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A Tannapfel
Immunoglobulin G4-associated (IgG4) autoimmune diseases are systemic multiorgan diseases with variable clinical presentation. Principally, all organs can be affected. All IgG4-associated diseases have the same morphological correlate in common, which includes lymphoplasmacellular inflammation with abundant IgG4-positive plasma cells, obliterative phlebitis and storiform fibrosis, each with a variable manifestation. The exact pathogenesis is not yet completely understood; however, as in most cases glucocorticoids induce a prompt clinical response to therapy, this new multisystemic disease must be taken into consideration not only by pathologists but also by radiologists...
October 17, 2016: Der Radiologe
Silvia Calviño Günther, Carole Schwebel, Rebecca Hamidfar-Roy, Agnès Bonadona, Maxime Lugosi, Claire Ara-Somohano, Clémence Minet, Leïla Potton, Jean-Charles Cartier, Aurelien Vésin, Magalie Chautemps, Lenka Styfalova, Stephane Ruckly, Jean-François Timsit
PURPOSE: To describe all post-insertion complications involving most used intravascular access, and to determine whether the use of a new-generation transparent dressing (3M™ IV Advanced) might reduce their number and impact on ICU patient outcomes. METHODS: Patients older than 18, with an expected length of stay ≥48 h and requiring at least one central venous catheter (CVC), arterial catheter (AC), haemodialysis catheter (HDC), pulmonary arterial catheters (PAC) or peripheral venous catheter (PVC) were randomized into two groups: a new-generation transparent dressing, or the hospital's classical transparent dressing, and were followed daily for any infectious and non-infectious complications...
October 12, 2016: Intensive Care Medicine
Aiqun Zhu, Ting Wang, Shali Wen
Peripheral intravenous catheters (PIVC) are widely used in clinical nursing, but indwelling time remains a subject of debate. This study aimed to assess the risk factors for PIVC phlebitis in adults and provide a basis for indwelling time decisions. A total of 189 first-time PIVC patients in the emergency ward were assessed between May and October 2015. Data were retrieved for patient characteristics and PIVC assessment records. This study showed that over two-thirds (67.72%) of PIVCs were removed because of phlebitis, including oedema (37...
October 10, 2016: International Journal of Nursing Practice
Annelijn M Meeder, Marijke S van der Steen, Annemieke Rozendaal, Arthur R H van Zanten
This case report series describes 3 cases of cisatracurium besylate associated phlebitis after an infusion period of 14-20 hours. No similar cases have been reported in the literature. Association of phlebitis with another neuromuscular blocking agent, atracurium, has been described in the literature. The acidity of atracurium is thought to be the main cause. It is recommended that atracurium is administered only via central venous catheters when indicated to infuse over prolonged periods of time due to the acidity...
October 3, 2016: BMJ Case Reports
Wendy Pritchett, Karen Kinsley
Fosaprepitant dimeglumine (Emend IV®) is an IV antiemetic that may be beneficial to patients receiving highly emetogenic regimens. Aprepitant (Emend®) is an oral medication that is administered for three consecutive days, whereas fosaprepitant is a single-dose IV medication that is administered on the day of chemotherapy for 20-30 minutes (depending on the IV access type). Fosaprepitant may be useful, yet it can also present a risk for hypersensitivity reactions and phlebitis. Oncology nurses must be aware of the signs and symptoms of these potential adverse events to properly care for their patients...
October 1, 2016: Clinical Journal of Oncology Nursing
Hidenori Tanabe, Ryoko Murayama, Koichi Yabunaka, Makoto Oe, Toshiaki Takahashi, Chieko Komiyama, Hiromi Sanada
INTRODUCTION: Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. METHODS: Observational studies were carried out at a medical ward in a university hospital...
September 20, 2016: Journal of Vascular Access
Keiko Ohno, Yurika Kimura, Yoko Matsuda, Masatoki Takahashi, Motomu Honjyou, Tomio Arai, Takeshi Tsutsumi
CONCLUSION: High levels of IgG4-positive plasma cells were observed in tissue samples from ∼30% of patients with chronic rhinosinusitis who satisfied the comprehensive diagnostic criteria for IgG4-related disease. Detection of increased numbers of IgG4-positive plasma cells in the nasal cavity or paranasal sinuses might not be sufficient to make a diagnosis of IgG4-related rhinosinusitis, and a comprehensive evaluation is required. OBJECTIVES: This study aimed to clarify the clinicopathological characteristics of IgG4-positive plasma cells in patients with chronic rhinosinusitis...
September 20, 2016: Acta Oto-laryngologica
Loreto Arias-Fernández, Belén Suérez-Mier, María Del Carmen Martínez-Ortega, Alberto Lana
OBJECTIVE: To determine the incidence and risk factors of phlebitis associated to the care of peripheral vascular catheters (PVC). METHOD: Prospective cohort study at the Central University Hospital of Asturias (Spain). A total of 178PVC were observed daily until their extraction. The incidence of phlebitis was measured using the Visual Infusion Phlebitis Scale, that distinguishes between gradei (possible phlebitis) andii (phlebitis). The independent diagnoses of phlebitis made by staff nurses were also collected...
September 15, 2016: Enfermería Clínica
Cameron C Wick, Joseph Zachariah, Sunil Manjila, William C Brown, Prerna Malla, Bashar Katirji, Mark Cohen, Cliff A Megerian
IgG4-related disease (IgG4-RD) is increasingly being recognized as an entity effecting the head and neck region. Although most commonly seen with salivary gland or paranasal sinus involvement, IgG4-RD may also involve the temporal bone and skull base. We report a rare care of a 61-year-old female with IgG4-RD presenting as synchronous lesions of the middle ear and middle cranial fossa with polyneuropathy of cranial nerves II, VI, and VII. Initial histopathological evaluation of her resected ear mass suggested a benign inflammatory process but no specific diagnosis...
August 18, 2016: American Journal of Otolaryngology
Yoshikuni Yonenaga, Fumiki Kushihata, Jota Watanabe, Taiji Tohyama, Hitoshi Inoue, Atsuro Sugita, Yasutsugu Takada
Autoimmune pancreatitis (AIP) is a unique form of pancreatitis, histopathologically characterized by dense lymphoplasmacytic infiltration and fibrosis of the pancreas with obliterative phlebitis. AIP is associated with a good response to steroid therapy. Differentiation between AIP and pancreatic cancer to determine a preoperative diagnosis is often challenging, despite the use of various diagnostic modalities, including computed tomography (CT), magnetic resonance imaging and endoscopic retrograde cholangiopancreatography...
September 2016: Oncology Letters
Matthew Chinn, M Riccardo Colella
CASE: A 57-year-old woman was found at home by paramedics to be hypoglycemic with altered mental status. She had multiple attempts at IV access and eventually a 22G IV was established and D50 was infused into her right forearm. Extravasation of the dextrose was noted after approximately 12 g of the medication was infused. She was given a dose of glucagon intramuscularly and her mental status improved. Shortly after her arrival to the emergency department, she was noted to have findings of compartment syndrome of her forearm at the site of the dextrose extravasation...
September 6, 2016: Prehospital Emergency Care
Armando De Virgilio, Marco de Vincentiis, Maurizio Inghilleri, Giovanni Fabrini, Michela Conte, Andrea Gallo, Maria Ida Rizzo, Antonio Greco
Hypertrophic pachymeningitis (HP) is a rare disorder that causes thickening of the dura mater. Inflammatory lesions may be located in the cerebral or spinal dura mater or, less frequently, in both locations simultaneously. Numerous clinico-pathological entities cause thickening of the pachymeninges. Indeed, HP is a potential manifestation of many different diseases, but the diagnosis often remains uncertain. Cases in which the pachymeningitis has no known aetiology are termed "idiopathic" HP (IHP). Recently, it has been suggested that IgG4-related disease represents a subset of cases previously diagnosed as idiopathic hypertrophic pachymeningitis...
September 3, 2016: Immunologic Research
Paula Parás-Bravo, María Paz-Zulueta, Raquel Sarabia-Lavin, Francisco Jose Amo-Setién, Manuel Herrero-Montes, Encarnación Olavarría-Beivíde, Mercedes Rodríguez-Rodríguez, Blanca Torres-Manrique, Carlos Rodríguez-de la Vega, Vanesa Caso-Álvarez, Laura González-Parralo, Francisco Manuel Antolín-Juárez
BACKGROUND AND AIM: The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients. MATERIALS AND METHODS: In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care...
2016: PloS One
John H Stone
IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect essentially any organ. The disease shows similar histopathology findings across organ systems, consisting of a lymphoplasmacytic infiltrate enriched in IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. IgG4 itself appears to be a reactive phenomenon rather than the primary disease driver. Recent investigations have focused on the interactions between cells of the B cell lineage and a novel CD4+ SLAMF7+ cytotoxic T cells capable of promoting fibrosis...
July 2016: Clinical and Experimental Rheumatology
Jing Zhang, Juan Shen, Weiwei Yin, Xiaoyu Wei, Ligao Wu, Hao Liu
PURPOSE: To develop a chemotherapeutics induced phlebitis and explore the effects of Xianchen on the phlebitis treatment. METHODS: Forty-eight rabbits were divided into two series. Phlebitis model induced by vincristine was established at each series. The first series had 24 rabbits, which were divided into four groups (6 hours, 12 hours, 18 hours, 24 hours) after vincristine infusion. The grades of phlebitis through visual observation and histopathological examination were observed...
August 2016: Acta Cirúrgica Brasileira
Rachel Heslop, Helen Roberts, Deralie Flower, Vanessa Jordan
BACKGROUND: Genital herpes is incurable, and is caused by the herpes simplex virus (HSV). First-episode genital herpes is the first clinical presentation of herpes that a person experiences. Current treatment is based around viral suppression in order to decrease the length and severity of the episode. OBJECTIVES: To determine the effectiveness and safety of the different existing treatments for first-episode genital herpes on the duration of symptoms and time to recurrence...
2016: Cochrane Database of Systematic Reviews
T N K W Gunasekara, S Di Palma, I N Bagwan
BACKGROUND: IgG4 related disease rarely affects the salivary glands and clinically is often confused with salivary gland malignancy. METHOD: This is a retrospective study comprising 137 cases of chronic sialadenitis diagnosed in a histopathology department over 4 years. The morphology was assessed by reviewing the histology slides and the incidence of IgG4 related sclerosing sialadenitis was calculated. IgG and IgG4 immunohistochemistry was performed and mean IgG4 count/hpf and IgG4/IgG ratio were determined...
August 2016: Malaysian Journal of Pathology
Delphine Diana Acar, Dominique A J Olyslaegers, Annelike Dedeurwaerder, Inge D M Roukaerts, Wendy Baetens, Sebastiaan Van Bockstael, Gaëtan M A De Gryse, Lowiese M B Desmarets, Hans J Nauwynck
One of the most characteristic pathological changes in cats that have succumbed to feline infectious peritonitis (FIP) is a multifocal granulomatous phlebitis. Although it is now well established that leukocyte extravasation elicits the inflammation typically associated with FIP lesions, relatively few studies have aimed at elucidating this key pathogenic event. The upregulation of adhesion molecules on the endothelium is a prerequisite for stable leukocyte-endothelial cell (EC) adhesion that necessarily precedes leukocyte diapedesis...
August 19, 2016: Journal of General Virology
Joanne Wong, Adam Sutherland
AIM: Ketamine is used for post-operative analgesia. There has been recent disruption in it's supply. It is usually prescribed by patient's weight (3 mg/kg in 50 ml 0.9% saline) at a rate of 1-5 ml/hr (1-5 microgram/kg/minute). To conserve ketamine supplies our policy was changed to a concentrated "standardised" concentration of ketamine (250 mg in 50 ml 0.9% sodium chloride) that could be run for a maximum of 72 hrs. There is evidence demonstrating no relationship between duration of infusion and microbiological contamination for 72 hrs...
September 2016: Archives of Disease in Childhood
Michelle M Williams, Hazem Mashaly, Vinay K Puduvalli, Ming Jin, Ehud Mendel
The authors report a case of immunoglobulin G4-related disease (IgG4-RD) presenting as a paraspinal, epidural mass. This disease encompasses a host of autoimmune conditions that were previously thought to be separate entities. It is characterized by fibrosis, mediated by the aberrant proliferation and tissue invasion of IgG4-positive plasma cells, which can occur in any organ. As with other autoimmune conditions, it tends to be responsive to steroids and other immunosuppressants. It can rarely present as a tumefactive lesion of the central nervous system, creating the potential for misdiagnosis (given its similar radiological appearance to malignancy) and mistreatment...
August 12, 2016: Journal of Neurosurgery. Spine
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