a common worldwide affliction. Recent advances in understanding the basic pathogenesis have led to new therapeutic intervention, both on-label and off-label. Aside from reducing the duration and symptomatology of acute outbreaks, another goal of treatment is to decrease the frequency of future episodes. Oral and topical acyclovir and its analogues are the mainstay of both chronic suppressive and episodic therapy. A new muco-adhesive formulation of acyclovir provides a decrease in outbreaks, probably due to a diminution of herpesvirus load in all reservoir sites...
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28299439/vitamin-b12-deficiency-evaluation-and-treatment-in-severe-dry-eye-disease-with-neuropathic-ocular-pain
#10
Serkan Ozen, Murat Atabey Ozer, Mehmet Orçun Akdemir
PURPOSE: This study aims to understand the effect of vitamin B12 deficiency on neuropathic ocular pain (NOP) and symptoms in patients with dry eye disease (DED). METHODS: Patients with severe DED (without receiving topical artificial tears treatment) and ocular pain were enrolled (n = 90). Patients with severe DED and vitamin B12 deficiency (group 1, n = 45) received parenteral vitamin B12 supplement + topical treatment (artificial tears treatment + cyclosporine), and patients with severe DED and normal serum vitamin B12 level (group 2, n = 45) received only topical treatment (artificial tears treatment + cyclosporine)...
March 15, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28298542/lipid-emulsion-added-to-a-liquid-high-carbohydrate-diet-and-voluntary-running-exercise-reduce-lipogenesis-and-ameliorate-early-stage-hepatic-steatosis-in-mice
#11
Kuan-Hsun Huang, Lei Hao, Philip B Smith, Connie J Rogers, Andrew D Patterson, A Catharine Ross
Background: The use of parenteral nutrition formulas is often associated with the development of hepatic steatosis. We have shown previously that the addition of a lipid emulsion (LE) rich in n-6 (ω-6) fatty acids (FAs) ameliorated triglyceride (TG) accumulation in the livers of nonobese mice fed a high-carbohydrate diet (HCD) for 5 wk. However, it remains unclear how rapidly this condition develops and whether it can be prevented by LE with or without a running wheel for voluntary exercise (Exe).Objective: We investigated in an 8-d study whether mice develop steatosis and whether the administration of LE with or without Exe reduces the concentration of total FAs and prevents an increase in the expression of genes in the liver associated with lipogenesis...
March 15, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28298173/effects-of-two-different-lipid-emulsions-on-morbidities-and-oxidant-stress-statuses-in-preterm-infants-an-observational-study
#12
Sezin Unal, Nihal Demirel, Sara Erol, Dilek Ulubas Isik, Ferit Kulali, Fatma Iyigun, Ahmet Yagmur Bas
OBJECTIVE: We examined the morbidities and oxidative stress statuses in preterms receiving either SMOFlipid or ClinOleic. STUDY DESIGN: This observational study was performed in Etlik Zubeyde Hanim Hospital, Turkey. Infants received SMOFlipid (5 months) or ClinOleic (7 months). Two hundred and twenty seven infants (SMOFlipid: 93, ClinOleic: 134) very low birth weighted infants were included. The oxidative stress status was evaluated in infants at low risk of oxidative stress by total antioxidant capacity (TAC) and total oxidant status (TOS) and oxidative stress index (OSI; TAC/TOS/100) at baseline, first week and third week...
March 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28298021/prophylactic-nimodipine-treatment-and-improvement-in-hearing-outcome-after-vestibular-schwannoma-surgery-a-combined-analysis-of-a-randomized-multicenter-phase-iii-trial-and-its-pilot-study
#13
Christian Scheller, Andreas Wienke, Marcos Tatagiba, Alireza Gharabaghi, Kristofer F Ramina, Oliver Ganslandt, Barbara Bischoff, Johannes Zenk, Tobias Engelhorn, Cordula Matthies, Thomas Westermaier, Gregor Antoniadis, Maria Teresa Pedro, Veit Rohde, Kajetan von Eckardstein, Thomas Kretschmer, Malte Kornhuber, Jörg Steighardt, Michael Richter, Fred G Barker, Christian Strauss
OBJECT In clinical routines, neuroprotective strategies in neurosurgical interventions are still missing. A pilot study (n = 30) and an analogously performed Phase III trial (n = 112) pointed to a beneficial effect of prophylactic nimodipine and hydroxyethyl starch (HES) in vestibular schwannoma (VS) surgery. Considering the small sample size, the data from both studies were pooled. METHODS The patients in both investigator-initiated studies were assigned to 2 groups. The treatment group (n = 70) received parenteral nimodipine (1-2 mg/hour) and HES (hematocrit 30%-35%) from the day before surgery until the 7th postoperative day...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297032/ultra-wide-field-fundus-autofluorescence-and-spectral-domain-optical-coherence-tomography-findings-in-syphilitic-outer-retinitis
#14
Mohamed G A Saleh, John Peter Campbell, Paul Yang, Phoebe Lin
BACKGROUND AND OBJECTIVE: To determine the ultra-wide-field fundus autofluorescence (UWFFAF) and optical coherence tomography (OCT) features of syphilitic outer retinopathy (SOR). PATIENTS AND METHODS: Retrospective chart review. RESULTS: Three patients with SOR were investigated. Treatment with parenteral penicillin led to improvement of outer retinopathy, visual acuity, and symptoms. UWFFAF showed speckled hyperautofluorescence, hypoautofluorescence, and normal autofluorescence, similar to what has been described as a trizonal pattern in acute zonal occult outer retinopathy (AZOOR) in the chronic case of SOR, but with hyperautofluorescent areas in the two acute cases...
March 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28295241/indirect-effects-of-immunological-tolerance-to-a-regular-dietary-protein-reduce-cutaneous-scar-formation
#15
Thiago Anselmo Cantaruti, Raquel Alves Costa, Kênia Soares de Souza, Nelson Monteiro Vaz, Cláudia Rocha Carvalho
Oral tolerance refers to the specific inhibition of immune responsiveness to T-cell dependent antigens contacted by the oral route before parenteral immunization. Oral tolerance to one protein does not inhibit immune responses to other unrelated proteins, but parenteral injection of tolerated antigens plus adjuvant into tolerant, but not normal mice inhibits immune responses to antigens injected concomitantly or soon thereafter. The inhibitory effect triggered by parenteral injection of tolerated proteins is known as bystander suppression or indirect effects of oral tolerance...
March 12, 2017: Immunology
https://www.readbyqxmd.com/read/28294970/krill-oil-in-water-emulsion-protects-against-lipopolysaccharide-induced-proinflammatory-activation-of-macrophages-in-vitro
#16
Gabriel A Bonaterra, David Driscoll, Hans Schwarzbach, Ralf Kinscherf
BACKGROUND: Parenteral nutrition is often a mandatory therapeutic strategy for cases of septicemia. Likewise, therapeutic application of anti-oxidants, anti-inflammatory therapy, and endotoxin lowering, by removal or inactivation, might be beneficial to ameliorate the systemic inflammatory response during the acute phases of critical illness. Concerning anti-inflammatory properties in this setting, omega-3 fatty acids of marine origin have been frequently described. This study investigated the anti-inflammatory and LPS-inactivating properties of krill oil (KO)-in-water emulsion in human macrophages in vitro...
March 15, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28293969/teduglutide-for-treatment-of-adult-patients-with-short-bowel-syndrome
#17
Lore Billiauws, Julie Bataille, Vanessa Boehm, Olivier Corcos, Francisca Joly
The European Society for Clinical Nutrition has published recommendations on the "definition and classification of intestinal failure (IF)". Two criteria must be present: a "decreased absorption of macronutrients and/or water and electrolytes due to a loss of gut function" and the "need for parenteral support". Home parenteral support (HPS) is the primary treatment for chronic IF but is associated with complications. Areas covered: The principal cause of chronic IF is short bowel syndrome (SBS). The aim of treatment is to maximize intestinal absorption and reduce or eliminate the need for HPS to achieve the best possible quality of life...
March 15, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28293699/-lues-ocular-syphilis
#18
T Neß
Ocular syphilis is not a new issue but due to increasing rates of new cases is now a contemporary issue. The clinical features are unspecific and can be manifested as all forms of ocular inflammation. Unspecific anterior uveitis is the most frequent ocular involvement; however, typical distinctive patterns are superficial white preretinal precipitates within a panuveitis and acute syphilitic posterior placoid chorioretinitis. The diagnosis should be confirmed by serological tests. Treatment is based on parenteral administration of penicillin...
March 14, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28293282/modeling-and-optimization-of-nanoemulsion-containing-sorafenib-for-cancer-treatment-by-response-surface-methodology
#19
Zahra Izadiyan, Mahiran Basri, Hamid Reza Fard Masoumi, Roghayeh Abedi Karjiban, Norazlinaliza Salim, Kamyar Shameli
The aim of this study is the development of nanoemulsions for intravenous administration of Sorafenib, which is a poorly soluble drug with no parenteral treatment. The formulation was prepared by a high energy emulsification method and optimized by response surface methodology. The effects of overhead stirring time, high shear rate, high shear time, and cycles of high-pressure homogenizer were studied in the preparation of nanoemulsion loaded with Sorafenib. Most of the particles in nanoemulsion are spherical in shape, the smallest particle size being 82...
2017: Chemistry Central Journal
https://www.readbyqxmd.com/read/28292873/variation-in-inpatient-croup-management-and-outcomes
#20
Amy Tyler, Lisa McLeod, Brenda Beaty, Elizabeth Juarez-Colunga, Meghan Birkholz, Daniel Hyman, Allison Kempe, James Todd, Amanda F Dempsey
BACKGROUND AND OBJECTIVES: Croup is a clinical diagnosis, and the available evidence suggests that, except in rare cases, ancillary testing, such as radiologic imaging, is not helpful. Given the paucity of inpatient-specific evidence for croup care, we hypothesized that there would be marked variability in the use of not routinely indicated resources (NRIRs). Our primary study objective was to describe the variation and predictors of variation in the use of NRIRs. METHODS: This was a retrospective cohort study that used the Pediatric Health Information System database of generally healthy inpatients with croup aged 6 months to 15 years who were admitted between January 1, 2012 and September 30, 2014...
March 14, 2017: Pediatrics
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