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G Suleyman, R Kenney, M J Zervos, A Weinmann
WHAT IS KNOWN AND OBJECTIVE: Outpatient parenteral therapy (OPAT) has become a safe and effective modality for patients requiring intravenous or prolonged antimicrobial therapy since the 1970s. It is being increasingly utilized in various settings; however, studies evaluating the safety and efficacy of clinic-based OPAT are limited. Since 2012, patients being considered for OPAT have required an infectious disease (ID) consultation at our institution. Candidates receiving once-daily antimicrobials who were ineligible for home infusion or nursing home placement as determined by their insurance companies and those who preferred the clinic over nursing home or home infusion were referred to the ID clinic...
October 16, 2016: Journal of Clinical Pharmacy and Therapeutics
Gauri Bhutani, Mireille El Ters, Walter K Kremers, Joe L Klunder, Sandra J Taler, Amy W Williams, Andrew H Stockland, Marie C Hogan
Introduction Peripherally inserted central venous catheters (PICCs) may adversely impact future successful arteriovenous fistulae (AVF). As part of a quality improvement project, the performance of tunneled small bore tunneled central venous catheters (TSB-CVCs), as alternatives to PICCs, was evaluated. Methods A retrospective observational study, involving individuals ≥18 years of age who underwent TSB-CVC placement by Interventional Radiology at Mayo Clinic, Rochester, MN between 1/1/2010 and 8/30/2013...
September 20, 2016: Hemodialysis International
Juan Peng, Xiao-Ming Zhang, Lin Yang, Hao Xu, Nan-Dong Miao, Yong-Jun Ren, Kang Liu, Xu-Li Min, Ke Yang, Shi Yang, Cheng Yang
Objective. To report the experience of a percutaneous technique for retrieving fractured peripherally inserted central catheter (PICC) segments migrating into the heart or the pulmonary artery. Method. From April 2013 to July 2015, we performed percutaneous retrieval of fractured PICC segments migrating into the heart or the pulmonary artery in five cancer patients who had undergone chemotherapy via PICC. The fractures were diagnosed with chest plain radiography. The patients included three cases of breast cancer, one case of rectal cancer, and one case of lower limb Ewing's tumor...
2016: BioMed Research International
Jian Zhang, Shichuan Zhang, Lintao Li, Yan Xing, Maoqiu Cao, Jinhua Wu, Bin Jiang, Ting Zhang
Peripherally inserted central catheter (PICC) has been widely used to treat cancer patients. It is unknown whether or not it can be applied safely during radiotherapy. The study aimed to investigate the direct effects of gamma radiation on physical properties of PICC. A total of 60 catheters were included in this study. Thirty PICCs were exposed to a radiation field, and another 30 PICCs received radiation in a 3-cm homogeneity water equivalent phantom and then were irradiated. Each group was divided into three subgroups: 10 PICCs were given conventional fractionation, 2 Gy per fraction, 5 fractions per week; 10 PICCs were continuously given hypofractionation, 10 Gy per fraction, for 6 weeks; and 10 PICCs were given mock radiation as controls...
2016: PloS One
Molly Harrod, Ana Montoya, Lona Mody, Helen McGuirk, Suzanne Winter, Vineet Chopra
OBJECTIVES: To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. DESIGN: Exploratory, qualitative pilot study. SETTING: Two community based SNFs. PARTICIPANTS: Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators...
September 7, 2016: Journal of the American Geriatrics Society
Kevin N Johnson, Tina Thomas, Jason Grove, Marcus D Jarboe
BACKGROUND: Neonates commonly require central access, and in those with very low or extremely low birthweight this can be challenging. Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes. METHODS: A retrospective chart review was conducted of all patients below 1500 g that underwent placement of a peripherally inserted central catheter under ultrasound guidance between January 1, 2012, and December 31, 2014 at a single center...
November 2016: Pediatric Surgery International
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
J J Menéndez, C Verdú, B Calderón, A Gómez-Zamora, C Schüffelmann, J J de la Cruz, P de la Oliva
: Essentials Pediatric studies on peripherally inserted central catheter (PICC)-related thrombosis are scarce. This study analyzes incidence and risk factors for PICC-related venous thrombosis in children. PICC-related thrombosis is a common, and nearly always, asymptomatic complication. Echo-guided insertion and a catheter to vein ratio < 0.33 may notably decrease this complication. SUMMARY: Background Upper-extremity venous thrombosis is associated with the use of peripherally inserted central catheters (PICCs)...
August 25, 2016: Journal of Thrombosis and Haemostasis: JTH
Tonghe Wang, Lei Zhu
Conventional dual-energy CT (DECT) reconstruction requires two full-size projection datasets with two different energy spectra. In this study, we propose an iterative algorithm to enable a new data acquisition scheme which requires one full scan and a second sparse-view scan for potential reduction in imaging dose and engineering cost of DECT. A bilateral filter is calculated as a similarity matrix from the first full-scan CT image to quantify the similarity between any two pixels, which is assumed unchanged on a second CT image since DECT scans are performed on the same object...
September 21, 2016: Physics in Medicine and Biology
Zhicong Yu, Shuai Leng, Zhoubo Li, Cynthia H McCollough
Photon-counting computed tomography (PCCT) is an emerging imaging technique that enables multi-energy imaging with only a single scan acquisition. To enable multi-energy imaging, the detected photons corresponding to the full x-ray spectrum are divided into several subgroups of bin data that correspond to narrower energy windows. Consequently, noise in each energy bin increases compared to the full-spectrum data. This work proposes an iterative reconstruction algorithm for noise suppression in the narrower energy bins used in PCCT imaging...
September 21, 2016: Physics in Medicine and Biology
Mohammad Refaei, Bruna Fernandes, Joseph Brandwein, Marilyn Dawn Goodyear, Arun Pokhrel, Cynthia Wu
Central venous catheters are a leading cause of upper-extremity deep vein thrombosis. Concomitant severe thrombocytopenia makes anticoagulation for catheter-related thrombosis (CRT) in patients with acute leukemia (AL) a challenge. Incidence of CRT has been reported to be increased in those with peripherally inserted central catheters (PICC) vs. those with centrally inserted ones (CICC). Our objective is to compare the incidence rate of CRT in leukemia inpatients who received either a PICC vs. CICC. We retrospectively reviewed adult inpatients admitted to hematology wards with a new diagnosis of AL and who received either a PICC or a CICC...
August 20, 2016: Annals of Hematology
Marcelo Pinto Guimarães, Angelica Baldin Picceli, Carolina Furtado Pereira
Universal Design is a very simple idea that is based on complex decisions and it involves user satisfaction during performance of activities and socially inclusive interaction. Generally, the design guidelines for application in architecture requires that both students and professionals explore their imagination about the situations in which the design of a certain building becomes more pleasant and inviting than simply accessible to the needs of people with permanent and temporary disabilities. In this paper, the aim is to discuss peculiar aspects in the design of a three storey building that make it special...
2016: Studies in Health Technology and Informatics
Marcelo Pinto Guimarães, Angélica Fátima Baldin Picceli, Paulo Roberto Sabino
This paper details a set of self-supporting and illuminated panels that work together but independently in order to emphasize the explanation of building features and activities that are based on Universal Design guidelines. The exhibition is based on two structures that are arranged in semi-circles (A and B). They are integrated to form a carpeted path where the visitor will be gradually exposed to the concepts related to the principles of Universal Design. Following the sequence of three-dimensional objects and swivelling box elements that support the tactile information on the subject, it is expected that visitors become familiar with each of the principles being demonstrated...
2016: Studies in Health Technology and Informatics
James Yip, David A Bruno, Charlotte Burmeister, Marwan Kazimi, Atsushi Yoshida, Marwan S Abouljoud, Gabriel T Schnickel
UNLABELLED: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are surgical complications estimated to occur in 5% to 10% of patients. There are limited data regarding DVT/PE in the early postoperative period in liver transplant patients. The aim of this study is to determine risk factors that influence the incidence of DVT/PE and the effectiveness of prophylaxis. METHODS: We reviewed the records of 999 patients who underwent initial liver transplant between January 2000 and June 2012 at Henry Ford Hospital...
April 2016: Transplantation Direct
R W Atmawidjaja, M Azri, I H Ismail
Pericardial effusion with cardiac tamponade is a rare and life-threatening complication of peripherally inserted central catheter (PICC) in a neonate. We report a 33-week preterm neonate who had sudden clinical deterioration at day seven of total parenteral nutrition regime via PICC. Recognition of pericardial effusion with cardiac tamponade in neonates with a PICC requires a high index of suspicion and steps in prevention include proper catheter tip placement and continuous monitoring of line position and function...
June 2016: Medical Journal of Malaysia
Andrew Jackson, Andrew Buttle
This article presents a number of case studies, spanning a 12-month period, associated with peripherally inserted central catheter (PICC) tip location. The aim is to generate debate around the journey PICC tips may take; it is not the purpose of this article to debate technological solutions to the issue of PICC tip location. The discussion of each case illustrates a wide range of potential aberrant PICC tip locations and offers an insight into how the abberant tip location was resolved in each case.
July 28, 2016: British Journal of Nursing: BJN
Roy Ventura, Chris O'Loughlin, Boris Vavrik
Since the introduction of sutureless securement products for vascular access devices (VADs), there has been a great deal of discussion of their advantages and disadvantages in comparison with sutures. This includes questions related to VAD securement, patients' comfort, infection control, user-friendliness and potential complications of using the device. The literature review of the available evidence indicates the superiority of the novel sutureless devices in the aforementioned aspects. The authors collected data to further contribute in the analysis of the attributes of these products, namely Statlock™ and Grip-Lok™ (current devices)...
July 28, 2016: British Journal of Nursing: BJN
Kwonoh Park, Hyun Jung Jun, So Yeon Oh
PURPOSE: The purpose of this study was to investigate the safety, efficacy, and subjective satisfaction of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. METHODS: All PICCs were inserted by an interventional radiologist with radiological guidance. We monitored the occurrence of PICC-related complication and evaluated the patient-perceived satisfaction for PICC using semi-structured questionnaire. RESULTS: A total of 36 terminally ill cancer patients underwent PICC...
July 26, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Robert P Richter, Mark A Law, Santiago Borasino, Jessica A Surd, Jeffrey A Alten
OBJECTIVE: To describe a novel real-time ultrasound (US)-guided distal superficial femoral vein (DSFV) cannulation technique for insertion of peripherally inserted central catheters (PICC) in critically ill infants with congenital heart disease. DESIGN: Descriptive retrospective cohort study SETTING: Pediatric cardiac intensive care unit in a pediatric tertiary hospital PATIENTS: First 28 critically ill infants that received DSFV PICCs via this new technique. RESULTS: Thirty-seven US-guided DSFV PICCs were attempted on 31 infants from September 2012 to November 2014; 34 PICCs were placed in 28 patients (success rate 92%)...
July 20, 2016: Congenital Heart Disease
Daniel Z Adams, Andrew Little, Charles Vinsant, Sorabh Khandelwal
BACKGROUND: Venous access in the emergency department (ED) is an often under-appreciated procedural skill given the frequency of its use. The patient's clinical status, ongoing need for laboratory investigation, and intravenous therapeutics guide the size, type, and placement of the catheter. The availability of trained personnel and dedicated teams using ultrasound-guided insertion techniques in technically difficult situations may also impact the selection. Appropriate device selection is warranted on initial patient contact to minimize risk and cost...
September 2016: Journal of Emergency Medicine
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