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https://www.readbyqxmd.com/read/29138677/oxidative-stress-in-hemodialysis-patients-a-review-of-the-literature
#1
REVIEW
Vassilios Liakopoulos, Stefanos Roumeliotis, Xenia Gorny, Evangelia Dounousi, Peter R Mertens
Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#2
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29137701/the-correlation-between-atls-and-junior-doctors-anatomical-knowledge-of-central-venous-catheter-insertion-in-trauma-service-in-south-africa
#3
V Y Kong, J J Odendaal, R Weale, M Liu, C M Keene, B Sartorius, D L Clarke
OBJECTIVE: To review the ability of junior doctors (JDs) in identifying the correct anatomical site for central venous catheterization (CVC) and whether prior Advanced Trauma Life Support (ATLS) training influences this. DESIGN: We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact site for CVC insertion via the internal jugular (IJV) and the subclavian (SCV) approach...
November 7, 2017: Injury
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#4
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#5
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29133462/improving-picc-use-and-outcomes-in-hospitalised-patients-an-interrupted-time-series-study-using-magic-criteria
#6
Lakshmi Swaminathan, Scott Flanders, Mary Rogers, Yvonne Calleja, Ashley Snyder, Rama Thyagarajan, Priscila Bercea, Vineet Chopra
BACKGROUND: Although important in clinical care, reports of inappropriate peripherally inserted central catheter (PICC) use are growing. OBJECTIVE: To test whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve PICC use and patient outcomes. DESIGN: Quasi-experimental, interrupted time series design at one study site with nine contemporaneous external controls. SETTING: Ten hospitals participating in a state-wide quality collaborative from 1 August 2014 to 31 July 2016...
November 13, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29133157/microbiological-and-clinical-characteristics-of-biofilm-forming-candida-parapsilosis-isolates-associated-with-fungaemia-and-their-impact-on-mortality
#7
Silvia Soldini, Brunella Posteraro, Antonietta Vella, Elena De Carolis, Elisa Borghi, Monica Falleni, Angela Raffaella Losito, Giuseppe Maiuro, Enrico Maria Trecarichi, Maurizio Sanguinetti, Mario Tumbarello
OBJECTIVES: Biofilm formation (BF) by fungal isolates may dramatically complicate infection. We determined the ability of C. parapsilosis isolates from single fungaemia episodes to form biofilms and we analysed biofilm subgroups for antifungal susceptibility and pathogenic potential. We then correlated BF with clinical characteristics and outcomes of the episodes. METHODS: BF was measured using the crystal-violet biomass assay, antifungal susceptibility of preformed biofilms was assessed, and virulence was studied using the Galleria mellonella model...
November 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29132456/-incidence-of-late-onset-sepsis-in-very-low-birth-weight-and-extremely-low-birth-weight-infants-and-risk-factors-for-late-onset-sepsis
#8
Xiao-Peng Zhao, Wei Zhou, Xu-Fang Li, Yan-Yan Song, Ting-Yan Zhang, Hong Liang
OBJECTIVE: To investigate the incidence of late-onset sepsis (LOS) in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU) and the risk factors for LOS. METHODS: A retrospective analysis was performed for the clinical data of all VLBW and ELBW infants who were hospitalized in the NICU between January 2011 and December 2013. According to the presence or absence of LOS, these infants were divided into LOS group and non-LOS group...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29132056/central-venous-pressure-and-ultrasonographic-measurement-correlation-and-their-associations-with-intradialytic-adverse-events-in-hospitalized-patients-a-prospective-observational-study
#9
Hiroshi Sekiguchi, Luke A Seaburg, Jun Suzuki, Walter J Astorne, Anil S Patel, A Scott Keller, Ognjen Gajic, Kianoush B Kashani
PURPOSE: To investigate correlation of central venous pressure (CVP) with ultrasonographic measurement of central veins, along with association between these variables and occurrence of intradialytic adverse events in hospitalized patients. MATERIALS AND METHODS: Patients requiring hemodialysis via dialysis catheter were prospectively enrolled. CVP measurements through catheter, internal jugular vein aspect ratio, subclavian vein collapsibility, inferior vena cava (IVC) maximal diameter, and IVC collapsibility were recorded before and after hemodialysis...
October 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29128948/a-dramatic-case-of-odynophagia
#10
B Sopeña, J Limeres, L García-Caballero, M Diniz-Freitas, J Seoane, P Diz
We report the case of a 77-year-old male with a history of aortic stenosis and interstitial lung disease, who debuted 3 years ago with an outbreak of necrotic and very painful canker sores. The severity of the lesions and their refractory response to treatment led to several hospital admissions and multiple consultations to different specialists (ENT, rheumatology, dermatology, ophthalmology, cardiology, and internal medicine). During this time, the patient received central parenteral nutrition with an episode of catheter-related septicemia, and he came to require psychiatric assistance for autolytic ideation...
November 11, 2017: Dysphagia
https://www.readbyqxmd.com/read/29128346/mortality-risk-factors-among-non-icu-patients-with-nosocomial-vascular-catheter-related-bloodstream-infections-a-prospective-cohort-study
#11
Patrick Saliba, Ana Hornero, Guillermo Cuervo, Immaculada Grau, Emilio Jimenez, Dolors García, Fe Tubau, Jose María Martínez-Sánchez, Jordi Carratalà, Miquel Pujol
BACKGROUND: Vascular catheter-related bloodstream infections (CRBSIs) are highly preventable hospital-acquired infections and a major threat to patient safety. While there is significant information regarding CRBSI outcome among Intensive Care Unit (ICU) patients, data regarding non-ICU patients are scarce. AIM: To determine the risk factors associated with 30-day mortality among non-ICU patients with nosocomial CRBSIs. METHODS: Prospective cohort study of non-ICU patients with nosocomial CRBSIs in a tertiary-care centre, between January 2004 and December 2014...
November 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29126814/a-daily-topical-decontamination-regimen-reduces-catheter-related-bloodstream-infections-in-haematology-patients
#12
C Samuelson, H Kaur, E I Kritsotakis, S D Goode, A Nield, D Partridge
OBJECTIVES: To assess impact of a topical decontamination regimen on rates of catheter-related bloodstream infections (CRBSI) in intensively-treated haematology patients. METHODS: A historically-controlled cohort study was used to evaluate the effect of applying chlorhexidine or Octenisan® body washes and nasal Prontoderm® ointment for 5 days around the time of Hickman line insertion on the incidence of CRBSI and infection-free catheter time. Lines inserted during a 24 month period prior to implementation of the decolonisation regimen were compared with those inserted during a 12 month period after the intervention was applied...
November 7, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29125332/abo-blood-group-related-venous-thrombosis-risk-in-patients-with-peripherally-inserted-central-catheters
#13
Chung Mo Koo, Ravi Vissapragada, Rebecca Sharp, Phi Nguyen, Thomas Ung, Chrismin Solanki, Adrian Esterman
OBJECTIVE: To investigate the association between ABO blood group and venous thrombosis (VT) risk in patients with peripherally inserted central catheters (PICC). METHODS: Single centre retrospective cohort study. A cohort of patients who underwent PICC insertion from September 2010 to August 2014 were followed up for symptomatic VT presentations diagnosed by ultrasound. Blood group status was identified from hospital information systems. RESULTS: 2270 participants had 3020 PICCs inserted...
November 10, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29124006/selective-pulmonary-artery-occlusion-to-treat-hemoptysis-associated-with-pulmonary-venous-obstruction
#14
Melissa S W Yamauchi, Mary Hunt Martin, Harlan R Muntz, Ronald W Day
Hemoptysis may occur in patients with pulmonary venous obstruction and prominent decompressing vessels in the airways adjacent to the affected pulmonary veins. The options for treatment of hemoptysis are limited, particularly when efforts to alleviate pulmonary venous obstruction have failed. Here we describe a patient with hemoptysis associated with stenosis of the central left upper pulmonary vein and occlusion of the central left lower pulmonary vein. The left upper pulmonary vein was dilated with balloon catheters and a vascular plug was placed in the left lower pulmonary artery...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29123361/personalized-learning-in-medical-education-designing-a-user-interface-for-a-dynamic-haptic-robotic-trainer-for-central-venous-catheterization
#15
Mary Yovanoff, David Pepley, Katelin Mirkin, Jason Moore, David Han, Scarlett Miller
While Virtual Reality (VR) has emerged as a viable method for training new medical residents, it has not yet reached all areas of training. One area lacking such development is surgical residency programs where there are large learning curves associated with skill development. In order to address this gap, a Dynamic Haptic Robotic Trainer (DHRT) was developed to help train surgical residents in the placement of ultrasound guided Internal Jugular Central Venous Catheters and to incorporate personalized learning...
September 2017: Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting
https://www.readbyqxmd.com/read/29123006/outcomes-of-simultaneous-peritoneal-dialysis-and-arteriovenous-fistula-placement-in-end-stage-renal-disease-patients
#16
Nosratollah Nezakatgoo, Albert Ndzengue, Manhunath Ramaiah, Elvira O Gosmanova
Peritoneal dialysis (PD) interruption requiring hemodialysis (HD) is not uncommon and its frequently abrupt nature prevents timely creation of permanent HD access and avoidance of central venous catheters (CVC). We retrospectively studied a cohort of 24 end-stage renal disease (ESRD) patients (mean age 50.7 years, 83.3% African-Americans, 58.3% females, time on dialysis interquartile range [IQR] 0 - 65 days) who had simultaneous PD catheter insertion and backup arteriovenous fistula (AVF) creation between January 1, 2012, and December 31, 2013...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29120892/ce-original-research-does-certification-in-vascular-access-matter-an-analysis-of-the-picc1-survey
#17
Vineet Chopra, Latoya Kuhn, Valerie Vaughn, David Ratz, Suzanne Winter, Nancy Moureau, Britt Meyer, Sarah Krein
Study reveals differences in practices and views between certified and noncertified inserters. ABSTRACT: Background: Although certification by an accredited agency is often a practice prerequisite in health care, it is not required of vascular access specialists who insert peripherally inserted central catheters (PICCs). Whether certification is associated with differences in practice among inserters is unknown. PURPOSE: The purpose of this study was to gather information regarding whether certified and noncertified PICC inserters differ with respect to their practices and views about PICC use...
November 8, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29119834/numerical-study-of-intrathecal-drug-delivery-to-a-permeable-spinal-cord-effect-of-catheter-position-and-angle
#18
G Pizzichelli, B Kehlet, Ø Evju, B A Martin, M E Rognes, K A Mardal, E Sinibaldi
Intrathecal delivery is a procedure involving the release of therapeutic agents into the cerebrospinal fluid (CSF) hrough a catheter. It holds promise for treating high-impact central nervous system pathologies, for which systemic administration routes are ineffective. In this study we introduce a numerical model able to simultaneously account for solute transport in the fluid and in the spinal cord. Using a Discontinuous Galerkin method and a three-dimensional patient-specific geometry, we studied the effect of catheter position and angle on local spinal cord drug concentration...
November 9, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29119023/improvement-in-quality-metrics-outcomes-and-patient-and-family-satisfaction-in-a-neurosciences-intensive-care-unit-after-creation-of-a-dedicated-neurocritical-care-team
#19
Yaw Sarpong, Premkumar Nattanmai, Ginger Schelp, Robert Bell, Keerthivaas Premkumar, Erin Stapleton, Ashley McCormick, Christopher R Newey
Introduction: Dedicated neurointensivists have been shown to improve outcome measurements in the neurosciences intensive care unit (NSICU). Quality outcome data in relation to patient and family satisfaction is lacking. This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods: This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29117919/guideliner-extension-catheter-facilitated-side-strut-stenting-technique-for-the-treatment-of-right-coronary-artery-ostial-in-stent-restenosis
#20
REVIEW
George Kassimis, Tushar Raina
Percutaneous coronary intervention (PCI) for the treatment of right coronary artery (RCA) ostial in-stent restenosis (ISR) can be challenging. The technical difficulties are compounded by excessive stent protrusion into the aorta, preventing coaxial engagement of the guiding catheter and wiring through the central stent lumen. Through this review, we aim to highlight the practical challenges encountered during the treatment of ostial RCA ISR through PCI and evaluate the various interventional techniques that have been used...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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