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Kyoko Otani, Dai Inoue, Tomoo Itoh, Yoh Zen
AIMS: The diagnosis of IgG4-related disease (IgG4-RD) requires a multidisciplinary approach, in which histology plays an important role. Although a diagnosis was previously established using surgically resected specimens, there is increasing clinical demand to diagnose this systemic condition by biopsies. The present study aimed to elucidate how useful transbronchial lung biopsies (TBLBs) are for this diagnostic purpose. METHODS AND RESULTS: The study cohort consisted of 20 consecutive patients diagnosed with IgG4-RD in other organs who underwent TBLBs for potential pulmonary involvement...
March 11, 2018: Histopathology
Kei Kawada, Tsuyoshi Ohta, Koudai Tanaka, Norifumi Miyamoto
BACKGROUND: Nicardipine is frequently used in the treatment of hypertension for patients with acute stroke; however, its dosing is complicated by a high risk of phlebitis. In the present study, we examined whether restricting nicardipine concentration under a specific value could reduce the incidence of nicardipine-related phlebitis in patients with acute stroke. METHODS: Intravenous nicardipine-related phlebitis was retrospectively analyzed. From July 2015, a simple proposition was made to dilute maximum intravenous nicardipine concentration to lower than 130 µg/mL...
March 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Nanthakumahrie Gunasegaran, Min Ting Alicia See, Siew Teing Leong, Long Xia Yuan, Shin Yuh Ang
Short peripheral catheter (SPC)-related phlebitis can lead to bloodstream infections and affect patients' quality of life. A randomized trial was carried out to evaluate the effectiveness of 2 treatment methods in reducing the incidence of SPC-related phlebitis. The 2 treatment methods differed in terms of the cleansing solution used before insertion and dressing material used after removal. The results demonstrated that the type of cleansing solution and postremoval dressing material did not make a difference in the incidence of phlebitis...
March 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Munashe Livion Nyika, Doreen Mukona, Mathilda Zvinavashe
This descriptive survey identified factors contributing to phlebitis among 46 adult inpatients using a systematic random sample. The visual infusion phlebitis score was used for assessment. All participants had phlebitis, with stage 4 being most frequent. Factors identified were gender (males-91.7%); immunosuppression (human immunodeficiency virus-63.0%; diabetes-100%; immunosuppressive drugs-100%; absolute leucocyte count <1000 μL-100%); number of catheters inserted (>1-90.9%); site of catheterization (dorsum of wrist-100%); catheter dwell time (2-4 days-100%); catheter gauge (18-gauge-75%); catheter securement (unsecured/contaminated dressing-90%); regularity of catheter flushing (catheter never flushed-72...
March 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Lina Meng, Cherwyn M Nguyen, Samit Patel, Michael Mlynash, Anna Finley Caulfield
PURPOSE: One institution's experience with use of peripheral i.v. (PIV) catheters for prolonged infusions of 3% sodium chloride injection at rates up to 100 mL/hr is described. METHODS: A prospective, observational, 13-month quality assurance project was conducted at an academic medical center to evaluate frequencies of patient and catheter phlebitis among adult inpatients who received both an infusion of 3% sodium chloride injection for a period of ≥4 hours through a dedicated PIV catheter and infusions of routine-care solutions (RCSs) through separate PIV catheters during the same hospital stay...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Namita Singh, Ana P Rossi, Marizela Savic, Ronald J Rubocki, Mark G Parker, John P Vella
Background: Rabbit antithymocyte globulin (rATG) is the most widely used kidney transplant induction immunotherapy in the United States. It was recently Food and Drug Administration approved for this indication with typical dose recommendations of 1.5 mg/kg for up to 7 days given via a central line. Methods: We theorized that reduced rATG dosing when compared with conventional dosing (6-10.5 mg/kg) is safe and effective, leading to development of a risk-stratified treatment protocol...
February 2018: Transplantation Direct
David Sugrue, Andrew S Jarrell, Rachel Kruer, Stephanie Davis, Dachelle Johnson, Evelyn Tsui, Sukyee Snyder, Jessica Crow
BACKGROUND & AIMS: Current evidence and guidelines identify patient populations who may benefit from parenteral nutrition. Peripheral parenteral nutrition (PPN) may be indicated for a subset of patients; however, PPN therapy carries a risk of associated adverse effects. The purpose of this project was to assess appropriateness of current PPN prescribing practices at an academic medical center to determine whether additional guidance and oversight may be beneficial. METHODS: Adult patients admitted from August 1, 2015 to November 30, 2015 with at least one order of PPN administered were included...
February 2018: Clinical Nutrition ESPEN
Kazushige Uchida, Kazuichi Okazaki
In 1995, Yoshida and colleagues proposed the concept of "autoimmune pancreatitis" (AIP), which has recently been recognized as a new pancreatic inflammatory disease. Recent studies have suggested the existence of two subtypes of AIP: type 1, which involves immunoglobulin G4 (IgG4) and is the pancreatic manifestation of IgG4-related disease (IgG4-RD); and type 2, which is characterized by granulocytic epithelial lesions. Type 2 AIP is thought to be rare in Japan. Type 1 AIP is characterized by increased serum IgG4 concentrations, lymphoplasmacytic infiltrations, storiform fibrosis, and obliterative phlebitis...
February 19, 2018: Journal of Gastroenterology
Atsuko Masunaga, Fumihiro Ishibashi, Eitetsu Koh, Takashi Oide, Yasuo Sekine, Kenzo Hiroshima
BACKGROUND: IgG4-related disease often forms a mass and the affected lesion is clinically removed because the mass cannot be differentiated from a neoplasm. Affected lesions commonly occur in the pancreas, hepatobiliary tract, kidney, and retroperitoneum. However, the lesion rarely occurs in the thymus. A histological worldwide consensus of IgG4-related disease proposed that pathological diagnosis of IgG4-related disease should meet more than two of three major features: 1) dense lymphoplasmacytic infiltration with greater than 40% IgG4+/IgG+ plasma cells, 2) storiform fibrosis; and 3) obliterative phlebitis...
January 17, 2018: Diagnostic Pathology
Shintaro Takeoka, Masahiro Kamata, Carren Sy Hau, Mihoko Tateishi, Saki Fukaya, Kotaro Hayashi, Atsuko Fukuyasu, Takamitsu Tanaka, Takeko Ishikawa, Takamitsu Ohnishi, Yuko Sasajima, Shinichi Watanabe, Yayoi Tada
Systemic plasmacytosis is a rare skin disorder characterized by marked infiltration of plasma cells in the dermis. IgG4-related disease is pathologically characterized by lymphoplasmacytic infiltration rich in IgG4+ plasma cells, storiform fibrosis, and obliterative phlebitis, accompanied by elevated levels of serum IgG4. Reports of cases of systemic plasmacytosis with abundant infiltration of IgG4+ plasma cells has led to discussion about the relationship between systemic plasmacytosis and IgG4-related disease...
February 13, 2018: Acta Dermato-venereologica
Xiaoting Lv, Feng Gao, Qicai Liu, Sheng Zhang, Zhihua Huang, Yongping Zhu, Haiyang Zong, Quwen Li, Sanyan Li
IgG4-related interstitial lung disease (IgG4-RILD), which is characterized by increased IgG4 levels, IgG4+ plasma cell infiltration and irregular whorled fibrosis, is a recently described lung disorder that belongs to the group of systemic fibroinflammatory IgG4-related diseases (IgG4-RD). The aim of the present study was to improve the current knowledge regarding the specific clinical and histopathological characteristics of IgG4-RILD and to investigate its underlying immune mechanism in vivo . A total of 7 patients newly diagnosed with IgG4-RILD were enrolled in the present study (4 men and 3 women; mean age, 57 years; range, 29-71 years)...
February 2018: Experimental and Therapeutic Medicine
Xin Li, Bo Yang, Xianlun Li, Shiyan Ren
PURPOSE: To compare the efficacy of ligation after foam sclerotherapy (FSL) with foam sclerotherapy (FS) alone for patients with varicose veins prospectively. METHODS: Ninety-four patients with varicose veins underwent foam sclerothrapy alone and eighty-eight patients with varicose veins received ligation after foam sclerotherapy. Patients were followed up at 1, 3, 6 and 12 months after treatment. The postoperative complications were documented prospectively. RESULTS: In comparison with patients underwent FSL, patients treated with FS only had higher incidence of phlebitis within 4 weeks (14...
February 8, 2018: Annals of Vascular Surgery
Lucie Bienfait, Nathalie Nagy, Imad El Moussaoui, Pierre Lingier, Issam El Nakadi, Pieter Demetter, Laurine Verset
No abstract text is available yet for this article.
February 7, 2018: Histopathology
Miriam Flores Moreno, Karina Saray Pueblas Bedoy, Aurelia Ojeda Sánchez, Jessie Zurita-Cruz
BACKGROUND: In pediatrics, complications of the peripherally inserted central venous catheters (PICC) are reported in 30% to 40% of cases, with the most frequent risk factors being the age of the patient and the location of PICC. The aim of this study was to describe the characteristics of PICCs and to identify factors related to their withdrawal due to complications. METHODS: Prospective cohort study. Patients from 2 months to 18 years of age were included and followed-up until PICC was withdrawn...
July 2017: Boletín Médico del Hospital Infantil de México
Po-Chang Wu, Peng-Tai Tien, Ying-Hsuan Li, Rui-Yun Chen, Der-Yang Cho
RATIONALE: Immunoglobulin G4-related disease (IgG4-RD) is characterized by tumor-like lesions, a dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. IgG4-RD has been described in a variety of organ systems; however, it rarely involves the central nervous system. PATIENT CONCERNS: A 17-year-old woman visited our clinic with a complaint of blurred vision for the past 5 months. She also reported a painless right submandibular mass that had been present for 1 year...
November 2017: Medicine (Baltimore)
R Opriţă, B Opriţă, D Berceanu, I B Diaconescu
Rationale (hypothesis): IgG4-related disease (IgG4-RD) is a pathological entity recently recognized by the medical world that can affect any organ or system. However, there is insufficient data about this disease in medical literature. Aim (objective): A more extensive clarification of the IgG4 molecule, the diversified aspects of IgG4-related disease, and the response of this disease to treatment, will provide a crucial understanding of the immune system and other diseases now known to be associated with IgG4...
October 2017: Journal of Medicine and Life
Y Fujimura, M Watanabe, K Natsuga, H Shimizu
Lipo-prostaglandin E1 (Lipo-PGE1) is a PGE1 product in lipid microspheres and acts as a vasodilator. Injection of Lipo-PGE1 is used clinically for chronic skin ulcers caused by collagen diseases, diabetes mellitus and impaired blood circulation. Erythema, vascular pain, and phlebitis of the injected sites are recognized as cutaneous manifestations of the side effects of PGE1. Here we present the first case of acute vascular reaction along veins injected with Lipo-PGE1. This article is protected by copyright...
January 22, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Smita Mary Matthai, Anjali Mohapatra, Raiyani Palak, Gopal Basu
Immunoglobulin G4-related tubulointerstitial nephritis (IgG4-TIN) is a newly recognized clinicopathological entity characterized by a dense interstitial infiltrate of IgG4-positive plasma cells accompanied by fibrosis and obliterative phlebitis causing acute or chronic renal dysfunction amenable to corticosteroid therapy. IgG4-TIN is the dominant manifestation of renal involvement in IgG4-related disease (IgG4-RD) which is a novel, immune-mediated, fibroinflammatory and multiorgan disorder. We describe a case of IgG4-TIN with isolated renal involvement in an elderly male patient with poor response to corticosteroid therapy...
October 2017: Indian Journal of Pathology & Microbiology
Ryusuke Anan, Mitsuhiro Akiyama, Yuko Kaneko, Jun Kikuchi, Kazuko Suzuki, Shiro Matsubara, Tsutomu Takeuchi
INTRODUCTION: Polymyositis (PM) is a type of autoimmune, inflammatory myopathy. IgG4-related disease (IgG4-RD) is a recently recognized disease entity characterized by elevated serum IgG4 levels and IgG4 plasma-cell infiltration of various organs. However, several reports have described cases of other diseases that present with those features, suggesting the importance of careful differential diagnosis. Herein, we report the first case of PM with elevated serum IgG4 levels and IgG4 plasma cells in the muscles, mimicking IgG4-RD...
December 2017: Medicine (Baltimore)
Ya Jin, Zimei Wu, Caibin Li, Weisai Zhou, John P Shaw, Bruce C Baguley, Jianping Liu, Wenli Zhang
PURPOSE: To enhance therapeutic efficacy and prevent phlebitis caused by Asulacrine (ASL) precipitation post intravenous injection, ASL-loaded hybrid micelles with size below 40 nm were developed to improve drug retention and tumor penetration. METHODS: ASL-micelles were prepared using different weight ratios of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-polyethyleneglycol-2000 (DSPE-PEG2000) and D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS) polymers...
January 4, 2018: Pharmaceutical Research
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