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Sample records for catheter-associated pericardial tamponade

  1. Central Venous Catheter-Associated Pericardial Tamponade in a 6-Day Old: A Case Report

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    Swati O. Arya

    2009-01-01

    Full Text Available Introduction. Pericardial effusion (PCE and tamponade can cause significant morbidity and mortality in neonates. Such cases have been reported in the literature in various contexts. Case Presentation. A 6-day old neonate with meconium aspiration syndrome and persistent pulmonary hypertension of newborn on high frequency oscillator ventilation and inhaled nitric oxide was referred to our hospital with a large pericardial effusion causing hemodynamic compromise. Prompt pericardiocentesis led to significant improvement in the cardio-respiratory status and removal of the central line prevented the fluid from reaccumulating. Cellular and biochemical analysis aided in the diagnosis of catheter related etiology with possibility of infusate diffusion into the pericardial space. Conclusion. We present this paper to emphasize the importance of recognizing this uncommon but serious complication of central venous catheters in intensive care units. We also discuss the proposed hypothesis for the mechanism of production of PCE.

  2. Pericardial Tamponade in an Adult Suffering from Acute Mumps Infection

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    Flieger, Robert Rainer; Mankertz, Annette; Yilmaz, Kadir; Roepke, Torsten Kai

    2016-01-01

    Here, we report a case of a 51-year-old man with acute pericardial tamponade requiring emergency pericardiocentesis after he suffered from sore throat, headache, malaise, and sweats for two weeks. Serological analyses revealed increased mumps IgM and IgG indicating an acute mumps infection whereas other bacterial and viral infections were excluded. In addition, MRI revealed atypical swelling of the left submandibular gland. Whereas mumps has become a rare entity in children due to comprehensive vaccination regimens in western civilizations, our case highlights mumps as an important differential diagnosis also in adults, where the virus can induce life-threatening complications such as pericardial tamponade.

  3. Pericardial effusion and cardiac tamponade in a dog with hypothyroidism

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    J Ojeda

    2015-01-01

    Full Text Available The relationship between hypothyroidism and cardiovascular diseases in dogs is frequently associated with clinical signs like sinusal bradicardia, myocardial alterations and ECG findings such as low voltage QRS and inverted T wave. Echocardiographic studies in hypothyroid dogs have not identified pericardial effusion. Hypothyroidism in human patients is a well-known cause of pericardial effusion, but cardiac tamponade is not a frequent clinical sign. A Golden Retriever was presented with a clinical history of progressive lethargy, exercise intolerance, cold intolerance and increased respiratory effort for 3 weeks. At the clinical examination the dog presented dyspnea, muffled heart sound and hypertension. Echocardiography showed fluid in the pericardial sac and cardiac tamponade and pericardiocentesis was performed. Analyses of the fluid showed a non-neoplastic etiology. The information given by the owners, the alopecia zones detected in tail and abdomen and the clinical response, led to analise the thyroid hormones, and hypothyroidism was confirmed. Following two pericardiocentesis and levothyroxine supplementation, the effusion resolved. Although the etiology of pericardial effusion was not clear, it is possible that the pericardial effusion had been caused by hypothyroidism or the dog had idiophatic pericardial effusion and coincidental hypothyroidism. However, according to the clinical signs and the evolution of the dog, an evaluation of thyroid hormones in dogs with pericardial effusion must be considered even though pericardial effusion is a non-described sign in canine hypothyroidism.

  4. Pericardial Effusion with Cardiac Tamponade as a Form of Presentation of Primary Hypothyroidism

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    Acir Rachid

    2002-06-01

    Full Text Available The authors describe a case of pericardial effusion accompanied by cardiac tamponade caused by primary hypothyroidism. Diagnosis was made by exclusion, because other causes of cardiac tamponade are more frequent. Emergency treatment of cardiac tamponade is pericardiocentesis (with possible pericardial window, and, after stabilization, performance of hormonal reposition therapy with L-thyroxin.

  5. The role of bedside ultrasound in the diagnosis of pericardial effusion and cardiac tamponade

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    Adam Goodman

    2012-01-01

    Full Text Available This review article discusses two clinical cases of patients presenting to the emergency department with pericardial effusions. The role of bedside ultrasound in the detection of pericardial effusions is investigated, with special attention to the specific ultrasound features of cardiac tamponade. Through this review, clinicians caring for patients with pericardial effusions will learn to rapidly diagnose this condition directly at the bedside. Clinicians will also learn to differentiate between simple pericardial effusions in contrast to more complicated effusions causing cardiac tamponade. Indications for emergency pericardiocentesis are covered, so that clinicians can rapidly determine which group of patients will benefit from an emergency procedure to drain the effusion.

  6. Recurrent Hemorrhagic Pericardial Effusion and Tamponade due to Filariasis Successfully Treated with Ivermectin and Albendazole.

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    Sinha, Santosh Kumar; Goel, Amit; Sachan, Mohit; Saraf, Sameer; Verma, Chandra Mohan

    2015-01-01

    Filariasis presenting with pericardial effusion with tamponade is rare. We report a case of a 30-year-old female who was admitted with severe dyspnea and chest pain since 2 days. Echocardiogram showed massive pericardial effusion with tamponade. Pericardial fluid aspiration drained 1.2 L of hemorrhagic fluid. Cytology examination revealed microfilaria of Wuchereria bancrofti. She was treated with diethyl carbamazine and discharged. Six weeks later, she presented again with massive pericardial effusion with cardiac tamponade. Pericardiocentesis was done. Cytology examination revealed microfilaria of W. bancrofti. This time she was treated with ivermectin and albendazole and cured. Hemorrhagic effusion resolved completely. Though relatively uncommon, tropical diseases must always be considered in the etiological diagnosis of recurrent pericardial effusion. PMID:26240733

  7. Recurrent hemorrhagic pericardial effusion and tamponade due to filariasis successfully treated with ivermectin and albendazole

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    Santosh Kumar Sinha

    2015-01-01

    Full Text Available Filariasis presenting with pericardial effusion with tamponade is rare. We report a case of a 30-year-old female who was admitted with severe dyspnea and chest pain since 2 days. Echocardiogram showed massive pericardial effusion with tamponade. Pericardial fluid aspiration drained 1.2 L of hemorrhagic fluid. Cytology examination revealed microfilaria of Wuchereria bancrofti. She was treated with diethyl carbamazine and discharged. Six weeks later, she presented again with massive pericardial effusion with cardiac tamponade. Pericardiocentesis was done. Cytology examination revealed microfilaria of W. bancrofti. This time she was treated with ivermectin and albendazole and cured. Hemorrhagic effusion resolved completely. Though relatively uncommon, tropical diseases must always be considered in the etiological diagnosis of recurrent pericardial effusion.

  8. Localized pericardial tamponade: Does it always need exploration?

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    Monish S Raut

    2014-01-01

    Full Text Available A 48-year-old female patient underwent coronary artery bypass surgery. One-hour after surgery, the patient developed hemodynamic instability. Transthoracic echocardiography (TTE was inconclusive. Transesophageal echocardiography (TEE was performed and it revealed localised collection around right atrium. In spite of the evidence of localized tamponade, wait and watch policy was employed rather than re-exploring the patient emergently. The patient recovered uneventfully. If hemodynamics remain stable and there is no fall in hematocrit and no increase in effusion on TEE/TTE examination, then localized tamponade can be managed conservatively without reexploring the patient.

  9. The bowed catheter sign: a risk for pericardial tamponade

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    Towbin, Richard [Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States)

    2008-03-15

    The use of a central venous catheter (CVC) has become commonplace in the care of children with a wide variety of medical and surgical problems. Complications resulting from the insertion of these catheters are well recognized and can be life-threatening. When a temporary CVC or other catheter is inserted into the central venous system it is secured to the skin with a combination of sutures and sterile dressing. This fixes the catheter in place and does not allow it to retract, thereby putting pressure on the right atrial wall via the catheter tip if it is too long. The probability of wall penetration is increased if a catheter or device is tapered at the point of contact. The purpose of this case report is to present the bowed catheter sign and to review the anatomy of the cavotricuspid isthmus, a possible predisposing factor to cardiac perforation and tamponade. (orig.)

  10. Pericardial tamponade and pancytopenia as the first manifestation of mixed connective tissue disorder and its complete reversal with corticosteroids

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    Ankur Jain

    2014-09-01

    Full Text Available We report a case of a 25-year-old lady who presented to our department with complaints of easy fatigability and shortness of breath since one week. She had a history of Raynaud’s phenomenon. Examination revealed scleroderma like skin changes and pericardial friction rub. Investigations revealed high titer of anti-U1 RNP antibodies along with co-existing pancytopenia. Chest x-ray and echocardiography confirmed pericardial tamponade. Patient was diagnosed as having mixed connective tissue disorder (MCTD and she was started on high dose prednisolone, which led to complete reversal of pancytopenia and pericardial tamponade after 1 month of treatment. There are only 6 reported cases of pericardial tamponade in a patient with MCTD, and none of them had pancytopenia. Present case highlights the need to investigate the patient of pericardial tamponade for MCTD, especially in the presence of pancytopenia and relevant clinical history, as prompt treatment with corticosteroids can avoid invasive procedures like pericardiocentesis.

  11. Pericardial tamponade and pancytopenia as the first manifestation of mixed connective tissue disorder and its complete reversal with corticosteroids

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    Ankur Jain

    2014-01-01

    We report a case of a 25-year-old lady who presented to our department with complaints of easy fatigability and shortness of breath since one week. She had a history of Raynaud’s phenomenon. Examination revealed scleroderma like skin changes and pericardial friction rub. Investigations revealed high titer of anti-U1 RNP antibodies along with co-existing pancytopenia. Chest x-ray and echocardiography confirmed pericardial tamponade. Patient was diagnosed as having mixed connective tissue disor...

  12. Predicting outcome of rethoracotomy for suspected pericardial tamponade following cardio-thoracic surgery in the intensive care unit

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    Beishuizen Albertus

    2011-05-01

    Full Text Available Abstract Objectives Pericardial tamponade after cardiac surgery is difficult to diagnose, thereby rendering timing of rethoracotomy hard. We aimed at identifying factors predicting the outcome of surgery for suspected tamponade after cardio-thoracic surgery, in the intensive care unit (ICU. Methods Twenty-one consecutive patients undergoing rethoracotomy for suspected pericardial tamponade in the ICU, admitted after primary cardio-thoracic surgery, were identified for this retrospective study. We compared patients with or without a decrease in severe haemodynamic compromise after rethoracotomy, according to the cardiovascular component of the sequential organ failure assessment (SOFA score. Results A favourable haemodynamic response to rethoracotomy was observed in 11 (52% of patients and characterized by an increase in cardiac output, and less fluid and norepinephrine requirements. Prior to surgery, the absence of treatment by heparin, a minimum cardiac index 2 and a positive fluid balance (> 4,683 mL were predictive of a beneficial haemodynamic response. During surgery, the evacuation of clots and > 500 mL of pericardial fluid was associated with a beneficial haemodynamic response. Echocardiographic parameters were of limited help in predicting the postoperative course, even though 9 of 13 pericardial clots found at surgery were detected preoperatively. Conclusion Clots and fluids in the pericardial space causing regional tamponade and responding to surgical evacuation after primary cardio-thoracic surgery, are difficult to diagnose preoperatively, by clinical, haemodynamic and even echocardiographic evaluation in the ICU. Only absence of heparin treatment, a large positive fluid balance and low cardiac index predicted a favourable haemodynamic response to rethoracotomy. These data might help in deciding and timing of reinterventions after primary cardio-thoracic surgery.

  13. Sanguineous Pericardial Effusion and Cardiac Tamponade in the Setting of Graves' Disease: Report of a Case and Review of Previously Reported Cases

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    2016-01-01

    Introduction. Pericardial effusion in the setting of hyperthyroidism is rare. We present a patient with Graves' disease who developed a sanguineous pericardial effusion and cardiac tamponade. Case Description. A 76-year-old man presenting with fatigue was diagnosed with Graves' disease and treated with methimazole. Two months later, he was hospitalized for uncontrolled atrial fibrillation. Electrocardiography showed diffuse low voltage and atrial fibrillation with rapid ventricular rate. Chest radiograph revealed an enlarged cardiac silhouette and left-sided pleural effusion. Thyroid stimulating hormone was undetectable, and free thyroxine was elevated. Diltiazem and heparin were started, and methimazole was increased. Transthoracic echocardiography revealed a large pericardial effusion with cardiac tamponade physiology. Pericardiocentesis obtained 1,050 mL of sanguineous fluid. The patient progressed to thyroid storm, treated with propylthiouracil, potassium iodine, hydrocortisone, and cholestyramine. Cultures and cytology of the pericardial fluid were negative. Thyroid hormone markers progressively normalized, and he improved clinically and was discharged. Discussion. We found 10 previously reported cases of pericardial effusions in the setting of hyperthyroidism. Heparin use may have contributed to the sanguineous nature of our patient's pericardial effusion, but other reported cases occurred without anticoagulation. Sanguineous and nonsanguineous pericardial effusions and cardiac tamponade may be due to hyperthyroidism.

  14. Pericardial tamponade masking associated pulmonary thrombo embolism in a case of adeno carcinoma of lung

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    Srinivasan Kandasamy

    2015-08-01

    Full Text Available This case report describes a patient admitted with shortness of breath of 15 days duration and found to have cardiac tamponade, which masked concomitant pulmonary embolism that was diagnosed by echocardiographic signs of dilate RA/RV with PAH only after successful pericardiocentesis. Subsequently patient was found to have widely metastatic adenocarcinoma of lungs. This case emphasizes the diagnostic challenge when cardiac tamponade is associated with pulmonary thromboembolism and requires high index of clinical suspicion in patients with underlying malignancy. [Int J Res Med Sci 2015; 3(8.000: 2126-2128

  15. Clinicopathological study of cardiac tamponade due to pericardial metastasis originating from gastric cancer

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    Michiya Kobayashi; Takehiro Okabayashi; Ken Okamoto; Tsutomu Namikawa; Keijiro Araki

    2005-01-01

    AIM: To review the cases reported in the literature,examined their clinicopathological features, and evaluated the efficacy of different therapeutic modalities for this rare condition.METHODS: A search of the MEDLINE database revealed 16 cases of pericarditis carcinomatosa (PC)originating from GC reported in the literature between1982 and 2005. Additional detailed data were obtained from the authors of these studies for subsequent clinicopathological investigation. We have also described about a case study from our own clinic.RESULTS: The mean age of cases with pericarditis carcinomatosa originating from GC was 54 years.Females were diagnosed at a younger age (46.3 years)compared to males (58 years). The mean survival period after diagnosis was 4.5 mo. No statistical differences in the length of survival time were found between different therapeutic modalities, such as drainage, and local and/or systemic chemotherapy after drainage. However,three cases who underwent systemic chemotherapy survived for more than 10 mo. Cases that developed metachronous cardiac tamponade for more than 2years after the diagnosis of GC generally survived for a longer period of time, although this was not statistically significant. Multivariate analysis revealed that low levels of carcinoembryonic antigen (CEA), and CEA and/or cancer antigen 19-9 (CA 19-9) were associated with longer survival.CONCLUSION: Cases with low levels of CEA, and CEA and/or CA 19-9 should undergo systemic chemotherapy with or without local chemotherapy after drainage.

  16. Massive pericardial effusion in a hypothyroid child.

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    Williams, L H; Jayatunga, R.; Scott, O

    1984-01-01

    A child with Down's syndrome and long standing severe hypothyroidism had a massive pericardial effusion without cardiac tamponade. The effusion completely resolved with medical treatment without pericardiocentesis.

  17. Rescue and nursing of complicated acute pericardial tamponade with cardiac interventional therapy%心脏介入治疗并发急性心包填塞的抢救与护理

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    李晓彤

    2012-01-01

    目的 总结心脏介入治疗并发12例急性心包填塞的护理经验.方法 回顾分析心脏介入治疗并发12例急性心包填塞患者的临床资料,总结护理要点.结果 急性心包填塞发生在冠状动脉介入治疗3例,射频消融术6例,永久起搏术1例,临时起搏术2例,无1例死亡.结论 严密观察病情,积极护理施救,加强心理护理,提高风险意识,各项护理环环相扣,从而保障患者的生命安全.%Objective To summarize the nursing experience of 12 cases of complicated acute pericardial tamponade with cardiac interventional therapy. Methods The clinical data of 12 complicated acute pericardial tamponade patients treated with cardiac interventional therapy were analyzed retrospectively,and nursing strategies were summarized as well. Results There were 3 cases of a-cute pericardial tamponade in coronary interventional therapy,6 cases of radiofrequency ablation,1 case of permanent pacing,and 2 cases of temporary pacing with no case of death. Conclusion The close observation of the disease,active care and rescue,enhancement of psychological nursing and risk awareness are interrelated. They can ensure the safety of patients.

  18. Cardiac tamponade in acute rheumatic carditis.

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    Tan, A T; Mah, P K; Chia, B L

    1983-01-01

    In patients with valvular heart disease, fever, and cardiomegaly echocardiography is an invaluable noninvasive tool. In this report we describe a young female presenting with cardiac tamponade due to acute rheumatic carditis. Echocardiography showed an exudative pericardial effusion which was haemorrhagic on pericardiocentesis. She responded to steroid therapy with resolution of carditis and pericardial effusion.

  19. Spontaneous chylous cardiac tamponade: a case report

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    Tsilikas Christodoulos

    2010-03-01

    Full Text Available Abstract Background Chylous cardiac tamponade is a rare condition with little known cause. Case presentation A case of an otherwise healthy woman who admitted with dyspnea and palpitations is presented. She had a history of a painful flexion-hyperextension of the spine. Diagnostic evaluation proved a chylous pericardial effusion with a disruption of the anterior longitudinal spinal ligament. Video-assisted thoracic surgery with mass supradiaphragmatic ligation of the thoracic duct and pericardial window formation was carried out successfully and resulted in the complete cure of the patient's condition. Conclusion Chylous pericardial effusion and subsequent tamponade is a rare entity. Endoscopic surgery is offering a safe and effective treatment.

  20. Cardiac tamponade: an initial presentation of SLE

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    Cheng, Wilson; Balachandar, Ramya; Mistry, Paresh

    2013-01-01

    A 45-year-old woman presented with dyspnoea, chest pain, orthopnoea and bilateral leg oedema. On admission, she was found to have nephrotic syndrome and global pericardial effusion with impending tamponade for which pericardiocentesis was performed. The diagnosis of systemic lupus erythematosus was made based on the clinical and biochemical findings. She was also started on dialysis and immunosuppressants for lupus nephritis.

  1. Cardiac Tamponade as Initial Presentation of Hodgkin Lymphoma

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    Adrija Hajra

    2015-01-01

    Full Text Available Cardiac involvement in malignant lymphoma is one of the least investigated subjects. Pericardial effusion is rarely symptomatic in patients of Hodgkin lymphoma (HL. Few case reports are available in the literature. There are case reports of diagnosed HL patients presenting with pericardial effusion. HL patients who present with recurrent episodes of pericardial effusion have also been reported. Pericardial effusion has also been reported in cases of non HL. However, pericardial effusion leading to cardiac tamponade as an initial presentation of HL is extremely rare. Very few such cases are there in the literature. Here, we present a case of a 26-year-old male patient who presented with cardiac tamponade and in due course was found to be a case of classical type of HL. This case is interesting because of its presentation.

  2. Hiatal hernia causing extrapericardial tamponade after coronary bypass surgery.

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    Papoulidis, Pavlos; Beatty, Jasmine Winter; Dandekar, Uday

    2014-10-01

    Cardiac tamponade is defined as compression of the heart due to accumulation of fluid in the pericardial sac, leading to raised pericardial pressures with haemodynamic compromise. We describe the case of a 76-year old female patient who underwent a routine off-pump coronary artery bypass graft operation and within 48 h developed classic signs of cardiac tamponade. The perioperative echocardiogram and operative findings at re-exploration revealed no clots or fluid collection. A giant hiatus hernia was found to be responsible for the tamponade through extrinsic compression. After insertion of a nasogastric tube and decompression of the stomach, there was a rapid improvement of the clinical picture. The remaining postoperative course was uneventful and the patient was discharged 5 days later, with referral to the general surgeon for further management. We conclude that, in cases of tamponade post-cardiac surgery, extrapericardial pathologies should be considered.

  3. False positive stress-test in a patient with pericardial effusion.

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    Mateja, Candice; Mishkin, Joseph; George, Malika; Chheda, Hemant; Guglin, Maya

    2009-10-01

    We report a case of false positive stress test in a patient with cardiac tamponade. After the drainage of pericardial effusion, reversible defect on a stress test resolved. Cardiac catheterization revealed normal coronary arteries. PMID:18768227

  4. Myxedema coma with cardiac tamponade and severe cardiomyopathy

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    Majid-Moosa, Abdulla; Schussler, Jeffrey M.; Mora, Adan

    2015-01-01

    Myxedema coma is an infrequent but potentially fatal complication of hypothyroidism. We present a rare case of previously undiagnosed hypothyroidism presenting in cardiogenic shock from pericardial tamponade and depressed myocardial contractility in myxedema coma. Here, we focus on cardiovascular complications associated with the condition.

  5. Guide Wire Induced Cardiac Tamponade: The Soft J Tip Is Not So Benign

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    Sankalp Dwivedi

    2016-01-01

    Full Text Available Central venous catheter (CVC insertion rarely causes cardiac tamponade due to perforation. Although it is a rare complication, it can be lethal if not identified early. We report a case of cardiac tamponade caused by internal jugular (IJ central venous catheter (CVC insertion using a soft J-tipped guide wire which is considered safe and rarely implicated with cardiac tamponade. A bedside transthoracic echocardiogram (TTE revealed a pericardial effusion with tamponade. An emergent bedside pericardiocentesis was done revealing bloody fluid and resulted in clinical stabilization.

  6. Burkitt lymphoma masquerading as cardiac tamponade

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    Javangula Kalyana

    2007-07-01

    Full Text Available Abstract A 61 year old man presented with diffuse large B cell lymphoma of the skin of the back of the shoulder which was excised and treated with chemotherapy (CHOP regime in 1998. He was in complete remission till he presented in 2002 with extranodal marginal zone lymphoma of the parotid gland for which he underwent superficial parotidectomy and radiotherapy. He continued in remission till 2006 when he presented with recurrent pericardial effusion and tamponade. At median sternotomy, pericardial effusion was drained, an anterior pericardiectomy was done and a left posterior pericardial window made, and an enlarged hard paraaortic lymph node excised. Histology, immunocytochemistry and chromosome analysis revealed Burkitt lymphoma. Patient underwent chemotherapy with CODOX-M regime and continues in remission. This report is unusual on account of the highly atypical presentation of Burkitt lymphoma as cardiac tamponade, only a few cases having been reported previously, the occurrence of three lymphomas of different pathological and genomic profiles in one patient over a period of eight years and the relatively slow rate of growth of an otherwise fulminant tumour with high tumour doubling time. A review of literature with special emphasis on chromosomal diagnosis, transformation of other lymphomas into Burkitt lymphoma and mediastinal and cardiac involvement with Burkitt lymphoma is presented.

  7. Porridge-like tuberculous cardiac tamponade: treatment difficulties in the Horn of Africa.

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    Massoure, Pierre-Laurent; Boddaert, Guillaume; Caumes, Jean-Luc; Gaillard, Pierre-Emmanuel; Lions, Christophe; Grassin, Frédéric

    2010-06-01

    A 16-year-old boy was hospitalized for fever, chest pain, and cardiovascular collapse. Transthoracic echocardiography revealed a 30-mm circumferential echogenic "porridge-like" pericardial effusion with signs of cardiac tamponade. Tuberculosis (TB) was suspected because of its prevalence in Djibouti. Emergency pericardiocentesis was attempted, but only 10 ml of pericardial fluid was obtained. Subxiphoid pericardiotomy and drainage were then performed, and pericardial fibrinous pockets were surgically collapsed. Antituberculosis chemotherapy was given, and the pericardial effusion progressively disappeared without corticosteroids. The diagnosis of TB was subsequently confirmed by cultures of the pericardial fluid. A pericardial biopsy was normal. After 3 months of follow-up, there was no sign of constrictive pericarditis. Pericardiocentesis may fail in cases of advanced-stage fibrinous TB pericardial effusion. Thus, pericardiotomy with complete open draining is the only lifesaving procedure.

  8. Pericardial effusion

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    Shah Lilam

    1979-01-01

    Full Text Available Detection of pericardial fluid by non-invasive ultrasonic techni-que is reported in a case of myxedema. Mediastinal swing and pseudo mitral valve prolapse are demonstrated. Equally increased thickness of the interventricular septum and left ventricular poste-rior wall may be due to myxedematous infiltrative changes.

  9. Cardiac tamponade and paroxysmal third-degree atrioventricular block revealing a primary cardiac non-Hodgkin large B-cell lymphoma of the right ventricle: a case report

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    Abdennadher Mohamed; Frikha Imed; Mallek Souad; Abid Dorra; Abid Leila; Frikha Zied; Rekik Noomen; Kammoun Samir

    2011-01-01

    Abstract Introduction Primary cardiac lymphoma is rare. Case Presentation We report the case of a 64-year-old non-immunodeficient Caucasian man, with cardiac tamponade and paroxysmal third-degree atrioventricular block. Echocardiography revealed the presence of a large pericardial effusion with signs of tamponade and a right ventricular mass was suspected. Scanner investigations clarified the sites, extension and anatomic details of myocardial and pericardial infiltration. Surgical resection ...

  10. Adult-Onset Still's Disease and Cardiac Tamponade: A Rare Association

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    Silva, Doroteia; de Jesus Silva, Maria; André, Rui; Varela, Manuel Gato; Diogo, António Nunes

    2015-01-01

    Adult-onset Still's disease is a rare disorder with potentially severe clinical features, including cardiac involvement. This systemic inflammatory disease of unknown origin should be considered in the differential diagnosis of pericarditis, with or without pericardial effusion. Cardiac tamponade is a very rare sequela that requires an invasive approach, such as percutaneous or surgical pericardial drainage, in addition to the usual conservative therapy. The authors describe a case of adult-onset Still's disease rendered more difficult by pericarditis and cardiac tamponade, and they briefly review the literature on this entity. PMID:26175648

  11. Cardiac tamponade mimicking tuberculous pericarditis as the initial presentation of chronic lymphocytic leukemia in a 58-year-old woman: a case report

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    Nathan Sandeep

    2010-08-01

    Full Text Available Abstract Introduction Chronic lymphocytic leukemia is an indolent disease that often presents with complaints of lymphadenopathy or is detected as an incidental laboratory finding. It is rarely considered in the differential diagnosis of patients presenting with tamponade or a large, bloody pericardial effusion. In patients without known cancer, a large, bloody pericardial effusion raises the possibility of tuberculosis, particularly in patients from endemic areas. However, the signs, symptoms and laboratory findings of pericarditis related to chronic lymphocytic leukemia can mimic tuberculosis. Case Presentation We report the case of a 58-year-old African American-Nigerian woman with a history of travel to Nigeria and a positive tuberculin skin test who presented with cardiac tamponade. She had a mild fever, lymphocytosis and a bloody pericardial effusion, but cultures and stains were negative for acid-fast bacteria. Assessment of blood by flow cytometry and pericardial biopsy by immunohistochemistry revealed CD5 (+ and CD20 (+ lymphocytes in both tissues, demonstrating this to be an unusual manifestation of early stage chronic lymphocytic leukemia. Conclusion Although most malignancies that involve the pericardium clinically manifest elsewhere before presenting with tamponade, this case illustrates the potential for early stage chronic lymphocytic leukemia to present as a large pericardial effusion with tamponade. Moreover, the presentation mimicked tuberculosis. This case also demonstrates that it is possible to treat chronic lymphocytic leukemia-related pericardial tamponade by removal of the fluid without chemotherapy.

  12. A case of tuberculous pericardial effusion

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    Wanjari K

    2009-01-01

    Full Text Available Tuberculosis accounts for up to 4% of acute pericarditis and 7% cases of cardiac tamponade. Prompt treatment can be life saving but requires accurate diagnosis. We report a case of 30-year-old male who presented with fever, chills, and dry nonproductive cough since one month. The case was diagnosed by radiological findings, which were suggestive of pulmonary tuberculosis, followed by acid fast staining and culture of the aspirated pericardial fluid. The patient was responding to antitubercular treatment at the last follow up.

  13. Cardiac tamponade in an infant during contrast infusion through central venous catheter for chest computed tomography; Tamponamento cardiaco durante infusao de contraste em acesso venoso central para realizacao de tomografia computadorizada do torax em lactente

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    Daud, Danilo Felix; Campos, Marcos Menezes Freitas de; Fleury Neto, Augusto de Padua [Hospital Geral de Palmas, TO (Brazil)

    2013-11-15

    Complications from central venous catheterization include infectious conditions, pneumothorax, hemothorax and venous thrombosis. Pericardial effusion with cardiac tamponade hardly occurs, and in infants is generally caused by umbilical catheterization. The authors describe the case of cardiac tamponade occurred in an infant during chest computed tomography with contrast infusion through a central venous catheter inserted into the right internal jugular vein. (author)

  14. Pericardial Fluid Analysis

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    ... Home Visit Global Sites Search Help? Pericardial Fluid Analysis Share this page: Was this page helpful? Formal name: Pericardial Fluid Analysis Related tests: Pleural Fluid Analysis , Peritoneal Fluid Analysis , ...

  15. Autopsy imaging for cardiac tamponade in a Thoroughbred foal

    Science.gov (United States)

    YAMADA, Kazutaka; SATO, Fumio; HORIUCHI, Noriyuki; HIGUCHI, Tohru; KOBAYASHI, Yoshiyasu; SASAKI, Naoki; NAMBO, Yasuo

    2016-01-01

    ABSTRACT Autopsy imaging (Ai), postmortem imaging before necropsy, is used in human forensic medicine. Ai was performed using computed tomography (CT) for a 1-month-old Thoroughbred foal cadaver found in a pasture. CT revealed pericardial effusion, collapse of the aorta, bleeding in the lung lobe, gas in the ventricles and liver parenchyma, and distension of the digestive tract. Rupture in the left auricle was confirmed by necropsy; however, it was not depicted on CT. Therefore, Ai and conventional necropsy are considered to complement each other. The cause of death was determined to be traumatic cardiac tamponade. In conclusion, Ai is an additional option for determining cause of death. PMID:27703406

  16. Survival after blunt left ventricular rupture with cardiac tamponade

    Institute of Scientific and Technical Information of China (English)

    Yu-Jang Su; Chang-Chih Chen

    2013-01-01

    A34-year-old man was drunk and drove to hit a traffic island.Cold sweating and unconscious status were found on arrival.Vital signs revealedBP42/25, and heart rate121/min.There was massive pericardial effusion with cardiac tamponade found byCT.Immediate surgical intervention and rupture of left ventricular(LV) free wall was found.He was discharged after2 d intensive care unit(ICU) observation and5-day regular ward care.There is high mortality rate in traumatic heart rupture although timely repair, over all mortality is around20%-36% in recent3 years.

  17. Contrast-fluid level in the inferior vena cava (IVC niveau sign) in patients with acute type A aortic dissection. Computed tomography findings during acute cardiac tamponade

    International Nuclear Information System (INIS)

    The purpose of this study was to report a new computed tomography (CT) finding in acute cardiac tamponade: a contrast-fluid level in the hepatic inferior vena cava (IVC) during an arterial dominant phase CT study (IVC niveau sign) in patients with acute type A aortic dissection. We retrospectively reviewed CT studies with the diagnosis of proximal aortic dissection (Stanford type A) with acute cardiac tamponade. There were 12 patients enrolled in the study (6 women, 6 men; mean age 66 years). A total of 62 patients were selected as a control chronic pericardial effusion group to compare with the acute cardiac tamponade group. Among the 12 patients with acute cardiac tamponade, the IVC niveau sign was seen in 7 (58%). In the control chronic pericardial effusion group (n=62), we identified the IVC niveau sign in only one patient (1.6%). There was a significant difference in the presence of the IVC niveau sign between the acute cardiac tamponade and chronic pericardial effusion groups (P<0.0001). The presence of the IVC niveau sign suggests acute cardiac tamponade in patients with acute type A aortic dissection. (author)

  18. Benign giant mediastinal schwannoma presenting as cardiac tamponade in a woman: a case report

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    Sekiya Mitsuaki

    2011-02-01

    Full Text Available Abstract Introduction Mediastinal schwannomas are typically benign and asymptomatic, and generally present no immediate risks. We encountered a rare case of a giant benign posterior mediastinal schwannoma, complicated by life-threatening cardiac tamponade. Case presentation We report the case of a 72-year-old Japanese woman, who presented with cardiogenic shock. Computed tomography of the chest revealed a posterior mediastinal mass 150 cm in diameter, with pericardial effusion. The cardiac tamponade was treated with prompt pericardial fluid drainage. A biopsy was taken from the mass, and after histological examination, it was diagnosed as a benign schwannoma, a well-encapsulated non-infiltrating tumor, originating from the intrathoracic vagus nerve. It was successfully excised, restoring normal cardiac function. Conclusion Our case suggests that giant mediastinal schwannomas, although generally benign and asymptomatic, should be excised upon discovery to prevent the development of life-threatening cardiopulmonary complications.

  19. Pericardial effusion after cardiac surgery: incidence, site, size, and haemodynamic consequences.

    Science.gov (United States)

    Pepi, M; Muratori, M; Barbier, P; Doria, E; Arena, V; Berti, M; Celeste, F; Guazzi, M; Tamborini, G

    1994-01-01

    OBJECTIVE--To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. DESIGN--Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of patients with moderate or large pericardial effusion after operation. SETTING--Patients undergoing cardiac surgery at a tertiary centre. PATIENTS--803 consecutive patients who had coronary artery bypass grafting (430), valve replacement (330), and other types of surgery (43). 23 were excluded because of early reoperation. MAIN OUTCOME MEASURES--Size and site of pericardial effusion evaluated by cross sectional echocardiography and signs of cardiac tamponade detected by ultrasound (right atrial and ventricular diastolic collapse, left ventricular diastolic collapse, distension of the inferior vena cava), and Doppler echocardiography (inspiratory decrease of aortic and mitral flow velocities). RESULTS--Pericardial effusion was detected in 498 (64%) of 780 patients and was more often associated with coronary artery bypass grafting than with valve replacement or other types of surgery; it was small in 68.4%, moderate in 29.8%, and large in 1.6%. Loculated effusions (57.8%) were more frequent than diffuse ones (42.2%). The size and site of effusion were related to the type of surgery. None of the small pericardial effusions increased in size; the amount of fluid decreased within a month in most patients with moderate effusion and in a few (7 patients) developed into a large effusion and cardiac tamponade. 15 individuals (1.9%) had cardiac tamponade; this event was significantly more common after valve replacement (12 patients) than after coronary artery bypass grafting (2 patients) or other types of surgery (1 patient after pulmonary embolectomy). In patients with cardiac tamponade aortic and mitral flow velocities invariably decreased during inspiration; the echocardiographic signs were less

  20. Pericardial effusion in patients with cancer: outcome with contemporary management strategies.

    Science.gov (United States)

    Laham, R. J.; Cohen, D. J.; Kuntz, R. E.; Baim, D. S.; Lorell, B. H.; Simons, M.

    1996-01-01

    OBJECTIVE--To investigate the clinical presentation and current management strategies of pericardial effusion in patients with malignancy. DESIGN--Retrospective single centre, consecutive observational study. SETTING--University hospital. PATIENTS--93 consecutive patients with a past or present diagnosis of cancer and a pericardial effusion, including 50 with a pericardial effusion > 1 cm. RESULTS--Of the 50 patients with pericardial effusions > 1 cm, most had stage 4 cancer (64%), were symptomatic at the time of presentation (74%), and had right atrial collapse (74%). Twenty patients were treated conservatively (without pericardiocentesis) and were less symptomatic (55% v 87%, P = 0.012), had smaller pericardial effusions (1.5 (0.4) v 1.8 (0.5), P = 0.02), and less frequent clinical (10% v 40%, P = 0.02) and echocardiographic evidence of tamponade (40% v 97%, P < 0.001) than the 30 patients treated invasively with initial pericardiocentesis (n = 29) or pericardial window placement (n = 1). Pericardial tamponade requiring repeat pericardiocentesis occurred in 18 (62%) of 29 patients after a median of 7 days. In contrast, only four (20%) of 20 patients in the conservative group progressed to frank clinical tamponade and required pericardiocentesis (P = 0.005 v invasive group). The overall median survival was 2 months with a survival rate at 48 months of 26%. Survival, duration of hospital stay, and hospital charges were similar with both strategies. By multivariable analysis, the absence of symptoms was the only independent predictor of long-term survival (relative hazards ratio = 3.2, P = 0.05). Survival was similar in the 43 patients with cancer and pericardial effusions of < or = 1 cm. CONCLUSION--Asymptomatic patients with cancer and pericardial effusion can be managed conservatively with close follow up. In patients with symptoms or clinical cardiac tamponade, pericardiocentesis provides relief of symptoms but does not improve survival and has a high recurrence

  1. Modified emergency department thoracotomy for postablation cardiac tamponade.

    Science.gov (United States)

    Wyatt, Thomas E; Haug, Eric W

    2012-04-01

    Cardiac dysrhythmias are a common problem in the United States. Radiofrequency ablation is being used more frequently as a treatment for these diagnoses. Although rare, serious complications such as cardiac tamponade have been reported as a result of ablation procedures. Traditionally, emergency department (ED) thoracotomy has been reserved for cases of traumatic arrest only. We report a case of a successful modified ED thoracotomy in a patient with postablation cardiac tamponade and subsequent obstructive shock who failed intravenous fluid resuscitation, pressor administration, and multiple attempts at pericardiocentesis. In this case, a modified approach was used to incise the pericardium. Although this was associated with large blood loss, we believed that using the traditional method of completely removing the pericardium would have resulted in uncontrolled hemorrhage. Instead, our method led to successful resuscitation of the patient until definitive care was available. A smaller pericardial incision than is traditionally used during ED thoracotomy deserves further consideration and research to determine whether and when it may be most useful as a temporizing treatment of cardiac tamponade when other methods have failed. PMID:22104519

  2. Effect of pericardiocentesis on right and left ventricular function and volumes in pericardial effusion.

    Science.gov (United States)

    Manyari, D E; Kostuk, W J; Purves, P

    1983-07-01

    To assess the effects of pericardial effusion on ventricular performance and volumes, electrocardiographically gated blood pool cardiac scintigraphy was performed immediately before and after 14 pericardiocenteses in 10 patients, 7 men and 3 women, aged 28 to 73 years (mean 50). Cardiac tamponade was present in 5 patients. After removal of 140 to 1,100 ml of pericardial fluid (527 +/- 305 ml [mean +/- standard deviation]), left ventricular (LV) ejection fraction increased from 63 +/- 5 to 64 +/- 4% (p greater than 0.05) and right ventricular (RV) ejection fraction decreased from 47 +/- 4 to 46 +/- 2% (p greater than 0.05). LV end-diastolic and end-systolic volumes increased (p less than 0.01) by 28 and 33%, and RV volumes by 40 and 43%, respectively. There were 8 patients with normal LV function (ejection fraction greater than 60%) and 6 patients with subnormal LV function. Changes in ejection fraction were nonsignificant in the 4 subgroups. LV end-diastolic volume changes were more marked (p less than 0.01) in patients with cardiac tamponade (+ 56%) than in those without tamponade (+ 17%), and in those with normal LV function (+ 36%) than in those with subnormal LV function (+ 21%). RV end-diastolic volume increased more markedly (p less than 0.05) in patients with tamponade (+ 72%) than in those without tamponade (+ 23%), but were similar in patients with normal (+ 38%) and abnormal (+ 43%) LV function. After pericardiocentesis, RV volume increased more markedly than did LV volume. Thus, hemodynamic and clinical improvement after pericardiocentesis may be related only to an increase in stroke volume. RV and LV ejection fraction, a measure of myocardial contractility, was not affected significantly by the presence of pericardial effusion, even in those patients who had cardiac tamponade.

  3. Idiopathic, aseptic, effusive, fibrinous, nonconstrictive pericarditis with tamponade in a standardbred filly.

    Science.gov (United States)

    Robinson, J A; Marr, C M; Reef, V B; Sweeney, R W

    1992-11-15

    A Standardbred filly was admitted for evaluation of pleuritis and pneumonia. Heart rate was 80 to 120 beats/min, and the pulse was barely palpable. Thoracic and abdominal ultrasonography and echocardiography revealed substantial pericardial effusion with cardiac tamponade, fibrinous pericarditis, pleural effusion, and ascites. Initial electrocardiography revealed normal sinus rhythm with decreased amplitude of the QRS complexes consistent with pericardial effusion. Following thoracentesis, echocardiogram-guided pericardiocentesis was performed. Bacterial culture yielded no growth from any of the fluids, and bacteria were not seen on cytologic examination. Initial treatment included broad-spectrum antibiotic treatments, IV fluid therapy, and anti-inflammatory agent administration. On the basis of negative culture results, an immune-mediated cause was considered, and dexamethasone was instituted in a decreasing dosage regimen. Pericardial effusion, ventral edema, and ascites began to resolve within 3 days after beginning dexamethasone treatment. Thirty days following discharge, the filly was reexamined, and at that time, the prognosis for athletic performance was considered good so the horse was returned to race training. The final diagnosis in this case was idiopathic, effusive, nonconstrictive pericarditis with tamponade. Early identification, clinical understanding, and application of knowledge of the pathophysiologic mechanisms of pericarditis in horses, combined with use of diagnostic aids such as ultrasonography and aggressive therapy consisting of effusion drainage, pericardial lavage, antibiotics that penetrate the pericardium, and corticosteroids when indicated are critical for a successful outcome in horses with pericarditis. PMID:1289343

  4. Catheter-associated urinary tract infection: antimicrobial sensitivity profile

    Directory of Open Access Journals (Sweden)

    Silvana Kelie Souza de Almeida Barros

    2013-11-01

    Full Text Available This descriptive quantitative study aimed to analyze the prevalence of microorganisms and the antimicrobial sensitivity profile from urine cultures of patients with catheter-associated urinary tract infection. We reviewed 394 medical records of adults hospitalized in the Intensive Care Units of the University Hospital of Londrina, Paraná, Brazil, from April to December 2011. The prevalence of catheter-associated urinary tract infection was of 34.0% (134 and 2.2% (3 of these patients developed sepsis. The most common microorganisms found in the urine cultures were Candida sp (44.4%, Acinetobacter baumannii (9.7% and Pseudomonas aeruginosa (9.2%. This last one showed resistance of 86.7% to third-generation cephalosporins and the Acinetobacter baumannii showed resistance of 83.3% to carbapenems. Klebsiella pneumonia had 87.5% of resistance to third and fourth generation cephalosporins and 75.0% to carbapenems. We concluded that bacterial resistance is frequent in catheter-associated urinary tract infection and that we should emphasize the control measures.

  5. Cardiac tamponade and paroxysmal third-degree atrioventricular block revealing a primary cardiac non-Hodgkin large B-cell lymphoma of the right ventricle: a case report

    Directory of Open Access Journals (Sweden)

    Abdennadher Mohamed

    2011-09-01

    Full Text Available Abstract Introduction Primary cardiac lymphoma is rare. Case Presentation We report the case of a 64-year-old non-immunodeficient Caucasian man, with cardiac tamponade and paroxysmal third-degree atrioventricular block. Echocardiography revealed the presence of a large pericardial effusion with signs of tamponade and a right ventricular mass was suspected. Scanner investigations clarified the sites, extension and anatomic details of myocardial and pericardial infiltration. Surgical resection was performed due to the rapid impairment of his cardiac function. Analysis of the pericardial fluid and histology confirmed the diagnosis of non-Hodgkin large B-cell lymphoma. He was treated with chemotherapy. Conclusion The prognosis remains poor for this type of tumor due to delays in diagnosis and the importance of the site of disease.

  6. Large pericardial effusion as a complication in adults undergoing SCT.

    Science.gov (United States)

    Norkin, M; Ratanatharathorn, V; Ayash, L; Abidi, M H; Al-Kadhimi, Z; Lum, L G; Uberti, J P

    2011-10-01

    Large pericardial effusion (LPE) leading to cardiac tamponade is a rare complication described in patients undergoing SCT. This complication is considered to be a manifestation of chronic GVHD; however its pathophysiology is poorly understood. Currently, there are no published data systematically describing the incidence, clinical characteristics and outcomes of LPEs in adult stem cell transplant recipients. We retrospectively evaluated 858 adult patients (512 autologous, 148 related and 198 unrelated donor) who underwent hematopoietic stem cell and BM transplants at our institution from 2005 to 2008 for the development of post transplant LPE. Seven patients (0.8%) were found to have LPEs and all these patients had undergone unrelated allografts. The median day of diagnosis post transplant was 229 (range 42-525). None of these patients had active manifestations of GVHD other than serositis at the time of LPE detection. Pericardial window (PW) was successfully placed in all patients who developed cardiac tamponade and most patients with LPE were effectively treated by increasing immunosuppression. We conclude that LPE is a rare late complication after allogeneic transplant in adults and in our study developed only after unrelated transplant. PW can be safely performed in these patients and LPEs can be successfully treated with intensification of systemic immunosupression.

  7. Primary Right Atrial Sarcoma Presenting with Cardiac Tamponade and Massive Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Shahram Momtahen

    2016-07-01

    Full Text Available Primary cardiac sarcomas are very rare and there is no consensus on management. Clinical presentation is usually late. Despite newer diagnostic technology, prognosis remains dismal. We report a case of right atrial sarcoma in a 28-year-old man who presented with acute cardiac tamponade. Emergency subxiphoid pericardial drainage stabilized the patient's critical condition. The lesion was advanced. Therefore, we only performed a suboptimal surgical resection. Despite planning for radiation, the patient's status deteriorated. Only palliative measures continued during the next four months before his death due to disseminated metastasis and progressive cardiopulmonary failure.

  8. Bacterial Pericarditis Accompanied by Sudden Cardiac Tamponade After Transbronchial Needle Aspiration Cytology.

    Science.gov (United States)

    Matsumoto, Takeshi; Otsuka, Kojiro; Imai, Yukihiro; Tomii, Keisuke

    2016-04-01

    A 48-year-old man was referred for an abnormal shadow in his chest x-ray. Transbronchial needle aspiration cytology was performed at the mediastinal necrotic lymph node #7, and he was diagnosed as having small cell carcinoma. Fifteen days after bronchoscopy, sudden cardiac tamponade occurred and pericardial drainage suggested a diagnosis of bacterial pericarditis. He was successfully treated by drainage and administration of antibiotics. Complication of bacterial pericarditis associated with bronchoscopy is rare. However, physicians should watch for the appearance of this condition for up to 3 weeks after bronchoscopy, especially in cases with necrotic lymph nodes. PMID:27058720

  9. Low-pressure cardiac tamponade masquerading as severe sepsis diagnosed with a bedside ultrasound and as the initial presentation of malignancy

    Directory of Open Access Journals (Sweden)

    Ricardo Augusto Slaibi Conti

    2014-07-01

    Full Text Available Objective: We report a patient with low-pressure cardiac tamponade masquerading as sepsis and as the initial presentation of malignancy. A quick diagnosis was done by the intensivist performing a bedside ultrasound. Background: The diagnosis of low-pressure cardiac tamponade is a challenge because the classic physical signs of cardiac tamponade can be absent. It is made even more challenging when the vital sign changes and physical examination findings mimic severe sepsis. One of the benefits of a bedside ultrasound in the assessment of a patient with an initial diagnosis of severe sepsis or septic shock is the rapid diagnosis of cardiac tamponade if it is present. Data Source and Synthesis: A 55-year-old male presented to the emergency department with weakness, cough, and syncope. His examination was notable only for dusky mottling of his cheeks, chest, and neck. Specifically, there was no jugular venous distension or pulsus paradoxus. A chest radiograph showed a right upper lobe infiltrate, whereas his electrocardiogram showed only sinus tachycardia. His white blood cell count and lactic acid were elevated. The sepsis protocol was started and a bedside ultrasound revealed signs of cardiac tamponade. The patient immediately improved after a pericardiocentesis. Analysis of the pericardial biopsy revealed adenocarcinoma, later determined to be from a pulmonary primary source. Conclusions: Because low-pressure cardiac tamponade is life-threatening and difficult to diagnose, evaluation of the pericardium with a bedside ultrasound should be considered in patients with syncope, severe sepsis, or shock.

  10. [Pericardial effusion and pleural serositis in patients with severe preeclampsia and HELLP syndrome].

    Science.gov (United States)

    Quiroz, María Nayeli Salas; Rodríguez, Héctor Xavier Alfaro; Lara, Daniel S Zúñiga

    2009-11-01

    The syndrome pre-eclampsia/eclampsia is a frequent entity in the obstetrical pathology and acquires interest to take to the patients to a critical state. It has repercussion in all the organism by his complications. The definitive treatment of pre-eclampsia/eclampsia is the interruption of the pregnancy. The pericardial effussion as severe complication of pre-eclampsia and Sx de HELLP is a little frequent entity. Few cases reported in Literature exists. In the Hospital Angeles Pedregal, two cases of patients embarrassed without antecedents of previous picture hypertensive, complicated are reported with severe pre-eclampsia and HELLP syndrome class II of Martin which developed pericardial effussion without presence of tamponade. The knowledge of the behavior of this cardiovascular complication as well as the multidisciplinary and integral handling, are without a doubt the best form to modify the evolution and to avoid the appearance of tamponade. The acute pericardial effussion can get to mean a medical urgency that puts in danger the life. Mainly when the intrapericardic pressure so is lifted that the heart is compressed and the diastolic pressures ventricular lefts and right are increased and in the absence of preexisting cardiac pathology, these pressures get to equal itself. This complication little frequents must be had in mind like more of the haemodynamic complications.

  11. Over-diuresis or cardiac tamponade? An unusual case of acute kidney injury and early closure

    Directory of Open Access Journals (Sweden)

    Gurkeerat Singh

    2016-04-01

    Full Text Available An 84-year-old man with hypertension and a history of deep venous thrombosis (on warfarin was admitted with shortness of breath presumed to be due to congestive heart failure. Echocardiogram performed the following day showed a low-normal ejection fraction with signs of elevated right-sided pressures but was otherwise normal. He improved with diuretic therapy but after a few days was found to be hypotensive with a concomitant rise in creatinine with decreased urine output. This was felt to be secondary to over-diuresis but he did not respond to small boluses of intravenous fluids as his kidney function continued to worsen and hypotension persisted. He was transferred to the intermediate care unit where a rapid, bedside ultrasound revealed a new, moderate-sized pericardial effusion with tamponade physiology. Pericardiocentesis, with removal of 750 cc of frank blood, led to dramatic improvement in blood pressure, kidney function, and urine output. Here, we demonstrate the utility of point-of-care ultrasound in a community hospital setting where urgent echocardiogram is not routinely available. We also report acute kidney injury due to pericardial tamponade reversed with therapeutic pericardiocentesis.

  12. Resistance of catheter-associated urinary tract infections to antibacterials

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    Verhaz Antonija

    2005-01-01

    Full Text Available Introduction. Catheter-associated urinary tract infections (CAUTI are the most common nosocomial infections. The worldwide data show the increasing resistance to conventional antibiotics among urinary tract pathogens. Aim. To evaluate the adequacy of initial antimicrobial therapy in relation to the antimicrobial resistance of pathogens responsible for CAUTI in Clinical Center of Banja Luka. Methods. A retrospective study on major causes of CAUTI, antibiotic resistance and treatment principles was conducted at four departments of the Clinical Center of Banja Luka from January 1st, 2000 to April 1st, 2003. Results. The results showed that 265 patients had developed CAUTI. The seven most commonly isolated microorganisms were, in descending order: E. coli (31.0%, Pseudomonas aeruginosa (13.8%, Proteus mirabilis (12.9%, Gr. Klebsiella-Enterobacter (12.3%, Enterococcus spp. (5.2%, Pseudomonas spp. (4.3%, Serratia spp. (4.0%. The most common pathogens were highly resistant to ampicillin (64−100%, gentamycin (63−100%, and trimethoprim-sulfamethoxazole (68−100%, while some bacterias, like Pseudomonas aeruginosa and Serratia spp. showed rates of ciprofloxacin resistance as high as 42.8% and 72.7%, respectively. In 55.5% of the cases, the initial antibiotic therapy was inadequate, and was corrected latter on. There were no standard therapeutic protocols for this type of nosocomial infections. Conclusion. The results of this study emphasized an urgency of the prevention and introduction of clinical protocols for better management of CAUTI. Treatment principles should better correspond to the antibiotic sensitivity of uropathogens.

  13. Tuberculous pericarditis presenting as multiple free floating masses in pericardial effusion.

    Science.gov (United States)

    Yoon, Shin-Ae; Hahn, Youn-Soo; Hong, Jong Myeon; Lee, Ok-Jun; Han, Heon-Seok

    2012-03-01

    Pericarditis is a rare manifestation of tuberculosis (Tb) in children. A 14-yr-old Korean boy presented with cardiac tamponade during treatment of pulmonary tuberculosis. He developed worsening anemia and persistent fever in spite of anti-tuberculosis medications. Echocardiography found free floating multiple discoid masses in the pericardial effusion. The masses and exudates were removed by pericardiostomy. The masses were composed of pink, amorphous meshwork of threads admixed with degenerated red blood cells and leukocytes with numerous acid-fast bacilli, which were confirmed as Mycobacterium species by polymerase chain reaction. The persistent fever and anemia were controlled after pericardiostomy. This is the report of a unique manifestation of Tb pericarditis as free floating masses in the effusion with impending tamponade.

  14. Pericardial effusion in celiac disease

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    Farzaneh Ashrafi

    2014-01-01

    Full Text Available Celiac disease is an autoimmune disorder that affected 1% of all population in United State. Classic manifestations of disease consist of early childhood diarrhea, malabsorption, steatorrhea and growth retardation but disease can affects adult at any age. In adult anemia is a more frequent finding. This patient was a 40-year-old lady with progressive fatigue and lower extremities pitting edema. Iron deficiency anemia and celiac disease were diagnosed on the basis of low serum ferritin, elevated serum level of IgA endomysial and tissue transglutaminase anti-bodies and histologic findings in small bowel biopsies. Pericardial effusion in her evaluation was detected incidentally. Asymptomatic pericardial effusion in this patient was only detectable with imaging. After starting of gluten free diet and iron supplement fatigue, peripheral edema and pericardial effusion on echocardiography decreased. It should be noted that asymptomatic pericardial effusion may be seen in adults with celiac disease.

  15. The efficacy and safety of complete pericardial drainage by means of intrapericardial fibrinolysis for the prevention of complications of pericardial effusion: a systematic review protocol

    Science.gov (United States)

    Kakia, Aloysious; Wiysonge, Charles S; Ochodo, Eleanor A; Awotedu, Abolade A; Ristic, Arsen D; Mayosi, Bongani M

    2016-01-01

    Introduction Intrapericardial fibrinolysis has been proposed as a means of preventing complications of pericardial effusion such as cardiac tamponade, persistent and recurrent pericardial effusion, and pericardial constriction. There is a need to understand the efficacy and safety of this procedure because it shows promise. Methods and analysis We aim to assess the effects of intrapericardial fibrinolysis in the treatment of pericardial effusion. We will search PubMed, the Cochrane Library, African Journals online, Cumulative Index to Nursing and Allied Health Literature, Trip database, Clinical trials.gov and the WHO International Clinical Trials Registry Platform for studies that evaluate the efficacy and/or safety of complete pericardial fluid drainage by intrapericardial fibrinolysis irrespective of study design, geographical location, language, age of participants, aetiology of pericarditis or types of fibrinolytics. Two authors will do the search independently, screen the search outputs for potentially eligible studies and assess whether the studies meet the inclusion criteria. Discrepancies between the two authors will be resolved through discussion and arbitration by a third author. Data from the selected studies shall be extracted using a standardised data collection form which will be piloted before use. The methodological quality of studies will be assessed using the Cochrane Collaboration's tools for assessing risk of bias for experimental studies and non-randomised studies, respectively. The primary meta-analysis will use random effects models due to expected interstudy heterogeneity. Dichotomous data will be analysed using relative risk and continuous with data mean differences, both with 95% CIs. Ethics and dissemination Approval by an ethics committee is not required for this study as it is a protocol for a systematic review of published studies. The results will be disseminated through a conference presentation and peer-reviewed publication. Review

  16. Reducing catheter-associated urinary tract infections in a neuro-spine intensive care unit.

    Science.gov (United States)

    Schelling, Kimberly; Palamone, Janet; Thomas, Kathryn; Naidech, Andrew; Silkaitis, Christina; Henry, Jennifer; Bolon, Maureen; Zembower, Teresa R

    2015-08-01

    A collaborative effort reduced catheter-associated urinary tract infections in the neuro-spine intensive care unit where the majority of infections occurred at our institution. Our stepwise approach included retrospective data review, daily rounding with clinicians, developing and implementing an action plan, conducting practice audits, and sharing of real-time data outcomes. The catheter-associated urinary tract infection rate was reduced from 8.18 to 0.93 per 1,000 catheter-days and standardized infection ratio decreased from 2.16 to 0.37.

  17. [The clinical practice guidelines of the Sociedad Española de Cardiología on pericardial pathology].

    Science.gov (United States)

    Sagristá Sauleda, J; Almenar Bonet, L; Angel Ferrer, J; Bardají Ruiz, A; Bosch Genover, X; Guindo Soldevila, J; Mercé Klein, J; Permanyer Miralda, C; Tello de Meneses Becerra, R

    2000-03-01

    The pericardium is a serous membrane consisting of two layers (parietal and visceral), which may be involved by different infectious, physical, traumatic, or inflammatory agents as well as in metabolic or systemic diseases. The reactions of the pericardium to these insults result in rather nonspecific clinical features, such as the characteristic inflammatory findings in acute pericarditis, the development of pericardial effusion with the possible complication of cardiac tamponade, and a fibrous retractile reaction that may lead to constrictive pericarditis. These phenomena are not mutually exclusive and can be simultaneous or consecutive in the same patient; however, for the sake of clarity they are independently discussed. The aim of the present guidelines is to provide orientation about the management of patients with pericardial disease. Such management should basically rest on the knowledge of the clinical and epidemiological features (such as disease frequency) of the different types of pericardial disease that determine the diagnostic and therapeutic yield of the different invasive pericardial procedures (pericardiocentesis, pericardial biopsy and pericardiectomy), and, therefore, their respective indications. In addition, the indication of the different types of medical therapy are discussed. On the other hand, emphasis is made on the possible limitation of the validity of these guidelines for patients belonging to geographical areas or socioeconomic contexts with different etiologic spectra.

  18. Case report: Methotrexate-induced pericardial effusion

    OpenAIRE

    Dündar, Betül; Karalök, Alper; Üreyen, Işın; Gündoğdu, Burcu; Öçalan, Reyhan; Taner TURAN; Boran, Nurettin; Tulunay, Gökhan; Köse, M. Faruk

    2013-01-01

    We report a case of pericardial effusion induced by methotrexate in a patient with low risk gestational trophoblastic neoplasia, who had been taking the first course of sequential methotrexate-folinic acid treatment. After aspiration of pericardial effusion another methotrexate-folinic acid course was given and the pericardial effusion did not relapse.

  19. Medical image of the week: malignant pericardial effusion and cardiac tamponade

    Directory of Open Access Journals (Sweden)

    Yun S

    2014-06-01

    Full Text Available No abstract available. Article truncated after 150 words. A 53 year old woman with history of metastatic breast cancer presented to the emergency department (ED with worsening shortness of breath for 2 weeks. She was initially diagnosed with grade III breast intraductal carcinoma was estrogen receptor, progesterone receptor, and HER2 negative 5 years earlier. A lumpectomy was performed followed by 4 cycles of chemotherapy with cyclophosphamide and taxol as well as radiation therapy. However, follow-up CT and MRI and subsequent biopsy demonstrated metastatic disease in the left adrenal gland, right ovary, and mediastinal lymph nodes, for which additional chemotherapy was started a month prior to presentation. In the ED, the patient was tachycardic and tachypneic. Vital signs showed BP 112/94 mmHg, HR 118 /min, RR 28 /min, temperature 97.5 °F, and SpO2 97 % with room air. EKG showed sinus tachycardia, low QRS voltage with electric alternans (Figure 1, and chest x-ray demonstrated cardiomegaly with a water bottle ...

  20. Bleeding heart: a case of spontaneous hemopericardium and tamponade in a hyperthyroid patient on warfarin.

    Science.gov (United States)

    Sajawal Ali, Muhammad; Mba, Benjamin I; Ciftci, Farah Diba; Ali, Ahya Sajawal

    2016-01-01

    We describe the case of an 81-year-old female, diagnosed with hyperthyroidism-related atrial fibrillation. Given her CHA2DS2VASc score of 3, she was started on warfarin for stroke prevention. One month later, she was admitted with cardiac tamponade. This tamponade was suspected to be secondary to hemopericardium, based on the elevated international normalized ratio (INR), drop in haemoglobin and the radiodensity (55 HU) of the pericardial effusion on CT. The patient was a Jehovah's witness who therefore initially refused measures for reversing coagulopathy. Given her coagulopathy and absence of imminent haemodynamic compromise, pericardiocentesis was deferred. Unfortunately, 1 day later, the patient deteriorated rapidly. By the time pericardiocentesis was performed and factor VIIa administered, the patient had already started developing multiple organ failure. She developed cardiac arrest and died 3 days after her admission. Only 10 cases of hemopericardium attributable to warfarin have previously been reported. In this report, we review the literature and also describe how hyperthyroidism most likely predisposed our patient to bleeding complications from warfarin. PMID:27413023

  1. Cardiac Tamponade Associated with the Presentation of Anaplastic Large Cell Lymphoma in a 2-Year-Old Child.

    Science.gov (United States)

    Mira-Perceval Juan, Gema; Alcalá Minagorre, Pedro J; Huertas Sánchez, Ana M; Segura Sánchez, Sheila; López Iniesta, Silvia; De León Marrero, Francisco J; Costa Navarro, Estela; Niveiro de Jaime, María

    2015-01-01

    The anaplastic large cell lymphoma is a rare entity in pediatric patients. We present an unusual case of pericardial involvement, quite uncommon as extranodal presentation of this type of disorder, that provoked a life-risk situation requiring an urgent pericardiocentesis. To our knowledge, this is the first report on a child with pericardial involvement without an associated cardiac mass secondary to anaplastic large cell lymphoma in pediatric age. We report the case of a 21-month-old Caucasian male infant with cardiac tamponade associated with the presentation of anaplastic large cell lymphoma. Initially, the child presented with 24-day prolonged fever syndrome, cutaneous lesions associated with hepatomegaly, inguinal adenopathies, and pneumonia. After a 21-day asymptomatic period, polypnea and tachycardia were detected in a clinical check-up. Chest X-ray revealed a remarkable increase of the cardiothoracic index. The anaplastic large cell lymphoma has a high incidence of extranodal involvement but myocardial or pericardial involvements are rare. For this reason, we recommend a close monitoring of patients with a differential diagnosis of anaplastic large cell lymphoma. PMID:26435869

  2. Cardiac Tamponade Associated with the Presentation of Anaplastic Large Cell Lymphoma in a 2-Year-Old Child

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    Gema Mira-Perceval Juan

    2015-01-01

    Full Text Available The anaplastic large cell lymphoma is a rare entity in pediatric patients. We present an unusual case of pericardial involvement, quite uncommon as extranodal presentation of this type of disorder, that provoked a life-risk situation requiring an urgent pericardiocentesis. To our knowledge, this is the first report on a child with pericardial involvement without an associated cardiac mass secondary to anaplastic large cell lymphoma in pediatric age. We report the case of a 21-month-old Caucasian male infant with cardiac tamponade associated with the presentation of anaplastic large cell lymphoma. Initially, the child presented with 24-day prolonged fever syndrome, cutaneous lesions associated with hepatomegaly, inguinal adenopathies, and pneumonia. After a 21-day asymptomatic period, polypnea and tachycardia were detected in a clinical check-up. Chest X-ray revealed a remarkable increase of the cardiothoracic index. The anaplastic large cell lymphoma has a high incidence of extranodal involvement but myocardial or pericardial involvements are rare. For this reason, we recommend a close monitoring of patients with a differential diagnosis of anaplastic large cell lymphoma.

  3. Unusual cause of pyopericardium with tamponade

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    Gowrinath K

    2015-01-01

    Full Text Available Acute pyopericardium due to tuberculosis is uncommon even in high prevalence countries. We report an unusual case of acute pyopericardium with cardiac tamponade complicating tuberculosis pneumonia of lingula in an adult. Prompt catheter drainage of pyopericardium under echocardiographic guidance and six month course of anti-tuberculosis treatment resulted in complete recovery without any sequelae during the follow-up period of ten months.

  4. MR imaging evaluation of pericardial constriction.

    Science.gov (United States)

    Groves, Robert; Chan, Danielle; Zagurovskaya, Marianna; Teague, Shawn D

    2015-02-01

    Abnormal thickening or rigidity of the pericardium may compromise normal cardiac function. This condition is known as pericardial constriction, or constrictive pericarditis. Several imaging modalities are used to evaluate the pericardium, including MR, computed tomography, and echocardiography, which can all play a complementary role aiding diagnosis. This article focuses on MR imaging and its role in the detection and evaluation of pericardial constriction. MR imaging has many advantages compared with other modalities including precise delineation of the pericardial thickness, evaluation of ventricular function, detection of wall motion abnormalities, and provision of information about common (and potentially harmful) sequelae of pericardial constriction. PMID:25476676

  5. 第2例:慢性持续性大量心包积液%Chronic continuous massive pericardial effusion

    Institute of Scientific and Technical Information of China (English)

    黄樱硕; 孙颖; 邢云利; 肖瑶; 王宇朋; 唐梅; 李敏; 王翠英

    2012-01-01

    A 77-year-old man was admitted to our hospital at July 5th,2010 with an unexplained massive pericardial effusion for 10 years.With dyspnea for one month and normal vital signs without pulsus paradoxus,other physical examination included a small amount of moist rale,normal heart sounds,jugular vein engorgement,positive hepatojugular reflux,hepatosplenomegaly and pitting edema of the extremities.The patient had a complex past history with lymph node tuberculosis,primary artertial hypertension,polycythernia vera,chronic renal insufficiency and hypothyroidism (Hashimoto's thyroiditis),and moreover,received a high dose radiation of 31p in 1967. Family history is negative.The patient had no cardiac tamponade or pericardial constriction during 10 years,he received pericardiocentesis twice,and pericardial effusion was exudative with a high proportion of monocyte.There was no evidences of tuberculosis infection,hypothyroidism,malignant tumor,severe heart failure,uremia,trauma,severe bacterial or fungus infection,chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis,indwelling catheter drainage or surgical therapy.In this rare case,the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

  6. Neoplastic pericardial disease. Analysis of 26 patients

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    Helena Nogueira Soufen

    1999-01-01

    Full Text Available PURPOSE: To characterize patients with neoplastic pericardial disease diagnosed by clinical presentation, complementary test findings, and the histological type of tumor. METHODS: Twenty-six patients with neoplastic pericardial disease were retrospectively analyzed. RESULTS: Clinical manifestations and abnormalities in chest roentgenograms and electrocardiograms were frequent, but were not specific. Most patients underwent surgery. There was a high positivity of the pericardial biopsy when associated with the cytological analysis of the pericardial liquid used to determine the histological type of the tumor, particularly when the procedure was performed with the aid of pericardioscopy. CONCLUSION: The correct diagnosis of neoplastic pericardial disease involves suspicious but nonspecific findings during clinical examination and in screen tests. The suspicious findings must be confirmed through more invasive diagnostic approaches, in particular pericardioscopy with biopsy and cytological study.

  7. Etiological diagnosis of pericardial effusion.

    Science.gov (United States)

    Levy, Pierre-Yves; Habib, Gilbert; Collart, Fréderic; Lepidi, Hubert; Raoult, Didier

    2006-08-01

    Detection and treatment of pericarditis remains a challenging problem and the etiology is unknown in 40-85% of cases. As a result, a large proportion of cases are labeled idiopathic pericarditis. The advent of echocardiography, an accurate noninvasive method for the detection of effusion, has clarified the definition from pericarditis to pericardial effusion, which is a standardized and clear entity. A systematic approach to diagnostic testing based on standardized practice guidelines has been proposed. This strategy has led to a decrease in the number of cases classified as idiopathic and to the identification of treatable conditions. Percutaneous pericardiocentesis, guided by fluoroscopy or echocardiography, can now be carried out safely and rapidly and has also allowed the intrapericardial instillation of drugs, representing a new treatment strategy. The inclusion of flexible pericardioscopy, immunohistochemistry and contemporary molecular biology tools has improved the diagnostic value of the biopsy.

  8. Catheter-associated urinary tract infections in Clinical Center of Banja Luka

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    Verhaz Antonija

    2003-01-01

    Full Text Available Introduction Catheter-associated urinary tract infections are the most common nosocomial infections of the urinary tract, and among the most common nosocomial infections in general. The major problems of these infections include antibiotic resistance and enormous direct and indirect cost of treatment. Material and methods A retrospective study on major causes of infections and antibiotic resistance was conducted at four clinics of the Clinical Center of Banja Luka. An anonymous questionnaire was distributed to nursing staff dealing with urinary catheters in order to get an overview of their clinical performance. Results The results showed that in 89% of cases (out of 198 patients with developed catheter-associated urinary tract infection infections were caused by gram-negative bacteria, in 7% by gram-positive bacteria and in 4% by Candida. The most common bacteria were: Escherichia coli (33.6%, Pseudomonas aeruginosa (14.1%, Proteus mirabilis (13.3%, and Enterobacter (10.5%. Majority of bacteria presented with extremely high resistance (72-100% to ampicillin, gentamycin and cotrimoxazole, and in some cases a significant resistance to ciprofloxacine, nalidixic acid, ceftriaxone and ceftazidime. The questionnaire showed that nursing staff did not follow guidelines for medical care of patients with urinary catheters. Conclusion It can be concluded that poor hygienic and epidemiological conditions, as well as irrational use of antibiotics contribute to uncontrolled development of urinary tract infections in catheterized patients.

  9. The efficacy of VATS, subxiphoid and minithoracotomy pericardial window for surgical management of symptomatic pericardial effusions

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    Sezai Çelik

    2014-03-01

    Full Text Available Objective: Pericardial effusion potentially cause significant morbidity and mortality. Pericardial window by video-assisted thoracic surgery (VATS, subxiphoid and minithoracotomy is available surgical treatment options. The aim of this study is to determine the efficacy and outcome of the three different methods for surgical management of symptomatic pericardial effusions. Methods: A retrospective study of patients operated for pericardial effusion between October 2007 to December 2011 at Dr. Siyami Ersek Hospital were divided into three groups according to surgical treatment d: Group 1 (VATS, n=24, Group 2 (Subxiphoid, n=28 Group 3 (Minithoracotomy, n=36. The groups were analyzed and compared using demographic information, operative and postoperative details and course, recurrence, follow-up data, morbidity, mortality and survival. Results: A total of 88 patients (37 women, 51 men, with mean age 54.47±16.81 underwent pericardial window were included in the study. The groups had similar perioperative characteristics except sex distribution and etiology. VATS, Subxiphoid and minithoracotomy pericardial window were well tolerated by patients, resulted in similar rates of mortality, 30-day mortality, overall postoperative complications, recurrence rates and survival. Operative time was significantly shorter in group 3 (p0.05. Group 2 had a significantly higher lenght of hospital stay (p<0.05. Conclusion: Minithoracotomy pericardial window provides rapid and definitive diagnosis and treatment for pericardial effusions of all causes acceptable morbidity rates. On the other hand, VATS and subxiphoid pericardial window should be performed in selected cases.

  10. Cardiovascular magnetic resonance in pericardial diseases

    OpenAIRE

    Francone Marco; Bogaert Jan

    2009-01-01

    Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the ep...

  11. Periprocedural anticoagulation of patients undergoing pericardiocentesis for cardiac tamponade complicating catheter ablation of atrial fibrillation.

    Science.gov (United States)

    Lin, Tao; Bai, Rong; Chen, Ying-wei; Yu, Rong-hui; Tang, Ri-bo; Sang, Cai-hua; Li, Song-nan; Ma, Chang-sheng; Dong, Jian-zeng

    2015-01-01

    Anticoagulation of patients with cardiac tamponade (CT) complicating catheter ablation of atrial fibrillation (AF) is an ongoing problem. The aim of this study was to survey the clinical practice of periprocedural anticoagulation in such patients. This study analyzed the periprocedural anticoagulation of 17 patients with CT complicating AF ablation. Emergent pericardiocentesis was performed once CT was confirmed. The mean drained volume was 410.0 ± 194.1 mL. Protamine sulfate was administered to neutralize heparin (1 mg neutralizes 100 units heparin) in 11 patients with persistent pericardial bleeding and vitamin K1 (10 mg) was given to reverse warfarin in 3 patients with supratherapeutic INR (INR > 2.1). Drainage catheters were removed 12 hours after echocardiography confirmed absence of intrapericardial bleeding and anticoagulation therapy was restored 12 hours after removing the catheter. Fifteen patients took oral warfarin and 10 of them were given subcutaneous injection of LMWH (1 mg/kg, twice daily) as a bridge to resumption of systemic anticoagulation with warfarin. Two patients with a small amount of persistent pericardial effusion were given LMWH on days 5 and 13, and warfarin on days 6 and 24. The dosage of warfarin was adjusted to keep the INR within 2-3 in all patients. After 12 months of follow-up, all patients had no neurological events and no occurrence of delayed CT. The results showed that it was effective and safe to resume anticoagulation therapy 12 hours after removal of the drainage catheter. This may help to prevent thromboembolic events following catheter ablation of AF. PMID:25503659

  12. Periprocedural anticoagulation of patients undergoing pericardiocentesis for cardiac tamponade complicating catheter ablation of atrial fibrillation.

    Science.gov (United States)

    Lin, Tao; Bai, Rong; Chen, Ying-wei; Yu, Rong-hui; Tang, Ri-bo; Sang, Cai-hua; Li, Song-nan; Ma, Chang-sheng; Dong, Jian-zeng

    2015-01-01

    Anticoagulation of patients with cardiac tamponade (CT) complicating catheter ablation of atrial fibrillation (AF) is an ongoing problem. The aim of this study was to survey the clinical practice of periprocedural anticoagulation in such patients. This study analyzed the periprocedural anticoagulation of 17 patients with CT complicating AF ablation. Emergent pericardiocentesis was performed once CT was confirmed. The mean drained volume was 410.0 ± 194.1 mL. Protamine sulfate was administered to neutralize heparin (1 mg neutralizes 100 units heparin) in 11 patients with persistent pericardial bleeding and vitamin K1 (10 mg) was given to reverse warfarin in 3 patients with supratherapeutic INR (INR > 2.1). Drainage catheters were removed 12 hours after echocardiography confirmed absence of intrapericardial bleeding and anticoagulation therapy was restored 12 hours after removing the catheter. Fifteen patients took oral warfarin and 10 of them were given subcutaneous injection of LMWH (1 mg/kg, twice daily) as a bridge to resumption of systemic anticoagulation with warfarin. Two patients with a small amount of persistent pericardial effusion were given LMWH on days 5 and 13, and warfarin on days 6 and 24. The dosage of warfarin was adjusted to keep the INR within 2-3 in all patients. After 12 months of follow-up, all patients had no neurological events and no occurrence of delayed CT. The results showed that it was effective and safe to resume anticoagulation therapy 12 hours after removal of the drainage catheter. This may help to prevent thromboembolic events following catheter ablation of AF.

  13. Cardiac tamponade caused by tuberculosis pericarditis in renal transplant recipients

    OpenAIRE

    Kim, Jong Man; Kim, Sung-Joo; Joh, Jae-Won; Kwon, Choon Hyuck David; Song, Yong Bin; Shin, Milljae; Moon, Ju Ik; Jung, Gum O; Choi, Gyu-Seong; Kim, Bok Nyeo; Lee, Suk-Koo

    2011-01-01

    A 50-year-old male, renal transplant recipient, was admitted with fever and chest discomfort. At admission, chest radiologic finding was negative and echocardiography showed minimal pericardial effusion. After 2 days of admission, chest pain worsened and blood pressure fell to 60/40 mmHg. Emergency echocardiography showed a large amount of pericardial effusion compressing the entire heart. Pericardiocentesis was performed immediately. Mycobacterium tuberculosis was isolated from pericardial f...

  14. Pseudozyma spp catheter-associated blood stream infection, an emerging pathogen and brief literature review.

    Science.gov (United States)

    Siddiqui, Wajid; Ahmed, Yasir; Albrecht, Helmut; Weissman, Sharon

    2014-01-01

    Pseudozyma spp are amorphic yeasts. They are commonly plant pathogens, but rarely cause invasive fungal disease in humans. Only three cases of central venous catheter (CVC)-associated blood stream infections due to this organism have been reported in the literature. Main underlying risk factors for Pseudozyma spp infection are bowel surgery, CVC and total parenteral nutrition. We present a rare case of Pseudozyma spp catheter-associated blood stream infection that was successfully treated with antifungal therapy and removal of CVC. It is important to recognise and differentiate this species from other yeasts as it may require the use of amphotericin B or voriconazole instead of fluconazole, to which the organism is variably resistant. PMID:25498807

  15. Treating Central Catheter-Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin.

    Science.gov (United States)

    Holt, Shannon; Thompson-Brazill, Kelly A; Sparks, E Ryan; Lipetzky, Juliana

    2016-08-01

    Methicillin-resistant Staphylococcus aureus is a frequent cause of hospital-associated infections, including central catheter-associated bacteremia. Vancomycin has been the drug of choice for treating this type of bacteremia for decades in patients who have no contraindications to the antibiotic. However, resistance to vancomycin is an emerging problem. Newer antibiotics approved by the Food and Drug Administration have activity against methicillin-resistant S aureus Some of the antibiotics also have activity against strains of S aureus that are intermediately susceptible or resistant to vancomycin. This article uses a case study to highlight the clinical signs of vancomycin failure and describes the indications for and appropriate use of alternative antimicrobials such as ceftaroline, daptomycin, linezolid, tigecycline, and telavancin. (Critical Care Nurse 2016;36[4]:46-57). PMID:27481801

  16. Amebic pericardial effusion: a rare complication of amebic liver abscess.

    Science.gov (United States)

    Agrawal, B V; Somani, P N; Khanna, M N; Srivastava, P K; Jha, B N; Verma, S P

    1975-06-01

    Two rare cases of amebic pericardial effusion as a complication of amoebic liver abscess in the left lobe are described. The pericardial amebiasis should be suspected in a patient presenting with signs and symptoms of pericardial effusion with an evidence of hepatic abscess (in the left lobe) or in a patient with pericardial effusion of uncertain etiology. Aspiration of "anchovy sauce" pus from both the pericardial cavity and the liver should be regarded as confirming the diagnosis of amebic pericarditis secondary to amebic liver abcess because demonstration of Entamoeba hystolytica is seldom possible. Removal of pericardial pus and metronidazole intake were markedly effective in treating our patients. PMID:123716

  17. Cardiovascular magnetic resonance in pericardial diseases

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    Francone Marco

    2009-05-01

    Full Text Available Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases.

  18. Potential Misclassification of Urinary Tract-Related Bacteremia Upon Applying the 2015 Catheter-Associated Urinary Tract Infection Surveillance Definition From the National Healthcare Safety Network.

    Science.gov (United States)

    Greene, M Todd; Ratz, David; Meddings, Jennifer; Fakih, Mohamad G; Saint, Sanjay

    2016-04-01

    The Centers for Disease Control and Prevention recently updated the surveillance definition of catheter-associated urinary tract infection to include only urine culture bacteria of at least 1 × 10(5) colony-forming units/mL. Our findings suggest that the new surveillance definition may fail to capture clinically meaningful catheter-associated urinary tract infections.

  19. Giant pericardial cyst mimicking dextrocardia on chest X-ray.

    Science.gov (United States)

    Hamad, Hamad M; Galrinho, Ana; Abreu, João; Valente, Bruno; Bakero, Luis; Ferreira, Rui C

    2013-01-01

    Pericardial cysts are rare benign congenital malformations, usually small, asymptomatic and detected incidentally on chest X-ray as a mass located in the right costophrenic angle. Giant pericardial cysts are very uncommon and produce symptoms by compressing adjacent structures. In this report, the authors present a case of a symptomatic giant pericardial cyst incorrectly diagnosed as dextrocardia on chest X-ray.

  20. Virulence factors in Proteus bacteria from biofilm communities of catheter-associated urinary tract infections.

    Science.gov (United States)

    Hola, Veronika; Peroutkova, Tereza; Ruzicka, Filip

    2012-07-01

    More than 40% of nosocomial infections are those of the urinary tract, most of these occurring in catheterized patients. Bacterial colonization of the urinary tract and catheters results not only in infection, but also various complications, such as blockage of catheters with crystalline deposits of bacterial origin, generation of gravels and pyelonephritis. The diversity of the biofilm microbial community increases with duration of catheter emplacement. One of the most important pathogens in this regard is Proteus mirabilis. The aims of this study were to identify and assess particular virulence factors present in catheter-associated urinary tract infection (CAUTI) isolates, their correlation and linkages: three types of motility (swarming, swimming and twitching), the ability to swarm over urinary catheters, biofilm production in two types of media, urease production and adherence of bacterial cells to various types of urinary tract catheters. We examined 102 CAUTI isolates and 50 isolates taken from stool samples of healthy people. Among the microorganisms isolated from urinary catheters, significant differences were found in biofilm-forming ability and the swarming motility. In comparison with the control group, the microorganisms isolated from urinary catheters showed a wider spectrum of virulence factors. The virulence factors (twitching motility, swimming motility, swarming over various types of catheters and biofilm formation) were also more intensively expressed.

  1. Virulence factors in Proteus bacteria from biofilm communities of catheter-associated urinary tract infections.

    Science.gov (United States)

    Hola, Veronika; Peroutkova, Tereza; Ruzicka, Filip

    2012-07-01

    More than 40% of nosocomial infections are those of the urinary tract, most of these occurring in catheterized patients. Bacterial colonization of the urinary tract and catheters results not only in infection, but also various complications, such as blockage of catheters with crystalline deposits of bacterial origin, generation of gravels and pyelonephritis. The diversity of the biofilm microbial community increases with duration of catheter emplacement. One of the most important pathogens in this regard is Proteus mirabilis. The aims of this study were to identify and assess particular virulence factors present in catheter-associated urinary tract infection (CAUTI) isolates, their correlation and linkages: three types of motility (swarming, swimming and twitching), the ability to swarm over urinary catheters, biofilm production in two types of media, urease production and adherence of bacterial cells to various types of urinary tract catheters. We examined 102 CAUTI isolates and 50 isolates taken from stool samples of healthy people. Among the microorganisms isolated from urinary catheters, significant differences were found in biofilm-forming ability and the swarming motility. In comparison with the control group, the microorganisms isolated from urinary catheters showed a wider spectrum of virulence factors. The virulence factors (twitching motility, swimming motility, swarming over various types of catheters and biofilm formation) were also more intensively expressed. PMID:22533980

  2. 10.10.Endocardial and Pericardial disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920087 The relationship between calcifica-tion of bovine pericardial tissue and itsproteoglycan content.JIN Lei (金磊),et al.Cardiovasc Instit,CAMS,Beijing.Chin Cir J 1991; 6(5): 347-349.Bovine pericardium (BP) was treated by

  3. Cocaine Induced Pleural and Pericardial Effusion Syndrome

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    Shehabaldin Alqalyoobi

    2015-01-01

    Full Text Available A 42-year-old African American female with chronic cocaine use for 20 years, presented with two-day history of exertional shortness of breath and pleuritic chest pain. She was admitted three years back with acute kidney injury and skin rashes. At that time, skin biopsy was consistent with leukocytoclastic vasculitis and renal biopsy revealed proliferative glomerulonephritis. She responded to oral prednisone and mycophenolate with complete recovery of her kidney functions. Skin rash was waxing and waning over the last two years. On the second admission, patient was found to have large pleural effusion on computerized tomography scan and pericardial effusion on echocardiogram as shown in the figures. Pleural fluid analysis was exudative. Her serology was negative for ANA (antineutrophilic antibody and anti-dsDNA (double stranded DNA. Complements levels were normal. She had positive low titers of ANCA levels. The patient was started on a course of prednisone for 6 months. Her pleural and pericardial effusion resolved completely on follow-up imaging with computerized tomography scan and echocardiogram. This case is unique since the pericardial and pleural effusions developed without any other etiology in the setting of cocaine; hence, we describe this clinical syndrome as cocaine induced pleural and pericardial effusions syndrome (CIPP.

  4. Catheter-associated urinary tract infections in intensive care units at a university hospital in Turkey

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    Derya Keten

    2014-11-01

    Full Text Available In this study, urinary catheter utilization rates, the causative agents for catheter-associated urinary tract infection (CAUTI and their antimicrobial susceptibilities in intensive care units (ICUs in 2009 were investigated at Gazi university hospital. We aimed to determine the causative agents and risk factors for CAUTIs, and antimicrobial susceptibilities of the pathogens; and also sensitivities of Candida spp. to antifungal agents with Microdilution and E-test. The most common etiological agents of CAUTIs were Candida spp. (34.7%. The most frequently isolated Candida spp. was C.albicans  (52.4%. All C. albicans spp. were sensitive to fluconazole. Microdilution, used as a reference method to determine the sensitivity to antifungal agents, was compared with E test. E test was found to be sufficient to analyze sensitivity to amphotericin B, caspofungin, fluconazole and voriconazole, but inappropriate for itraconazole. E.coli and Klebsiella spp. were found to be causative agents for CAUTI in 20.6% and 9.9% of cases respectively. Pseudomonas spp. and Acinetobacter spp.  were isolated in 14% and 8.2% of the cases, respectively. All E.coli and Klebsiella strains were found sensitive to carbapenems. Carbapenem sensitivity was found in 47.1% and 30% of the cases infected with Pseudomonas and  Acinetobacter  strains, respectively. According to our results, fluconazole therapy seems to be an appropriate choice for the treatment of CAUTIs caused by  C.albicans. Third and fourth generation cephalosporins should not be used for empirical treatment because of the high prevalence of extended spectrum beta-lactamase production among E.coli and Klebsiella isolates. 

  5. MICROBIAL FLORA AND RISK FACTORS ASSOCIATED WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS

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    Ravi Prakash

    2015-05-01

    Full Text Available INTRODUCTION: Catheter associated Urinary Tract Infection (UTI represent the most common type of nosocomial infection and is a major health concern due to its complications and frequent recurrence. Among the nosocomial infections UTI contributes a major part. About 80% of nosocomial UTI are associated with using indwelling urinary catheters and most of them are asymptomatic. Only 5% of them develop s symptomatic UTI which leads to development of complications like bacteremia & pyelonephritis. MATERIALS AND METHODS: In th e present study a random collection of 100 urine samples from different clinical “groups ˮ like surgery, urology, AMCU, Ob stetrics & Gynecology patients with indwelling urinary catheter of different durations of catheter stay. Organisms isolated in culture, biochemical c haracterization, and antibiotic susceptibility was done. RESULTS: Among the samples tested 41/100 (41% showed culture positivity. within them surgery patients were 40.90% (18/41 , Urology accounted for, 71.42 % (20/28, in AMCU patients 20% (2/10, with more than 3 days of duration of catheter stay and in Obs & Gyn department showed 0 culture positivity. The predominant organism isolated is pseudomonas aeruginosa (34.2%, followed by Escherichia coli (22%, enterococci (12.19%, Klebsiella (12.19% and Ca ndida 19.5%. Among GNB 90% showed ESBL production, 10% ß - lactam inhibitors resistance, 90% quinolones resistant, 50% resistant to amikacin, 100% to gentamycin was o bserved. CONCLUSION: Incidence of bacteriuria in patients with indwelling urinary catheters is 41 %. Onset of bacteriuria is as early as on 3 rd day of catheterization, and gradually increases with duration of stay, technique of insertion and daily catheter care done. Pseudomonas aeruginosa and Escherichia coli are common organisms isolated. Use o f prophylactic antibiotics without doing culture, and antibiotic susceptibility testing leads to development of drug resistant organisms. So, active

  6. Catheter-associated urinary tract infections in intensive care units at a university hospital in Turkey.

    Science.gov (United States)

    Keten, Derya; Aktas, Firdevs; Guzel Tunccan, Ozlem; Dizbay, Murat; Kalkanci, Ayse; Biter, Gülsah; Keten, Hamit Sirri

    2014-01-01

    In this study, urinary catheter utilization rates, the causative agents for catheter-associated urinary tract infection (CAUTI) and their antimicrobial susceptibilities in intensive care units (ICUs) in 2009 were investigated at Gazi university hospital. We aimed to determine the causative agents and risk factors for CAUTIs, and antimicrobial susceptibilities of the pathogens; and also sensitivities of Candida spp. to antifungal agents with Microdilution and E-test. The most common etiological agents of CAUTIs were Candida spp. (34.7%). The most frequently isolated Candida spp. was C.albicans (52.4%). All C. albicans spp. were sensitive to fluconazole. Microdilution, used as a reference method to determine the sensitivity to antifungal agents, was compared with E test. E test was found to be sufficient to analyze sensitivity to amphotericin B, caspofungin, fluconazole and voriconazole, but inappropriate for itraconazole. E.coli and Klebsiella spp. were found to be causative agents for CAUTI in 20.6% and 9.9% of cases respectively. Pseudomonas spp. and Acinetobacter spp. were isolated in 14% and 8.2% of the cases, respectively. All E.coli and Klebsiella strains were found sensitive to carbapenems. Carbapenem sensitivity was found in 47.1% and 30% of the cases infected with Pseudomonas and Acinetobacter strains, respectively. According to our results, fluconazole therapy seems to be an appropriate choice for the treatment of CAUTIs caused by C.albicans. Third and fourth generation cephalosporins should not be used for empirical treatment because of the high prevalence of extended spectrum beta-lactamase production among E.coli and Klebsiella isolates.

  7. Catheter-associated urinary tract infection in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Mladenović Jovan

    2015-01-01

    Full Text Available Background/Aim. Because patients in intensive care units usually have an urinary catheter, the risk of urinary tract infection for these patients is higher than in other patients. The aim of this study was to identify risk factors and causative microrganisms in patients with catheter-associated urinary tract infection (CAUTI in the Surgical Intensive Care Unit (SICU during a 6-year period. Methods. All data were collected during prospective surveillance conducted from 2006 to 2011 in the SICU, Military Medical Academy, Belgrade, Serbia. This case control study was performed in patients with nosocomial infections recorded during surveillance. The cases with CAUTIs were identified using the definition of the Center for Disease Control and Prevention. The control group consisted of patients with other nosocomial infections who did not fulfill criteria for CAUTIs according to case definition. Results. We surveyed 1,369 patients representing 13,761 patient days. There were a total of 226 patients with nosocomial infections in the SICU. Of these patients, 64 had CAUTIs as defined in this study, and 162 met the criteria for the control group. Multivariate logistic regression analysis identified two risk factors independently associated to CAUTIs: the duration of having an indwelling catheter (OR = 1.014; 95% CI 1.005-1.024; p = 0.003 and female gender (OR = 2.377; 95%CI 1.278-4.421; p = 0.006. Overall 71 pathogens were isolated from the urine culture of 64 patients with CAUTIs. Candida spp. (28.2%, Pseudomonas aeruginosa (18.3% and Klebsiella spp. (15.5% were the most frequently isolated microorganisms. Conclusions. The risk factors and causative microrganisms considering CAUTIs in the SICU must be considered in of planning CAUTIs prevention in this setting.

  8. Tamponamento cardíaco em dois recém-nascidos causado por cateter umbilical Cardiac tamponade caused by central venous catheter in two newborns

    Directory of Open Access Journals (Sweden)

    Andrey José Monteiro

    2008-09-01

    Full Text Available Tamponamento cardíaco secundário ao uso de cateter venoso central é uma complicação rara, porém potencialmente tratável, quando identificada a tempo. Nós relatamos dois casos de tamponamento cardíaco, diagnosticados por ecocardiograma transtorácico, seguido de pericardiocentese de urgência e drenagem pericárdica cirúrgica como complicação de cateterização venosa umbilical. Em um caso, a ponta do cateter estava adequadamente localizada e, no outro caso, não. Em ambos os casos, solução hiperosmolar estava sendo infundida. Apesar de situação incomum, esta deve ser sempre considerada em neonato, evoluindo com choque cardiogênico sem causa aparente.Cardiac tamponade secondary to the use of central venous catheter is a rare complication; however, it is potentially reversible when it is caught in time. We report two cases of cardiac tamponade that was diagnosed using a transthoracic echocardiography, followed by urgent pericardiocentesis and surgical pericardial drainage as a complication from umbilical venous catheterization. In one case, the tip of the catheter was properly placed, and in the other case, it was not. In both cases, a hyperosmolar solution was being injected. Although it may be an uncommon situation, it should be always considered as a possibility in a newborn who develops cardiogenic shock without an apparent cause.

  9. MRI Findings of Pericardial Fat Necrosis: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyo Hyeok; Ryu, Dae Shick; Jung, Sang Sig; Jung, Seung Mun; Choi, Soo Jung; Shin, Dae Hee [Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung (Korea, Republic of)

    2011-06-15

    Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.

  10. Pericardial effusions in two boys with chronic granulomatous disease.

    OpenAIRE

    Macedo, F.; McHugh, K; Goldblatt, D

    1999-01-01

    Pediatr Radiol. 1999 Nov;29(11):820-2. Pericardial effusions in two boys with chronic granulomatous disease. Macedo F, McHugh K, Goldblatt D. SourceDepartment of Radiology, Hospital Geral de Santo Antonio, Porto, Portugal. Abstract Pericardial involvement in chronic granulomatous disease (CGD) is very rare. We present two children with known CGD and pericardial effusions in whom no microbial cause for the effusions was found. PMID: 10552060 [PubMed - indexed for MEDLINE

  11. Effect of colchicine in prevention of pericardial effusion and atrial fibrillation: a meta-analysis.

    Science.gov (United States)

    Wang, Ming-Xuan; Deng, Xiao-Long; Mu, Bing-Yao; Cheng, Yong-Jing; Chen, Ying-Juan; Wang, Qian; Huang, Jia; Zhou, Rong-Wei; Huang, Ci-Bo

    2016-09-01

    Randomized, controlled trials (RCTs) have assessed the effect of colchicine therapy in prevention of pericardial effusion (PE) and atrial fibrillation (AF). However, the effects are still inconclusive. PubMed, Cochrane Library, Google Scholar, and EMBASE database were searched. Primary outcome was the risk of PE and AF. Ten RCTs with 1981 patients and a mean follow-up of 12.6 months were included. Colchicine therapy was not associated with a significantly lower risk of post-operative PE (RR, 0.89; 95 % CI 0.70-1.13; p = 0.33, I (2) = 72.8 %) and AF (RR, 0.77; 95 % CI 0.52-1.13; p = 0.18, I (2) = 47.3 %). However, rates of pericarditis recurrence, symptoms persistence, and pericarditis-related hospitalization were significantly decreased with colchicine treatment. In addition, cardiac tamponade occurrence was similar between groups, and adverse events were significantly higher in the colchicine group. Colchicine may not significantly decrease the post-operative risk of PE and AF. However, only limited studies about patients undergoing cardiac surgery provide data about PE and AF. PMID:27378573

  12. Tamponamento cardíaco tardio traumático: análise de cinco casos Traumatic late cardiac tamponade: analysis of five cases

    Directory of Open Access Journals (Sweden)

    FERNANDO LUIZ WESTPHAL

    2000-09-01

    Full Text Available São analisados cinco casos de tamponamento cardíaco tardio traumático. Os pacientes eram masculinos, idade média de 26,2 anos, vítimas de ferimento por arma branca em região precordial, área de Ziedler, sendo admitidos em centro de referência para trauma. Foram classificados pelo índice fisiológico de Ivatury para trauma cardíaco e inicialmente tratados por pleurotomia intercostal e reposição volêmica, com estabilização do quadro hemodinâmico e respiratório. Os pacientes foram readmitidos após intervalo de oito a 24 dias (mediana de 20 dias, agora no serviço de cirurgia torácica de um hospital de referência terciária, com sinais de tamponamento cardíaco. Os exames diagnósticos confirmaram derrame pericárdico com espessamento pericárdico associado a encarceramento de base pulmonar esquerdo em quatro casos, os quais foram abordados por toracotomia póstero-lateral, com realização de pericardiectomia parcial e descorticação pulmonar. Um paciente evoluiu com pericardite purulenta, comprovada por exames complementares, e foi submetido à drenagem pericárdica subxifóidea. Ocorreu arritmia pós-operatória em um paciente; os demais evoluíram sem complicações pós-operatórias ou recidiva do tamponamento.Five traumatic late cardiac tamponade cases were analyzed. All patients were male, mean age was 26.2, victims of thoracic penetrating stabbing wound in the precordial region, Ziedler area, admitted to a trauma reference center. They were classified by the Ivatury physiological index for cardiac trauma. The first treatment approach was intercostal pleurectomy and volemic resuscitation followed by hemodynamic and respiratory recovery. Patients with cardiac tamponade symptoms were re-admitted within an interval from eight to twenty four days (mean 20 days in a thoracic surgery service of a tertiary reference hospital. Diagnostic exams confirmed thickening and pericardial effusion associated with a left pulmonary base

  13. Silicone Oil Tamponade Combined with Lensectomy Preserving Anterior Lens Capsule

    Institute of Scientific and Technical Information of China (English)

    LuL; YangJ

    1999-01-01

    Purpose:To investigate the therapeutic effect and indicatio n of silicone oil tamponade combined with lensectomy preserving anterior lens capsule.Methods:Silicone oil tamponade combined with lensectomy preserving anterior lens capsule was performed in 33 cases (33 eyes)of high myopia ,proliferative vitroretinopathy(PVR)D grade and giant retinal tear(GRT).10 cases were onlyeye and 11 cases had harder nucleus of lens.The surgical methods included:1.smashing lens nucleus and lensectomy preserving complete anterior capsule;2,vitrectomy and membrane peeling;3,usage of liquid perfluorocarbin or retinotomy or drainage;4.silicone oil tamponade;5.postoperative Nd;YAG laser for anterior capsulectomy. Results:Follow-up time was 6 months or more in 29 cases.Total retinal reattachment was achieved in 22 cases,macular retinal reattachment in 5 cases.The visual acuity was 20/800 to 20/200 in 13 cases,20/100 to 20/50 in 12 cases.Visual acuity was significantly improved in GRT group(P<0.05).Complications included unexpected anterior capsule break intraoperatively,anterior capsule opacity,silicone oil emulsification and liquid perfluorocarbin remainig postoperatively.Conclusions:Silicone oil tamponade combined with lensectomy preserving anterior capsule was safe and can reduce the operative complications.The indications included:1.GRT complicated with high myopia;2,advanced PVR cases complicated with high myopia in which silicone oil must be used;3.severe lens opacity cases in which silicone oil must be used;4.complex retinal detachment of only ye.

  14. Huge Pericardial Cyst Misleading Symptoms of COPD

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    Göktürk Fındık

    2012-04-01

    Full Text Available Pericardial cysts are rare benign congenital mediastinal lesions. It accounts 30% of all mediastinal cysts. They are usually asemptomatic. They can produce the compression of the mediastinal structures typically caused the symptoms of dyspnea, thoracic pain, tachicardia and cough due to the unusual large size of the cyst. It can performed symptoms of lung atelectasia. The case was a sixty-five years old woman followed with a diagnosis of COPD for seven years. The patient was admitted to our center with the diagnosis of elevation of the right hemidiaphragm on chest radiography. The computed tomography revealed a cystic lesion adjacent to the right hemidiaphragm and cyst excision was performed via right thoracotomy. Patient%u2019s postoperative clinical findings indicated that the symptoms of COPD regressed completely and the patient did not require any further bronchodilator therapy. The aim of this case report is to demonstrate that the pericardial cysts can be missed in chest radiographs and impression of cysts may cause COPD like symptoms in these patients.

  15. Chasing Zero: A Nurse-Driven Process for Catheter-Associated Urinary Tract Infection Reduction In a Community Hospital.

    Science.gov (United States)

    Quinn, Paul

    2016-01-01

    Due to treatment costs and lack of reimbursement, community hospitals are charged with implementing innovative strategies that will reduce the incidence of hospital-acquired catheter-associated urinary tract infections (CAUTI). A nurse-driven system for decreasing the number of hospital-acquired CAUTI is effective and useful for a community hospital. One nurse with accountability for implementing a simple evidence-based protocol can dramatically decrease the total incidence of hospital-acquired CAUTI. The basis for the success of this initiative relied heavily on the ease of using the eight-point Question the Foley criteria, the availability of the electronic medical record, interdisciplinary collaboration, and support from nursing and physician administration. With collaboration and support from nursing leadership, the goals for patient safety by reducing hospital-acquired CAUTI can become a reality in a short period of time. PMID:27281867

  16. 导尿管相关尿路感染的监测%Monitoring Catheter-associated Urinary Tract Infection

    Institute of Scientific and Technical Information of China (English)

    蔡玉琴

    2013-01-01

    Objective: To search the condition and reasons of indwelling catheter patients with urinary tract infection in medical ward, and to provide a scientific basis for the effective prevention and control of infection. Methods: The catheter-related urinary tract infection of all patients with indwelling catheters who hospitalized in medical ward from January 2011 to June 2012 were investigated by proactive monitoring. Results : 335 cases of patients with indwelling catheter were monitored, and there were 15 cases with urinary tract infection, so the infection rate was 4.48%. The rate of catheter-associated urinary tract infection was 2.5/ 1000 catheters per day. Conclusion: Understanding the occurrence of catheter associated urinary tract infection in a medical ward by targeted monitoring, it provides guidance for the effective control of urinary tract infections.%目的:了解内科病房留置尿管患者尿路感染发生状况及原因,为有效预防和控制感染提供科学依据.方法:采取主动监测方法,对2011年1月-2012年6月内科病房所有住院留置尿管患者发生导尿管相关尿路感染情况进行调查.结果:335例留置尿管患者,发生尿路感染15例,感染率为4.48%,导尿管相关尿路感染发生率为2.5/千导管日.结论:通过目标性监测,了解了内科病房导尿管相关尿路感染的发生状况,为有效控制尿路感染提供了指导.

  17. Computed tomography and magnetic resonance imaging evaluation of pericardial disease.

    Science.gov (United States)

    Hoey, Edward T D; Shahid, Muhammad; Watkin, Richard W

    2016-06-01

    Pericardial diseases are commonly encountered in clinical practice and may present as an isolated process or in association with various systemic conditions. Traditionally transthoracic echocardiography (TTE) has been the method of choice for the evaluation of suspected pericardial disease but increasingly computed tomography (CT) and magnetic resonance imaging (MRI) are also being used as part of a rational multi-modality imaging approach tailored to the specific clinical scenario. This paper reviews the role of CT and MRI across the spectrum of pericardial diseases. PMID:27429911

  18. Some Physicochemical Remarks on Spontaneous Emulsification of Vitreal Tamponades

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    Ciro Costagliola

    2014-01-01

    Full Text Available The importance of gravitational instability in determining the emulsification of vitreal tamponades is discussed. Theoretical results and numerical simulations indicate that the spontaneous formation of water-silicon oil is a rare event and that the very low concentration of surface active agents cannot justify the systematic formation of emulsions. The gravitational instabilities seem to play the main role. Our theoretical results seem in agreement with the experimental evidences; furthermore they indicate a future research line for the improvement of endotamponades. Indeed, the use of biodegradable antifoam may avoid the formation of bubbles and delay the formation of emulsions.

  19. Some physicochemical remarks on spontaneous emulsification of vitreal tamponades.

    Science.gov (United States)

    Costagliola, Ciro; Semeraro, Francesco; dell'Omo, Roberto; Zeppa, Lucio; Bufalo, Gennaro; Cardone, Michele; Romano, Mario; Ambrosone, Luigi

    2014-01-01

    The importance of gravitational instability in determining the emulsification of vitreal tamponades is discussed. Theoretical results and numerical simulations indicate that the spontaneous formation of water-silicon oil is a rare event and that the very low concentration of surface active agents cannot justify the systematic formation of emulsions. The gravitational instabilities seem to play the main role. Our theoretical results seem in agreement with the experimental evidences; furthermore they indicate a future research line for the improvement of endotamponades. Indeed, the use of biodegradable antifoam may avoid the formation of bubbles and delay the formation of emulsions. PMID:25133159

  20. Hydrothorax, hydromediastinum and pericardial effusion: a complication of intravenous alimentation.

    OpenAIRE

    Damtew, B.; Lewandowski, B

    1984-01-01

    Complications secondary to intravenous alimentation are rare but potentially lethal. Massive bilateral pleural effusions and a pericardial effusion developed in a patient receiving prolonged intravenous alimentation. Severe respiratory distress and renal failure ensued. He recovered with appropriate treatment.

  1. Methotrexate-induced pericarditis and pericardial effusion; first reported case.

    OpenAIRE

    Forbat, L N; Hancock, B W; Gershlick, A H

    1995-01-01

    We report a case of methotrexate-induced pericarditis and pericardial effusion in a 22-year-old pregnant woman. These complications have not previously been described as isolated phenomena associated with methotrexate therapy.

  2. Kocher-debre-semelaigne syndrome with pericardial effusion

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    Dharaskar Praveen

    2007-09-01

    Full Text Available We report a 10-year-old female child with hypothyroidism and limb muscle pseudohypertrophy (i.e., Kocher-Debre-Semelaigne syndrome with pericardial effusion. The child presented with generalized swelling, breathlessness and difficulty in walking and in getting up from sitting position (of chronic duration. She had bradycardia, dull facies, marked hypertrophy of both calf muscles and nonpitting edema of legs. Pericardial effusion was detected clinically and confirmed on investigations. Muscle pseudohypertrophy was a striking feature, and hypothyroidism was confirmed on thyroid studies. The response to thyroxine replacement was excellent, with resolution of the pericardial effusion and clinical improvement. The unusual presence of pericardial effusion in Kocher-Debre-Semelaigne syndrome is discussed in the report.

  3. [Massive pericardial effusion as initial manifestation of hypothyroidism].

    Science.gov (United States)

    Thirone, Ana Cláudia Pelegrinelli; Danieli, Rafael Vinícius; Ribeiro, Vanessa Marajó Fernandes Corrêa

    2012-08-01

    The aim of this study is to report a rare case of massive pericardial effusion as initial manifestation of hypothyroidism. A previously healthy 21-year-old female patient suddenly began presenting dyspnea at rest and lower limb edema. Routine laboratory tests performed at admission showed hypothyroidism (TSH 146.14 mUI/L) and echocardiography showed significant pericardial effusion. Therapy was instituted with levothyroxine, resulting in clinical improvement without pericardiocentesis. The patient was followed up for 1 year, with total remission of dyspnea and edema. However, she developed typical symptoms of hypothyroidism, and remained with asthenia, dyslipidemia, weight gain, and mild pericardial effusion at the end of one year, even with the optimization of the levothyroxine dose. This case highlights the need for early investigation of hypothyroidism in patients with pericardial effusion. PMID:22990643

  4. Giant Pericardial Cyst: A Case Report and Review of Literature

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    Hekmat

    2015-11-01

    Full Text Available Pericardial cysts are rare lesions. These benign anomalies are located in the middle mediastinum. In this article, we present a 24-year-old man who was referred to the emergency department with dyspnea and persistent cough. In physical exam, no abnormality was found. His past medical history was normal. His trans-thoracic echocardiogram showed an echo-lucent space next to the right atrium at the right cardiophrenic angle. No pericardial effusion was found. The patient underwent surgery. After midsternotomy, a huge cyst measuring approximately 13 × 8 × 5 cm in diameters was found on the right side and outside the pericardium that was totally excised. After 5 days, the patient was discharged and pathologic report confirmed preoperative diagnosis of pericardial cyst. Giant pericardial cysts are not common and in this report, we will review published case reports.

  5. Kocher-debre-semelaigne syndrome with pericardial effusion

    OpenAIRE

    Dharaskar Praveen; Tullu Milind; Lahiri Keya; Kondekar Santosh; Vaswani Rajwanti

    2007-01-01

    We report a 10-year-old female child with hypothyroidism and limb muscle pseudohypertrophy (i.e., Kocher-Debre-Semelaigne syndrome) with pericardial effusion. The child presented with generalized swelling, breathlessness and difficulty in walking and in getting up from sitting position (of chronic duration). She had bradycardia, dull facies, marked hypertrophy of both calf muscles and nonpitting edema of legs. Pericardial effusion was detected clinically and confirmed on investigations. Muscl...

  6. Pericardial Window Formation Complicated by Intrapericardial Diaphragmatic Hernia

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    Jeremy Docekal

    2014-01-01

    Full Text Available In rare circumstances, a diaphragmatic defect may allow for herniation of intra-abdominal contents into the pericardial space. These occurrences are exceedingly rare and may be due to trauma or congenital defects of the septum transversum or as the result of surgical procedures. We describe a 73-year-old female who presented with cardiac and abdominal symptoms one month after undergoing a subxiphoid pericardioperitoneal window for treatment and evaluation of a symptomatic pericardial effusion.

  7. Traumatic Mitral Valve and Pericardial Injury

    Directory of Open Access Journals (Sweden)

    Nissar Shaikh

    2013-01-01

    Full Text Available Cardiac injury after blunt trauma is common but underreported. Common cardiac trauma after the blunt chest injury (BCI is cardiac contusion; it is very rare to have cardiac valve injury. The mitral valve injury during chest trauma occurs when extreme pressure is applied at early systole during the isovolumic contraction between the closure of the mitral valve and the opening of the aortic valve. Traumatic mitral valve injury can involve valve leaflet, chordae tendineae, or papillary muscles. For the diagnosis of mitral valve injury, a high index of suspicion is required, as in polytrauma patients, other obvious severe injuries will divert the attention of the treating physician. Clinical picture of patients with mitral valve injury may vary from none to cardiogenic shock. The echocardiogram is the main diagnostic modality of mitral valve injuries. Patient’s clinical condition will dictate the timing and type of surgery or medical therapy. We report a case of mitral valve and pericardial injury in a polytrauma patient, successfully treated in our intensive care unit.

  8. A Tool to Assess the Signs and Symptoms of Catheter-Associated Urinary Tract Infection: Development and Reliability.

    Science.gov (United States)

    Blodgett, Tom J; Gardner, Sue E; Blodgett, Nicole P; Peterson, Lisa V; Pietraszak, Melissa

    2015-08-01

    The purpose of this pilot study was to determine the inter-rater reliability of four clinical manifestations of catheter-associated urinary tract infections (CAUTI) among hospitalized adults with short-term indwelling urinary catheters using a tool developed for this purpose: the CAUTI Assessment Profile (CAP). Study participants included 30 non-pregnant English-speaking adults, recruited from two community hospitals. Three nurses assessed each participant for fever, suprapubic tenderness, flank tenderness, and delirium using standardized techniques. Based on the generalized Kappa statistic and 95% confidence intervals, there was evidence of strong inter-rater reliability for fever (K = 1.00, 0.793-1.207), suprapubic tenderness (K = 0.39, 0.185-0.598), and delirium (K = 0.58, 0.379-0.792), but not for flank tenderness (K = 0.29, -0.036 to 0.617). This study provides preliminary evidence that the CAP can be used to consistently identify these clinical signs and symptoms of CAUTI in hospitalized adults. PMID:25246536

  9. Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

    Directory of Open Access Journals (Sweden)

    Åse Nilsson

    2009-07-01

    Full Text Available Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient’s condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19–76 years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases. Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases. Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months.

  10. 先天性心脏病患儿术后心包纵隔引流管的观察与护理%Observation and nursing care on pericardial mediastinal drainage tube after surgery in children with congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    何小霞

    2015-01-01

    Objective:To summarize holistic nursing measures on pericardial mediastinal drainage tube after surgery in children with congenital heart disease.Methods:38 children with congenital heart disease were given continuous seamless high-quality nursing care on pericardial mediastinal drainage tube after operation,and we observed its clinical effect.Results:None of the adverse events that due to improper care on pericardial mediastinal drainage tube had occured,such as acute pericardial tamponade,accidental extubation,plugging or slipping.Conclusion:Children with congenital heart disease were given closely observation on the drainage tube after operation,and the complications reduced effectively through high quality nursing continuous seamless,so this method of nursing care can guarantee the success of operation effectively.%目的:总结先天性心脏病患儿术后心包纵隔引流管的整体护理措施。方法:对38例先天性心脏病患儿术后给予心包纵隔引流管的连续无缝隙优质护理,观察其临床效果。结果:未发生因护理不当而导致的急性心包填塞、意外拔管、堵管或滑脱等心包纵隔引流管相关不良事件。结论:对术后患儿引流管进行严密观察,通过连续无缝隙的优质护理可有效减少并发症的发生,是手术成功的有效保障。

  11. Pericardial Effusion in Langerhans Cell Histiocytosis: A Case Report

    Science.gov (United States)

    Gholami, Narges

    2016-01-01

    Introduction Langerhans cell histiocytosis (LCH) is a proliferative disorder of histiocytes in multiple organs. Langerhans cell histiocytosis involves bones, skin, lung and other organs. Case Presentation This study describes a seven-month-old Iranian girl who presented with skin rash and cervical lymphadenopathy. Langerhans cell histiocytosis was suspected when it was associated with anemia, splenomegaly and lytic bone lesions. A skin biopsy confirmed the diagnosis of Langerhans cell histiocytosis. During hospitalization, the patient looked ill with respiratory distress. A chest X-ray showed a ground glass view, and echocardiography showed moderate pericardial effusion. Conclusions Pericardial effusion was a rare finding in this case of Langerhans cell histiocytosis. Pericardial effusion in Langerhans cell histiocytosis, which is an unusual presentation, should be considered when the patient experiences respiratory distress. PMID:27621925

  12. Giant bronchogenic cyst with pericardial defect: a case report & literature review in Japan

    Science.gov (United States)

    Kamata, Toshiko; Iwata, Takekazu; Nakatani, Yukio; Yoshino, Ichiro

    2016-01-01

    Congenital pericardial defects are a rare anomaly, found during autopsy and cardiothoracic surgery. We describe a case of a 69-year-old female, with a right-sided congenital pericardial defect associated with a giant bronchogenic cyst (BC) found during surgery. The cyst was resected and the patient developed arrhythmia following surgery. A review of the literature in Japan was performed, focusing on congenital anomalies associated with pericardial defects and its pathogenesis. We paid particular attention to complications following thoracic surgery in patients with pericardial defects and indications of pericardial reconstruction in such patients. PMID:27621900

  13. Pericardial effusion in a diabetic patient with prostatic abscess

    International Nuclear Information System (INIS)

    Purulent pericarditis is a rare and potentially fatal disease. Its diagnosis and treatment is difficult. An aggressive antibiotic treatment and pericardial drainage are essentials for the treatment of purulent pericarditis. We report an unusual case of a diabetic patient with purulent pericarditis and prostatic abscess with good evolution after appropriate treatment. (author)

  14. Purulent Pericarditis with Greenish Pericardial Effusion Caused by Shewanella algae▿

    OpenAIRE

    Tan, Che-Kim; Lai, Chih-Cheng; Kuar, Wei-Khie; Hsueh, Po-Ren

    2008-01-01

    We report the first case of purulent pericarditis with greenish pericardial effusion caused by Shewanella algae in a patient with gastric and gallbladder cancer. This case expands the reported spectrum of infection caused by S. algae and raises the possibility that S. algae is a causative pathogen for purulent pericarditis.

  15. Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    M Kaur

    2015-01-01

    Full Text Available Purpose : Central venous catheters (CVCs though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC-BSI in the intensive care unit (ICU patients and studied the formation of biofilm in CVCs. Materials and Methods: The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO and Gram staining methods. Biofilm production in catheters was detected by ′tissue culture plate′ (TCP method. The results were analysed using the computer-based program statistical package for the social sciences (SPSS. Results : In 25/115 patients, definite diagnosis of CVC-BSI was made. The mean age was 48.44 ± 17.34 years (cases vs 40.10 ± 18.24 years (controls and the mean duration of catheterisation was 25.72 ± 8.73 days (cases vs 11.89 ± 6.38 days (controls. Local signs of infection (erythema, tenderness and oozing were found more significantly in CVC-BSI cases. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Staphylococcus aureus followed by Pseudomonas aeruginosa and non-albicans Candida were common CVC-BSI pathogens. Multidrug-resistant (MDR strains were isolated in bacterial agents of CVC-BSI. Non-albicans Candida and Enterococcus faecalis showed strong biofilm production. Conclusion : The incidence of CVC-BSI was 21.73% and the rate was 14.59 per 1000 catheter days. Prolonged ICU stay and longer catheterisation were major risk factors. S. aureus was isolated most commonly in CVC-BSI cases. The menace of multidrug resistance and

  16. A combination of cis-2-decenoic acid and antibiotics eradicates pre-established catheter-associated biofilms.

    Science.gov (United States)

    Rahmani-Badi, Azadeh; Sepehr, Shayesteh; Mohammadi, Parisa; Soudi, Mohammad Reza; Babaie-Naiej, Hamta; Fallahi, Hossein

    2014-11-01

    The catheterized urinary tract provides ideal conditions for the development of biofilm populations. Catheter-associated urinary tract infections (CAUTIs) are recalcitrant to existing antimicrobial treatments; therefore, established biofilms are not eradicated completely after treatment and surviving biofilm cells will carry on the infection. Cis-2-decenoic acid (CDA), an unsaturated fatty acid, is capable of inhibiting biofilm formation by Pseudomonas aeruginosa and of inducing the dispersion of established biofilms by multiple types of micro-organisms. Here, the ability of CDA to induce dispersal in pre-established single- and dual-species biofilms formed by Escherichia coli and Klebsiella pneumoniae was measured by using both semi-batch and continuous cultures bioassays. Removal of the biofilms by combined CDA and antibiotics (ciprofloxacin or ampicillin) was evaluated using microtitre plate assays (crystal violet staining). The c.f.u. counts were determined to assess the potential of combined CDA treatments to kill and eradicate pre-established biofilms formed on catheters. The effects of combined CDA treatments on biofilm surface area and bacteria viability were evaluated using fluorescence microscopy, digital image analysis and live/dead staining. To investigate the ability of CDA to prevent biofilm formation, single and mixed cultures were grown in the presence and absence of CDA. Treatment of pre-established biofilms with only 310 nM CDA resulted in at least threefold increase in the number of planktonic cells in all cultures tested. Whilst none of the antibiotics alone exerted a significant effect on c.f.u. counts and percentage of surface area covered by the biofilms, combined CDA treatments led to at least a 78% reduction in biofilm biomass in all cases. Moreover, most of the biofilm cells remaining on the surface were killed by antibiotics. The addition of 310 nM CDA significantly prevented biofilm formation by the tested micro-organisms, even within

  17. Giant Purulent Pericarditis with Cardiac Tamponade Due to Streptococcus intermedius Rapidly Progressing to Constriction.

    Science.gov (United States)

    Tigen, Elif T; Sari, Ibrahim; Ak, Koray; Sert, Sena; Tigen, Kursat; Korten, Volkan

    2015-08-01

    Purulent pericardial effusion, although rare, is a life-threatening condition usually produced by the extension of a nearby bacterial infection locus or by blood dissemination in the immune-suppressed subjects or in the course of cardiothoracic surgery. Because clinical features of purulent pericardial effusion are often nonspecific, it can cause delay in diagnosis. Therefore, a high index of suspicion is required for timely diagnosis and management. Herein, we describe a case of giant purulent pericardial effusion due to Streptococcus intermedius with the history of bronchiectasis and pneumonia, which was successfully treated with pericardiocentesis via parasternal approach, appropriate antibiotics, and pericardiectomy.

  18. Influence of silicone oil tamponade on self-sealing sclerotomy using 25-gauge transconjunctival sutureless vitrectomy: a retrospective comparative study

    OpenAIRE

    Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

    2015-01-01

    Background Characteristic complications have been reported for transconjunctival sutureless vitrectomy, such as postoperative sclerotomy leakage and postoperative hypotony. Particular attention to sclerotomy closure is required in cases of silicone oil tamponade, because postoperative supplementation of silicone oil implies reoperation, whereas postoperative supplement of gas is comparatively easy. This study investigated sclerotomy closure in cases of silicone oil tamponade using 25-gauge tr...

  19. Life-Threatening Cardiac Tamponade Secondary to Chylopericardium Following Orthotopic Heart Transplantation-A Case Report.

    Science.gov (United States)

    Wierzbicki, Karol; Mazur, Piotr; Węgrzyn, Piotr; Kapelak, Bogusław

    2016-08-23

    Chylopericardium is a rare complication in cardiac surgery, and an extremely rare occurrence in patients following orthotopic heart transplantation (OHT), which, however, can lead to cardiac tamponade. Here we present a case of a 59-year-old man who underwent OHT and suffered from chylopericardium resulting in cardiac tamponade late in the postoperative course, despite the initially uneventful early postoperative period (decreasing blood drainage was observed directly after the procedure, and the drains were safely removed). After the diagnosis of chylopericardium was made, the conservative treatment was initiated, which turned out to be insufficient, and eventually invasive approach for the recurrence of tamponade secondary to chylopericardium was required. We discuss the available therapeutic options for chylopericardium and demonstrate the successful invasive therapeutic approach with use of the absorbable fibrin sealant patch. PMID:26548537

  20. Giant pericardial cyst in a 5-year-old child: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Kumar Sanjay

    2011-01-01

    Full Text Available Pericardial cysts are uncommon congenital abnormalities that occur in the middle mediastinum. Most of these are found incidentally on chest x-rays. The occurrence of pericardial cyst in children is quite rare. It needs to be differentiated from other cystic mediastinal masses. A rare case of pericardial cyst in a 5 year old male child is reported. The child presented with chest pain, cough and fever. The preoperative diagnosis of pericardial cyst was suggestive on echocardiography and CT scan. It was confirmed on histopathology after successful surgical excision. The rarity of this benign mediastinal lesion in children prompted us to report this case.

  1. Thoracoscopic pericardial drainage for gastric tube ulcer penetrated into the pericardium.

    Science.gov (United States)

    Watanabe, Masayuki; Matsuura, Koki; Baba, Hideo; Yoshizumi, Tomoharu; Ikegami, Toru; Soejima, Yuji; Ikeda, Tetsuo; Kawanaka, Hirofumi; Uchiyama, Hideaki; Yamashita, Yo-ichi; Morita, Masaru; Oki, Eiji; Mimori, Koshi; Sugimachi, Keishi; Saeki, Hiroshi; Maehara, Yoshihiko

    2013-10-01

    Peptic ulcer occurring in the gastric conduit for esophageal reconstruction sometimes penetrates into the mediastinal structures. We herein reported a case of pericardial penetration of gastric tube ulcer successfully treated with thoracoscopic pericardial drainage. A 66-year-old Japanese man, who had undergone esophagectomy for esophageal cancer 20 months before, visited our emergency room complaining severe back pain. Computed tomography revealed gastric tube ulcer penetrated into the pericardial space. Thoracoscopic pericardiotomy and drainage was performed and the patient made an uneventful recovery. Thoracoscopic pericardial drainage is useful to manage acute pyogenic pericarditis due to penetration of peptic ulcer which occurred in the gastric tube.

  2. Direct transatrial pericardiocentesis for tamponade caused by left atrial perforation after trans-septal puncture.

    Science.gov (United States)

    Picard, Fabien; Millán, Xavier; de Hemptinne, Quentin; L L'allier, Philippe

    2016-01-01

    Trans-septal puncture is associated with risks of serious complications. We report a case of an obese 52-year-old man with hypertrophic cardiomyopathy who underwent preoperative coronary angiography and cardiac catheterisation complicated by left atrial perforation. We describe a direct transatrial pericardiocentesis approach to treating cardiac tamponade. PMID:27389729

  3. Failure of Sengstaken balloon tamponade for rebleeding after tissue adhesive injection in a fundic varix

    NARCIS (Netherlands)

    Nieuwenhuis, JA; Peters, FTM; Sanders, J; Van der Werf, TS; Zijlstra, JG

    1998-01-01

    A 61-year-old man developed a huge fundic varix due to portal hypertension in alcoholic liver cirrhosis. After a third injection therapy session with tissue adhesive (Histoacryl(R)) massive hemorrhage developed. Sengstaken (gastric) balloon tamponade failed. Autopsy showed a huge, solid varix with a

  4. The Changes of Retinal Saturation after Long-Term Tamponade with Silicone Oil

    Directory of Open Access Journals (Sweden)

    Bingsheng Lou

    2015-01-01

    Full Text Available Purpose. To evaluate the effects of long-term tamponade with silicone oil on retinal saturation. Methods. A total of 49 eyes that received tamponade with silicone oil were included. The patients were divided into 3 groups (3–6 months, 6–9 months, and >9 months according to the duration of silicone oil tamponade. Retinal oximetry was performed using the Oxymap system before and 2 months after silicone oil removal. Results. The mean retinal oxygen saturation before silicone oil removal was 107% ± 12% in the arterioles and 60% ± 10% in the venules, with an overall arteriovenous difference (AVD of 47% ± 14%. The AVD in the >9-month group was significantly higher than that in the 3–6-month group (54% ± 16% versus 44% ± 11%, P=0.042. After silicone oil removal, the AVD in the >9-month group was significantly decreased (45% ± 9% versus 54% ± 16%, P=0.009; additionally, the arterioles were significantly wider than before surgery (10.8 ± 0.7 pixels versus 10.4 ± 0.9 pixels, P=0.015. Conclusions. The tamponade with silicone oil for more than 9 months will cause the alterations of retinal saturation and the narrowing of retinal arterioles, which may further interfere with the oxygen metabolism in the retina.

  5. A hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of catheter-associated asymptomatic bacteriuria

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    Hysong Sylvia

    2011-04-01

    Full Text Available Abstract Background Catheter-associated urinary tract infection (CAUTI is one of the most common hospital-acquired infections. However, many cases treated as hospital-acquired CAUTI are actually asymptomatic bacteriuria (ABU. Evidence-based guidelines recommend that providers neither screen for nor treat ABU in most catheterized patients, but there is a significant gap between these guidelines and clinical practice. Our objectives are (1 to evaluate the effectiveness of an audit and feedback intervention for increasing guideline-concordant care concerning catheter-associated ABU and (2 to measure improvements in healthcare providers' knowledge of and attitudes toward the practice guidelines associated with the intervention. Methods/Design The study uses a controlled pre/post design to test an intervention using audit and feedback of healthcare providers to improve their compliance with ABU guidelines. The intervention and the control sites are two VA hospitals. For objective 1 we will review medical records to measure the clinical outcomes of inappropriate screening for and treatment of catheter-associated ABU. For objective 2 we will survey providers' knowledge and attitudes. Three phases of our protocol are proposed: the first 12-month phase will involve observation of the baseline incidence of inappropriate screening for and treatment of ABU at both sites. This surveillance for clinical outcomes will continue at both sites throughout the study. Phase 2 consists of 12 months of individualized audit and feedback at the intervention site and guidelines distribution at both sites. The third phase, also over 12 months, will provide unit-level feedback at the intervention site to assess sustainability. Healthcare providers at the intervention site during phase 2 and at both sites during phase 3 will complete pre/post surveys of awareness and familiarity (knowledge, as well as of acceptance and outcome expectancy (attitudes regarding the relevant

  6. Calculating the respiratory flow velocity fluctuations in pericardial diseases.

    Science.gov (United States)

    Siniorakis, Eftychios; Arvanitakis, Spyridon; Zarreas, Elias; Barlagiannis, Dimitris; Skandalakis, Nikos; Karidis, Constantinos

    2010-11-01

    An excessive respiratory fluctuation (RTFV) in transmitral early diastolic velocity E is a pivotal Doppler echocardiographic sign of haemodynamic compromise, in constrictive pericardial diseases. RTFV is expressed as a percentage and 25% is considered a threshold value. Unfortunately there is no unanimity in calculating RTFV. Sometimes it is expressed as a percentage of expiratory E velocity, while others of inspiratory E velocity. This disparity has led to gross misinterpretations in medical literature. Here we emphasize the importance of a rational procedure calculating RTFV and we propose the appropriate mathematical model.

  7. Acute fatal pericardial effusion induced by accidental ingestion of cigarette butts in a dog.

    Science.gov (United States)

    Kim, Jung-Hyun; Lim, Jae-Hyun

    2016-02-01

    A dog was referred for collapse and tachypnea after ingesting cigarette butts. Thoracic radiography and echocardiography indicated pericardial effusion, and an electrocardiogram showed tachycardia, variable QRS complexes, and ventricular premature complexes. This is the first description of fatal pericardial effusion associated with cigarette butt ingestion in a veterinary patient.

  8. A Rare Case of Situs Inversus with Dextrocardia, Lutembacher Syndrome, and Pericardial Effusion

    Directory of Open Access Journals (Sweden)

    Vishakha V Jain

    2011-01-01

    Full Text Available Incidence of congenital cardiac anomalies in dextrocardia with situs inversus is low as compared to congenital cardiac anomalies in isolated dextrocardia. We describe the first ever case of situs inversus with dextrocardia, Lutembacher′s syndrome, and pericardial effusion. The pericardial effusion in our case was acquired and was tubercular in etiology.

  9. Thoracoscopic monitoring for pericardial application of local drug or gene therapy

    NARCIS (Netherlands)

    Tio, RA; Grandjean, JG; Suurmeijer, AJH; van Gilst, WH; van Veldhuisen, DJ; van Boven, AJ

    2002-01-01

    Cardiovascular gene therapy is a promising new approach for a variety of diseases. As far as gene therapy aimed at the myocardium is concerned a new transcutaneous delivery method may be into the pericardial sac. Objective: To evaluate the safety and applicability of the percutaneous pericardial del

  10. Pediatric tracheal reconstruction with pericardial patch and strips of autologous cartilage

    NARCIS (Netherlands)

    M.G. Hazekamp; D.R. Koolbergen; J. Kersten; J. Peper; B. de Mol; A. König-Jung

    2009-01-01

    OBJECTIVE: To analyze the results of pediatric tracheal reconstruction with autologous pericardial patch and strips of cartilage. METHODS: From September 2003 to February 2008 14 non-consecutive children were operated using pericardial patch augmentation of the trachea combined with external reinfor

  11. European Guidelines on Pericardial Diseases: a Focused Review of Novel Aspects.

    Science.gov (United States)

    Fardman, Alexander; Charron, Philippe; Imazio, Massimo; Adler, Yehuda

    2016-05-01

    Pericardial diseases are not uncommon in daily clinical practice. The spectrum of these syndromes includes acute and chronic pericarditis, pericardial effusion, constrictive pericarditis, congenital defects, and neoplasms. The extent of the high-quality evidence on pericardial diseases has expanded significantly since the first international guidelines on pericardial disease management were published by the European Society of Cardiology in 2004. The clinical practice guidelines provide a useful reference for physicians in selecting the best management strategy for an individual patient by summarizing the current state of knowledge in a particular field. The new clinical guidelines on the diagnosis and management of pericardial diseases that have been published by the European Society of Cardiology in 2015 represent such a tool and focus on assisting the physicians in their daily clinical practice. The aim of this review is to outline and emphasize the most clinically relevant new aspects of the current guidelines as compared with its previous version published in 2004. PMID:27007597

  12. Taponamiento cardíaco secundario a carcinoma papilar esclerosante difuso de tiroides Metastatic cardiac tamponade as initial manifestation of papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Verónica Riva

    2011-12-01

    gland. At the time of diagnosis, patients present lymph node and lung metastasis. It affects mainly young women. This case report describes a cardiac tamponade as the initial manifestation of an unusual variant of papillary thyroid carcinoma. A 32 year-old woman was attended at the emergency room with epigastric pain and dry cough. Physical examination revealed hypotension, tachycardia and decreased heart sounds. An echocardiogram confirmed severe pericardial effusion. Pericardial fluid cytology was positive for malignancy. The patient evolved with recurrent pericardial effusion and a pleuropericardial window was performed. At this procedure, a subpleural nodular lesion was found, which histology corresponded to metastases of papillary carcinoma, probably from thyroid origin. Total thyroidectomy was performed. The final diagnosis was papillary carcinoma, diffuse sclerosing variant. This variant infiltrates the connective tissue of the interfollicular spaces, mimicking thyroiditis and it is associated with early vascular permeation. This tumor, compared to the classic variants of thyroid carcinoma, is more aggressive and it has higher risk of recurrence. Papillary thyroid carcinoma should be considered as differential diagnosis in our population, in all metastatic papillary lesions, and even more in young female patients.

  13. Therapeutic Angiogenesis Using Local Perivascular and Pericardial Delivery.

    Science.gov (United States)

    Laham; Post; Sellke; Simons

    2000-08-01

    Therapeutic angiogenesis is a potential new treatment strategy that promises to grow new blood vessels to the ischemic myocardium in patients with ischemic heart disease. Despite its investigation in more than 550 patients with ischemic heart disease, the concept of clinical therapeutic angiogenesis remains a theoretic one with more questions than answers. This is due in part to a poor understanding of the fundamental mechanisms of adult collateralization and growth factor-induced angiogenesis, a poor understanding of the relative importance of large epicardial feeding collaterals versus intramyocardial neovascularization, and limited data concerning the best angiogenic cytokine, the best delivery modality, and the need for sustained exposure to that cytokine. This article discusses the available data on local perivascular delivery and pericardial delivery as they pertain to therapeutic angiogenesis. These delivery strategies have several characteristics that may make them ideal as adjuncts for coronary artery bypass surgery (local perivascular delivery) or in noninstrumented pericardium (pericardial delivery). They also have the theoretic advantage of affecting epicardial vessels and potentially promoting epicardial feeding collaterals.

  14. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  15. Densiron® 68 as an intraocular tamponade for complex inferior retinal detachments

    Directory of Open Access Journals (Sweden)

    Hussain RN

    2011-05-01

    Full Text Available Rumana N Hussain, Somnath BanerjeeLeicester Royal Infirmary, Leicester, UKIntroduction: Densiron® 68 is a high-density liquid used to tamponade inferior retinal detachments. We present a case series of 12 patients treated with Densiron as an intraocular tamponade agent.Methods: A retrospective analysis of 12 eyes in 12 patients was carried out. The primary endpoint was anatomic reattachment of the retina following removal of Densiron oil.Results: All patients had inferior detachments; 33% had associated proliferative vitreoretinopathy (PVR. Densiron was utilized as a primary agent in five patients (42%; the remaining patients had prior unsuccessful surgery for retinal reattachment, including pars plana vitrectomy, cryotherapy, laser, encirclement, gas (C3F8 or C2F6, or silicone oil. Eleven patients (91% had successful reattachment of the retina at 3 months following removal of Densiron; one patient had extensive PVR, total retinal detachment, preretinal macula fibrosis, and chronic hypotony, and surgical intervention was unsuccessful. Six patients (50% had raised intraocular pressure (IOP, resolving in the majority of cases following Densiron removal; two patients had long-term raised IOP requiring topical or surgical therapy. Of the six phakic patients, 50% developed significant cataract in the operated eye. Of those with successful retinal reattachment, visual outcome was variable, with 36% patients gaining two to four lines on Snellen, 27% remaining objectively the same, and 36% losing one to two lines.Conclusion: The anatomic success rate is high (91% in patients requiring Densiron tamponade for inferior retinal detachments with or without evidence of PVR either as a primary or secondary intervention. A common complication is raised IOP; however, this most often resolves following removal of the oil.Keywords: intraocular tamponade, silicone oil, retinal detachment, retinal reattachments

  16. Distinctive features of the microsurgical technique of the silicone oil tamponade in aphakic eyes

    Directory of Open Access Journals (Sweden)

    V.D. Zakharov

    2013-01-01

    Full Text Available ABSTRACT Purpose. To optimize the surgical technique of the silicone oil (SO tamponade in aphakic eyes with the retinal detachment (RD. Material and methods. The RD surgery treatment was performed in 49 eyes of 46 patients. All the patients have undergone pars plana vitrectomy with the silicone oil tamponade. During the operations 20G and 25G instruments were used. All the eyes were aphakic. The technological features of the operation were: the silicone oil injection by the single-step replacing method of perfluorocarbon liquid for silicone oil, the replacement of substances only on a sealed anterior chamber, the light silicone injection after the pre-contraction of the pupil, the peripheral iridectomy, the injection of the saline solution into the anterior chamber in order to prevent the SO migration during the mydriasis, the injection of the miotic solution into the anterior chamber in case of SO migration. Results. The silicone oil tamponade was performed successfully in all aphakic eyes. Silicone oil migrated into the anterior chamber intra-operatively in one case (2% and during the first day after operation in 2 cases (4.1%. In both cases silicone oil was removed from the anterior chamber by injecting the solution of miotic agent. A prominence of the silicone oil surface into the anterior chamber in the pupil area of various intensity degrees took place in 14 cases (28.6% intra-operatively and in 3 cases (6.1% in the early postoperative follow-up. Conclusions. The application of the above described technique of operation allows to prevent in proper time the migration of silicone into the anterior chamber of an eye at different stages of treatment, which makes the operation pars plana vitrectomy with silicone oil tamponade an effective and safe method of RD treatment in aphakic eyes.

  17. DFPE, PARTIALLY FLUORINATED ETHER: A Novel Approach for Experimental Intravitreal Tamponade.

    LENUS (Irish Health Repository)

    Santos, Rodrigo A V

    2012-07-16

    PURPOSE:: To evaluate decafluoro-di-n-pentyl ether (DFPE) as a vitreous tamponade by examining ocular tolerance in rabbits\\' eyes. METHODS:: Thirteen rabbits were divided into 4 groups after mechanical vitrectomy and were followed up to 12 months. The tamponade remained in the eye for 6 months in Group 1 (DFPE) and Group 3 (DFPE and silicone oil) and for 12 months in Group 2 (DFPE). Group 4 served as control. RESULTS:: In Groups 1, 2, and 3, dispersion of the fluid appeared 2 weeks postoperatively. Posterior subcapsular cataracts appeared in rabbits\\' eyes with large fills of DFPE (>50%). Histologic findings in Groups 1 and 2 showed no detectable change in outer nuclear layer thickness. Except for some vacuolations, the inner retina was well preserved in all injected rabbits\\' eyes. On the electroretinography of injected rabbits\\' eyes, there was no effect on the a wave amplitude and b wave implicit time, but the b wave amplitude was elevated with statistical significance (P < 0.001) at 1, 3, and 6 months postoperatively but with no statistical significance (P > 0.05) after that period when compared with Group 4 and unoperated fellow rabbits\\' eyes of each group. CONCLUSION:: Decafluoro-di-n-pentyl ether demonstrated minimum adverse effects in retinal rabbits; further studies are needed before clinical use as short-term tamponade.

  18. Visual and anatomical success with short-term macular tamponade and autologous platelet concentrate.

    LENUS (Irish Health Repository)

    Mulhern, M G

    2012-02-03

    BACKGROUND: This study aimed to determine whether, in eyes treated for macular hole by vitrectomy and autologous platelet injection, short-term tamponade with SF6 gas was as effective as longer tamponade with C3F8 gas. METHODS: Patients in group 1 (n=31) had vitrectomy, injection of platelet concentrate, and 16% C3F8 gas\\/air exchange. Patients in group 2 (n=31) were similarly treated, except that 23% SF6 gas was used. Group 1 patients were required to posture prone for 2-4 weeks, group 2 for 6 days. RESULTS: All patients had 3 months\\' follow-up. Postoperatively, visual acuity improved faster in group 2. However, the final mean improvement in logMAR acuity was similar in both groups. Intraocular pressure (IOP) spikes occurred in 12 patients in group 2 and in 17 patients in group 1. Posterior subcapsular cataract (PSCC) occurred in 55% of cases in group 1 and in just 37% in group 2. The rate of anatomical success in group 1 was 96.7%, and in group 2, 93.5% (P=1.0). CONCLUSIONS: The combination of SF6 gas, platelet concentrate, and short-term prone posturing gave a degree of anatomical and visual success comparable to that of the group which had longer tamponade. Although no differences were statistically significant, several trends did emerge; in group 2, patients recovered visual acuity faster, had fewer IOP spikes, and there were fewer cases of PSCC formation.

  19. MR imaging findings in 76 consecutive surgically proven cases of pericardial disease with CT and pathologic correlation.

    Science.gov (United States)

    Young, Phillip M; Glockner, James F; Williamson, Eric E; Morris, Michael F; Araoz, Philip A; Julsrud, Paul R; Schaff, Hartzell V; Edwards, William D; Oh, Jae K; Breen, Jerome F

    2012-06-01

    To describe findings of patients with surgically confirmed pericardial disease on state of the art MR sequences. Retrospective review was performed for patients who underwent pericardiectomy and preoperative MR over a 5 year period ending in 2009. Patients' records were reviewed to confirm the diagnosis of chronic recurrent pericarditis, constrictive pericarditis, or pericardial tumor. MR imaging findings of pericardial thickness, IVC diameter, presence or absence of pericardial or pleural effusion, pericardial edema, pericardial enhancement, and septal "bounce" were recorded. Patients with constriction had a larger IVC diameter (3.1 ± 0.4 cm) than patients with recurrent pain and no constriction (2.0 ± 0.4 cm). Mean pericardial thickness for the 16 patients with chronic recurrent pericarditis but no evidence of constriction was 4.8 ± 2.9 mm. Mean pericardial thickness for patients with constriction was 9.2 ± 7.0 cm with calcification, and 4.6 ± 2.1 cm without calcification. 94% of patients with chronic recurrent pericarditis had gadolinium enhancement of the pericardium, while 76% of patients with constriction had pericardial enhancement. Septal "bounce" was present in 19% of chronic recurrent pericarditis cases and 86% of constriction cases. 5 patients had a pericardial neoplasm, 1 of which was not identified preoperatively. State of the art MR techniques can identify significant and distinct findings in patients with chronic recurrent pericarditis, constrictive pericarditis, and pericardial tumors. PMID:21735292

  20. Recurrent hemorrhagic pericardial effusion in a child due to diffuse lymphangiohemangiomatosis: a case report

    Directory of Open Access Journals (Sweden)

    Bakhshi Sameer

    2010-02-01

    Full Text Available Abstract Introduction Recurrent hemorrhagic pericardial effusion in children with no identifiable cause is a rare presentation. Case presentation We report the case of a 4-year-old Indian girl who presented with recurrent hemorrhagic pericardial effusion. Diffuse lymphangiomatosis was suspected when associated pulmonary involvement, soft tissue mediastinal mass, and lytic bone lesions were found. Pericardiectomy and lung biopsy confirmed the diagnosis of diffuse lymphangiohemangiomatosis. Partial clinical improvement occurred with thalidomide and low-dose radiotherapy, but our patient died from progressive respiratory failure. Conclusion Diffuse lymphangiohemangiomatosis should be considered in the differential diagnosis of hemorrhagic pericardial effusion of unclear cause.

  1. Role of interspecies interactions in dual-species biofilms developed in vitro by uropathogens isolated from polymicrobial urinary catheter-associated bacteriuria.

    Science.gov (United States)

    Galván, E M; Mateyca, C; Ielpi, L

    2016-10-01

    Most catheter-associated urinary tract infections are polymicrobial. Here, uropathogen interactions in dual-species biofilms were studied. The dual-species associations selected based on their prevalence in clinical settings were Klebsiella pneumoniae-Escherichia coli, E. coli-Enterococcus faecalis, K. pneumoniae-E. faecalis, and K. pneumoniae-Proteus mirabilis. All species developed single-species biofilms in artificial urine. The ability of K. pneumoniae to form biofilms was not affected by E. coli or E. faecalis co-inoculation, but was impaired by P. mirabilis. Conversely, P. mirabilis established a biofilm when co-inoculated with K. pneumoniae. Additionally, E. coli persistence in biofilms was hampered by K. pneumoniae but not by E. faecalis. Interestingly, E. coli, but not K. pneumoniae, partially inhibited E. faecalis attachment to the surface and retarded biofilm development. The findings reveal bacterial interactions between uropathogens in dual-species biofilms ranged from affecting initial adhesion to outcompeting one bacterial species, depending on the identity of the partners involved.

  2. 导尿管相关性泌尿系感染的研究%Clinical Analysis of Guide Catheter Associated Urinary System Infection

    Institute of Scientific and Technical Information of China (English)

    韩静

    2015-01-01

    Urethral catheterization and catheterization technique of diagnosis and nursing measures are the most common, due to dif iculty in urination and other reasons need retention catheterization, subject to the asepsis operating rules, as far as possible to shorten the catheter retention time, strengthening of routine maintenance of urinary catheter, improve the monitoring measures, the sterile principle runs through the whole process of indwel ing catheter prevention is an important measure guided catheter associated urinary tract infection.%导尿术及留置导尿是最常见的诊疗技术和护理措施,因排尿困难及其他原因需要保留导尿时,在遵循无菌操作规程前提下,尽可能缩短尿管保留时间,加强导尿管的日常维护,完善各项监测措施,将无菌原则贯穿保留尿管的全过程是预防发生导尿管相关性泌尿系感染的重要措施。

  3. Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

    Directory of Open Access Journals (Sweden)

    Daiane Silva Resende

    2011-12-01

    Full Text Available INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7% CA-BSIs were observed. There were 46 (32% episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]. Neonates in the group after implementation of the intervention had 21 (19.6% episodes of CA-BSI (14.9 per 1,000 CVC days. The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04. In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

  4. Role of interspecies interactions in dual-species biofilms developed in vitro by uropathogens isolated from polymicrobial urinary catheter-associated bacteriuria.

    Science.gov (United States)

    Galván, E M; Mateyca, C; Ielpi, L

    2016-10-01

    Most catheter-associated urinary tract infections are polymicrobial. Here, uropathogen interactions in dual-species biofilms were studied. The dual-species associations selected based on their prevalence in clinical settings were Klebsiella pneumoniae-Escherichia coli, E. coli-Enterococcus faecalis, K. pneumoniae-E. faecalis, and K. pneumoniae-Proteus mirabilis. All species developed single-species biofilms in artificial urine. The ability of K. pneumoniae to form biofilms was not affected by E. coli or E. faecalis co-inoculation, but was impaired by P. mirabilis. Conversely, P. mirabilis established a biofilm when co-inoculated with K. pneumoniae. Additionally, E. coli persistence in biofilms was hampered by K. pneumoniae but not by E. faecalis. Interestingly, E. coli, but not K. pneumoniae, partially inhibited E. faecalis attachment to the surface and retarded biofilm development. The findings reveal bacterial interactions between uropathogens in dual-species biofilms ranged from affecting initial adhesion to outcompeting one bacterial species, depending on the identity of the partners involved. PMID:27642801

  5. STUDY OF AGE, SEX AND ETIOLOGIC SPECTRUM OF PERICARDIAL EFFUSION IN TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ravikaladhar Reddy

    2015-10-01

    Full Text Available Pericardial effusion is perhaps one of the most commonly overlooked clinical conditions and definite establishment of etiological agent is not always easy, successful or satisfactory. In this study, 50 cases of pericardial effusion admitted in Medical wards were analysed with emphasis on pattern of age and gender distribution, clinical presentation and et iology. The incidence of pericardial effusion common in age group between 21 - 40 years. The incidence of pericardial effusion is more in males. In the present study, the youngest patient is 15 year old and the oldest is 62 year old. Breathlessness being com monest symptom and raised JVP Is commonest sign. 60% of cases are of tuberculosis etiology, 15% are due to uremia and malignancy each, and 5% due to collagen vascular disease

  6. Procalcitonin and C-reactive protein in pericardial fluid for postmortem diagnosis of sepsis

    OpenAIRE

    Schrag, Bettina; Iglesias, Katia; Mangin, Patrice; Palmiere, Cristian

    2016-01-01

    The aim of this study was to investigate the presence and concentrations of procalcitonin and C-reactive protein in pericardial fluid and compare these levels to those found in the postmortem serum obtained from the femoral blood. Two groups were formed, a sepsis-related fatalities group and a control group. Postmortem native CT scans, autopsies, histology, neuropathology and toxicology as well as other postmortem biochemistry investigations were performed in all cases. Pericardial fluid proc...

  7. Neoinnervation and neovascularization of acellular pericardial-derived scaffolds in myocardial infarcts

    OpenAIRE

    Gálvez-Montón, Carolina; Fernandez-Figueras, M Teresa; Martí, Mercè; Soler-Botija, Carolina; Roura, Santiago; Perea-Gil, Isaac; Prat-Vidal, Cristina; Llucià-Valldeperas, Aida; Raya, Ángel; Bayes-Genis, Antoni

    2015-01-01

    Engineered bioimplants for cardiac repair require functional vascularization and innervation for proper integration with the surrounding myocardium. The aim of this work was to study nerve sprouting and neovascularization in an acellular pericardial-derived scaffold used as a myocardial bioimplant. To this end, 17 swine were submitted to a myocardial infarction followed by implantation of a decellularized human pericardial-derived scaffold. After 30 days, animals were sacrificed and hearts we...

  8. Symptomatic pericardial schwannoma treated with video-assisted thoracic surgery: a case report

    Science.gov (United States)

    Yun, Po-Jen; Huang, Tsai-Wang; Li, Yao-Feng; Chang, Hung; Lee, Shih-Chun

    2016-01-01

    Intrathoracic schwannomas are neurogenic tumors derived from the Schwann cells of the nerve sheath, most often seen in the posterior mediastinum with anatomical correlations to nerves. Although they are typically benign, a malignant transformation can occur, and thoracotomy instead of video-assisted thoracoscopic surgery (VATS) is required to achieve a complete resection. Only a few cases of pericardial schwannoma have been reported so far. We present a rare case of pericardial schwannoma confirmed by video-assisted thoracoscopic resection. PMID:27162698

  9. Assessment of pulmonary veins after atrio-pericardial anastomosis by cardiovascular magnetic resonance

    OpenAIRE

    Greenway Steven C; Yoo Shi-Joon; Baliulis Giedrius; Caldarone Christopher; Coles John; Grosse-Wortmann Lars

    2011-01-01

    Abstract Background The atrio-pericardial anastomosis (APA) uses a pericardial pouch to create a large communication between the left atrium and the pulmonary venous contributaries in order to avoid direct suturing of the pulmonary veins during the repair of congenital cardiac malformations. Post-operative imaging is routinely performed by echocardiography but Cardiovascular Magnetic Resonance (CMR) offers excellent anatomical imaging and quantitative information about pulmonary blood flow. W...

  10. A case of interventional and surgical treatment of ventricular tachycardia and pericardial cyst

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2013-12-01

    Full Text Available Pericardial cysts are infrequent lesions, accounting for approximately 7% of the mediastinal tumors. Asymptomatic patients with mediastinal cysts generally don’t require any surgical intervention. In published articles in Russia and abroad we did’t find any data on pericardial cysts that caused ventricular rhythm disturbances. In 49-years-old woman Holter ECG revealed 15 thousand monomorphic premature ventricular contractions and runs of non-sustained ventricular tachycardia. Transthoracic echocardiography showed deformation of the right atrium. Contrast-enhanced MRI of the heart showed a pericardial cyst. Parasitic origin of the cyst was excluded. After successful radiofrequency catheter ablation of premature ventricular contractions localized in interventricular septum from the left ventricular cavity, runs of non-sustained ventricular tachycardia with LBBB-morphology were diagnosed. Correlation between runs of non-sustained ventricular tachycardia and pericardial cyst was suspected. After successful surgical excision of the pericardial cyst there were no runs of ventricular tachycardia. Appropriate interventions allowed to treat patient with heart rhythm disturbances and to prevent complications due to pericardial cyst.

  11. Diagnosis of pericardial cysts using diffusion weighted magnetic resonance imaging: A case series

    Directory of Open Access Journals (Sweden)

    Mousavi Negareh

    2011-09-01

    Full Text Available Abstract Introduction Congenital pericardial cysts are benign lesions that arise from the pericardium during embryonic development. The diagnosis is based on typical imaging features, but atypical locations and signal magnetic resonance imaging sequences make it difficult to exclude other lesions. Diffusion-weighted magnetic resonance imaging is a novel method that can be used to differentiate tissues based on their restriction to proton diffusion. Its use in differentiating pericardial cysts from other pericardial lesions has not yet been described. Case presentation We present three cases (a 51-year-old Caucasian woman, a 66-year-old Caucasian woman and a 77-year-old Caucasian woman with pericardial cysts evaluated with diffusion-weighted imaging using cardiac magnetic resonance imaging. Each lesion demonstrated a high apparent diffusion coefficient similar to that of free water. Conclusion This case series is the first attempt to investigate the utility of diffusion-weighted magnetic resonance imaging in the assessment of pericardial cysts. Diffusion-weighted imaging may be a useful noninvasive diagnostic tool for pericardial cysts when conventional imaging findings are inconclusive.

  12. Outcome of 20-gauge transconjunctival cannulated sutureless vitrectomy using silicone oil or air tamponade

    Directory of Open Access Journals (Sweden)

    Mohamed AA

    2013-02-01

    Full Text Available Ahmed Abdel Alim Mohamed,1 Mohamed Abdrabbo21Ain Shams University, Faculty of Medicine, Ophthalmology Department, Cairo; 2Faculty of Medicine, Ophthalmology Department, Benha University, Benha, EgyptBackground: The purpose of this study was to assess the outcome of pars plana vitrectomy using a 20-gauge transconjunctival cannulated sutureless system with air or silicone oil tamponade in cases of retinal detachment of different etiologies.Methods: A prospective study was performed in 60 eyes from consecutive 60 patients who underwent 20-gauge transconjunctival cannulated sutureless vitrectomy (30 eyes with air tamponade and 30 eyes with silicone oil tamponade, with the inclusion of a further 30 patients who underwent conventional 20-gauge vitrectomy and served as a control group. The main outcome measures were intraocular pressure, wound leakage, and comfort score.Results: Preoperative intraocular pressure increased from 17.67 ± 5.6 mmHg preoperatively to 18.78 ± 6.1 mmHg on the first postoperative day in group A and decreased from 16.97 ± 4.9 mmHg to 15.88 ± 5.3 mmHg in group B. These changes were not statistically significant (P > 0.05. The comfort score ranged from 1 to 5 (1 = very bad, 2 = bad, 3 = good, 4 = very good, and 5 = excellent, with a mean of 4.4 ± 0.94 in group A and 4.35 ± 0.99 in group B on the first postoperative day, and no significant difference in scores between the groups at any follow-up visit. There was intraoperative wound leakage in two cases (6.7% in group A which required suturing and one case (3.3% in group B, but the difference was not statistically significant (P > 0.05. There was no wound leakage at follow-up in either group. No cases of hypotony, endophthalmitis, or unsealed sclerotomies were noted.Conclusion: Pars plana vitrectomy using a 20-gauge transconjunctival cannulated sutureless system combines the advantages of smaller-gauge vitrectomy systems with the economic advantage of not needing to purchase

  13. The effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation after off-pump coronary artery bypass graft.

    OpenAIRE

    Mahdi Haddadzadeh; Mahtab Motavaselian; Ali Akbar Rahimianfar; Seyed Khalil Forouzannia; Mahmood Emami; Kazem Barzegar

    2015-01-01

    The most common type of arrhythmia following coronary artery bypass graft (CABG) is atrial fibrillation (AF) with an incidence rate of 20-30%. Pericardial effusion is one of the etiologic factors of atrial fibrillation occurring after CABG. Posterior pericardiotomy (PP) causes the drainage of blood and fluids from the pericardial space into the pleural space leading to a decreased pericardial effusion. Most of the studies dealing with the occurrence of AF in the surgical operation of CABG hav...

  14. Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy 
in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer

    OpenAIRE

    Luo, Pengfei; Cao, Peiguo; Zhiping YAO

    2011-01-01

    Background and objective Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer. Methods Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined t...

  15. CT measurement of normal pericardial thickness in adults on computed tomography

    International Nuclear Information System (INIS)

    The purpose of this study was to establish, using computed tomography, the normal thickness of the pericardium in adults. Materials and Methods: CT scans of 50 patients, including sections through the level of the heart, were reviewed. Patients were excluded if there were any suspicions of pericardial abnormality such as infectious or neoplastic diseases. Twenty-four of the 50 were men and 26 were women; their mean age was 47.0(range,18-76) years. We measured pericardial thickness at the level of the right ventricle, interventricular septum and left ventricle, and also compared pericardial thickness in terms of age and sex. Results: In all patients, the pericardium was observed in the right ventricular region; in 41 (82%) at the interventricular septum; and in 41 (82%) along the left ventricle. The mean thickness of normal pericardium at the level of the right ventricle, interventricular septum, and left ventricle was 1.8 mm ± 0.5 mm, 1.8 mm ± 0.4 mm, and 1.7 mm ± 0.5 mm, respectively. No statistically significant correlation was apparent between pericardial thickness and age group (p > 0.63, ANOVA test). Mean pericardial thickness was 1.9 mm ± 0.6 mm in males and 1.7 mm ± 0.4 mm in females; thus, no statistically significant correlation was apparent between pericardial thickness and sex (p >0.29, Student's t-test). Conclusion: The pericardium was best visualized in sections through the right ventricle.The mean thickness of normal pericardium was 1.8 mm ± 0.5 mm and pericardial thickness did not differ according to age or sex

  16. Uterine Balloon Tamponade in Combination with Topical Administration of Tranexamic Acid for Management of Postpartum Hemorrhage

    Directory of Open Access Journals (Sweden)

    Masato Kinugasa

    2015-01-01

    Full Text Available While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.

  17. Calcium-phosphate deposits on a hydrophilic acrylic intraocular lens after silicon oil tamponade

    Directory of Open Access Journals (Sweden)

    Rashid Alsaeidi

    2008-01-01

    Full Text Available We report a 52-year-old man who underwent uncomplicated cataract operation and posterior chamber lens implantation (hydrophilic acrylic lens in his left eye 5 years prior to presentation. Two years after surgery he developed pseudophakic retinal detachment which was successfully treated with pars plana vitrectomy and silicon oil tamponade. The silicon oil was removed one year after surgery. A year later he complained of increasing blurred vision in the left eye. Clinical examination revealed vesicular alterations located superficially on the intraocular lens (IOL, which could not be removed by perflourocarbon-perflourohexloctane lavage. As the patient complained about increasing visual impairment, the IOL was removed. The IOL was investigated by electronmicroscopy and biochemical analysis. During electron microscopy and following biochemical analysis the observed alterations were identified as calcium-phosphate particles located on the superficial aspect of the IOL. The occurrence of calcium-phosphate deposits on a posterior chamber IOL after silicon oil tamponade is a rare complication and has not been described so far. As these deposits interfere with visual acuity, removal of the lens has to be considered.

  18. Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions

    Directory of Open Access Journals (Sweden)

    Paulo M. Pêgo-Fernandes

    2001-11-01

    Full Text Available OBJECTIVE: To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period. METHODS: From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion. Video-assisted pericardioscopy was performed through a small incision of the Marfan type. RESULTS: The diagnosis of pericardial effusion was established as follows: idiopathic in 9 (45% patients, neoplastic in 4 (20%, resulting from hypothyroidism in 3 (15%, tuberculous in 2 (10%, due to cholesterol in 1 (5%, and chylopericardial in 1 (5%. The biopsy was positive in 30% of the patients, and the etiology could not be defined in 45% of the patients. CONCLUSION: Video-assisted pericardioscopy proved to be a method with low morbidity and a high index of diagnostic positivity. A high percentage of pericardial effusions are caused by viral infections, which are not diagnosed through current methods, being, therefore, classified as idiopathic.

  19. 经皮心包穿刺术进行室性心律失常心外膜标测和消融的应用体会%Application of pericardial puncture for mapping and ablation of ventricular arrhythmias

    Institute of Scientific and Technical Information of China (English)

    薛玉梅; 詹贤章; 廖洪涛; 方咸宏; 魏薇; 刘洋; 廖自立; 邓海; 吴书林

    2015-01-01

    with VA who ac-cepted the subxyphoid pericardial puncture ( Sosa ’ s method ) for epicardial mappings. There were 28 men, 12 women,aged(46±13)years. Sixteen patients suffered from non-ischemic cardiomyopathies(NICM),11 arrhythmo-genic right ventricular cardiomyopathies( ARVC) ,3 ischemic cardiomyopathies( ICM) ,10 idiopathic VA. We ana-lyzed how to minimize the occurrence of complications associated with this technique,and how to rapidly recognize and treat the complications that they encountered. Results The pericardial punctures were done successfully at the first attempt in 25 patients,while in 15 patients the pericardial puncture were done successfully at the second attempt or more. Fifteen pericardial punctures were directed to the anterior wall of the right ventricle,while 25 were directed to the inferior wall. Totally in 35 cases(87. 5%) the ablations were successful,including targets on the epicardium in 15 patients,targets on both the endocardium and the epicardium in 14 patients,targets on the endocardium in 6 patients demonstrated by the combined endocardial and epicardial mappings. The combined en-docardial and epicardial ablation failed in two patients with ventricular tachycardias due to NICM. The ablations in 2 cases with idiopathic premature ventricular contractions were abandoned due to vicinity of coronary arteries. In one patient,the ablation was given up due to coronary artery injured by puncture. Totally 13 patients(32. 5%)suf-fered from complications including a severe one(2. 5%). There were 6 cases(15%)of right ventricular injuries without adverse results. There were 2 cases(5%)of bleeding in pericardial cavities,cured by drainage. The guide-wires entered the pleural cavities in 2 cases(5%),without adverse results. There was one case(2. 5%) of late pericardial tamponade,cured by drainage of 80 ml effusion. There was one case of acute pericardial tamponade due to injury of coronary artery,cured by emergent surgery. Thirty-five(87. 5%) patients

  20. Yellow Nail Syndrome Associated with Pericarditis and Pericardial Effusion: a Case Report

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2015-10-01

    Full Text Available Yellow nail syndrome (YNS is an uncommon condition characterized by nail changes, lymphedema, in addition to pulmonary disorders and pleural effusion. Pericarditis and non-cardiac disorders can evolve with pericardial effusions including autoimmune conditions, hypothyroidism, malignancies, tuberculosis, and uremia. A 72-year-old Brazilian woman under treatment for arterial hypertension and hypothyroidism was admitted with pericarditis and pericardial effusion concomitant with yellow nail syndrome. She denied tobacco smoking, alcohol abuse, and similar disorders in her family. Clinical and complementary evaluation ruled out infectious diseases, malignancies, and autoimmune disorders as etiologic factors in this case. Hypothyroidism is a well-known cause of pericardial effusion, the vast majority in the absence of pericarditis, and has been described as an associated condition in some individuals with YNS. Case studies might contribute to better understanding of these causal or casual relationships.

  1. The effectiveness of rigid pericardial endoscopy for minimally invasive minor surgeries: cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation

    Directory of Open Access Journals (Sweden)

    Kimura Takehiro

    2012-11-01

    Full Text Available Abstract Background The efficacy and safety of rigid pericardial endoscopy as the promising minimally invasive approach to the pericardial space was evaluated. Techniques for cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation were developed. Methods Two swine and 5 canines were studied to evaluate the safety and efficacy of rigid pericardial endoscopy. After a double pericardiocentesis, a transurethral rigid endoscope was inserted into the pericardial space. The technique to obtain a clear visual field was examined, and acute complications such as hemodynamic changes and the effects on intra-pericardial pressure were evaluated. Using custom-made needles, pacemaker leads, and forceps, the applications for cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation were also evaluated. Results The use of air, the detention of a stiff guide wire in the pericardial space, and the stretching of the pericardium with the rigid endoscope were all useful to obtain a clear visual field. A side-lying position also aided observation of the posterior side of the heart. As a cell transplantation methodology, we developed an ultrasonography-guided needle, which allows for the safe visualization of transplantation without major complications. Pacemaker leads were safely and properly implanted, which provides a better outcome for cardiac resynchronizing therapy. Furthermore, the success of clear visualization of the pulmonary veins enabled us to perform epicardial ablation. Conclusions Rigid pericardial endoscopy holds promise as a safe method for minimally invasive cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation by allowing clear visualization of the pericardial space.

  2. Analysis of integrated ICU catheter associated nosocomial infection and related factors%综合性ICU导管相关性医院感染及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    范红莉

    2016-01-01

    Objective:To explore the integrated ICU catheter associated nosocomial infection and related factors.Methods:320 patients with integrated ICU catheter associated nosocomial infection were selected.The clinical data were retrospectively analyzed.Results:The positive rate of blood flow infection,pulmonary infection and urinary tract infection was 22.81%,51.56% and 25.63% respectively,and the positive rate of pulmonary infection was the highest(P0.05).Conclusion:Pulmonary infection was the most in integrated ICU catheter associated nosocomial infection,and gram negative bacteria were the main pathogens.Catheter associated nosocomial infection may not be an independent risk factor for mortality.%目的:探讨综合性ICU导管相关医院感染和相关因素。方法:收治综合性ICU导管相关性医院感染患者320例,回顾性分析临床资料。结果:血流感染、肺部感染及尿路感染阳性检出率分别为22.81%、51.56%及25.63%,其中,肺部感染阳性率最高(P<0.01)。革兰阴性菌、革兰阳性菌及假丝酵母菌构成比分别为67.81%、16.88%及15.31%,其中,革兰阴性菌构成比最高(P<0.01)。血流感染、肺部感染及尿路感染患者中死亡率分别为16.44%、15.76%及13.41%(P>0.05)。结论:ICU导管相关性医院感染以肺部感染为主,革兰阴性菌为主要病原菌。导管相关性医院感染可能并非影响死亡率的独立危险因素。

  3. Plasma Cell Type of Castleman's Disease Involving Renal Parenchyma and Sinus with Cardiac Tamponade: Case Report and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Un; Kim, Suk; Lee, Jun Woo; Lee, Nam Kyung; Jeon, Ung Bae; Ha, Hong Gu; Shin, Dong Hoon [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2012-09-15

    Castleman's disease is an uncommon disorder characterized by benign proliferation of the lymphoid tissue that occurs most commonly in the mediastinum. Although unusual locations and manifestations have been reported, involvement of the renal parenchyma and sinus, and moreover, manifestations as cardiac tamponade are extremely rare. Here, we present a rare case of Castleman's disease in the renal parenchyma and sinus that also accompanied cardiac tamponade.

  4. [Progress or regress or both? ESC guidelines on pericardial diseases 2015].

    Science.gov (United States)

    Maisch, B

    2015-12-01

    Eleven years after the publication of the first guidelines worldwide on pericardial diseases by the European Society of Cardiology (ESC), the international expert group of the ESC has updated the original document of 28 pages with 275 references. The final version of the new guidelines is more voluminous with 44 pages of recommendations but only 233 references. A continuing medical education (CME) certified update of the 2004 guidelines was published in the journal Herz volume 7/2014. In comparison to 2004 the 2015 guidelines have remained virtually unchanged in the sections detailing diagnostics, differential diagnosis, pathology and pathophysiology. Substantial progress has been made in magnetic resonance imaging (MRI) of pericarditis and epicarditis and in the practically universal recommendation of colchicine for all forms of pericarditis and pericardial effusion, whether acute, chronic or recurrent. This can truly be called progress; however, little has changed since 2004 even in tertiary referral centers or universities with respect to the etiological classification of acute or recurrent forms of pericarditis or pericardial effusion. By classifying pericardial syndromes much too often as idiopathic when a malignant or bacterial cause has been excluded, the underlying cause is often overlooked. Standstill in diagnosis is in the end regress because we too often lag behind our actual diagnostic and interventional possibilities. PMID:26644393

  5. Pericardial and abdominal fluid accumulation in congenital disorder of glycosylation type Ia.

    NARCIS (Netherlands)

    Truin, G.; Guillard, M.; Lefeber, D.J.; Sykut-Cegielska, J.; Adamowicz, M.; Hoppenreijs, E.; Sengers, R.C.A.; Wevers, R.A.; Morava, E.

    2008-01-01

    The association of fetal hydrops with Congenital Disorders of Glycosylation (CDG) has been reported previously. Pericardial fluid accumulation and ascites were also observed in a few young patients with CDG type Ia. Here we describe the clinical and biochemical features in three children developing

  6. Pericardial effusion in atrial fibrillation ablation: a comparison between cryoballoon and radiofrequency pulmonary vein isolation.

    NARCIS (Netherlands)

    Chierchia, G.B.; Capulzini, L.; Droogmans, S.; Sorgente, A.; Sarkozy, A.; Muller-Burri, A.; Paparella, G.; Asmundis, C. de; Yazaki, Y.; Kerkhove, D.; Camp, G. van; Brugada, P.

    2010-01-01

    AIMS: Atrial fibrillation (AF) ablation is increasingly being performed in electrophysiology laboratories. Pericardial effusion (PE) is certainly one of the most frequently observed complications during AF ablation. The aim of our study was to investigate the incidence and outcome of PE following cr

  7. Silent Ischemic Heart Disease and Pericardial Fat Volume in HIV-Infected Patients

    DEFF Research Database (Denmark)

    Kristoffersen, Ulrik S; Lebech, Anne-Mette; Wiinberg, Niels;

    2013-01-01

    to determine the prevalence of asymptomatic ischemic heart disease (IHD) in HIV patients by myocardial perfusion scintigraphy (MPS) and to determine the value of coronary artery calcium score (CACS), carotid intima-media thickness (cIMT) and pericardial fat volume as screening tools for detection...

  8. Comparison of Primary Gas Tamponade and a Vitrectomy for Repair of Macular Holes with Retinal Detachment in Highly Myopic Eyes

    OpenAIRE

    Chien-Neng Kuo; Hsi-Kung Kuo; Chian-Jue Kuo; Hsueh-Wen Chang; Min-Lun Kao; Yeong-Ren Chen; Hsih-Hao Tsai; Pei-Chang Wu; Chun-Chia Su

    2003-01-01

    Background: A preference for the primary use of standard gas tamponade or a vitrectomycombined with other adjuvant measures to treat myopic eyes with macularholes (MHs) and retinal detachment (RD) has not been established. This articleevaluates postoperative outcomes of both surgeries, and recommends asurgical method based on the findings.Methods: We reviewed the records of 61 patients (62 eyes) with high myopia (> -6.0diopter, > 26 mm of axial length, or visible posterior staphyloma) and MHs...

  9. Full Thickness Macular Hole Closure after Exchanging Silicone-Oil Tamponade with C3F8 without Posturing

    Directory of Open Access Journals (Sweden)

    Tina Xirou

    2011-05-01

    Full Text Available Purpose: To report a case of macular hole closure after the exchange of a silicone-oil tamponade with gas C3F8 14%. Method: A 64-year-old female patient with a stage IV macular hole underwent a three-port pars-plana vitrectomy and internal limiting membrane peeling. Due to the patient’s chronic illness (respiratory problems, a silicone-oil tamponade was preferred. However, the macula hole was still flat opened four months postoperatively. Therefore, the patient underwent an exchange of silicone oil with gas C3F8 14%. No face-down position was advised postoperatively due to her health problems. Results: Macular hole closure was confirmed with optical coherence tomography six weeks after exchanging the silicone oil with gas. Conclusions: Macular hole surgery using a silicone-oil tamponade has been proposed as treatment of choice for patients unable to posture. In our case, the use of a long-acting gas (C3F8 14%, even without posturing, proved to be more effective.

  10. Acute Central Retinal Artery Occlusion Associated with Intraocular Silicone Oil Tamponade

    Directory of Open Access Journals (Sweden)

    Mehmet Yasin Teke

    2012-05-01

    Full Text Available Many systemic and ocular factors may cause acute central retinal artery occlusion (CRAO. Herein, we aimed to describe a case of CRAO due to intraocular silicone oil (SO tamponade. To the best of our knowledge, a case like our has not been reported previously. A 58-yearold male patient had undergone combined pars plana vitrectomy-lensectomy and intraocular SO for lens luxation and vitreus hemorrhage associated with a blunt ocular trauma in his right eye. Two weeks after the surgery, he presented with acute vision loss in the same eye. He was diagnosed with acute CRAO and it should be related with mechanical press or raised intraocular pressure (IOP associated with SO. He was treated by partial removal of SO immediately. In spite of the regression of retina edema, his visual acuity did not improve due to optic atrophy. SO may cause CRAO due to raised IOP and/or its mechanical pressure and this complication must be kept in mind. (Turk J Oph thal mol 2012; 42: 238-40

  11. The value of serum tumour markers in the prediction of aetiology and follow up of patients with pericardial effusion

    OpenAIRE

    Bildirici, U; Celikyurt, U; ACAR, E.; Sahin, T.; Kozdag, G; Ural, D; Bulut, O

    2012-01-01

    Background The aim of this study was to evaluate the value of tumour markers in the differential diagnosis of pericardial effusions and to assess their changing levels during follow up. Methods Sixty-nine patients who were admitted to hospital with a diagnosis of pericardial effusion were included in the study. Serum tumour markers were measured on admission and after a mean of 18 ± 7 months’ follow up. An aetiological diagnosis was made on clinical evaluation, imaging techniques and biochemi...

  12. Myogenic differentiation and reparative activity of stromal cells derived from pericardial adipose in comparison to subcutaneous origin

    OpenAIRE

    Wang, Xiaoming; Zhang, Hui; Nie, Liangming; Xu, Linhai; Chen, Min; Ding, Zhaoping

    2014-01-01

    Introduction Adipose tissue-derived stromal cells (ADSCs) are abundant and easy to obtain, but the diversity of differentiation potential from different locations may vary with the developmental origin of their mesenchymal compartment. We therefore aim to compare the myogenic differentiation and reparative activity of ADSCs derived from the pericardial tissue to ADSCs of subcutaneous origin. Methods Pericardial and inguinal adipose tissues from Wistar rats were surgically obtained, and the st...

  13. [Suggesting the Significance of Pericardial Fat Pad in Bronchial Stump Fistula].

    Science.gov (United States)

    Fukuoka, Tomoki; Sano, Masaaki; Tominaga, Nasa; Sanada, Shotaro; Uno, Yasuo; Oya, Hisaharu; Nishi, Tetsuo; Koshikawa, Katsumi

    2016-05-01

    Bronchial stump fistula is a post-operative complication with poor outcome after pulmonary lobectomy. In order to prevent this complication, the bronchial stump is covered with pericardial fat tissue in our hospital. The case was 58 year old male who received adjuvant chemotherapy after sigmoidectomy for sigmoid colon cancer. As he developed multiple pulmonary metastases, 48 courses of chemotherapy were performed. The lesions had been localized at the right lower lobe, and neither increase in the size of these lesions nor development of other lesions were observed. Hence, an operation was performed. After right lower lobectomy, the bronchial stump was covered with the pericardial fat tissue. Three months after the operation, he developed pneumothorax, and bubbles were detected inside the fat. The pneumothorax was cured conservatively, and the bubbles disappeared spontaneously after 10 months. It is rare that the patient with bubbles in the covering tissue observed for a long time is cured conservatively, suggesting the significance of the stump pad.

  14. Surgical management of macular holes: results using gas tamponade alone, or in combination with autologous platelet concentrate, or transforming growth factor beta 2.

    LENUS (Irish Health Repository)

    Minihan, M

    2012-02-03

    BACKGROUND: Vitrectomy and gas tamponade has become a recognised technique for the treatment of macular holes. In an attempt to improve the anatomic and visual success of the procedure, various adjunctive therapies--cytokines, serum, and platelets--have been employed. A consecutive series of 85 eyes which underwent macular hole surgery using gas tamponade alone, or gas tamponade with either the cytokine transforming growth factor beta 2 (TGF-beta 2) or autologous platelet concentrate is reported. METHODS: Twenty eyes had vitrectomy and 20% SF6 gas tamponade; 15 had vitrectomy, 20% SF6 gas, and TGF-beta 2; 50 had vitrectomy, 16% C3F8 gas tamponade, and 0.1 ml of autologous platelet concentrate prepared during the procedure. RESULTS: Anatomic success occurred in 86% of eyes, with 96% of the platelet treated group achieving closure of the macular hole. Visual acuity improved by two lines or more in 65% of the SF6 only group, 33% of those treated with TGF-beta 2 and in 74% of the platelet treated group. In the platelet treated group 40% achieved 6\\/12 or better and 62% achieved 6\\/18 or better. The best visual results were obtained in stage 2 holes. CONCLUSION: Vitrectomy for macular holes is often of benefit and patients may recover good visual acuity, especially early in the disease process. The procedure has a number of serious complications, and the postoperative posturing requirement is difficult. Patients need to be informed of such concerns before surgery.

  15. Hemoglobin-associated Oxidative Stress in the Pericardial Compartment of Post-operative Cardiac Surgery Patients

    OpenAIRE

    Kramer, Philip A.; Chacko, Balu K; Ravi, Saranya; Johnson, Michelle S.; Mitchell, Tanecia; Barnes, Stephen; Arabshahi, Alireza; Dell’Italia, Louis J.; George, David J.; Steele, Chad; George, James F.; Darley-Usmar, Victor M.; Melby, Spencer J.

    2014-01-01

    Atherosclerosis and valvular heart disease often require treatment with corrective surgery to prevent future myocardial infarction, ischemic heart disease, and heart failure. Mechanisms underlying the development of the associated complications of surgery are multifactorial and have been linked to inflammation and oxidative stress, classically as measured in the blood or plasma of patients. Post-operative pericardial fluid (PO-PCF) has not been investigated in depth with respect to the potent...

  16. Atherosclerosis associated with pericardial effusion in a central bearded dragon (Pogona vitticeps).

    Science.gov (United States)

    Schilliger, Lionel; Lemberger, Karin; Chai, Norin; Bourgeois, Aude; Charpentier, Maud

    2010-09-01

    Atherosclerosis is a common disease in pet birds, particularly in psittacines, and is frequently found when performing postmortem examinations on adult and old dogs, in which it is mainly associated with endocrine diseases, such as hypothyroidism and diabetes mellitus. However, atherosclerosis is poorly documented in reptiles and consequently poorly understood. In the current case report, atherosclerosis and pericardial effusion were diagnosed in a 2-year-old male central bearded dragon (Pogona vitticeps) based on ultrasound visualization, necropsy, and histologic examination. PMID:20807945

  17. Pericardial sac perforation: a rare complication of neonatal nasogastric tube feeding

    Energy Technology Data Exchange (ETDEWEB)

    El-Din Mahmoud Hanafy, Emad; Al Naqeeb, Niran [Al-Adan Hospital, Neonatal ICU, Department of Paediatrics, Hawally (Kuwait); Ashebu, Samuel D.; Bopaya Nanda, Harini [Al-Adan Hospital, Department of Diagnostic Radiology and Imaging, P.O. Box 43721, Hawally (Kuwait)

    2006-10-15

    The insertion of a nasogastric tube for feeding and gastric aspiration is a common practice in the care of newborns, especially if they are preterm and unwell. Esophageal perforation is a rare but serious complication of this procedure. Associated perforation of the pericardial sac is an unusual, severe, and previously unreported complication of nasogastric tube feeding in a neonate. We present an illustrative case. (orig.)

  18. Commentary on: Pericardial Fat is Independently Associated with Human Atrial Fibrillation by Al Chekakie et al.

    OpenAIRE

    Omar Batal, MD; Mina K. Chung, MD

    2010-01-01

    Obesity is an established risk factor for atrial fibrillation (AF).1 In fact, it has been reported that the increasing prevalence of obesity in the United States could account for up to 60 % of the increasing incidence of age and sex adjusted AF.2 Adipose tissue has been shown to be highly metabolically active and secretes several proinflammatory mediators; however, different fat depots differ in metabolic and inflammatory activity.3 Pericardial fat produces several inflammatory cytokines and...

  19. Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine.

    Science.gov (United States)

    Iles, Tinen L; Howard, Brian; Howard, Stephen; Quallich, Stephen; Rolfes, Christopher; Richardson, Eric; Iaizzo, Hanna R; Iaizzo, Paul A

    2016-01-01

    To date, many pharmacological agents used to treat or prevent arrhythmias in open-heart cases create undesired systemic side effects. For example, antiarrhythmic drugs administered intravenously can produce drops in systemic pressure in the already compromised cardiac patient. While performing open-heart procedures, surgeons will often either create a small port or form a pericardial cradle to create suitable fields for operation. This access yields opportunities for target pharmacological delivery (antiarrhythmic or ischemic preconditioning agents) directly to the myocardial tissue without undesired side effects. We have developed a swine model for testing pharmacological agents for target delivery within the pericardial fluid. While fully anesthetized, each animal was instrumented with a Swan-Ganz catheter as well as left and right ventricle pressure catheters, and pacing leads were placed in the right atrial appendage and the right ventricle. A medial sternotomy was then performed and a pericardial access cradle was created; a plunge pacing lead was placed in the left atrial appendage and a bipolar pacing lead was placed in the left ventricle. Utilizing a programmer and a cardiac mapping system, the refractory period of the atrioventricular node (AVN), atria and ventricles was determined. In addition, atrial fibrillation (AF) induction was produced utilizing a Grass stimulator and time in AF was observed. These measurements were performed prior to treatment, as well as 30 min and 60 min after pericardial treatment. Additional time points were added for selected studies. The heart was then cardiopleged and reanimated in a four chamber working mode. Pressure measurements and function were recorded for 1 hr after reanimation. This treatment strategy model allowed us to observe the effects of pharmacological agents that may decrease the incidence of cardiac arrhythmias and/or ischemic damage, during and after open-heart surgery. PMID:27500319

  20. Fibrinous Pericardial Effusion and Valvulitis Secondary to Previous Acute Rheumatic Fever: An Unusual Clinical Presentation

    OpenAIRE

    Osman Yılmaz; Ömer Kılıç; Murat Çiftel

    2014-01-01

    Rheumatic heart disease, a sequela to acute rheumatic fever (ARF), is a major cause of acquired heart disease in children and young adults in developing countries. Valvular disease of variable severity, heart failure, and pericarditis has been observed in patients with rheumatic heart disease. A 12-year-old female patient presented with fever presented for 3 days, continuing for fatigue, exhaustion, and chest pain. Echocardiography revealed a pericardial effusion with a 24-mm-thick fibrin acc...

  1. Genomic analysis of a pathogenicity island in uropathogenic Escherichia coli CFT073: distribution of homologous sequences among isolates from patients with pyelonephritis, cystitis, and Catheter-associated bacteriuria and from fecal samples.

    Science.gov (United States)

    Guyer, D M; Kao, J S; Mobley, H L

    1998-09-01

    Urinary tract infection is the most frequently diagnosed kidney and urologic disease and Escherichia coli is by far the most common etiologic agent. Uropathogenic strains have been shown to contain blocks of DNA termed pathogenicity islands (PAIs) which contribute to their virulence. We have defined one of these regions of DNA within the chromosome of a highly virulent E. coli strain, CFT073, isolated from the blood and urine of a woman with acute pyelonephritis. The 57,988-bp stretch of DNA has characteristics which define PAIs, including a size greater than 30 kb, the presence of insertion sequences, distinct segmentation of K-12 and J96 origin, GC content (42.9%) different from that of total genomic DNA (50.8%), and the presence of virulence genes (hly and pap). Within this region, we have identified 44 open reading frames; of these 44, 10 are homologous to entries in the complete K-12 genome sequence, 4 are nearly identical to the sequences of E. coli J96 encoding the HlyA hemolysin, 11 encode P fimbriae, and 19 show no homology to J96 or K-12 entries. To determine whether sequences found within the junctions of the PAI of CFT073 were common to other uropathogenic strains of E. coli, 11 probes were isolated along the length of the PAI and were hybridized to dot blots of genomic DNA isolated from clinical isolates (67 from patients with acute pyelonephritis, 38 from patients with cystitis, 49 from patients with catheter-associated bacteriuria, and 27 from fecal samples). These sequences were found significantly more often in strains associated with the clinical syndromes of acute pyelonephritis (79%) and cystitis (82%) than in those associated with catheter-associated bacteriuria (58%) and in fecal strains (22%) (P < 0.001). From these regions, we have identified a putative iron transport system and genes other than hly and pap that may contribute to the virulent phenotype of uropathogenic E. coli strains.

  2. Preventing catheter-associated infections in the Pediatric Intensive Care Unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    Marcelo Luiz Abramczyk

    2011-12-01

    Full Text Available Objectives: To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit. Patients and Methods: All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance. Results: One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions and in 2,954 patient-days (39.9 infections per 1,000 patient-days. The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28-1.01]. Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07-1.49], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32-1.14]. Conclusion: A prevention strategy targeted at the insertion and maintenance of vascular access can decrease rates of vascular-access infections in pediatric intensive care unit.

  3. Implementation of the updated 2015 Commission for Hospital Hygiene and Infection Prevention (KRINKO recommendations “Prevention and control of catheter-associated urinary tract infections” in the hospitals in Frankfurt/Main, Germany

    Directory of Open Access Journals (Sweden)

    Heudorf, Ursel

    2016-06-01

    Full Text Available Aim: The Commission for Hospital Hygiene and Infection Prevention (KRINKO updated the recommendations for the prevention of catheter-associated urinary tract infections in 2015. This article will describe the implementation of these recommendations in Frankfurt’s hospitals in autumn, 2015.Material and methods: In two non-ICU wards of each of Frankfurt’s , inspections were performed using a checklist based on the new KRINKO recommendations. In one large hospital, a total of were inspected. The inspections covered the structure and process quality (operating instructions, training, indication, the placement and maintenance of catheters and the demonstration of the preparation for insertion of a catheter using an empty bed and an imaginary patient, or insertion in a model.Results: Operating instructions were available in all hospital wards; approximately half of the wards regularly performed training sessions. The indications were largely in line with the recommendations of the KRINKO. Alternatives to urinary tract catheters were available and were used more often than the urinary tract catheters themselves (15.9% vs. 13.5%. In accordance with the recommendations, catheters were placed without antibiotic prophylaxis or the instillation of antiseptic or antimicrobial substances or catheter flushing solutions. The demonstration of catheter placement was conscientiously performed. Need for improvement was seen in the daily documentation and the regular verification of continuing indication for a urinary catheter, as well as the omission of regular catheter change.Conclusion: Overall, the recommendations of the KRINKO on the prevention of catheter-associated urinary tract infections were adequately implemented. However, it cannot be ruled out that in situations with time pressure and staff shortage, the handling of urinary tract catheters may be of lower quality than that observed during the inspections, when catheter insertion was done by two

  4. ACUTE PHASE REACTANCTS IN PERICARDIAL FLUID ARE INDICATORS OF CORONARY ARTERY DISEASE

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    Yılmaz Mehmet Ali

    2012-12-01

    Full Text Available Inflammation in formation of atherosclerosis, and acute phase reactants in the site of inflammation have major functions. Thus, do the acute phase reactants constitute the biggest risk factor for coronary artery disease? 55 patients are included in the study. Patients with coronary artery bypass surgery are included in Group I (38 patients and patients with valve operation are included in Group II (17 patients. CABG patients are further divided into two sub-groups as on-pump and off-pump. In both groups, homocystein, high sensitivity C reactive protein, ceruloplasmin, lipoprotein A and serum amyloid A protein levels are analyzed from blood and pericardial fluid. In patients with coronary artery disease, the measured high specific C- reactive protein levels from blood and pericardial fluid are found to be significantly high compared to patients with valve operation.Homocystein levels of pericardial fluids of patients with CABG are found to be higher than patients with valve operation and it is confirmed that the situation is correlated with blood homocystein levels. Although there are lots studies expressing the relation between coronary artery disease and lipoprotein A, ceruloplasmin and serum amyloid A protein levels; no significant difference for those parameters was obtained in our study. We determined that other phase reactants are higher in patients with coronary artery disease, in accordance with the literature. We aimed to state that acute phase reactants not only increase as a result of disease, but their levels are also elevated beforehand, as an indicator of the disease.

  5. Pericardial Mesothelioma in a Yellow-naped Amazon Parrot (Amazona auropalliata).

    Science.gov (United States)

    McCleery, Brynn; Jones, Michael P; Manasse, Jorden; Johns, Sara; Gompf, Rebecca E; Newman, Shelley

    2015-03-01

    A 37-year-old female yellow-naped Amazon parrot (Amazona auropalliata) was presented with a history of lethargy, inappetence, and decreased vocalizations. On examination, the coelom was moderately distended and palpated fluctuant, and the heart was muffled on auscultation. Coelomic ultrasound, coelomocentesis, and radiographs were performed and revealed an enlarged cardiac silhouette and marked coelomic effusion. Pericardial effusion was confirmed by echocardiography. A well-circumscribed, hyperechoic soft tissue density was observed at the level of the right atrium on initial echocardiography; however, a cardiac mass was not identified by computed tomography scan or repeat echocardiograms. Ultrasound-guided pericardiocentesis was performed under anesthesia, and cytology results were consistent with hemorrhage; no neoplastic cells were identified. A repeat echocardiogram 4 days after pericardiocentesis revealed recurrence of the pericardial effusion. Due to the grave prognosis, the owners declined endoscopic pericardiectomy, and the patient died the following day. On postmortem examination, the pericardial surface of the heart was covered in a white to yellow, multinodular mass layer. Histologic analysis revealed a multinodular mass extending from the atria, running along the epicardium distally, and often extending into the myocardium. Neoplastic cells present in the heart mass and pericardium did not stain with a Churukian-Schenk stain, and thyroglobulin immunohistochemistry was negative. Cytokeratin and vimentin stains showed positive expression in the neoplastic cells within the mass. These results are consistent with a diagnosis of mesothelioma. This is the first report of mesothelioma in a psittacine bird. PMID:25867668

  6. A rare combination of hepatic and pericardial hydatid cyst and review of literature

    Directory of Open Access Journals (Sweden)

    Kallol Dasbaksi

    2015-01-01

    Full Text Available Hydatid disease in human beings, as in all intermediate hosts, manifest as hydatid cyst (HC. It is an important cyclozoonotic disease, endemic in various sheep and cattle raising areas of the world, including India. The tapeworm commonly involved is Echinococcus granulosus. HC can occur almost anywhere in the body, most common organs being liver and lungs, and are usually solitary. In 25% of cases combination of liver HC with HC in other extra pulmonary locations are found. Cardiac HCs comprise of 0.5–2% of all HC cases. Within the heart, HCs are usually situated in the left or right ventricle and rarely found in the peri-cardium. Pericardial HC does not produce symptoms and is often painless and silent, until the cysts grow to a large size over the years, when the usual complications develop, such as cyst rupture, cardiac compression, atrial fibrillation, and even sudden death. We describe the case of a 39 year old house wife, of rural origin, with proximity to livestock, who had an asymptomatic pericardial HC along with a symptomatic hepatic HC. She clinically presented with an abdominal lump for one year with recent onset of abdominal pain for 1 month, when radiological imaging confirmed the diagnosis of an unruptured hepatic HC and a pericardial HC. The patient recovered after pericardiectomy along with excision of the HC over the left ventricle and enucleation of hepatic HC, by thoracoabdominal approach. She is doing well after 5 years of followup without recurrence.

  7. REGULATING EFFECTS OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND ANGⅡ ON FROG'S PERICARDIAL STOMATA, MESOTHELIUM AND ANGIOGENESIS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. To observe the regulating effects of vascular endothelial growth factor (VEGF) and angiotensinⅡ (ANG II) on the frog's pericardium, lymphatic stomata and angiogenesis so as to reveal their effects and mechanism on the mesothelial permeability, lymphatic stoma regulation and myocardial hypertrophy. Methods. VEGF and ANGⅡ were injected into the frog's peritoneal cavity so as to examine the changes of the pericardial stromata by using transmission electron microscopy, scanning electron microscopy and computerized imaging analysis. Results. Scattered distributed pericardial stomata were found on the parietal pericardium of the frog with a few sinusoid mesothelial cells, whose blood supply was directly from the cardiac chambers flowing into the trabecular spaces of the myocardium (because there are no blood vessels in the myocardium of the frog). The average diameters of the pericardial stomata in VEGF and ANGⅡ groups were 1.50 μ m and 1.79 μ m respectively, which were much larger than those in the control group (0.72 μ m, P< 0.01); the average distribution densities of the stomata were 8.25/0.1 mm2 and 12.80/0.1 mm2 in VEGF and ANGⅡ groups, which were also much higher than those in the control group (3.57/0.1 mm2, P< 0.01); the sinusoid areas in VEGF and ANGⅡ groups were 2442.95 μ m2/0.1 mm2 and 2121.79 μ m2/0.1 mm2, which were larger than that in the control group (995.08 μ m2 /0.1 mm2 , P< 0.01); no angiogenesis was found in the frogs of the experimental groups. Conclusions. VEGF and ANGⅡ could strongly regulate the pericardial stomata by increasing their numbers and openings with larger diameters and higher distribution density. They could also increase the sinusoid areas with the result of the higher permeability of the pericardium, which clearly indicated that VEGF and ANGⅡ could speed up the material transfer of the pericardial cavity and play an important role in preventing myocardial interstitial edema. Yet there was no strong

  8. Development of ocular hypertension secondary to tamponade with light versus heavy silicone oil: A systematic review

    Directory of Open Access Journals (Sweden)

    Vito Romano

    2015-01-01

    Full Text Available Aim: The intraocular silicone oil (SO tamponades used in the treatment of retinal detachment (RD have been associated with a difference ocular hypertension (OH rate. To clarify, if this complication was associated to use of standard SO (SSO versus heavy SO (HSO, we performed a systematic review and meta-analysis of comparative study between two kind of SO (standard or light vs. heavy for the treatment of RD and macular hole, without restriction to study design. Materials and Methods: The methodological quality of two randomized clinical trials (RCTs were evaluated using the criteria given in the Cochrane Handbook for Systematic Reviews of Intervention, while three non-RCTs were assessed with the Newcastle-Ottawa Scale and Strengthening the Reporting of Observational Studies in Epidemiology checklists. We calculated Mantel-Haenszel risk ratio (RR with 95% confidence intervals (95% CIs. The primary outcome was the rate of patients with OH treated with SSO compared to HSO. Results: There were a higher number of rates of OH in HSO compared to SSO. This difference was statistically significant with the fixed effect model (Mantel-Haenszel RR; 1.55; 95% CI, 1.06-2.28; P = 0.02 while there was not significative difference with the random effect model (Mantel-Haenszel RR; 1.51; 95% CI, 0.98-2.33; P = 0.06. Conclusion: We noted a trend that points out a higher OH rate in HSO group compared to SSO, but this finding, due to the small size and variable design of studies, needs to be confirmed in well-designed and large size RCTs.

  9. The effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation after off-pump coronary artery bypass graft.

    Directory of Open Access Journals (Sweden)

    Mahdi Haddadzadeh

    2015-01-01

    Full Text Available The most common type of arrhythmia following coronary artery bypass graft (CABG is atrial fibrillation (AF with an incidence rate of 20-30%. Pericardial effusion is one of the etiologic factors of atrial fibrillation occurring after CABG. Posterior pericardiotomy (PP causes the drainage of blood and fluids from the pericardial space into the pleural space leading to a decreased pericardial effusion. Most of the studies dealing with the occurrence of AF in the surgical operation of CABG have focused on patients undergoing on-pump CABG. The purpose of the present study was to determine the effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation following the off-pump CABG. This study was a clinical trial conducted on 207 patients. The patients were randomly assigned to groups A, and B. Posterior pericardiotomy was performed on the patients in Group A. This was not done on patients in Group B. Following general anesthesia and median sternotomy, the left internal mammary artery (LIMA and saphenous vein were harvested simultaneously. Following the injection of heparin, distal and proximal anastomosis was performed and at the end of surgery, a longitudinal incision with a length of 4 cm was performed parallel and posterior to the left phrenic nerve from the left vein to diaphragm for patients in the pericardiotomy group. 105 patients in the pericardiotomy group and 102 patients in the control group were examined regarding demographic variables, AF incidence, and pericardial effusion. There was no statistically significant correlation between two groups. There was no statistically significant difference between the two groups regarding the rate of AF incidence (P=0.719 and the rate of pericardial effusion (P=1. Posterior pericardiotomy has no effect on postoperative AF incidence and pericardial effusion in patients undergoing the off-pump CABG.

  10. A case of Hodgkin`s disease presenting a cardiac tamponade during treatment developed a pancytopenia after cessation of chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Shigeru; Iwami, Mika; Narita, Tsutomu; Higashino, Katsumi; Suzuki, Atsushi; Taga, Takashi; Shimada, Morimi [Shiga Univ. of Medical Science, Otsu (Japan)

    1998-10-01

    There had been many reports about cardiac complications of patients with Hodgkin`s disease (HD) after cessation of treatment in Europe and the United States. However, cases of HD accompanied with these complications were extremely rare in Japan. We report a case with HD that developed a cardiac tamponade during the clinical course of chemotherapy and showed a pancytopenia after cessation of chemotherapy. The case was a 14 year-old boy with HD (nodular sclerosis) of anterior upper mediastinum origin. He received modified MOPP therapy and irradiation to the semimantle field and to the mediastinum. The total dose of radiation was 36.3 Gy. He suddenly developed a chest pain, chest discomfort, and dyspnea during the sixth course of chemotherapy. He was diagnosed to have a cardiac tamponade by thoracentesis. The symptoms were improved by continuous transcutaneous drainage. The invasion of HD into the effusion was not detected by cytology, and the chemotherapy was completed after one course. However, he gradually developed a macrocytic anemia and finally developed a pancytopenia. The bone marrow specimen revealed a hypoplasia without evidence of pathological cells. The karyotype of marrow derived cells was normal. With oxymetholone administration, the pancytopenia has improved in four months. He has now been doing well for five years after the cessation of therapy. (author)

  11. Distribution and Resistance Analysis of Pathogenic Bacteria Causing Catheter Associated Urinary Tract Infection in ICU%ICU导尿管相关性尿路感染的病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    邵俊; 郑瑞强; 林华; 卢年芳; 於江泉

    2013-01-01

    Objective :To explore the distribution and resistance of pathogenic bacteria causing catheter associated uri-nary tract infection in ICU so as to guide the clinical rational use of antibiotics .Methods :Urine culture and its drug sus-ceptibility results of patients who were diagnosed catheter associated urinary tract infection were analyzed retrospective-ly from July 2009 to June 2013 in ICU of Subei People’s Hospital of Jiangsu Province .Results:226 strains of pathogenic bacteria was detected from 4558 urine specimens ,of which 138 strains of gram-negative bacteria (61 .06% ) ,57 strains of gram-positive bacteria(25 .22% ) ,31 fungi strains(13 .72% ) .Top five of pathogenic bacteria was followed by acine-tobacter baumannii ,pneumonia klebsiella ,Escherichia coli ,Enterococcus faecalis ,candida albicans .Resistance of acine-tobacter baumannii in most drug was >50% .Under 50% of the resistance was just cefoperazone/sulbactam ,meropen-em ,imipenem/Cilastatin ,SMZ/TMP .Conclusion:Gram-negative bacteria is still the main pathogenic bacteria of catheter associated urinary tract infections in ICU .Acinetobacter baumannii has risen to the first pathogenic bacteria ,and drug resistance is very severe .Rational use of antibiotics and good hand hygiene is very important according to the results of drug susceptibility .%目的:探讨IC U导尿管相关性尿路感染的病原学分布及耐药性,为临床合理使用抗菌药物提供依据。方法:回顾性对2009年7月-2013年6月入住我院IC U确诊导尿管相关性尿路感染的患者送检的尿液标本培养及药敏结果进行统计分析。结果:4558份尿标本共检出226株致病菌,其中革兰氏阴性菌138株,占61.06%,革兰氏阳性菌株57株,占25.22%,真菌株31株,占13.72%。排名前五位的病原菌依次是鲍曼不动杆菌、肺炎克雷伯氏菌、大肠埃希菌、粪肠球菌、白色念珠菌。鲍曼不动杆菌对大部分药物耐药性均>50

  12. Incidental finding of congenital pericardial and mediastinal pleural defect by pneumothorax in an adult

    International Nuclear Information System (INIS)

    Introduction: Congenital pericardial defect (CPD) is an uncommon anomaly. If once cardiac herniation occurs, it threatens life. We report a case of left-sided pneumothorax with consequent protrusion of the heart into left thoracic cavity through not only a large CPD but also congenital pleuropericardium window. Case presentation: A 67-year-old man presenting with sudden-onset left-sided chest pain and slight dyspnea was referred to our hospital. Chest X-ray showed a left lung collapse, and also revealed a pneumopericardium along the right border of the ascending aorta. Subsequent computed tomography (CT) scan revealed that the heart was displaced into the left hemithorax. Thus, we diagnosed the patient with pneumothorax and a defect of the pericardial and mediastinal pleurae. Subsequently, a chest tube was inserted into the left thoracic cavity, and the collapsed lung was promptly inflated. The cardiac position was reinstated within mediastinum as evidenced by follow-up CT scan. The QRS axis on his electrocardiogram (ECG) was altered from 52° to 73°. Together with the cardiac relocation evidenced by the QRS axis shift on ECG and findings of CT, we determined that there was a low potential for complications and opted against surgical repair. Discussion: When the CPD is sufficiently large, surgical intervention is not necessary. The size of the CPD can be assessed not only by CT findings, but the alteration of the QRS axis on ECG also provides useful information whether cardiac herniation can be resolved by the inflated lung. - Highlights: • We reported a case of congenital pericardial defect (CPD) with pneumothorax. • We described how to manage to alleviate life-threatening complications. • The size of CPD was assessed by CT findings and the alteration of QRS axis on ECG

  13. Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

    Science.gov (United States)

    Manshanden, Johan S.J.; Gielen, Chantal L.I.; de Borgie, Corianne A.J.M.; Klautz, Robert J.M.; de Mol, Bas A.J.M.; Koolbergen, David R.

    2015-01-01

    Background Prolonged or excessive blood loss is a common complication after cardiac surgery. Blood remnants and clots, remaining in the pericardial space in spite of chest tube drainage, induce high fibrinolytic activity that may contribute to bleeding complications. Continuous postoperative pericardial flushing (CPPF) with an irrigation solution may reduce blood loss by preventing the accumulation of clots. In this pilot study, the safety and feasibility of CPPF were evaluated and the effect on blood loss and other related complications was investigated. Methods Between November 2011 and April 2012 twenty-one adult patients undergoing surgery for congenital heart disease (CHD) received CPPF from sternal closure up to 12 h postoperative. With an inflow Redivac drain that was inserted through one of the chest tube incision holes, an irrigation solution (NaCl 0.9% at 38 °C) was delivered to the pericardial cavity using a volume controlled flushing system. Safety aspects, feasibility issues and complications were registered. The mean actual blood loss in the CPPF group was compared to the mean of a retrospective group (n = 126). Results CPPF was successfully completed in 20 (95.2%) patients, and no method related complications were observed. Feasibility was good in this experimental setting. Patients receiving CPPF showed a 30% (P = 0.038) decrease in mean actual blood loss 12 h postoperatively. Conclusions CPPF after cardiac surgery was found to be safe and feasible in this experimental setting. The clinically relevant effect on blood loss needs to be confirmed in a randomized clinical trial. PMID:26501121

  14. 导尿管相关性尿路感染的病原菌分布及耐药性%Distribution and antimicrobial resistance of pathogenic bacteria causing urethral catheter-associated urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    程光敏; 姜玲; 尧兴水

    2012-01-01

    OBJECTIVE To understand the constituent ratio and antimicrobial resistance of pathogenic bacteria causing urethral catheter-associated urinary tract infection and offer reference for clinical use of antibiotics. METHODS Referring to National Guide to Clinical Laboratory Procedures, bacterial culture and identification were performed. The susceptibility testing was performed by K-B method as recommended by CLSI. RESULTS Among 159 strains of pathogenic bacteria, Escherichia coli (38. 4%) ranked the top one, followed by Pseudomonas aeruginosa (13. 2%) and coagulase-negative Staphylococci (12. 6%). All of the pathogenic bacteria were resistant to commonly used antibiotics to varying degrees. CONCLUSION Clinicians should attach importance to pathogenic surveillance and reasonably use the antibiotics according to susceptibility testing results to effectively control urelhral catheter-associated urinary tract infection and raise the clinical recovery rate.%目的 了解医院导尿管相关性尿路感染的病原菌分布及耐药特征,为临床医师合理使用抗菌药物提供参考依据.方法 严格按照《全国临床检验操作规程》,采集患者的尿液进行细菌培养与鉴定;采用CLSI推荐的K- B法进行药敏试验.结果 159株尿路感染病原菌以大肠埃希菌为主,占38.4%,铜绿假单胞菌第2位,占13.2%,凝固酶阴性葡萄球菌第3位,占12.6%;所有病原菌对常用抗菌药物均产生了不同的耐药性.结论 临床医师应重视病原学监测,按照药敏试验结果规范用药,才能有效控制导尿管相关性尿路感染,提高临床治愈率.

  15. Marked pericardial inhomogeneity of specific ventilation at total lung capacity and beyond

    DEFF Research Database (Denmark)

    Sun, Yanping; Butler, James P; Lindholm, Peter;

    2009-01-01

    We measured regional ventilation at 1l above functional residual capacity (FRC+1L) and total lung capacity (TLC) in three normal subjects and four elite breath-hold divers, and above TLC after glossopharyngeal insufflation (TLC+GI) in the divers. Hyperpolarized (3)He MRI was used to map the local...... ventilation per unit volume over the entire lung. At TLC and above, there was markedly increased regional ventilation of the lungs in the pericardial region compared with the relatively uniform ventilation throughout the rest of the lung. The distribution of fractional ventilation regionally was relatively...

  16. Adjuvant Pericardial Sac Restraining in Heart Failure Treatment. A Medical Hypothesis Illustrated by a Case Report.

    Science.gov (United States)

    Evora, Paulo Roberto Barbosa; Romano, Minna Moreira D; Gali, Luis Gustavo; Schmidt, André; Rodrigues, Alfredo José

    2016-02-01

    Ventricular constraint therapy has been used to prevent and reverse the progression of heart failure in ischemic and nonischemic cardiomyopathies. We hypothesized that ventricular restraint should be tried by closing the pericardium that was previously opened following left ventricle topographical projection. The surgical technique presentation is illustrated by a remarkable 13-year outcome of one patient with dilated cardiomyopathy treated surgically by mitral prosthesis, Cox/Maze III surgery to treat atrial fibrillation, and associated to the ventricular constraint using the patient's own pericardium. The ventricular pericardial restraint role is unclear, since the patient had multiple corrections that could be responsible for the good outcome; however it is viable deserving investigations. PMID:27074278

  17. Correlation of different imaging modalities in pre-surgical evaluation of pericardial metastasis of liposarcoma

    Institute of Scientific and Technical Information of China (English)

    Zeljko Z Markovic; Ana Mladenovic; Marko Banovic; Branislava Ivanovic

    2012-01-01

    A patient presented with a large pericardial tumor of uncertain etiology.Five years earlier,she had been treated for myxoid liposarcoma of the thigh.For pre-surgical evaluation,conventional radiography,positron emission tomography/computed tomography (PET/CT),magnetic resonance imaging (MRI),CT of the heart,transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were performed.The final histopathologic diagnosis was metastatic liposarcoma.Each of the imaging modalities used had advantages and disadvantages,and their coordination was necessary for optimal evaluation.

  18. Late onset ipilimumab-induced pericarditis and pericardial effusion: a rare but life threatening complication.

    Science.gov (United States)

    Yun, Seongseok; Vincelette, Nicole D; Mansour, Iyad; Hariri, Dana; Motamed, Sara

    2015-01-01

    Metastatic cutaneous melanoma has poor prognosis with 2-year survival rate of 10-20%. Melanoma cells express various antigens including gp100, melanoma antigen recognized by T cells 1 (MART-1), and tyrosinase, which can induce immune-mediated anticancer response via T cell activation. Cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) is an immune check point molecule that negatively regulates T cell activation and proliferation. Accordingly, recent phase III clinical trials demonstrated significant survival benefit with ipilimumab, a human monoclonal antibody (IgG1) that blocks the interaction of CTLA-4 with its ligands. Since the efficacy of ipilimumab depends on T cell activation, it is associated with substantial risk of immune mediated adverse reactions such as colitis, hepatitis, thyroiditis, and hypophysitis. We report the first case of late onset pericarditis and cardiac tamponade associated with ipilimumab treatment in patient with metastatic cutaneous melanoma. PMID:25918658

  19. Late Onset Ipilimumab-Induced Pericarditis and Pericardial Effusion: A Rare but Life Threatening Complication

    Directory of Open Access Journals (Sweden)

    Seongseok Yun

    2015-01-01

    Full Text Available Metastatic cutaneous melanoma has poor prognosis with 2-year survival rate of 10–20%. Melanoma cells express various antigens including gp100, melanoma antigen recognized by T cells 1 (MART-1, and tyrosinase, which can induce immune-mediated anticancer response via T cell activation. Cytotoxic T-lymphocyte associated antigen-4 (CTLA-4 is an immune check point molecule that negatively regulates T cell activation and proliferation. Accordingly, recent phase III clinical trials demonstrated significant survival benefit with ipilimumab, a human monoclonal antibody (IgG1 that blocks the interaction of CTLA-4 with its ligands. Since the efficacy of ipilimumab depends on T cell activation, it is associated with substantial risk of immune mediated adverse reactions such as colitis, hepatitis, thyroiditis, and hypophysitis. We report the first case of late onset pericarditis and cardiac tamponade associated with ipilimumab treatment in patient with metastatic cutaneous melanoma.

  20. Role of Klebsiella pneumoniae type 1 and type 3 fimbriae in colonizing silicone tubes implanted into the bladders of mice as a model of catheter-associated urinary tract infections.

    Science.gov (United States)

    Murphy, Caitlin N; Mortensen, Martin S; Krogfelt, Karen A; Clegg, Steven

    2013-08-01

    Catheter-associated urinary tract infections are biofilm-mediated infections that cause a significant economic and health burden in nosocomial environments. Using a newly developed murine model of this type of infection, we investigated the role of fimbriae in implant-associated urinary tract infections by the Gram-negative bacterium Klebsiella pneumoniae, which is a proficient biofilm former and a commonly isolated nosocomial pathogen. Studies have shown that type 1 and type 3 fimbriae are involved in attachment and biofilm formation in vitro, and these fimbrial types are suspected to be important virulence factors during infection. To test this hypothesis, the virulence of fimbrial mutants was assessed in independent challenges in which mouse bladders were inoculated with the wild type or a fimbrial mutant and in coinfection studies in which the wild type and fimbrial mutants were inoculated together to assess the results of a direct competition in the urinary tract. Using these experiments, we were able to show that both fimbrial types serve to enhance colonization and persistence. Additionally, a double mutant had an additive colonization defect under some conditions, indicating that both fimbrial types have unique roles in the attachment and persistence in the bladder and on the implant itself. All of these mutants were outcompeted by the wild type in coinfection experiments. Using these methods, we are able to show that type 1 and type 3 fimbriae are important colonization factors in the murine urinary tract when an implanted silicone tube is present.

  1. Reduction of Catheter-Associated Urinary Tract Infections Through the Use of an Evidence-Based Nursing Algorithm and the Implementation of Shift Nursing Rounds: A Quality Improvement Project.

    Science.gov (United States)

    Thomas, Kamishia L

    2016-01-01

    Catheter-associated urinary tract infections (CAUTIs) are the most common hospital-acquired infections. The purpose of this quality improvement (QI) project was to successfully implement a nurse-led evidence-based practice change designed to reduce CAUTIs in a cardiac intensive care and step-down unit. The QI project was implemented using a convenience sample of patients admitted to the cardiac intensive care and step-down unit.Evaluation data were collected 3 months preimplementation and 9 months postimplementation. We used Wick's Check-Plan-Do-Check-Act model of continuous QI to guide the project. A statistically significant change in the number of CAUTIs (P = .009) and CAUTI occurrences (P = .005) was observed following the intervention. The number of indwelling catheter days and indwelling catheter utilization did not significantly differ following implementation of the intervention. Nurse compliance with the intervention was computed for each month; the average compliance rate was 91%. Findings from this project indicate that a nurse-led evidence-based practice project exerted a positive influence on CAUTI occurrences. PMID:26808302

  2. Reduction of Catheter-Associated Urinary Tract Infections Through the Use of an Evidence-Based Nursing Algorithm and the Implementation of Shift Nursing Rounds: A Quality Improvement Project.

    Science.gov (United States)

    Thomas, Kamishia L

    2016-01-01

    Catheter-associated urinary tract infections (CAUTIs) are the most common hospital-acquired infections. The purpose of this quality improvement (QI) project was to successfully implement a nurse-led evidence-based practice change designed to reduce CAUTIs in a cardiac intensive care and step-down unit. The QI project was implemented using a convenience sample of patients admitted to the cardiac intensive care and step-down unit.Evaluation data were collected 3 months preimplementation and 9 months postimplementation. We used Wick's Check-Plan-Do-Check-Act model of continuous QI to guide the project. A statistically significant change in the number of CAUTIs (P = .009) and CAUTI occurrences (P = .005) was observed following the intervention. The number of indwelling catheter days and indwelling catheter utilization did not significantly differ following implementation of the intervention. Nurse compliance with the intervention was computed for each month; the average compliance rate was 91%. Findings from this project indicate that a nurse-led evidence-based practice project exerted a positive influence on CAUTI occurrences.

  3. Effects of colchicine on pericardial diseases: a review of the literature and current evidence

    Directory of Open Access Journals (Sweden)

    Syed Raza Shah

    2016-07-01

    Full Text Available Colchicine, extracted from the colchicum autumnale plant, used by the ancient Greeks more than 20 centuries ago, is one of the most ancient drugs still prescribed even today. The major mechanism of action is binding to microtubules thereby interfering with mitosis and subsequent modulation of polymorphonuclear leukocyte function. Colchicine has long been of interest in the treatment of cardiovascular disease; however, its efficacy and safety profile for specific conditions have been variably established in the literature. In the subset of pericardial diseases, colchicine has been shown to be effective in recurrent pericarditis and post-pericardiotomy syndrome (PPS. The future course of treatment and management will therefore highly depend on the results of the ongoing large randomized placebo-controlled clinical trial to evaluate the efficacy and safety of colchicine for the primary prevention of several postoperative complications and in the perioperative period. Also, given the positive preliminary outcomes of colchicine usage in pericardial effusions, the future therapeutical use of colchicine looks promising. Further study is needed to clarify its role in these disease states, as well as explore other its role in other cardiovascular conditions.

  4. Effects of colchicine on pericardial diseases: a review of the literature and current evidence

    Science.gov (United States)

    Shah, Syed Raza; Alweis, Richard; Shah, Syed Arbab; Arshad, Mohammad Hussham; Manji, Adil Al-Karim; Arfeen, Arham Amir; Javed, Maheen; Shujauddin, Syed Muhammad; Irfan, Rida; Shabbir, Sakina; Shaikh, Shehryar

    2016-01-01

    Colchicine, extracted from the colchicum autumnale plant, used by the ancient Greeks more than 20 centuries ago, is one of the most ancient drugs still prescribed even today. The major mechanism of action is binding to microtubules thereby interfering with mitosis and subsequent modulation of polymorphonuclear leukocyte function. Colchicine has long been of interest in the treatment of cardiovascular disease; however, its efficacy and safety profile for specific conditions have been variably established in the literature. In the subset of pericardial diseases, colchicine has been shown to be effective in recurrent pericarditis and post-pericardiotomy syndrome (PPS). The future course of treatment and management will therefore highly depend on the results of the ongoing large randomized placebo-controlled clinical trial to evaluate the efficacy and safety of colchicine for the primary prevention of several postoperative complications and in the perioperative period. Also, given the positive preliminary outcomes of colchicine usage in pericardial effusions, the future therapeutical use of colchicine looks promising. Further study is needed to clarify its role in these disease states, as well as explore other its role in other cardiovascular conditions. PMID:27406462

  5. Pericardial effusion as the only manifestation of infection with Francisella tularensis: a case report

    Directory of Open Access Journals (Sweden)

    Landais Cécile

    2008-06-01

    Full Text Available Abstract Introduction Francisella tularensis, a facultative intracellular Gram-negative bacterium, has rarely been reported as an agent of pericarditis, generally described as a complication of tularemia sepsis. F. tularensis is a fastidious organism that grows poorly on standard culture media and diagnosis is usually based on serological tests. However, cross-reactions may occur. Western blotting allows the correct diagnosis. Case presentation A non-smoking 53-year-old woman was admitted to hospital with a large posterior pericardial effusion. Serological tests showed a seroconversion in antibody titers to F. tularensis (IgG titer = 400 and Legionella pneumophila (IgG titer = 512. F. tularensis was identified by Western immunoblotting following cross-adsorption. The patient reported close contact with rabbits 2 weeks prior to the beginning of symptoms of pericarditis. Conclusion We report a rare case of pericardial effusion as the only manifestation of infection by F. tularensis. The etiological diagnosis is based on serology. Western blotting and cross-adsorption allow differential diagnosis.

  6. Idiopathic pericardial effusion in 2 year old labrador managed with ultrasound-guided pericardiocentesis: Case report

    Directory of Open Access Journals (Sweden)

    JB Adeyanju

    2012-06-01

    Full Text Available A two-year old, 38kg-wt male Labrador was presented for management because of progressive exercise intolerance. At presentation, rectal temperature was 38.5oC, pulse rate was135 beats per minute (but weak. There was ascites along with oedema of the extremities. The heart sound was muffled and pulsus paradoxus was very mild. The patient was well hydrated. Thoracic radiography revealed a globoid shaped heart occupying most of the equatorial thoracic volume; there was loss of details of cardiac silhouette and there was dorsal deviation of trachea at carina. Ultrasonography revealed a distinct epicardium, pericardium and a very wide anechoic space in between. Blood picture was within normal findings. Idiopathic chronic pericardial effusion was diagnosed. Ultrasound-guided pericardiocentesis was carried out using a 16 gauge over the needle catheter attached to a 3-way stopcock and a 20mls syringe; about 65mls of clear effusate was aspirated. Laboratory analysis of the effusate revealed that it was a transudate. The patient was placed on 3mg/kg furosemide, twice daily for 5 days and the patient returned to gradual exercise during hospitalization. Oedema of the extremities and ascities decreased, the appetite improved and the dog became more active. Thoracic radiography fourth week post pericardiocentesis revealed a normal cardiac silhouette. The cause of pericardial effusion was not known.

  7. Effects of colchicine on pericardial diseases: a review of the literature and current evidence.

    Science.gov (United States)

    Shah, Syed Raza; Alweis, Richard; Shah, Syed Arbab; Arshad, Mohammad Hussham; Manji, Adil Al-Karim; Arfeen, Arham Amir; Javed, Maheen; Shujauddin, Syed Muhammad; Irfan, Rida; Shabbir, Sakina; Shaikh, Shehryar

    2016-01-01

    Colchicine, extracted from the colchicum autumnale plant, used by the ancient Greeks more than 20 centuries ago, is one of the most ancient drugs still prescribed even today. The major mechanism of action is binding to microtubules thereby interfering with mitosis and subsequent modulation of polymorphonuclear leukocyte function. Colchicine has long been of interest in the treatment of cardiovascular disease; however, its efficacy and safety profile for specific conditions have been variably established in the literature. In the subset of pericardial diseases, colchicine has been shown to be effective in recurrent pericarditis and post-pericardiotomy syndrome (PPS). The future course of treatment and management will therefore highly depend on the results of the ongoing large randomized placebo-controlled clinical trial to evaluate the efficacy and safety of colchicine for the primary prevention of several postoperative complications and in the perioperative period. Also, given the positive preliminary outcomes of colchicine usage in pericardial effusions, the future therapeutical use of colchicine looks promising. Further study is needed to clarify its role in these disease states, as well as explore other its role in other cardiovascular conditions. PMID:27406462

  8. Pericardial effusion in a diabetic patient with prostatic abscess; Derrame pericardico associado a abscesso prostatico em paciente diabetico

    Energy Technology Data Exchange (ETDEWEB)

    Omais, Ali Kassen; Oliveira, Julio Cesar; Tenuta, Marcos de Thadeu; Marchese, Miriam; Ricca, Rene A. Mattos; Tenuta, Maria Carolina Antunes de Oliveira, E-mail: aliomais@yahoo.com [Hospital Geral Universitario (HGU/UNIC), Cuiaba, MT (Brazil); Chauchar, Fause; Cardoso Junior, Valdiro Jose; Carvalho, Valdinei Vieira de [Centro de Cardiologia, Cuiaba, MT (Brazil)

    2009-04-15

    Purulent pericarditis is a rare and potentially fatal disease. Its diagnosis and treatment is difficult. An aggressive antibiotic treatment and pericardial drainage are essentials for the treatment of purulent pericarditis. We report an unusual case of a diabetic patient with purulent pericarditis and prostatic abscess with good evolution after appropriate treatment. (author)

  9. The alterations of plasma ET-1 and NO post selective pericardial devascularization in patients with hepatic portal hypertension

    International Nuclear Information System (INIS)

    Objective: To investigate the alterations of plasma endothelin-1 (ET-1) and nitric oxide (NO) post the selective pericardial devascularization in patients with hepatic portal hypertension,and to investigate the relationship between such alterations with illness and therapeutic effects. Methods: Before treatment,plasma ET-1 and NO contents were determined by radioimmunoassay (RIA) and Griss method respectively in 92 patients with hepatic portal hypertension. One day and three weeks after operation, 66 operated cases with selective pericardial devascularization in patients with hepatic protal hypertension were also determined the levels of plasma ET-1 and NO with RIA. Results: The levels of plasma ET-1 and NO were increased in 92 patients with hepatic portal hypertension, and which closely related to the stage of illness. Post effective selective pericardial devascularization the high levels of plasma ET-1 and No were improved and were closely returned to normal after 3 week's. Conclusion: Clinical detection of plasma ET-1 and NO levels were useful for assessment of the therapeutic effects of selective pericardial devascularization in patients with hepatic portal hypertension. (authors)

  10. Interaction of the tracheal tubules of Scutigera coleoptrata (Chilopoda, Notostigmophora with glandular structures of the pericardial septum

    Directory of Open Access Journals (Sweden)

    Gero Hilken

    2015-06-01

    Full Text Available Notostigmophora (Scutigeromorpha exhibit a special tracheal system compared to other Chilopoda. The unpaired spiracles are localized medially on the long tergites and open into a wide atrium from which hundreds of tracheal tubules originate and extend into the pericardial sinus. Previous investigators reported that the tracheal tubules float freely in the hemolymph. However, here we show for the first time that the tracheal tubules are anchored to a part of the pericardial septum. Another novel finding is this part of the pericardial septum is structured as an aggregated gland on the basis of its specialized epithelium being formed by hundreds of oligocellular glands. It remains unclear whether the pericardial septum has a differently structure in areas that lack a connection with tracheal tubules. The tracheal tubules come into direct contact with the canal cells of the glands that presumably secrete mucous substances covering the entire luminal cuticle of the tracheal tubules. Connections between tracheae and glands have not been observed in any other arthropods.

  11. Chronic active Epstein-Barr virus infection with marked pericardial effusion successfully treated with allogeneic peripheral blood stem cell transplantation.

    Science.gov (United States)

    Matsui, Shinichiro; Takeda, Yusuke; Isshiki, Yusuke; Yamazaki, Atsuko; Nakao, Sanshiro; Takaishi, Koji; Nagao, Yuhei; Hasegawa, Nagisa; Togasaki, Emi; Shimizu, Ryoh; Kawajiri, Chika; Sakai, Shio; Mimura, Naoya; Takeuchi, Masahiro; Ohwada, Chikako; Sakaida, Emiko; Iseki, Tohru; Imadome, Ken-Ichi; Nakaseko, Chiaki

    2016-05-01

    A 23-year-old woman presented with a persistent fever and shortness of breath. Computed tomography showed marked pericardial effusion, hepatosplenomegaly, and cervical and mediastinal lymph node swelling. Epstein-Barr virus (EBV) antibody titers were abnormally elevated, and the copy number of EBV-DNA was increased in peripheral blood. Based on these observations, she was diagnosed with chronic active EBV infection (CAEBV). The EBV-infected cells in her peripheral blood were CD4(+)T lymphocytes. Fever and pericardial effusion improved following treatment with a combination of prednisolone, etoposide, and cyclosporine; however, peripheral blood EBV-DNA levels remained high. The patient underwent allogeneic peripheral blood stem cell transplantation from an EBV-seronegative, HLA-matched sibling donor, with fludarabine and melphalan conditioning. The post-transplantation course was uneventful, except for mild skin acute graft-versus-host disease (grade 2). EBV-DNA became undetectable in peripheral blood 98 days post transplantation. She has since been in good health without disease recurrence. CAEBV is a potentially fatal disease caused by persistent EBV infection of T lymphocytes or natural killer cells, thus requiring prompt treatment and allogeneic transplantation. Pericardial effusion is rarely observed in CAEBV and can impede its diagnosis. Therefore, we should be aware that patients may present with marked pericardial effusion as an initial manifestation of CAEBV. PMID:27263789

  12. Clinic and echocardiographic characteristics of pericardial effusions in a university hospital, Medellín, Colombia Características clínicas y ecocardiográficas de los derrames pericárdicos en pacientes del Hospital Universitario San Vicente de Paúl

    Directory of Open Access Journals (Sweden)

    Carlos José Jaramillo G.

    2002-03-01

    Full Text Available Purpose: To determine the clinical and echocardiographic characteristics of pericardial effusions. Methods: Retrospective information was obtained from medical records of all patients who were diagnosed with echocardiographic pericardial effusions. Results: We studied 62 medical records of patients with echocardiographic pericardial effusions. We obtained medical records of 28 (45.2% patients with mild effusion, 19 (30.6% with moderate effusion and 15 (24.2% with severe effusion. Fourteen patients (22.6% showed inflammatory signs of pericarditis. Inflammatory signs had an Odds Ratio of 5.1. (CI 95% 1.28 to 23 wich was significant (p = 0.006. Uremia was the most common diagnosis in all patients (22.6% followed by metastatic tumors (14.5%, pyogenic pericarditis (11.3%, acute idiopathic pericarditis (11.3% and others. Conclusions: In almost all patients, etiology of pericardial effusion is the same of the underlying condition, but if the cause is unknown, the size of effusion, inflammatory signs and the presence of cardiac tamponade may help suggest etiology. Objetivos: determinar las características clínicas y ecocardiográficas de los derrames pericárdicos. Metodología: revisar retrospectivamente las historias clínicas de los pacientes con diagnóstico de derrame pericárdico hecho por ecocardiografía transtorácica entre febrero de 2000 y agosto de 2001. Resultados: se evaluaron las historias clínicas de 62 pacientes con diagnóstico de derrame pericárdico; 28 (45.2% presentaron derrames leves, 19 (30.6% derrames moderados y 15 (24.2% derrames severos; 21 (33.9% pacientes presentaron taponamiento cardíaco y el 50% de éstos tenían derrame severo. Se buscó la presencia de signos inflamatorios y se encontró que 14 (22.6% de los pacientes los presentaban. Además, estos pacientes tuvieron 5 veces más probabilidad de presentar taponamiento cardíaco (OR = 5.40. La principal causa de derrames pericárdicos fue la uremia (22.6%, seguida

  13. ICU 导尿管相关泌尿系感染危险因素分析及护理对策%Analysis of risk factors of catheter-associated urinary tract infection in ICU and the nursing countermeasures

    Institute of Scientific and Technical Information of China (English)

    谢金兰; 秦颖; 石纯娟; 曾涛; 姚惠; 窦英茹; 朱金兰

    2014-01-01

    ABSTRACT:Objective To discuss the risk factors of ICU patients with catheter-associate-durinary tract infection (CAUTI)so as to provide scientific basis for effective nursing measures. Methods ICU patients from April 2012 to March 2014 in our hospital were monitored,and in-dwelling catheter chances,indwelling catheter days,maintenance of urinary catheter,perineum nursing,the urine property,urine culture results were observed.Results 92 cases of urinary tract infection occurred in 1421 urinary catheter indwelling patients.Patients in emergency department with indwelling catheter more than 7 days and perineum nursing less than 2 times a day had more risk factors of urinary tract infection (P <0.05).A total of 153 pathogenic bacteria were separated in 92 patients.Among these pathogenic bacteria,23 cases were multiple drug-resistant bacteria. The top three pathogens were 17.65% of klebsiella,15.69% of candidaalbicans and 9.80% of es-cherichia coli.Conclusion Effective nursing strategies are to shorten the urine tube indwelling time,improve the technique of emergency patients with catheter,correctly maintain urine tube,en-sure the drainage device sealability,strengthen the perineum nursing,apply multiple drug-resis-tant bacteria isolation measures so as to prevent catheter-associated urinary tract infection.%目的:探讨 ICU 患者导尿管相关泌尿系感染(CAUTI)的危险因素,为针对性采取有效的护理措施提供科学依据。方法目标性监测2012年4月—2014年3月收住本院 ICU 的患者,观察并统计留置尿管时机、留置天数、尿管维护、会阴护理、尿液性状及尿培养结果等。结果1421例留置尿管患者中发生泌尿系感染92例,急诊入院患者留置尿管、留置尿管超过7 d、会阴护理每日2次以下是泌尿系感染的高危因素(P <0.05)。92例患者共分离病原菌153株,其中23例为多重耐药菌,前3位的病原菌分别是肺炎克雷伯菌17.65

  14. A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients – the HEALTHY-CATH trial

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2012-11-01

    Full Text Available Abstract Background Tunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI. Methods Patients undergoing haemodialysis (HD via a tunnelled catheter were randomised 1:1 to once per week ethanol locks (with two heparin locks between other dialysis sessions vs thrice per week heparin locks. Results Observed catheter days in the heparin (n=24 and ethanol (n=25 groups were 1814 and 3614 respectively. CRBSI occurred at a rate of 0.85 vs. 0.28 per 1000 catheter days in the heparin vs ethanol group by intention to treat analysis (incident rate ratio (IRR for ethanol vs. heparin 0.17; 95%CI 0.02-1.63; p=0.12. Flow issues requiring catheter removal occurred at a rate of 1.6 vs 1.4 per 1000 catheter days in the heparin and ethanol groups respectively (IRR 0.85; 95% CI 0.20-3.5 p =0.82 (for ethanol vs heparin. Conclusions Catheter survival and catheter-related blood stream infection were not significantly different but there was a trend towards a reduced rate of infection in the ethanol group. This study establishes proof of concept and will inform an adequately powered multicentre trial to definitively examine the efficacy and safety of ethanol locks as an alternative to current therapies used in the prevention of catheter-associated blood stream infections in patients dialysing with tunnelled catheters. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000493246

  15. Primary pericardial extragastrointestinal stromal tumor: A case report and literature review

    Science.gov (United States)

    ARPACI, TANER; TOKAT, FATMA; ARPACI, RABIA BOZDOGAN; AKBAS, TUGANA; UGURLUER, GAMZE; YAVUZ, SINAN

    2015-01-01

    Gastrointestinal stromal tumors (GISTs) are the most prevalent mesenchymal tumors of the gastrointestinal tract. GISTs are considered to originate from the interstitial cells of Cajal, the pacemakers of the peristaltic activity of the gastrointestinal tract. More than 95% of GISTs express KIT protein and discovered on GIST-1. GISTs may also be encountered in locations outside the gastrointestinal tract, in which case they are referred to as extra-GISTs (EGISTs) and often behave more aggressively. This is the case report of a primary pericardial EGIST in a 53-year-old male patient, confirmed by immunohistochemistry. To the best of our knowledge, this is the third case of EGIST diagnosed above the diaphragm, without being associated with the esophageal wall. Two cases of primary EGIST arising from the pleura were reported previously. In addition, this is the first reported case of an EGIST originating from the pericardium. PMID:26137136

  16. Left ventricular aneurysm repair with use of a bovine pericardial patch.

    Science.gov (United States)

    Henry, Matthew J; Preventza, Ourania; Cooley, Denton A; de la Cruz, Kim I; Coselli, Joseph S

    2014-08-01

    Left ventricular aneurysm, which can impair systolic function, has a reported incidence of 10% to 35% in patients after myocardial infarction. In a 58-year-old woman who had a history of myocardial infarction, we excised a large left ventricular aneurysm and restored left ventricular geometry with use of a bovine pericardial patch. The aneurysm's characteristics and the patient's preoperative left ventricular ejection fraction of 0.25 had indicated surgical intervention. The patient had an uneventful postoperative course, and her left ventricular ejection fraction was 0.50 to 0.55 on the 4th postoperative day. This case illustrates the value of surgical treatment for patients who have a debilitating left ventricular aneurysm.

  17. Elastin organization in pig and cardiovascular disease patients' pericardial resistance arteries

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Leurgans, Thomas; Nissen, Inger;

    2015-01-01

    Peripheral vascular resistance is increased in essential hypertension. This involves structural changes of resistance arteries and stiffening of the arterial wall, including remodeling of the extracellular matrix. We hypothesized that biopsies of the human parietal pericardium, obtained during...... coronary artery bypass grafting or cardiac valve replacement surgeries, can serve as a source of resistance arteries for structural research in cardiovascular disease patients. We applied two-photon excitation fluorescence microscopy to study the parietal pericardium and isolated pericardial resistance...... of 100 mm Hg) is fiber like, and no prominent external elastic lamina could be observed. This microarchitecture is very different from that in rat mesenteric arteries frequently used for resistance artery research. In conclusion, we add three-dimensional information on the structure of the extracellular...

  18. Prevalence of 'high-riding' superior pericardial recesses on thin-section 16-MDCT scans

    International Nuclear Information System (INIS)

    Objective: The aim of this study was to evaluate the prevalence of 'high-riding' superior pericardial recess (HRSPR) on thin-section (1 mm) 16-multidetector computed tomography (MDCT) scans. Materials and methods: Three hundred and fourteen consecutive chest CT scans obtained with a thin-section 16 MDCT were retrospectively evaluated. The prevalence and characteristic of HRSPR were analyzed. Results: HRSPR was depicted in 21 patients (11 men and 10 women) (6.6%) who ranged in age from 28 to 72 years (mean age, 57 years). The extended recesses were rounded/oval shaped in five patients and triangular, spindle, half moon or irregular shaped in the other 16 patients. Conclusion: Our data suggest as HRSPRs are more frequently and better depicted on thinsection MDCT scans, and this improves the capability to distinguish this superior extension of the superior aortic recess from abnormal findings such as lymphadenopathy, cystic lesions, and aortic dissection

  19. Ergotamine-induced pleural and pericardial effusion successfully treated with colchicine.

    Science.gov (United States)

    Helsen, V; Decoutere, L; Spriet, I; Fagard, K; Boonen, S; Tournoy, J

    2013-01-01

    A 83-year-old woman was admitted to hospital with chest pain, fever, dry cough and palpitations. Chest X-ray revealed a pleural effusion, assumed to be caused by cardiac failure and respiratory infection. Despite treatment with antibiotics and diuretics, the pleural effusion increased on chest X-ray and there were signs of pleural and pericardial effusion on computed tomography (CT) scan. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was not successful. Meanwhile patients' long-term use of ergotamine for migraine was revealed, which is associated with pleuropulmonary and cardiac fibrotic reactions. Tentative treatment with colchicine was successful, with complete resolution of pleural fluid, fever, cough and inflammatory parameters. This case highlights the importance of establishing an ergot alkaloid use registry in unexplained pleuropericardial effusions and supports the use of colchicine as a potential therapeutic approach. PMID:23967719

  20. Neoinnervation and neovascularization of acellular pericardial-derived scaffolds in myocardial infarcts.

    Science.gov (United States)

    Gálvez-Montón, Carolina; Fernandez-Figueras, M Teresa; Martí, Mercè; Soler-Botija, Carolina; Roura, Santiago; Perea-Gil, Isaac; Prat-Vidal, Cristina; Llucià-Valldeperas, Aida; Raya, Ángel; Bayes-Genis, Antoni

    2015-01-01

    Engineered bioimplants for cardiac repair require functional vascularization and innervation for proper integration with the surrounding myocardium. The aim of this work was to study nerve sprouting and neovascularization in an acellular pericardial-derived scaffold used as a myocardial bioimplant. To this end, 17 swine were submitted to a myocardial infarction followed by implantation of a decellularized human pericardial-derived scaffold. After 30 days, animals were sacrificed and hearts were analyzed with hematoxylin/eosin and Masson's and Gallego's modified trichrome staining. Immunohistochemistry was carried out to detect nerve fibers within the cardiac bioimplant by using βIII tubulin and S100 labeling. Isolectin B4, smooth muscle actin, CD31, von Willebrand factor, cardiac troponin I, and elastin antibodies were used to study scaffold vascularization. Transmission electron microscopy was performed to confirm the presence of vascular and nervous ultrastructures. Left ventricular ejection fraction (LVEF), cardiac output (CO), stroke volume, end-diastolic volume, end-systolic volume, end-diastolic wall mass, and infarct size were assessed by using magnetic resonance imaging (MRI). Newly formed nerve fibers composed of several amyelinated axons as the afferent nerve endings of the heart were identified by immunohistochemistry. Additionally, neovessel formation occurred spontaneously as small and large isolectin B4-positive blood vessels within the scaffold. In summary, this study demonstrates for the first time the neoformation of vessels and nerves in cell-free cardiac scaffolds applied over infarcted tissue. Moreover, MRI analysis showed a significant improvement in LVEF (P = 0.03) and CO (P = 0.01) and a 43 % decrease in infarct size (P = 0.007). PMID:26205795

  1. Adipokine Imbalance in the Pericardial Cavity of Cardiac and Vascular Disease Patients.

    Directory of Open Access Journals (Sweden)

    Atlanta G I M Elie

    Full Text Available Obesity and especially hypertrophy of epicardial adipose tissue accelerate coronary atherogenesis. We aimed at comparing levels of inflammatory and atherogenic hormones from adipose tissue in the pericardial fluid and circulation of cardiovascular disease patients.Venous plasma (P and pericardial fluid (PF were obtained from elective cardiothoracic surgery patients (n = 37. Concentrations of leptin, adipocyte fatty acid-binding protein (A-FABP and adiponectin (APN were determined by enzyme-linked immunosorbent assays (ELISA. The median concentration of leptin in PF (4.3 (interquartile range: 2.8-9.1 μg/L was comparable to that in P (5.9 (2.2-11 μg/L and these were significantly correlated to most of the same patient characteristics. The concentration of A-FABP was markedly higher (73 (28-124 versus 8.4 (5.2-14 μg/L and that of APN was markedly lower (2.8 (1.7-4.2 versus 13 (7.2-19 mg/L in PF compared to P. APN in PF was unlike in P not significantly related to age, body mass index, plasma triglycerides or coronary artery disease. PF levels of APN, but not A-FABP, were related to the size of paracardial adipocytes. PF levels of APN and A-FABP were not related to the immunoreactivity of paracardial adipocytes for these proteins.In cardiac and vascular disease patients, PF is enriched in A-FABP and poor in APN. This adipokine microenvironment is more likely determined by the heart than by the circulation or paracardial adipose tissue.

  2. 硅油注入后高眼压的治疗策略%Therapy for elevated intraocular pressure after silicone oil tamponade

    Institute of Scientific and Technical Information of China (English)

    张歆; 梁四妥; 杨艳; 赵华; 徐深

    2012-01-01

    Objective To analyze intraocular pressure (IOP) after silicone oil tamponade for one month.Methods This is a retrospective study.There were 46 cases (46 eyes) from 2004 to 2011 registered in our hospital who accepted vitrectomy and silicone oil tamponade,after one month later,who had elevated IOP.We compared the rate of elevated IOP between two types of silicon oil tamponade for one month,as well as the treatment for elevated IOP.x2 test was used to analyze the results.Result The time for light silicon oil removal was three months ( the rate is 68.8% ) after the operation,and after the second surgery the IOP could be normal.And the time for heavy silicon oil removal was two months (the rate is 64.3% ),then the IOP could be normal.The two results had no statistical differences.But the rate of glaucoma surgery after heavy silicone oil tamponade was higher than that of light silicone oil tamponade.And this result had statistical difference.Conclusion The rate of elevated IOP after light or heavy silicone oil tamponade after one month was the same.The rate of glaucoma surgery after heavy silicone oil tamponade was higher than that of light silicone oil tamponade.%目的 回顾性分析轻重硅油注入术后1个月高眼压的发生及其治疗策略.方法 玻切+轻/重硅油注入术后1个月发生高眼压共46例(46眼).对两种硅油注入术后1个月高眼压的发生率进行分析对比,且对高眼压的处理方式进行对比.结果用x2检验进行分析.结果 轻硅油注入术后取油的时机一般在3个月(68.8%)左右,取出后高眼压可以降至正常范围;重硅油在2个月左右取油(64.3%),取出后高眼压可以降至正常范围.二者没有统计学差异.但重硅油注入术后因高眼压行抗青光眼手术的比例较轻硅油者高,差异有统计学意义.结论 轻重硅油注入术后1个月高眼压的发生率没有统计学差异,但重硅油引起的高眼压最终行抗青光眼手术的比例较轻硅油者高.

  3. Valvoplastia mitral percutânea complicada com tamponamento cardíaco em paciente gestante Percutaneous mitral valvuloplasty complicated by cardiac tamponade in a pregnant patient

    Directory of Open Access Journals (Sweden)

    Luís Seca

    2008-11-01

    Full Text Available A ocorrência de Hemopericárdio com Tamponamento Cardíaco é uma complicação da Valvoplastia Mitral Percutânea por balão (VMB, que apesar de pouco freqüente, pode ter graves conseqüências materno-fetais. Este artigo descreve o caso de um tamponamento cardíaco após VMB em uma mulher de 28 anos, com estenose mitral reumática severa na 20ª semana de gravidez.The occurrence of hemopericardium with cardiac tamponade is a complication of percutaneous balloon mitral valvuloplasty (BMV which, although uncommon, may have severe maternal and fetal consequences. This article describes a case of cardiac tamponade following BMV in a 28-year-old woman with severe rheumatic mitral stenosis in the 20th week of gestation.

  4. Unusual Thymic Hyperplasia Mimicking Lipomatous Tumor in an Eight-Year-Old Boy with Concomitant Pericardial Lipomatosis and Right Facial Hemihypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo Jin; Kim Woo Sun; Cheon, Jung Eun; Lim, Yun Jung; Kim, In One; Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Kyeong Cheon; Byun, Sun Ju [Seoul National University Hospital, Seoul (Korea, Republic of)

    2011-06-15

    We report a case of thymic hyperplasia accompanied by pericardial lipomatosis and right facial hemihypertrophy in an 8-year-old boy. On imaging studies, the hyperplastic thymus had prominent curvilinear and nodular fatty areas simulating a fat-containing anterior mediastinal mass, which is an unusual finding in children. To our knowledge, this is the first report on a child with a combination of thymic hyperplasia, pericardial lipomatosis, and right facial hemihypertrophy. The radiologic findings are presented with a brief discussion.

  5. A rare case of isolate pericardial effusion detected by SPECT/CT on a post-therapeutic radioiodine whole-body scan

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Teik Hin [Dept. of Nuclear Medicine, National Cancer Institute, Putrajaya (Malaysia); Hassan, Siti Zarina Amir [Dept. of Nuclear Medicine, Kuala Lumpur Hospital, Kuala Lumpur (Malaysia)

    2015-09-15

    We reported a rare finding of isolated pericardial uptake detected by SPECT/CT on posttherapeutic radioiodine whole body scan. This case highlights the usefulness of hybrid SPECT/CT, with subsequent correlation with biochemical results, in ruling out metastatic pericardial effusion in the postsurgical radioiodine remnant ablation setting. The effusion was resolved after reinstituted thyroid replacement therapy. Recombinant thyrotropin is recommended to avoid such rare but life-threatening complication.

  6. Etiology of pericardial hemorrhagic effusion%血性心包积液病因分析

    Institute of Scientific and Technical Information of China (English)

    张天龙; 訾杰; 申芳芳; 张蕾; 孙艳明

    2015-01-01

    Objective To discuss the etiological distribution features of pericardial hemorrhagic effusion. Methods The patients (n=68, male 28, female 40 and aged from 19 to 87) were chosen from Apr. 2013 to Apr. 2014. All patients were divided into elderly group (≥60) and middle-aged and young group (18-59) according to age, and divided also male group (n=28) and female group (n=40) according to sex. The clinical materials were collected from all patients and etiological distribution of pericardial hemorrhagic effusion was analyzed. Results The common causes were malignant tumor (55.9%), tuberculosis (26.4%) and non-specific pericardial effusion (7.4%), and other causes included heart failure, aortic dissection and congenital heart disease. The difference in etiological distribution had no statistical significance between elderly group and middle-aged and young group (all P>0.05). The common causes were tumor and tuberculosis respectively in male group and female group and difference had no statistical significance (all P>0.05). The pathogenic tumors included lung tumor (60.5%), gynecologic tumor (13.2%), gastrointestinal tumor (10.5%), pericardium mesothelioma (5.3%), kidney and adrenal gland tumor (5.3%) and skin tumor and cervical lymphangioma (2.6%). Conclusion Tumors and tuberculosis are major pathogenic causes of pericardial hemorrhagic effusion, and age and sex are not significantly correlated to pericardial hemorrhagic effusion.%目的:探讨血性心包积液的病因分布特点。方法选自2002年1月至2012年7月北京军区总医院东区64例和2013年4月至2014年4月北京朝阳急诊抢救中心4例,行心包穿刺明确诊断为血性心包积液患者68例。其中男性28例,女性40例,年龄范围19~87岁。按年龄将患者分为2组,老年组33例(≥60岁)和中青年组35例(18~59岁)。按性别分男性组(28例)和女性组(40例)。收集所有患者临床资料,分析血性心包积液病因分布。结果患

  7. Prevention and control of catheter-associated urinary tract infections – implementation of the recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO in nursing homes for the elderly in Frankfurt am Main, Germany

    Directory of Open Access Journals (Sweden)

    Heudorf, Ursel

    2016-06-01

    Full Text Available Introduction: Urinary tract infections range among the most frequent infections not only in hospital patients but also in residents of long-term care facilities for the elderly. Urinary catheters are the greatest risk factor for urinary tract infections. In the guidance paper on the “prevention of infections in nursing homes” (2005 as well as in the updated recommendations for the “prevention and control of catheter-associated urinary tract infections” (2015, the Commission for Hospital Hygiene and Infection Prevention (KRINKO has recommended adequate preventive measures. In 2015, the implementation of these KRINKO recommendations was investigated.Method: All of Frankfurt’s 40 nursing homes were evaluated using a checklist based on the KRINKO recommendations. The evaluation included assessing the availability of operating instructions, appropriate indications for the placement of catheters etc. Age, sex and duration of catheterization, as well as current and previous infections within the past 6 months were documented for every resident with a catheter.Results: In 35 (87.5% of the nursing homes, operating instructions for the handling of urinary tract catheters were available. The decision as to whether a catheter is indicated is made by physicians, while its placement is often delegated to the nursing service. Typically, silicon catheters are used. In three-quarters of the nursing homes, regular intervals of 4–6 weeks for changing catheters were reported. On the respective survey day, 7.3% of the residents were catheterized. On the survey day, 3.6% (4.2% and in the previous 6 months a total of 28% (28.9% of the residents had a urinary tract infection (prevalence of antibiotic therapy in parentheses. Ciprofloxacin was used most often followed by cefuroxime and cotrimoxazole.Discussion: In the current evaluation, fewer nursing home residents were catheterized than in previous years and the rate of urinary tract infections was low

  8. Causes of central venous catheter associated infections and prevention countermeasures%中心静脉导管相关性感染原因分析及预防对策

    Institute of Scientific and Technical Information of China (English)

    桂煜

    2011-01-01

    OBJECTIVE To understand the central venous catheter related infections and to propose preventive measures. METHODS From Apr 2008 to Mar 2010, the causes of 54 patients with deep catheter related infections were analyzed, and the definite preventive measures were taken in accordance with the causes. RESULTS Among 54 patients received the central venous catheterization, the infection of catheter export was found in 5 cases,accounting for 9.3%, 3 cases of catheter-related bloodstream infection, accounting for 5.6%, both of which were recovery after the corresponding disposals. CONCLUSIONS The risk factors of catheter related infections are the inserted time of the catheter,the sites, tle catheter types, the dressing and the nursing care of medical staff. To improve the training of the medical personnel, establish the preventive barrier to a maximum and strictly execute the aseptic manifestation is better propitious to prevent the occurrence of central venous catheter associated infection.%目的 了解中心静脉导管相关性感染的原因及应采取的预防措施.方法 分析医院2008年4月-2010年3月住院的54例深静脉留置管患者发生的导管相关性感染原因,并针对原因采取一定的预防措施.结果 54例行中心静脉置管术的患者中,置管出口部位感染5例,占9.3%;导管相关血流感染3例,占5.6%;经相应处理后均好转.结论 导管相关性感染的危险因素中重要是导管留置时间、插管部位、导管类型、敷料及医务人员操作护理;加强人员教育培训、最大限度的建立防护屏障、严格执行无菌操作等有利于更好的预防中心静脉导管相关性感染的发生.

  9. Prevention and control of catheter-associated urinary tract infections – implementation of the recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) in nursing homes for the elderly in Frankfurt am Main, Germany

    Science.gov (United States)

    Heudorf, Ursel; Gasteyer, Stefanie; Müller, Maria; Samoiski, Yvonne; Serra, Nicole; Westphal, Tim

    2016-01-01

    Introduction: Urinary tract infections range among the most frequent infections not only in hospital patients but also in residents of long-term care facilities for the elderly. Urinary catheters are the greatest risk factor for urinary tract infections. In the guidance paper on the “prevention of infections in nursing homes” (2005) as well as in the updated recommendations for the “prevention and control of catheter-associated urinary tract infections” (2015), the Commission for Hospital Hygiene and Infection Prevention (KRINKO) has recommended adequate preventive measures. In 2015, the implementation of these KRINKO recommendations was investigated. Method: All of Frankfurt’s 40 nursing homes were evaluated using a checklist based on the KRINKO recommendations. The evaluation included assessing the availability of operating instructions, appropriate indications for the placement of catheters etc. Age, sex and duration of catheterization, as well as current and previous infections within the past 6 months were documented for every resident with a catheter. Results: In 35 (87.5%) of the nursing homes, operating instructions for the handling of urinary tract catheters were available. The decision as to whether a catheter is indicated is made by physicians, while its placement is often delegated to the nursing service. Typically, silicon catheters are used. In three-quarters of the nursing homes, regular intervals of 4–6 weeks for changing catheters were reported. On the respective survey day, 7.3% of the residents were catheterized. On the survey day, 3.6% (4.2%) and in the previous 6 months a total of 28% (28.9%) of the residents had a urinary tract infection (prevalence of antibiotic therapy in parentheses). Ciprofloxacin was used most often followed by cefuroxime and cotrimoxazole. Discussion: In the current evaluation, fewer nursing home residents were catheterized than in previous years and the rate of urinary tract infections was low. This

  10. Measurements of pericardial adipose tissue using contrast enhanced cardiac multidetector computed tomography—comparison with cardiac magnetic resonance imaging

    DEFF Research Database (Denmark)

    Elming, Marie Bayer; Lønborg, Jacob; Rasmussen, Thomas;

    2013-01-01

    Recent studies have suggested that pericardial adipose tissue (PAT) located in close vicinity to the epicardial coronary arteries may play a role in the development of coronary artery disease. PAT has primarily been measured with cardiac magnetic resonance imaging (CMRI) or with non...... tested, and the smallest difference in PAT was noted when -30 to -190 HU were used in MDCT measures. The median difference between MDCT and CMRI for the assessment of PAT was 9 ml (SD 50) suggesting a reasonable robust method for the assessment of PAT in a large-scale study. Pericardial adipose tissue...... and CMRI scans were performed. The optimal fit for measuring PAT using contrast MDCT was developed and validated by the corresponding measures on CMRI. The median for PAT volume in patients was 175 ml (SD 68) and 153 ml (SD 60) measured by MDCT and CMRI respectively. Four different attenuation values were...

  11. Fat contamination of pericardial suction blood in cardiac surgery : clinical and experimental studies in perspectives of transfusion logistics

    OpenAIRE

    Appelblad, Micael

    2006-01-01

    Introduction: During cardiac surgery aided by cardiopulmonary bypass (CPB) the autotransfusion of pericardial suction blood (PSB) is regarded mandatory to limit allogeneic blood exposure. PSB is however proposed as a source of lipid microemboli and to contribute to brain damage. This thesis addresses the logistics of allogeneic blood transfusion during coronary artery bypass grafting (CABG), the embolic potential of reinfused PSB, and means to reduce PSB fat contamination, investigated both c...

  12. Polymicrobial Purulent Pericarditis Probably caused by a Broncho-Lymph Node-Pericardial Fistula in a Patient with Tuberculous Lymphadenitis

    OpenAIRE

    Lee, Seung(Department of Physics, Korea Advanced Institute of Science and Technology, 335 Gwahak-ro, Yuseong-gu, Daejeon, 305-701, Korea); Lee, Kanglok; Ko, Jun Kwon; Park, Jaekeun; Yu, Mi Yeon; Oh, Chang Kyo; Hong, Seung Pyo; Kim, Yeonjae; Lim, Younghyo; Kim, Hyuck; Pai, Hyunjoo

    2015-01-01

    Purulent pericarditis is a rare condition with a high mortality rate. We report a case of purulent pericarditis subsequently caused by Candida parapsilosis, Peptostreptococcus asaccharolyticus, Streptococcus anginosus, Staphylococcus aureus, Prevotella oralis, and Mycobacterium tuberculosis in a previously healthy 17-year-old boy with mediastinal tuberculous lymphadenitis. The probable route of infection was a bronchomediastinal lymph node-pericardial fistula. The patient improved with antibi...

  13. Evaluation of the effects of combined endoscopic variceal ligation and splenectomy with pericardial devascularization on esophageal varices

    Institute of Scientific and Technical Information of China (English)

    Bo Liu; Mei-Hai Deng; Nan Lin; Wei-Dong Pan; Yun-Biao Ling; Rui-Yun Xu

    2006-01-01

    AIM:To detect the hemodynamic alterations in collateral circulation before and after combined endoscopic variceal ligation (EVL) and splenectomy with pericardial devascularization by ultrasonography,and to evaluate their effect using hemodynamic parameters.METHODS: Forty-three patients with esophageal varices received combined EVL and splenectomy with pericardial devascularization for variceal eradication. The esophageal vein structures and azygos blood flow (AZBF) were detected by endoscopic ultrasonography and color Doppler ultrasound. The recurrence and rebleeding of esophageal varices were followed up.RESULTS:Patients with moderate or severe varices in the esophageal wall and those with severe periesophageal collateral vein varices had improvements after treatment, while the percentage of patients with severe para-esophageal collateral vein varices decreased from 54.49% to 2.33%, and the percentage of patients with detectable perforating veins decreased from 79.07% to 4.65% (P < 0.01). Color Doppler flowmetry showed a significant decrease both in AZBF (43.00%,P < 0.05) and in diameter of the azygos vein (28.85%, P < 0.05), while the blood flow rate was unchanged. The recurrence rate of esophageal varices was 2.5% (1/40,mild), while no re-bleeding cases were recorded.CONCLUSION:EVL in combination with splenectomy with pericardial devascularization can block the collateral veins both inside and outside of the esophageal wall, and is more advantagious over splenectomy in combination with pericardial devascularization or EVL in preventing recurrence and re-bleeding of varices.

  14. Effects of pericardial effusates of various conductivities on body-surface potentials in dogs. Documentation of the eccentric spheres model.

    Science.gov (United States)

    Kramer, D A; Hamlin, R L; Weed, H R

    1984-12-01

    The purpose of this study was to discover the cause and magnitude of changes in the body-surface potentials occurring when: (1) fluids of various conductivity were added to the pericardial sac, or (2) the volume of the blood within chambers of the heart was either increased or decreased. Fluids added to the pericardium were physiological saline, whole-blood, and mineral oil. Magnitudes of body-surface potentials were compared to the predictions based on a mathematical eccentric spheres model of the heart and torso developed previously by Rudy and Plonsey. Data demonstrated conclusively that there is a nonlinear relationship between the body-surface potentials and the conductivity of the pericardial layer. This relationship is one in which the body-surface potentials of the anterior chest were found to decrease when conductivity of the pericardial layer was either increased or decreased. These changes in body-surface potentials were caused solely by alterations in the conductivity and volume of the fluid effusate. It was demonstrated that these changes were not caused by any "stretching" or "compression" of the cardiac tissue caused by the altered fluid volumes in and around the heart. Findings were accurately predicted by the eccentric spheres model, thereby confirming the model's usefulness as a predictive instrument. The model provides an explanation for the nonlinear relationship that was exhibited by the data. PMID:6499134

  15. Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy 
in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer

    Directory of Open Access Journals (Sweden)

    Pengfei LUO

    2011-07-01

    Full Text Available Background and objective Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer. Methods Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group and chemotherapy group. The combined therapy group was treated with radiofrequency hyperthermia after the pericardiocentesis and intracavitary injection (cisplatin 20 mg and dexamethasone 5 mg, when patients’ general state of health improved, systemic chemotherapy was performed. The chemotherapy group was treated only with intracavitary injection and systemic chemotherapy. Intracavitary chemotherapy was performed for 1-6 times (average 3 times. Hyperthermia was performed twice per week with an average of 6 times following intracavitary and systemic chemotherapy. The temperature of intracavitary was 40.5 oC-41.5 oC for 60 min during the hyperthermia periods. Systemic chemotherapy consists of cisplatin (75 mg/m2 and vinorelbine (50 mg/m2. Results The complete remission rate (CR of malignant pericardial effusion was 54.3% and the response rate (RR was 91.4% in the combined therapy group, while the rates of CR and RR of chemotherapy group were 25.0% and 70.0%, and the differences of CR and RR between the two groups were significant (P<0.05. After treatment, the quality of life improved significantly in both groups, but the combined therapy group had a higher KPS score than in the chemotherapy group (P<0.05. The adverse events associated with the chemotherapy included gastrointestinal toxicity and myelosup-pression, and there were no significant differences between the two groups. The main side effects associated with radiofrequency hyperthermia

  16. Contaminating fat in pericardial suction blood: a clinical, technical and scientific challenge.

    Science.gov (United States)

    Engström, Karl Gunnar

    2004-01-01

    Stroke and diffuse brain damage after cardiac surgery are too common. It is important to find means to reduce the incidence in view of future competition to surgery from less invasive procedures. Stroke is fairly well defined in clinical terms and with several identified mechanisms. Diffuse brain damage is less well defined and more complex in nature. One suggested mechanism is from cerebral fat microembolization of retrieved pericardial suction blood (PSB). The present study aimed to describe a simple method to measure fat content of PSB, how experimental artefacts interfere with the results, and how the unstable character of a fat-blood suspension can be used to design a simple fat-separation system. The quantity of small amounts of fat can be amplified by centrifugation to the tapered tip of a standard glass pipette. The coefficient of variation after repeated experiments was 9.5%. PSB after coronary bypass surgery contained 0.22 +/- 0.04% fat of which 15 +/- 3% was bound to the surface of the plastic collecting bag. Experimentation requires standardized routines. Static incubation, blood-fat mixing routines, and transfer steps of blood samples between syringes induce substantial artefacts from spontaneous density separation and surface-adhesion of fat. Soya oil is a common reference substance replacing human fat in technical laboratory science, but is associated with artefacts of its own. These artefacts cause problems during experimentation but the oil is a good resource in the design of a simple fat-separation system. PMID:15161061

  17. SING CRYOPRESERVED HOMOGRAFT PERICARDIAL PATCH IN STAGED COMPLETE REPAIR FOR TETRALOGY OF FALLOT

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To compare the difference of effect while using homograt pericardium patch and Gore-tex patch in staged complete repair for Tetralogy of Fallot (TOF) to enlarge the right ventricular ouflow tract (RVOT). Methods Twenty-eight patients with TOF underwent the staged complete repair. Gore-tex patches were used to enlarge the RVOT of 13 patients, and cryopreserved homograft pericardium patches were used to enlarge the RVOT of 15 patients. The patients were followed up with 2-dimensional echocardiography and chest x-ray.Results One operative death in Gore-tex patch group, the mortality was 7. 7%; 1 early postoperative death in cryopreserved homograft pericardium patch group, the mortality was 6. 7%. Between 2 groups, hemostasia time in operation room with significant difference ( P < 0. 01 ) , pericardial cavity drainage volume with difference ( P < 0. 05). Gore-tex patch group was followed up 2 to 4.5 years, homograft pericardium patch group was followed up 0. 8 to 2. 1 years. Echocardiography showed that there was significant difference of the residual obstruction at RVOT level ( P < 0. 01 ). No calcification shadow was discovered on the chest x-ray of both groups. Conclusion Homograft pericardium is tissue with high density and intensity, its elasticity and compliance are good. Using homograft pericardium patch maybe helpful to decrease the residual obstruction of RVOT after operation. It can be adapted as a repairing material in cardiac surgery.

  18. 临床操作路径应用于降低内科导尿管相关性尿路感染的临床观察%Clinical observation of clinical operation path to be applied to reduce medical catheter associated urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    梁维红

    2015-01-01

    目的:观察临床操作路径应用于降低内科导尿管相关性尿路感染临床效果。方法:在2013年目标性监测有效预防措施基础上制定导尿管相关性尿路感染的临床操作路径干预措施,以2014年应用者310例为观察组,2013未应用者322例为对照组。结果:观察组发生泌尿系感染19例,感染率6.13%,对照组发生泌尿系感染37例,感染率11.49%。结论:临床操作路径应用于内科导尿管相关性尿路感染,有效降低泌尿道感染的发生,值得临床推广。%objective: to observe clinical path used to reduce catheter-associated urinary tract infection internal medicine clinical effects. Method:in the 2013 target monitoring effective prevention of catheter-associated urinary tract infections based on clinical path of interventions by 2014 in 310 cases of application for observer group, 2013 322 cases is not applied as a control group. Results:observation of urinary infection in 19 cases, the rate of infection 6.13%, 37 cases occurred in the control group urinary tract infections, infection rate was 11.49%. Conclusions:clinical path applied to medical catheter-associated urinary tract infections, effectively reducing the occurrence of urinary tract infections, isworthy of promotion.

  19. ICU 导管相关感染患者干预前后的费用分析%Medical cost of intensive care unit patients with catheter-associated infec-tion before and after intervention

    Institute of Scientific and Technical Information of China (English)

    潘颖颖; 朱熠; 庄建文; 唐娜; 李辉; 邹建文; 张淑敏

    2015-01-01

    Objective To compare whether there is a difference in medical cost of intensive care unit(ICU)pa-tients with catheter-associated infection (CAI)between before and after targeted intervention.Methods CAI in ICU patients in 2010(pre-intervention group)and 2013 (post-intervention group)were investigated by retrospective survey,hospitalization cost of two groups of patients before and after intervention was compared.Results The morbidity and mortality in patients with CAI both decreased significantly after intervention,morbidity of healthcare-associated infection(HAI)decreased from 13.47% in 2010 to 4.41 % in 2013,mortality decreased from 10.36% in 2010 to 2.2% in 2103.Total hospitalization cost,blood transfusion cost,and cost of special material before and af-ter the implementation of targeted intervention all significantly different (all P <0.05),the difference of procalcito-nin and antimicrobial agents cost were also significant(all P <0.05).Conclusion Medical cost in ICU patients with CAI decreased after intervention.%目的:比较目标性干预前后重症监护室(ICU)导管相关感染患者医疗费用有无差异。方法采用回顾性调查方法,调查2010年(干预前组)、2013年(干预后组)某院 ICU 患者导管相关感染情况,比较两组患者的住院费用在干预前后的差异。结果干预后 ICU 导管相关感染患者发病率和病死率均明显下降,医院感染发病率由2010年的13.47%下降至2013年4.41%;病死率由2010年的10.36%下降至2013年的2.2%。实施目标性干预前后患者住院总费用、血费以及特殊材料费用比较,差异均有统计学意义(均 P <0.05);各感染指标相关费用比较中降钙素原检测和抗菌药物使用费用经统计学分析,差异均有统计学意义(均 P <0.05)。结论干预后 ICU 患者发生导管相关医院感染医疗费用有下降。

  20. Analysis of risk factors of indwell ing catheter associated urinary tract infection and nursing prevention%留置尿管相关性尿路感染的危险因素分析及护理预防

    Institute of Scientific and Technical Information of China (English)

    王竹君; 付林; 王玉; 陈汉霞

    2014-01-01

    Objective:To probe into the risk factors of indwelling cathe-ter associated urinary tract infection,so as to improve the clinical medi-cal security.Methods:A total of 255 patients with indwelled urinary and data integrity were included.According to whether catheter relat-ed urinary infection occurred or not,all patients were divided into infec-tion group (73 cases)and not infection group (182 cases).Single fac-tor analysis was used to investigate the differences of risk factors of catheter related urinary infection between both groups,and further Logistic regression analysis was used to analyze independent risk fac-tors of influencing catheter related urinary infection.Results:Univa-riate analysis of two groups of data showed that the age,indwelling uri-nary tube time ≥ 7 d,application of hormone,operation ≥ 2 or more times,bladder irrigation <7 times every week,urethral opening clean-ing<7 times every week in infection group were higher than those in non infection group,all differences were statistically significant (all P <0.05).Multi factor analysis of two groups data showed that in infec-tion groups,the age,indwelling urinary tube time≥7d,operation≥2 or more times and urethral opening cleaning<7 times every week were high-er than those in non infection group,the difference was statistically significant (P < 0.05).Conclusion:Old age,long indwelling time,the operation of more than 2 times and urethral mouth cleaning <7 times per week are the independent risk factors of catheter related urinary tract infection.%[目的]探讨留置尿管相关性尿路感染的危险因素,以提高临床医疗安全性。[方法]纳入资料完整的留置尿管病人255例,以是否发生导管相关性尿路感染为判断标准分为感染组(73例)和非感染组(182例)。采用单因素分析两组导管相关性尿路感染的危险因素的差异,并进一步通过 Logistic 回归分析影响导管相关性尿路感染发生的独立危险因素。[结果]两组资料单因素分析表明,感染组年龄、留置尿管时间≥7 d、应用激素、操作次数≥2次、膀胱冲洗<7次/周及尿道口清洗<7次/周均高于非感染组,差异均有统计学意义(均 P <0.05)。两组资料多因素分析表明,感染组年龄、留置尿管时间≥7 d、操作次数≥2次及尿道口清洗<7次/周均高于非感染组,差异均有统计学意义(均 P <0.05)。[结论]年龄大、留置尿管时间长、操作次数≥2次及尿道口清洗<7次/周是发生导管相关性尿路感染的独立危险因素。

  1. 导管相关尿道感染的病原学及耐药性分析%Pathogenesis and drug resistance of catheter-associated urinary tract infections

    Institute of Scientific and Technical Information of China (English)

    蒋雁; 夏邦世; 林奇龙

    2013-01-01

    目的 分析导管相关尿道感染(CAUTI)的病原菌分布及对抗菌药物的耐药情况,为临床诊断和治疗提供依据.方法 收集2009年1月至2011年12月留置导管患者尿标本分离出的414株病原菌,采用美国PHOENIX 100细菌鉴定及药敏系统进行鉴定及药敏试验.结果 导管相关尿道感染的主要致病菌依次是大肠埃希菌(22.7%)、肠球菌(21.7%)、白假丝酵母菌(7.7%)和肺炎克雷伯菌(7.0%).药敏结果显示肺炎克雷伯菌、大肠埃希菌及肠球菌对常用抗菌药物有较高耐药性;肺炎克雷伯菌、大肠埃希菌超广谱β-内酰胺酶阳性率为51.7%、65.9%,高浓度庆大霉素耐药肠球菌为64.4%.结论 CAUTI病原菌以大肠埃希菌和肠球菌属为主,且呈多重耐药现象,开展耐药性监测对临床合理用药具有重要意义.%Objective To analyze the distribution and resistance to antibiotics of the pathogens in catheter-associated urinary tract infections (CAUTI), and provide doctors with the laboratory evidence of CAUTI diagnosis. Methods 414 strains of pathogens from patients with indwelling catheter were collected from January 2009 to December 2011. The pathogens were identified and tested for drug sensitivity by American PHOENIX 100 Analys's systems for bacteria identification and drug sensitivity. Results The top four CAUTI pathogens were Escherichia coli (22. 7%), Enterococcus (21. 7%), Candida albicans (7. 7%) and Klebsiella pneumoniae (7. 0%). Klebsiel-la pneumoniae and Escherichia coli and Enterococcus were highly resistant to common antimicrobials and demonstrated multi-drug resistance. The positive rates of ESBLs-producers in Klebsiella pneumoniae and Escherichia coli were 51. 7% and 65. 9%, and that of HLGR in Enterococcus was 64. 4%. Conclusion Escherichia coli and Enterococcus are predominant in CAUTI patients, and often demonstrate multi-drug resistance. The surveillance of bacterial resistance have great significance to the

  2. 基层医院ICU中心静脉导管相关性血流感染的危险因素分析%Risk Factors of Catheter-Associated Bloodstream Infections in Intensive Care Unit of Primary Hospital

    Institute of Scientific and Technical Information of China (English)

    张细江

    2012-01-01

    Objective To explore the risk factors of catheter-associated bloodstream infections (CRBSI) in intensive care unit (ICU) of primary hospital. Methods A total of 623 patients with central venous catheters were recruited in the study. 60 of them suffered from CRBSI served as an observation group and other 563 cases without CRBSI served as control. Univariate analysis was used to scan possible risk factors. Then logistic regression analysis was used to exclude the confounding factors. Results The overall incidence rate of CRBSI was 9. 63% (60/623). There were significant differences in APACHE score, type of catheter,location of catheter,duration of central venous catheter,intravenous nutrition, use of steroid,times of intubation, urgent intubations, nutritional status, diabetes, and MODS between the two groups. Logistic regression analysis revealed that higher APACHE score, double-lumen catheter, femoral vein catheter, catheter indwelling more than two weeks, intravenous nutrition, intubation more than 2 times, and emergency intubation were risk factors of CRBSI. Conclusions Higher APACHE score,double-lumen catheter,femoral vein catheter,catheter indwelling more than two weeks,intravenous nutrition,intubation more than 2 times, and emergency intubation were major risk factors of CRBSI in ICU of primary hospital.%目的 探讨基层医院ICU中心静脉导管相关血流感染(CRBSI)的危险因素.方法 以台州市立医院ICU就诊的中心静脉导管留置患者为研究对象,根据是否发生CRBSI分成感染组(60例)和非感染组(563例),首先单因素分析初步筛查CRBSI的危险因素,然后以是否发生CRBSI(1=是,0=否)为因变量,以单因素分析有差别的危险因素为自变量,进行Logistic多因素回归分析,寻找CRBSI的危险因素.结果 CRBSI的发生率为9.63% (60/623);感染组与非感染组APACHE评分、导管类型、导管留置部位、留置时间、静脉营养、激素使用、插管次数、紧急插管、营

  3. Blunt traumatic pericardial rupture and cardiac herniation with a penetrating twist: two case reports

    Directory of Open Access Journals (Sweden)

    Galloway Robert

    2009-12-01

    Full Text Available Abstract Background Blunt Traumatic Pericardial Rupture (BTPR with resulting cardiac herniation following chest trauma is an unusual and often fatal condition. Although there has been a multitude of case reports of this condition in past literature, the recurring theme is that of a missed injury. Its occurrence in severe blunt trauma is in the order of 0.4%. It is an injury that frequently results in pre/early hospital death and diagnosis at autopsy, probably owing to a combination of diagnostic difficulties, lack of familiarity and associated polytrauma. Of the patients who survive to hospital attendance, the mortality rate is in the order of 57-64%. Methods We present two survivors of BTPR and cardiac herniation, one with a delayed penetrating cardiac injury secondary to rib fractures. With these two cases and literature review, we hope to provide a greater awareness of this injury Conclusion BTPR and cardiac herniation is a complex and often fatal injury that usually presents under the umbrella of polytrauma. Clinicians must maintain a high index of suspicion for BTPR but, even then, the diagnosis is fraught with difficulty. In blunt chest trauma, patients should be considered high risk for BTPR when presenting with: Cardiovascular instability with no obvious cause Prominent or displaced cardiac silhouette and asymmetrical large volume pneumopericardium Potentially, with increasing awareness of the injury and improved use and availability of imaging modalities, the survival rates will improve and cardiac Herniation could even be considered the 5th H of reversible causes of blunt traumatic PEA arrest.

  4. Assosiation of Epicardial and Pericardial Fat Thickness with Coronary Artery Disease

    Science.gov (United States)

    Ghaderi, Fereshteh; Eshraghi, Ali; Shamloo, Alireza Sepehri; Mousavi, Sareh

    2016-01-01

    Introduction Visceral adipose tissue is a known important risk factor for coronary artery disease (CAD). While some studies have suggested relationship between epicardial fat thickness (EFT) and CAD, there are no adequate studies for pericardial fat thickness (PFT). The aim of this study was to determine the association of EFT and PFT with CAD. Methods This cross-sectional study was conducted on patients who were candidates for elective coronary artery angiography, referred to Emam Reza Hospital, Mashhad, Iran during Jan 2014–2016. Demographic and laboratory data were collected. Transthoracic echocardiography was performed to determine average EFT and PFT at the standard parasternal long-axis view at end-systole for 3 cardiac cycles. SCA was performed on the same day. The patients were divided into two groups: CAD (n=59) and non-CAD (n=41) based on presence or absence of epicardial coronary artery stenosis of > 50%. Chi-square, independent T-test, and receiver operating characteristic (ROC) curve were used by SPSS Version 16 for data analysis. Results One hundred patients (44 women and 56 men) with an average age of 56.4 ± 9.9 years were studied. The two groups were not significantly different in demographic profile and cronary risk factors. While PFT was not significantly different between the two groups, EFT was significantly higher in CAD group (3.0 ± 3.69 vs. 1.2 ± 3.6, p coronary arteries, EFT increased (p <0.0001). Gensini score had a strong correlation with amount of EFT (r = 0.765, p <0.0001). EFT with a cutoff value of 4.25 mm (sensitivity=79%, specificity=68%) was specified in predicting CAD. Conclusion EFT measured by echocardiography can be used as an independent marker to predict CAD. More studies are needed to determine the predictive role of PFT for CAD.

  5. A Comparative Study between Vitrectomy with Internal Tamponade and a New Modified Fiber Optic Illuminated Ando Plombe for Cases of Macular Hole Retinal Detachment in Myopic Eyes

    Directory of Open Access Journals (Sweden)

    Ahmed M. Bedda

    2015-01-01

    Full Text Available Aim. To compare pars plana vitrectomy (PPV with silicone tamponade or gas (Groups Ia and Ib and a new modified Ando plombe equipped with a fiber optic light (Group II for cases with macular hole retinal detachment (MHRD in high myopic eyes (axial length > 26 mm. Methods. A prospective interventional randomized case series included 60 eyes (20 in each group. Successful outcome was considered if the retina was completely attached at the end of the follow-up period. Complications were identified for each group. Results. Visual acuity improved by 37.31%, 40.67%, and 49.40% in Groups Ia, Ib, and II, respectively. The success rate was 55%, 60%, and 100% in Groups Ia , Ib, and II, respectively, with a statistically significant difference between Groups Ia, Ib, and II (p < 0.001 in Ia, p: 0.002 in Ib. Complications rates were 60%, 45%, and 20% in Groups Ia, Ib, and II, respectively, with a statistically significant difference between Groups Ia and II (p: 0.01. Conclusion. Fiber optic illuminated Ando plombe allows better positioning under the macula and consequently improves the success rate of epimacular buckling in comparison to PPV with internal tamponade in MMHRD.

  6. Investigation of peripherally inserted central catheter-associated infection in neonates%新生儿经外周置入中心静脉导管相关血流感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    闫钢风; 曹云; 胡晓静; 陈超; 蒋思远; 王传清

    2011-01-01

    目的 分析新生儿经外周置入中心静脉导管(PICC)相关感染的发生情况、病原学及临床特点,探讨有关感染防治措施的效果,以提供有效的防治策略.方法 回顾分析2007年7月至2009年8月期间我院新生儿重症监护病房(NICU)72例新生儿PICC置管病例(置管83例次)的临床资料、血培养和导管尖端培养结果,分析其病原菌分布与药物敏感性,比较新旧置管规范下,PICC相关感染发生情况.结果 83例次置管中,导管相关感染发生15例次(18.1%),其中确诊败血症为11例次(13.2%),诊断临床败血症4例次(4.8%),细菌定植0例次(0%).导管相关感染率10.2/1 000置管日;旧置管规范下的感染发生率16.1/1 000置管日,新置管规范下的感染发生率7.7/1 000置管日.共分离菌株11株,其中凝固酶阴性葡萄球菌4株,鲍曼不动杆菌3株,肺炎克雷白杆菌2株,屎肠球菌1株,近平滑假丝酵母1株.结论 留置PICC新生儿发生的导管相关血流感染多由条件致病菌引起,耐药严重;加强感染防治措施能减少PICC相关感染发生.%Objective To analyze the incidence,bacterial spectrum and clinical features of peripherally inserted central catheter-associated bloodstream infection in neonates, and to investigate the effect of infection control strategies on the occurrence of infection,by which it is helpful in choosing effective strategies for clinical practice. Methods Clinical data, results of blood culture and culture of the catheter tip were collected from 72 infants (66 of them were very low birth weight) admitted to NICU from July, 2007 to August, 2008. The incidence of PICC-associated bloodstream infection (PICC-BSI) in the old hospital was compared with that of the new hospital. Results Bacterial colonization was not found. PICC-BSI was found in 15 cases (18. 1%), including 11 cases (13.2%) with definite sepsis and 4 cases (4. 8 %) with clinical sepsis.The incidence of PICC-BSI was 10. 2/1 000 PICC-days as

  7. Lymphangiopathy in neurofibromatosis 1 manifesting with chylothorax, pericardial effusion, and leg edema

    Directory of Open Access Journals (Sweden)

    Finsterer J

    2013-09-01

    Full Text Available Josef Finsterer,1 Claudia Stollberger,2 Elisabeth Stubenberger,3 Sasan Tschakoschian4 1Krankenanstalt Rudolfstiftung, Vienna, Austria; 2Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria; 3Thoracic Surgery Department, Vienna, Austria; 4Interne Lungenabt, Vienna, Austria Background: This case report documents the affliction of the lymph vessels as a phenotypic feature of neurofibromatosis-1 (NF-1. Methodology: Routine transthoracic echocardiography, computed tomography scan of the thorax, magnetic resonance angiography of the renal arteries, and conventional digital subtraction angiography were applied. Comprehensive NF-1 mutation analysis was carried out by fluorescence in situ hybridization analysis, long-range reverse transcriptase polymerase chain reaction, and multiple-ligation probe assay. All other investigations were performed using routine, well-established techniques. Results: The subject is a 34-year-old, half-Chinese male; NF-1 was suspected at age 15 years for the first time. His medical history included preterm birth, mild facial dysmorphism, "café au lait" spots, subcutaneous and paravertebral fibromas, multifocal tachycardia, atrial fibrillation, and heart failure in early infancy. Noncalcified bone fibromas in the femur and tibia were detected at age 8 years. Surgical right leg lengthening was carried out at age 11 years. Bilateral renal artery stenosis, stenosis and aneurysm of the superior mesenteric artery, and an infrarenal aortic stenosis were detected at age 15 years. Leg edema and ectasia of the basilar artery were diagnosed at age 18 years. After an episode with an erysipela at age 34 years, he developed pericardial and pleural effusion during a 4-month period. Stenosis of the left subclavian vein at the level of thoracic duct insertion was detected. After repeated pleural punctures, pleural effusion was interpreted as chylothorax. Reduction of lymph fluid production by diet and injection of talcum into

  8. Characteristics of the Pathogens Causing Catheter-associated Urinary Tract Infection in Critically Ill Patients%危重患者导管相关性尿路感染病原菌特征分析

    Institute of Scientific and Technical Information of China (English)

    何超; 刘钰琪; 李纪文; 戴仲秋; 朱丽娜; 谢轶; 陈知行; 康梅

    2015-01-01

    目的 了解危重患者导管相关性尿路感染(catheter-associated urinary tract infection,CAUTI)的病原菌菌种分布及耐药表型,为其临床治疗和院感控制提供依据.方法 回顾性分析2012年1月至2014年12月在我院重症监护病房发生CAUTI的患者临床资料和实验室检查结果.对CAUTI患者尿标本分离的病原菌及其耐药表型进行统计分析.结果 共纳入CAUTI患者370例,从其尿标本共分离出病原菌517株,其中:真菌222株,占42.9%;革兰阴性菌181株,占35.0%;革兰阳性菌114株,占22.0%.从菌种分布看,真菌主要有白色念珠菌(105株,20.3%)、热带念珠菌(78株,15.1%)和光滑念珠菌(30株,5.8%);革兰阴性菌主要有大肠埃希菌(81株,15.7%)、肺炎克雷伯菌(37株,7.2%)和鲍曼/醋酸钙不动杆菌复合体(23株,4.4%);革兰阳性菌主要有屎肠球菌(79株,15.3%)和粪肠球菌(13株,2.5%).耐药表型分析结果显示:念珠菌对伊曲康唑、伏立康唑和氟康唑的耐药率均在10.0%以上;大肠埃希菌和肺炎克雷伯菌对大多数常规药物耐药率均大于30%;鲍曼/醋酸钙不动杆菌复合体对大多数常规药物耐药率均大于60%,对亚胺培南耐药率为60.8%;屎肠球菌和粪肠球菌对大多数常规药物耐药率均大于60%,对万古霉素耐药率分别为16.5%和31.0%.结论 引起我院危重患者CAUTI的主要病原菌是念珠菌,并对唑类药物表现出一定耐药性;革兰阴性菌和革兰阳性菌的耐药性值得关注.应合理使用抗生素,并采取有效措施,减少CAUTI的发生.%Objective To investigate the species and resistance phenotypes of the pathogens causing catheterassociated urinary tract infection (CAUTI) in critically ill patients in West China Hospital of Sichuan University,and to provide the basis for the prevention and treatment of this kind of infection.Methods The clinical data and findings of the laboratory examination of the patients,who were

  9. 硅油长期眼内填充的可行性分析%Analysis of the possibility for long-term intraocular silicone oil tamponade

    Institute of Scientific and Technical Information of China (English)

    马利波; 王颖; 赵健; 李垚

    2014-01-01

    目的 探讨硅油眼内长期填充的可行性及其转归.方法 收集2004年9月至2014年6月在沈阳爱尔眼视光医院随访资料完整的硅油眼内填充达3年以上的病例23例23只眼,男16例,女7例,硅油填充时间3年至15年,对其进行分析.其中严重孔源视网膜脱离16只眼、急性视网膜坏死2只眼、增殖性糖尿病视网膜病变Ⅵ期2只眼、眼球破裂伤3只眼,均行玻璃体切除、硅油填充.其中视网膜切开6只眼,联合晶状体一期切除17只眼.结果 末次手术后依然硅油填充17只眼,其中视网膜复位良好7只眼,视网膜部分复位7只眼;全视网膜脱离2只眼,眼底不清1只眼;6只眼硅油取出,其中5只眼硅油取出后视网膜复位保持良好,1只眼视网膜脱离复发.视力0.01~0.06者6只眼,光感~指数者10只眼,无光感者3只眼.随访期间并发症有角膜带状变性、角膜大泡病变、继发青光眼、硅油乳化、晶状体混浊、视乳头颜色变淡、低眼压、虹膜红变和硅油进入视网膜下等.结论 硅油长期填充会导致眼组织结构和功能的异常,但对于一些视网膜复位不佳的严重玻璃体视网膜病变病例,硅油的长期填充可以获得维持视网膜复位,延长有用的视功能,保持眼球外观的机会.%Objective To study the etiology,symptoms and prognosis of long-term intraocular silicone tamponade.Methods This study collected 23 patients (23 eyes) with intraocular silicone oil tamponade for more than 3 years during 8 years follow-up.Male was 16; female was 7; the time of silicone oil tamponade was from 3 to 15 years,including 16 eyes of rhegmatogenous retinal detachment; 2 eyes of acute retinal necrosis; 2 eyes of proliferative diabeticretinopathy; 3 eyes of traumatic ocular rupture.All patients had been performed vitrectomy and silicone oil tamponade,including 6 eyes with retinal incision and 17 eyes with lesectomy.Results Of 17 eyes with long-term silicone oil tamponade

  10. Genetic counselling and testing in cardiomyopathies : a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases

    NARCIS (Netherlands)

    Charron, Philippe; Arad, Michael; Arbustini, Eloisa; Basso, Cristina; Bilinska, Zofia; Elliott, Perry; Helio, Tiina; Keren, Andre; McKenna, William J.; Monserrat, Lorenzo; Pankuweit, Sabine; Perrot, Andreas; Rapezzi, Claudio; Ristic, Arsen; Seggewiss, Hubert; van Langen, Irene; Tavazzi, Luigi

    2010-01-01

    Advances in molecular genetics present new opportunities and challenges for cardiologists who manage patients and families with cardiomyopathies. The aims of this position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases are to review the general i

  11. Successful Salvage Radiotherapy for a Chemo-refractory, Non-resectable, Undifferentiated Pleomorphic Sarcoma Lung Metastasis with Pericardial Involvement: A Case Report.

    Science.gov (United States)

    Al-Hajri, Thuraya; Chan, Jessica; Caudrelier, Jean-Michel

    2016-01-01

    We report a case of an undifferentiated pleomorphic sarcoma in a 73-year-old female, with a solitary lung metastasis involving the pericardium that progressed on first-line chemotherapy. Partial removal of the lesion was achieved after lingular segmentectomy, which required en-bloc pericardial resection due to deep pericardial invasion. However, the residual disease significantly grew despite second-line chemotherapy, and the tumor became unresectable due to near encasement of the left anterior descending coronary artery. Therefore, we opted for a salvage radical dose of intensity-modulated radiotherapy (60Gy in 25 fractions) to the pericardial lesion. No acute side effects were observed, and after three years of follow-up, good local control has been achieved with no significant late effects observed. This case suggests that radical radiotherapy using IMRT could be considered to treat sarcomatous pericardial lesions in patients who do not respond to chemotherapy and who are inoperable or non-resectable. PMID:26918213

  12. Silent ischemic heart disease and pericardial fat volume in HIV-infected patients: a case-control myocardial perfusion scintigraphy study.

    Directory of Open Access Journals (Sweden)

    Ulrik S Kristoffersen

    Full Text Available OBJECTIVES: to determine the prevalence of asymptomatic ischemic heart disease (IHD in HIV patients by myocardial perfusion scintigraphy (MPS and to determine the value of coronary artery calcium score (CACS, carotid intima-media thickness (cIMT and pericardial fat volume as screening tools for detection of IHD in subjects with HIV. BACKGROUND: Patients with HIV seem prone to early development of IHD. METHODS: 105 consecutive HIV patients (mean age 47.4 years; mean duration of HIV 12.3 years; mean CD4+ cell count 636×10⁶/L; all receiving antiretroviral therapy and 105 controls matched for age, gender and smoking status, without history of IHD were recruited. MPS, CACS, cIMT, pericardial fat volume, and cardiovascular risk scores were measured. RESULTS: HIV patients demonstrated higher prevalence of perfusion defects than controls (18% vs. 0%; p<0.001 despite similar risk scores. Of HIV patients with perfusion defects, 42% had a CACS = 0. CACS and cIMT were similar in HIV patients and controls. HIV patients on average had 35% increased pericardial fat volume and increased concentration of biomarkers of atherosclerosis in the blood. HIV patients with myocardial perfusion defects had increased pericardial fat volume compared with HIV patients without perfusion defects (314±43 vs. 189±12 mL; p<0.001. CONCLUSIONS: HIV patients had an increased prevalence of silent IHD compared to controls as demonstrated by MPS. The finding was strongly associated with pericardial fat volume, whereas cardiovascular risk scores, cIMT and CACS seem less useful as screening tools for detection of myocardial perfusion defects in HIV patients.

  13. Endovascular Repair Using Suture-Mediated Closure Devices and Balloon Tamponade following Inadvertent Subclavian Artery Catheterization with Large-Caliber Hemodialysis Catheter

    Science.gov (United States)

    Park, Taek Kyu; Yang, Jeong Hoon

    2016-01-01

    Accidental subclavian artery cannulation is an uncommon but potentially serious complication of central venous catheterization. Removal of a catheter inadvertently placed in the subclavian artery can lead to substantial bleeding, as achieving hemostasis in this area through manual compression presents considerable difficulty. Additionally, surgical treatment might be unsuitable for high-risk patients due to comorbidities. Here, we report a case of an inadvertently-inserted 11.5-French hemodialysis catheter in the subclavian artery during internal jugular venous catheterization. We performed percutaneous closure of the subclavian artery using three 6-French Perclose Proglide® devices with a balloon tamponade in the proximal part of the subclavian artery. Closure was completed without embolic neurological complications. PMID:27482271

  14. Treatment of hemodialysis vascular access rupture irresponsive to prolonged balloon tamponade: Retrospective evaluation of the effectiveness of N-butyl cyanoacrylate seal-off technique

    Energy Technology Data Exchange (ETDEWEB)

    Weng, Mei Jul; Liang, Huei Lung; Pan, Huay Ben [Dept. of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung (China); Chen, Matt Chiung Yu [Dept. of Radiology, Yuan' s General Hospital, Kaohsiung (China)

    2013-01-15

    The current study retrospectively evaluated whether the percutaneous N-butyl cyanoacrylate (NBCA) seal-off technique is an effective treatment for controlling the angioplasty-related ruptures, which are irresponsive to prolonged balloon tamponade, during interventions for failed or failing hemodialysis vascular accesses. We reviewed 1588 interventions performed during a 2-year period for dysfunction and/or failed hemodialysis vascular access sites in 1569 patients. For the angioplasty-related ruptures, which could not be controlled with repeated prolonged balloon tamponade, the rupture sites were sealed off with an injection of a glue mixture (NBCA and lipiodol), via a needle/needle sheath to the rupture site, under a sonographic guidance. Technical success rate, complications and clinical success rate were reported. The post-seal-off primary and secondary functional patency rates were calculated by a survival analysis with the Kaplan-Meier method. Twenty ruptures irresponsive to prolonged balloon tamponade occurred in 1588 interventions (1.3%). Two technical failures were noted; one was salvaged with a bailout stent-graft insertion and the other was lost after access embolization. Eighteen accesses (90.0%) were salvaged with the seal-off technique; of them, 16 ruptures were completely sealed off, and two lesions were controlled as acute pseudoaneurysms. Acute pseudoaneurysms were corrected with stentgraft insertion in one patient, and access ligation in the other. The most significant complication during the follow-up was delayed pseudoaneurysm, which occurred in 43.8% (7 of 16) of the completely sealed off accesses. Delayed pseudoaneurysms were treated with surgical revision (n = 2), access ligation (n = 2) and observation (n = 3). During the follow-up, despite the presence of pseudoaneurysms (acute = 1, delayed = 7), a high clinical success rate of 94.4% (17 of 18) was achieved, and they were utilized for hemodialysis at the mean of 411.0 days. The post

  15. Undetected Aorto-RV Fistula With Aortic Valve Injury and Delayed Cardiac Tamponade following a Chest Stab Wound: A Case Report

    Directory of Open Access Journals (Sweden)

    Jamil Esfahanizadeh

    2013-06-01

    Full Text Available Introduction: Although a few patients will survive after penetrating cardiac injuries, some of them may have unnoticeable intracardiac injuries. The combination of aorto-right ventricular fistula with aortic valve injury is rare.Case Presentation: A 19 year-old man referred with an aorto-right ventricular fistula accompanied with aortic regurgitation and delayed tamponade following a stab in the chest. The patient was scheduled for fistula repair, aortic valve replacement and pericardectomy two months after trauma.Conclusions: To prevent missing intracardiac injury and also late cardiac injury complications, in all pericordial stab wounds, serial clinical examinations and serial echocardiography should be performed. In addition, cardiac injuries should be repaired during the same hospital stay.

  16. F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

    Directory of Open Access Journals (Sweden)

    Gian Marco Tosi

    2014-01-01

    Full Text Available Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8 for intraoperative flattening of the retina and of F6H8/silicone oil (SO 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy. Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70. Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months. Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40 cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios. Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.

  17. Prevalence of 'high-riding' superior pericardial recesses on thin-section 16-MDCT scans

    Energy Technology Data Exchange (ETDEWEB)

    Basile, Antonio [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy)]. E-mail: antodoc@yahoo.com; Bisceglie, Paola [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Giulietti, Giorgio [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Calcara, Giacomo [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Figuera, Michele [Department of Radiology, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania (Italy); Mundo, Elena [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Granata, Antonio [Department of Nephrology, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania (Italy); Runza, Giuseppe [Department of Radiology, Policlinico Universitario, Via del Vespro 129, 90127 Palermo (Italy); Privitera, Carmelo [Department of Radiology, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania (Italy); Privitera, Giambattista [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Patti, Maria Teresa [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy)

    2006-08-15

    Objective: The aim of this study was to evaluate the prevalence of 'high-riding' superior pericardial recess (HRSPR) on thin-section (1 mm) 16-multidetector computed tomography (MDCT) scans. Materials and methods: Three hundred and fourteen consecutive chest CT scans obtained with a thin-section 16 MDCT were retrospectively evaluated. The prevalence and characteristic of HRSPR were analyzed. Results: HRSPR was depicted in 21 patients (11 men and 10 women) (6.6%) who ranged in age from 28 to 72 years (mean age, 57 years). The extended recesses were rounded/oval shaped in five patients and triangular, spindle, half moon or irregular shaped in the other 16 patients. Conclusion: Our data suggest as HRSPRs are more frequently and better depicted on thinsection MDCT scans, and this improves the capability to distinguish this superior extension of the superior aortic recess from abnormal findings such as lymphadenopathy, cystic lesions, and aortic dissection.

  18. 硅油填充手术后继发性青光眼的临床观察%Clinical observation on secondary glaucoma after silicone oil tamponade

    Institute of Scientific and Technical Information of China (English)

    张忠红; 栾洁

    2011-01-01

    目的 探讨硅油填充手术后继发性青光眼(SOG)的危险因素和治疗方法.方法 玻璃体切割手术同时眼内硅油填充的93例患者95只眼纳入本研究.其中,手术中保留晶状体37只眼,摘除晶状体58只眼;摘除晶状体眼中,植入人工晶状体10只眼.硅油填充时间≤6个月者32只眼,>6个月者63只眼.手术后1、2周,1个月时复查眼底和眼压,均随访至硅油取出.随访时间2~25个月,平均随访时间(9.5±5.1)个月.手术后1个月眼压高于21 mm Hg(1 mm Hg=0.133 kPa),同时排除有明显原发因素及新生血管性青光眼等其他继发因素所引起的眼压升高者诊断为SOG.SOG确诊后,立刻给予盐酸卡替洛尔、布林佐胺滴眼液、甘露醇静脉滴注降眼压治疗,治疗1周眼压仍不能降至正常者行硅油取出手术,仍不能降至正常者行小梁切除手术.结果 21只眼发生SOG,占总眼数的22.1%.21只眼的平均硅油填充时间为(10.8±5.1)个月.其中,16只眼为无晶状体眼,占无晶状体眼的33.3%;5只眼为有晶状体眼或人工晶状体眼,占有晶状体眼或人工晶状体眼的10.6%.18只眼的硅油填充时间>6个月,占硅油填充时间>6个月眼的28.6%;3只眼的硅油填充时间≤6个月,占硅油填充时间≤6个月眼的9.4%.17只眼查见硅油乳化,占81.0%.行硅油取出手术后17只眼1周内眼压恢复正常,占SOG眼的81.0%.结论 无晶状体眼、硅油填充时间长是SOG发病的危险因素,硅油乳化是主要的发病原因,及时取出硅油是有效的治疗方法.%Objective To investigate the risk factors and treatment of silicone oil glaucoma (SOG).Methods Ninety-five eyes of 93 patients who underwent pars plana vitrectomy and silicone oil tamponade were evaluated in this study. The lens was removed in 58 eyes in which intraocular lens (IOL) was implanted in 10 eyes, so 48 eyes were aphakic. Silicone oil tamponade time was ≤6 months in 32 eyes,and >6 months in 63 eyes. The

  19. Targeted monitoring and analysis of catheter associated urinary tract infection in patients with severe brain injury%重症脑损伤患者留置尿管相关尿路感染的目标性监测与分析

    Institute of Scientific and Technical Information of China (English)

    曹闻亚; 刘芳; 王冉

    2016-01-01

    Objective To monitor the catheter associated urinary tract infection in patients with severe brain injury and analyze the incidence and risk factors of urinary tract infection in hospital, so as to take preventive measures and reduce the incidence of urinary tract infection. Methods Based on the monitoring program of indwelling urinary catheter in patients with severe brain injury and combining the method of microbial monitoring and retrospective study of patients in hospital, a total of 204 catheterized patients with severe brain injury were selected and analyzed the catheter associated urinary tract infection. Results There were 12 patients with urinary tract infections, and a higher incidence of urinary tract infection in elderly, serious condition, long-term bed ridden patients and longer catheter indwelling time with severe brain injury. The incidence of urinary tract infection in patients with more invasive operations was 3. 8‰. Fungus was the most common pathogenic bacteria. Conclusions Following indwelling catheter indications strictly, strengthening the aseptic management of catheter, shortening time of detaining urethral catheterization, and proper using of antibiotics are recommended as effective measures to lower the incidence of catheter associated urinary tract infection in patients with severe brain injury.%目的:通过对重症脑损伤患者留置尿管的目标性监测,总结出院内尿路感染的发生率和危险因素,便于积极采取预防措施,降低尿路感染的发生。方法通过制定出重症脑损伤患者留置尿管的监测方案,采取住院期间对患者的微生物监测和回顾性调查相结合的方法,收集了204例重症脑损伤同时伴有留置导尿管患者,并针对患者留置导尿管情况进行了分析。结果发生尿路感染的病例12例,重症脑损伤患者高龄、病情严重、长期卧床、导尿管留置时间长患者的尿路感染发生率高;有创性操作较多

  20. 119例导尿管相关性尿路感染的病原体分布及耐药性分析%Analysis on the distribution and the antimicrobial resistance of pathogens from 119 cases of catheter associ-ated urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    王效雷; 罗婕; 丁兆霞; 曹地芹; 娄瑞

    2015-01-01

    Objective To obtain the pathogens distribution and drug resistance characteristics of catheter associated urinary tract infection (CAUTI), so as to provide the evidence of controlling urinary tract infection .Methods 119 cases of CAUTI microbial culture and drug sensitive were collected and analyzed from January 2012 to June 2014.Results Isolated 97 pathogens from 119 urine specimens.Top 6 pathogens were:Escherichia coli (26.80%), Enterococcus faecalis (15.46%), Candida albicans (11.34%), Feces Enterococcus (10.31%), Pseudomonas aeruginosa (5.15%), Coagulase negative staphylococcus (5.15%), and the multi-drug-resistance was found.Some bacterial resistance rate was higher than the results of chinet 2013 surveillance.Conclusion The surveillance of bacterial resistance and the supervision of clinical rational drug use should be enhanced , and the further heavy interven-tions should be necessary to prevent the contact transmission of the multidrug -resistant organisms and CAUTI also .%目的:掌握导尿管相关性尿路感染( catheter associated urinary tract infection ,CAUTI)的病原体分布以及耐药性特征,为控制尿路感染提供依据。方法通过统计2012年1月-2014年6月解放军81医院119例CAUTI尿液微生物培养及药敏结果,分析CAUTI病原体分布及耐药性特征。结果119例CAUTI尿液标本中检出病原菌97株,前6位病原体依次为大肠埃希菌(26.80%)、粪肠球菌(15.46%)、白色念珠菌(11.34%)、屎肠球菌(10.31%)、铜绿假单胞菌(5.15%)和凝固酶阴性葡萄球菌(5.15%),并呈现出多耐药性,部分耐药率超过2013年Chinet的相关监测结果。结论应加强CAUTI病原体耐药性监测和临床合理用药监管,重视对多重耐药菌的隔离预防和对CAUTI的预防干预。

  1. Effect of Temperature-Sensitive Poloxamer Solution/Gel Material on Pericardial Adhesion Prevention: Supine Rabbit Model Study Mimicking Cardiac Surgery.

    Directory of Open Access Journals (Sweden)

    Hyun Kang

    Full Text Available We investigated the mobility of a temperature-sensitive poloxamer/Alginate/CaCl2 mixture (PACM in relation to gravity and cardiac motion and the efficacy of PACM on the prevention of pericardial adhesion in a supine rabbit model.A total of 50 rabbits were randomly divided into two groups according to materials applied after epicardial abrasion: PACM and dye mixture (group PD; n = 25 and saline as the control group (group CO; n = 25. In group PD, rabbits were maintained in a supine position with appropriate sedation, and location of mixture of PACM and dye was assessed by CT scan at the immediate postoperative period and 12 hours after surgery. The grade of adhesions was evaluated macroscopically and microscopically two weeks after surgery.In group PD, enhancement was localized in the anterior pericardial space, where PACM and dye mixture was applied, on immediate post-surgical CT scans. However, the volume of the enhancement was significantly decreased at the anterior pericardial space 12 hours later (P < .001. Two weeks after surgery, group PD had significantly lower macroscopic adhesion score (P = .002 and fibrosis score (P = .018 than did group CO. Inflammation score and expression of anti-macrophage antibody in group PD were lower than those in group CO, although the differences were not significant.In a supine rabbit model study, the anti-adhesion effect was maintained at the area of PACM application, although PACM shifted with gravity and heart motion. For more potent pericardial adhesion prevention, further research and development on the maintenance of anti-adhesion material position are required.

  2. Sarcoidosis in a 65-year-old woman presenting with a lung mass and pericardial effusion: a case report

    Directory of Open Access Journals (Sweden)

    Margaritopoulos George A

    2012-08-01

    Full Text Available Abstract Introduction Sarcoidosis is a multi-systemic disorder of unknown origin and most commonly affects the lungs. Diagnosis relies on the presence of non-caseating granulomas on histologic specimens. In high-resolution computed tomography, the most characteristic findings are peribronchovascular thickening, perilymphatic nodular distribution, and bilateral hilar adenopathy. Confluent nodular opacities or large masses are rare manifestations of the disease. It is well recognized that sarcoidosis can mimic infectious, malignant, and granulomatous conditions. Here, we report a case with a high initial index of suspicion for lung malignancy in terms of clinical, lung imaging, and endoscopic findings. Case presentation A 65-year-old Caucasian woman, lifelong non-smoker with an unremarkable medical history, presented with a 10-month history of progressive breathlessness, dry cough, fatigue, arthralgias, and mild weight loss. The only significant clinical finding was bilateral enlargement of auxiliary lymph nodes. High-resolution computed tomography revealed a soft tissue density mass at the right hilum which was surrounding and narrowing airways and vascular components, nodules with vascular distribution, enlarged mediastinal lymph nodes, and pericardial effusion. Our patient underwent a bronchoscopy, which revealed the presence of submucosal infiltration and narrowing of the right upper bronchus. Endobronchial biopsies showed non-caseating granulomas. As local sarcoid reactions with non-caseating granulomas can be observed near tumors, our patient underwent video-assisted thoracoscopy and surgical removal of an auxiliary lymph node, both of which confirmed the presence of non-caseating granulomas and the diagnosis of sarcoidosis. She was treated with steroids with improvement of clinical and imaging findings. However, while on a maintenance dose, she presented with a pleural effusion, which, after the diagnostic work-up, proved to be sarcoidosis

  3. Implications of Pericardial, Visceral and Subcutaneous Adipose Tissue on Vascular Inflammation Measured Using 18FDG-PET/CT.

    Directory of Open Access Journals (Sweden)

    Ho Cheol Hong

    Full Text Available Pericardial adipose tissue (PAT is associated with adverse cardiometabolic risk factors and cardiovascular disease (CVD. However, the relative implications of PAT, abdominal visceral and subcutaneous adipose tissue on vascular inflammation have not been explored.We compared the association of PAT, abdominal visceral fat area (VFA, and subcutaneous fat area (SFA with vascular inflammation, represented as the target-to-background ratio (TBR, the blood-normalized standardized uptake value measured using 18F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET in 93 men and women without diabetes or CVD. Age- and sex-adjusted correlation analysis showed that PAT, VFA, and SFA were positively associated with most cardiometabolic risk factors, including systolic blood pressure, LDL-cholesterol, triglycerides, glucose, insulin resistance and high sensitive C-reactive proteins (hsCRP, whereas they were negatively associated with HDL-cholesterol. In particular, the maximum TBR (maxTBR values were positively correlated with PAT and VFA (r = 0.48 and r = 0.45, respectively; both P <0.001, whereas SFA showed a relatively weak positive relationship with maxTBR level (r = 0.31, P = 0.003.This study demonstrated that both PAT and VFA are significantly and similarly associated with vascular inflammation and various cardiometabolic risk profiles.

  4. Comparison of fatty acid composition of subcutaneous, pericardial and epicardial adipose tissue and atrial tissue in patients with heart disease

    DEFF Research Database (Denmark)

    Echen, Rikke Bulow; Gu, Jiwei; Andreasen, Jan Jesper;

    2016-01-01

    (EPA) and docosahexaenoic acid (DHA), from three different adipose tissue compartments [epicardial (EAT), pericardial (PAT) and subcutaneous (SAT)]. Furthermore, we studied the correlation between the content of EPA and DHA in these compartments and in atrial tissue (AT). METHODS We obtained AT from...... auricles, EAT above the right ventricle, PAT, and SAT below the sternum from 50 patients undergoing cardiac surgery. Samples were frozen at -80°C and the content of n-3 PUFAs determined by gas chromatography with results given in relative weight%. RESULTS EPA and DHA were significantly correlated in EAT......, PAT and SAT with high r-values from 0.70 to 0.87. There was a significant correlation between the content of EPA in adipose tissue and in AT from 0.49 to 0.59, with minor/no correlation between contents of DHA in adipose tissue and in AT. Correlations: DHA / EPA SAT PAT EAT AT SAT 1.00 / 1.00 PAT 0...

  5. Delaying urinary catheter insertion in the reception and resuscitation of blunt multitrauma and using a full bladder to tamponade pelvic bleeding.

    Science.gov (United States)

    Huang, Sean; Vohora, Ashray; Russ, Matthias K; Mathew, Joseph K; Johnny, Cecil S; Stevens, Jeremy; Fitzgerald, Mark C

    2015-01-01

    This article proposes a counter-argument to standard Advanced Trauma Life Support (ATLS) training--which advocates bladder catheterisation to be performed as an adjunct to the primary survey and resuscitation for early decompression of the bladder and urine output monitoring. We argue the case for delaying bladder catheterisation until after definitive truncal Computed Tomography (CT) imaging. To reduce pelvic volume and associated bleeding, our trauma team delay catheter insertion until after the initial CT scan. The benefits of a full bladder also include improved views on initial Focussed Assessment with Sonography in Trauma (FAST) scan and improved interpretation of injuries on CT. Our urinary catheter related infection rates anecdotally decreased when insertion was delayed and consequently performed in a more controlled, non-resuscitation setting following CT. Adult blunt multitrauma patients with pelvic ring fractures are at risk of significant haemorrhage. Venous, arterial and medullary injuries with associated bleeding may be potentiated by an increased pelvic volume with ring disruption, as well as a reduced pressure effect from retroperitoneal and intra-pelvic organs on bleeding sites. Various techniques are used to reduce intra-pelvic bleeding. For shocked patients who have sustained major pelvic injuries with no other signs of urinary tract trauma and minimal urine in the bladder on initial FAST scan, we advocate careful, aseptic Foley catheter insertion followed by bladder insufflation with 500-600 mL of Normal Saline (NS) and subsequent catheter clamping to tamponade pelvic bleeding. PMID:25805552

  6. Effect of different duration of pericardial catheter drainage on the outcome of lung cancer patients with malignant pericardial effusion%心包置管引流时间对肺癌心包转移疗效的影响

    Institute of Scientific and Technical Information of China (English)

    都彩菊; 刘效波; 李献兵

    2011-01-01

    Objective To evaluate the early effects and safety of prolonged implanted catheter in pericardium on the patients with lung cancer and pericardial transmission. Methods Eighty-eight cases enrolled were randomly devided into two groups(group A and group B),the period of implanted catheter was more than four weeks in group A and less than four weeks in group B. The treatment protocal of the two groups was the same, then to observe the outcome, survival time of patients, the recurrence rate of pericardial effusion, the complications relevant to the catheter. Results The early complete relief rate (CRR) of two groups(A and B) was of no statistical significance (χ2=2.93,P=0.09), but the total effective rate of two groups had a significant statistical difference(90.91% vs 70.45%,χ2=5.91,P=0.02), OR=4.19, 95%CI(confidence interval):1.24-14.13. The recurrence rate of two groups within half a year was 20.45% vs 38.63%,χ2=3.91,P=0.04,the survival rate of group A and group B was 72.47% and 51.38%(Log rank=4.76,P=0.04).The median survival period of two groups within half a year was 7.96 months and 3.52 months. There were no difference in complication(4.55% vs 2.77%,χ2=0.34,P>0.05),and there were not pyogenic infection in pericardium, fistula formation, penicarditis severe pericardiosymphysis and myocardial injury. Conclusions The moderate prolonged time of catheter drainage treatment is an effective and safe approach for lung cancer patients with pericardial transmission, it can be the main treatment.%目的 探讨不同心包内置管引流时间对肺癌伴恶性心包积液心包填塞的临床疗效和安全性.方法 将入选的88例患者随机分为A、B两组.A组44例,为长时间置管组,置管时间为>4周;B组44例,为短期置管组,置管时间<4周.两组患者均接受相同的心包注射和全身静脉注射药物治疗方案,分别观察6个月内的疗效、生存时间、复发率、生存率及置管并发症发生率.结果 A

  7. Splenectomy with endoscopic variceal ligation is superior to splenectomy with pericardial devascularization in treatment of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Nan Lin; Bo Liu; Rui-Yun Xu; He-Ping Fang; Mei-Hai Deng

    2006-01-01

    AIM: To investigate the therapeutic efficacy and complications of splenectomy with endoscopic variceal ligation (EVL) and splenectomy with pericardial devascularization (i.e. Hassab's operation) in patients with portal hypertension.METHODS: A total of 103 patients with liver cirrhosis and portal hypertension were randomly selected to receive either splenectomy with EVL (n = 53, group A) or Hassab's operation (n = 50, group B).RESULTS: The portal blood flow volume, the presence of portal vein thrombosis, gastric emptying time and free portal venous pressure (FPP) before and after the operation were determined. Patients were followed up for up to 64 mo with an average of 45 mo, and the Dagradi classification of variceal veins and the grading of portal hypertension gastropathy (PHG) were evaluated.It was found that all esophageal varices were occluded or decreased to grade Ⅱ or less in both groups. There was little difference in the recurrence rate of esophageal varices (11.9% vs13.2%) and the re-bleeding rate (7.1% vs 5.3%) between groups A and B. The incidence of complications and the percentage of patients with severe PHG after the operation were significantly higher in group B (60.0% and 52.0%) than in group A (32.1%and 20.8%, P < 0.05). No patients died of operationrelated complications. There was no significant difference in gastric emptying time, FPP and portal blood flow volume between the two groups.CONCLUSION: The results suggest that splenectomy with EVL achieves similar therapeutic efficacy to that of Hassab's operation interms of the recurrence rate of esophageal varices and the re-bleeding rate, but the former results in fewer and milder complications.

  8. Application of uterine tamponade with balloon catheter for treatment of postpartum hemorrhage%应用子宫填塞球囊导管治疗产后出血的初步经验

    Institute of Scientific and Technical Information of China (English)

    阮颖清

    2012-01-01

    Objective To investigate the efficacy and safety of uterine tamponade with balloon catheter for the treatment of postpartum hemorrhage.Methods The data on 24 patients with postpartum hemorrhage who had received uterine tamponade with balloon catheter during the period of January 2010 to February 2012 were retrospectively analyzed.The average age of the patients was 27.5 years old ( 22-34 ).Of the 24 patients,12 had uterine inertia,4 had placenta previa,and 8 had placenta accrete.Results All the patients were cured by uterine tamponade with balloon catheter,and no one needed to undergo hysterectomy.The primary effectiveness rate of hemostasis was 91.6%.Two patients had rebleeding,and the tamponade balloon was inflated again to stop bleeding.The tamponade balloon was removed after 24 hours.None had rebleeding,nor hysterectomy needed.The total effectiveness rate of hemostasis was 100%.No patients required hysterectomy or were dead.All the patients were followed up for 1 to 24 months postoperatively and had a normal uterine involution and menstrual restoration within 1 to 3 months.No puerperal infection or symptoms of premature ovarian failure occurred.Conclusions Application of uterine tamponade with balloon catheter in the treatment of postpartum hemorrhage is safe,effective,and worth popularizing clinically.%目的 探讨应用子宫填塞球囊导管治疗产后出血的疗效及安全性.方法 对我院2010年1月-2012年2月,24例使用子宫填塞球囊导管治疗产后出血患者进行回顾性分析.患者年龄22~34岁,平均27.5岁,其中产后出血病因宫缩乏力12例、前置胎盘4例,胎盘粘连8例.结果 全部病例均能应用子宫填塞球囊导管达到止血目的,无一例行子宫切除术.一次止血有效率达91.6%.2例患者出现再发出血,再次充盈气囊止血后,两例患者于24小时再尝试取出水囊,未再发大出血,总止血有效率达100%.无一例需行子宫切除术或死亡,术后随访1~24

  9. A 30-year-old female Behçet's disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report.

    Science.gov (United States)

    Choi, Joon Young; Kim, Sung-Hwan; Kwok, Seung-Ki; Jung, Jung Im; Lee, Kyo-Young; Kim, Tae-Jung; Kang, Ji Young

    2016-07-01

    Behçet's disease is a systemic disease which may involve various organs. We describe a case of a patient diagnosed as pleuropericardial involvement of Behçet's disease. A 30-year-old woman visited our clinic presented with left pleuritic chest pain for s days. She had been diagnosed as Behçet's disease and admitted to our clinic due to pericardial and pleural effusion repeatedly in past two years. In the previous studies, effusion analysis revealed to be lympho-dominant exudate with high adenosine deaminase level. Acid-fast bacilli (AFB) culture and polymerase chain reaction (PCR) for mycobacterial tuberculosis (M.TB) were negative in the pericardial tissue, and pathologic finding showed mild endothelitis with micro-thrombi formation in the lumen. The patient had been treated with antituberculous medication for a year. In the current admission, chest computed tomography (CT) again showed left pleural effusion without other significant lesion. Pleural fluid analysis was similar with the previous study. Video-assisted thoracoscopic pleural biopsy was performed to obtain the definite diagnosis. Pathology confirmed the diagnosis as pleuropericardial involvement of Behçet's disease, and we treated the patient with oral steroid in the out-patient department. Pleuropericardial involvement of Behçet's disease may mimic TB pleurisy or pericarditis due to high adenosine deaminase (ADA) level in effusion analysis. Clinicians should keep in mind that Behçet's disease may manifest as pleural or pericardial effusion, and pathologic confirmation could be helpful for the definite diagnosis. PMID:27499994

  10. 硅油基磁性流体作为玻璃体腔填充剂的初步研究%Preliminary Study:Silicone Oil Based Magnetic Fluid as A Vitreous Cavity Tamponade

    Institute of Scientific and Technical Information of China (English)

    龚雁; 王正才; 陆樟献; 乔纳森·莱文; 周子梅; 周行涛; 袁建树

    2014-01-01

    通过制备的硅油基磁性流体,将其注入猪的眼球内,在外磁场下观察流体在眼球内壁的运动行为,探究其作为填充剂的效果。研究结果表明:从磁性流体的实时运动行为中可以看出,在外磁场作用下磁性颗粒从硅油基磁性流体中分离出来,携带部分硅油移到磁场强度高的地方并覆盖其局部位置。实验结果为磁性液体作为新型玻璃体填充剂提供了一定的数据支持,在视网膜脱离修复中将有很好的应用前景。%The paper aims at investigating the potential application of silicone oil based Fe3O4 magnetic fluid as a vitreous tamponade agent. The silicone oil based Fe3O4 magnetic fluid is prepared and deposited in a pig eye. An external magnetic field is applied to the eye to test the behavior of the fluid in vitro as well as the tamponade effect of the magnetic fluid. In the vitro study, it shows that under the influence of an external magnet, the magnetic Fe3O4 micelles are separated from silicone oil toward the maximum magnetic field strength (toward the magnet) and coated on the inner scleral wall evenly in that area. The experiment result provides the preliminary data supporting silicone oil based Fe3O4 magnetic nanoparticles as a novel vitreous tamponade agent, especially in the case of inferior retinal detachments.

  11. A case involving an Ahmed™ glaucoma valve transferred from the vitreous into the anterior chamber of the eye with a silicone oil tamponade for the treatment of neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Miki M

    2013-02-01

    Full Text Available Michiko Miki, Mari Ueki, Tetsuya Sugiyama, Shota Kojima, Tsunehiko IkedaDepartment of Ophthalmology, Osaka Medical College, Takatsuki, JapanPurpose: To report the short-term efficacy and safety of the transfer of an Ahmed™ glaucoma valve (AGV™ tube from the vitreous into the anterior chamber, in a patient with neovascular glaucoma who had undergone pars plana AGV™ implantation and ultimately needed a silicone oil tamponade.Case: A 41-year-old male with proliferative diabetic retinopathy in both eyes was referred to us for treatment in December 2009. Although the patient previously underwent several surgeries, he ultimately lost vision in his right eye. His left eye suffered from neovascular glaucoma after undergoing a pars plana vitrectomy for tractional retinal detachment. After several vitreous and glaucoma surgeries, the patient underwent implantation of a pars plana AGV™. Postoperatively, although his intraocular pressure was stabilized at approximately 10 mmHg, he had repeated vitreous hemorrhage and hyphema without improvement. He ultimately underwent PPV with a silicone oil tamponade and at the same time, the AGV™ tube was pulled out from the vitreous and inserted into the anterior chamber in order to avoid complications caused by the silicone oil.Results: At 19 months postoperative, the patient’s intraocular pressure had stabilized at 10 mmHg with no recurrence of vitreous hemorrhage and hyphema. Eventually, he lost vision in his left eye because of cerebral hemorrhage.Conclusion: The findings show that insertion of a pars plana AGV™ tube into the anterior chamber in a patient undergoing a silicone oil tamponade is both effective and safe in the short-term.Keyword: tube implantation, glaucoma surgery, tube transfer, pars plana, proliferative diabetic retinopathy, intraocular pressure

  12. Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks

    International Nuclear Information System (INIS)

    Background: Coronary atherosclerosis has traditionally been proposed to be associated with several cardiovascular risk factors and anthropometric measures. However, clinical data regarding the independent value of visceral adipose tissue in addition to such traditional predictors remains obscure. Materials and methods: We subsequently studied 719 subjects (age: 48.1 ± 8.3 years, 25% females) who underwent multidetector computed tomography (MDCT) for coronary calcium score (CCS) quantification. Baseline demographic data and anthropometric measures were taken with simultaneous body fat composition estimated. Visceral adipose tissue of pericardial and thoracic peri-aortic fat was quantified by MDCT using TeraRecon Aquarius workstation (San Mateo, CA). Traditional cardiovascular risk stratification was calculated by metabolic (NCEP ATP III) and Framingham (FRS) scores and high-sensitivity CRP (Hs-CRP) was taken to represent systemic inflammation. The independent value of visceral adipose tissue to systemic inflammation and CCS was assessed by utilizing multivariable regression analysis. Results: Of all subjects enrolled in this study, the mean values for pericardial and peri-aortic adipose tissue were 74.23 ± 27.51 and 7.23 ± 3.69 ml, respectively. Higher visceral fat quartile groups were associated with graded increase of risks for cardiovascular diseases. Both adipose burdens strongly correlated with anthropometric measures including waist circumference, body weight and body mass index (all p < 0.001). In addition, both visceral amount correlates well with ATP and FRS scores, all lipid profiles and systemic inflammation marker in terms of Hs-CRP (all p < 0.001). After adjustment for baseline variables, both visceral fat were independently related to Hs-CRP levels (all p < 0.05), but only pericardial fat exerted independent role in coronary calcium deposit. Conclusion: Both visceral adipose tissues strongly correlated with systemic inflammation beyond traditional

  13. Successful early diagnosis and treatment in a case of Toxocara canis-induced eosinophilic myocarditis with eosinophil-rich pericardial effusion.

    Science.gov (United States)

    Sangen, Hideto; Tanabe, Jun; Takano, Hitoshi; Shimizu, Wataru

    2015-01-01

    Fulminant myocarditis can become fatal if left untreated. Treatments for most types of myocarditis, including mechanical support, are limited. However, immediate systemic corticosteroids are known to be effective against eosinophilic myocarditis; therefore, prompt diagnosis of this disease is crucial. Unfortunately, the standard diagnostic tool for myocarditis, endomyocardial biopsy, does not provide immediate histopathological findings. Thus, a rapid diagnostic tool for identifying types of myocarditis is urgently required. We report here the first case of Toxocara canis-induced eosinophilic fulminant myocarditis which was diagnosed based on eosinophil-rich pericardial effusion where the patient recovered with early corticosteroid therapy. PMID:26338242

  14. 冠脉介入治疗并发急性心脏压塞的急救及护理%Coronary Intervention of Acute Cardiac Tamponade and Emergency Care

    Institute of Scientific and Technical Information of China (English)

    涂雪梅

    2015-01-01

    目的:探讨并分析冠状动脉介入治疗术并发心脏压塞的急救方法及护理措施。方法选取我院2010年4月~2014年9月期间接受冠脉介入治疗并发心脏压塞的5例患者,对其治疗结果进行研究和分析,总结抢救方法及护理措施。结果5例患者经过积极有效抢救及护理,均痊愈出院。结论术前充分的应急准备及急救预案是抢救成功的前提;中术术后密切病情观察,及时准确的科学判断是抢救成功的关键;大量快速的补充血容量及升压、抗肝素治疗,及时的心包穿刺减压是心脏压塞有效的急救方法;娴熟的急救技能和各项急救护理措施的落实是促进心脏压塞患者良好转归的重要保证。%Objective To study and analyze the coronary artery intervention treatment technique of complicated with cardiac tamponade first aid method and nursing measures. Methods From April 2010 to September 2014 during coronary interventional therapy in 5 patients complicated with cardiac tamponade, to study the treatment result and analysis, summarizes the rescue methods and nursing measures. Results 5 patients through positive and ef ective rescue and care, hospital were recovered. Conclusion Preoperative suf icient emergency preparedness and emergency plans is the precondition of successful rescue; In postoperative close observation, timely and accurate scientific judgment is critical to the success of the rescue; Large amounts of quickly added blood volume and pressure, resist heparin therapy, timely pericardium puncture decompression is cardiac tamponade and ef ective emergency measures; Skil ed first aid skil and implement of first aid measures are the important guarantee of promoting good outcome in patients with cardiac tamponade.

  15. Development of quality of life scale for compulsive position patients after intraocular tamponade%眼内填充术后强迫体位患者生活质量量表的研制

    Institute of Scientific and Technical Information of China (English)

    章莉莉; 王惠琴; 董佩芳; 孙静

    2013-01-01

    Objective To develop a quantifiable scale to assess quality of life for compulsive position patients after intraocular tamponade. Method Study a initial quality of life scale for compulsive position patients after intraocular tamponade after review relevant documents and consulting a professional group. Assess compulsive position patients after intraocular tamponade and 37 cases of non-intraocular tamponade by initial scale on quality of life. Analyze and screen on items of information. Then analyze on exploratory factor. Confirm the beta version of scale has 6 dimensions of social communication, activity of daily living, self-management, emotion, diet quality and social support, including 37 items. Test the reliability and validity of beta version. Result Cronbach's a coefficient of the scale is 0. 929. Split half reliability is 0. 856. Correlation coefficient between all items and factors is 0. 391 - 0. 886. Correlation coefficient between all factors is 0. 068 ~ 0. 642. Correlation coefficient between all factors and the scale is 0. 342 ~0. 842. Related validity with SF -36 is 0. 806. Conclusion Quality of life scale for compulsive position patients after intraocular tamponade has high reliability and validity, which can indicate patients' quality of life sensitively.%目的 制定眼内填充术后强迫体位患者生活质量评定量表.方法 查阅国内外文献,建立专家组,拟定眼内填充术后强迫体位患者生活质量初始量表.应用初始量表对138例眼内填充术后强迫体位患者和37例非眼内填充术后患者进行生活质量测评.对资料进行条目分析和筛选,再进行探索性因子分析,确定量表测试版为社会交往、日常生活能力、自我管理、情绪活动、进食质量和社会支持6个维度,含37条目.检验测试版量表的信度和效度.结果 量表的Cronbach's α系数为0.929,分半信度为0.856;各条目与因子间的相关系数为0.391~0.886,

  16. Application of the three kinds of balloon tamponade methods in emergency of postpartum hemorrhage%三种球囊填塞方法在产后出血急救中的应用比较

    Institute of Scientific and Technical Information of China (English)

    田冬梅; 杨洋; 李华丽

    2012-01-01

    Objective To compare the hemostatic effects of the three balloon tamponade methods(condom balloon,Foley catheter uterine tamponade,Sengstaken-Blakemore tube) in the postpartum hemorrhage. Methods Ninety-two patients were randomly divided into three groups: condoms group (intrauterine tamponade condom, n = 30) , catheter group (intrauterine tamponade Foley catheter balloon, n = 31) , three-chamber two-balloon catheter group ( intrauterine tamponade Sengstaken-Blakemore tube, n = 31 ). The efficacy of the three methods in stopping bleeding was compared. Results The postoperative bleeding volume and operation time were not significantly different among three groups. The time of retention in catheter group and three-cavity two-balloon catheter group was shorter than that in condoms group (P < 0. 05 ). The three-chamber two-balloon catheter was superior to catheter and condoms in monitoring the bleeding. Conclusion Foley catheter and Sengstaken-Blakemore tube have a good first-aid effect in postpartum hemorrhage with simple operation and shorter retention time. The condom balloon could be widely used in the basic hospitals due to the lower cost. The Sengstaken-Blakemore tube in the controllability of hemostasis is superior to condom balloon and Foley catheter.%目的 比较三种球囊填塞(避孕套水囊、Foley导尿管宫腔填塞、Sengstaken-Blakemore管)应用于产后出血中的止血效果. 方法 我们将92例患者随机分为三组:避孕套组(宫腔内填塞避孕套水囊,n =30),导尿管组(宫腔内填塞Foley导尿管气囊,n=31),三腔两囊管组(宫腔内填塞Sengstaken-Blakemore管,n=31).比较三种止血方法的疗效. 结果 三组间出血量、手术时间均无明显差异,但导尿管组和三腔两囊管组在宫腔填塞留置时间方面均短于避孕套组(P<0.05);三腔两囊管组在监测止血效果方面要优于导尿管组及避孕套组. 结论 Foley导尿管与Sengstaken-Blakemore管用于产后吕血急救效果

  17. Endocardial and pericardial disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930109 A study of immunocompetence of pep-tide hormones in human pericardium.WENShaojun(温绍君),et al.Xuanwu Hosp,CapitalInstit Med,Beijing.100053.Chin J Cardiol1992;20(4):240-242.With RIA/HPLC and immunohistochemistry.the presence of angiotensin(A)and atrial natri-uretic factor-like materials(ANF-LMs)was

  18. Pericardial fluid Gram stain

    Science.gov (United States)

    ... skin of the chest is cleaned with antibacterial soap. A trained physician, often a cardiologist, inserts a ... of the pericardium or heart. Blood tests and bacterial culture can help identify the specific organism causing ...

  19. Endocardial and pericardial disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970308 Study on the mechanism of effect ofangiotensin converting enzyme inhibitor on renin-angiotensin system while undergoing bicycle exercisetest. WU Shendi(吴顺娣), et al. Shanghai Hyperten-sive Instit, Ruijin Hosp, 2nd Med Univ, Shanghai,200025. Acta Univ Med 2nd Shanghai 1997; 17(2); 81

  20. Endocardial and pericardial disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920664 Serious complications and potentialdanger of endomyocardial biopsy.QUNailu (曲乃路), et al. Cardiovascular Dept,Dalian Centr Hosp, Dalian. Chin Cir J1992; 7(3): 257-258. Endomyocardial biopsy(EMB)of 86 patients,aged 15-57 yrs; has been prerformed in this

  1. Technical note: subclavian artery misplacement of a 12F Shaldon catheter: percutaneous repair with a local closure device under temporary balloon tamponade; Technische Mitteilung: Entfernung eines fehlplatzierten 12F Shaldon Katheters aus der A. subclavia und Abdichtung mittels Verschlusssystem bei temporaerer Ballonblockade

    Energy Technology Data Exchange (ETDEWEB)

    Wildberger, J.E.; Katoh, M.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Fussen, R. [Anaesthesiologische Klinik, Medizinisches Zentrum Kreis Aachen GmbH (Germany)

    2006-06-15

    A case of subsequent percutaneous repair using a local closure device with a collagen block (VasoSeal {sup registered}) and temporary balloon tamponade after inadvertent subclavian artery misplacement of a 12F Shaldon catheter is reported. Balloon occlusion safely prevented displacement of collagen into the vascular lumen by occluding the 12F entry site. Furthermore, collagen-induced coagulation was facilitated. (orig.)

  2. Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection

    DEFF Research Database (Denmark)

    Bonser, Robert S; Ranasinghe, Aaron M; Loubani, Mahmoud;

    2011-01-01

    malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection...

  3. A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions

    Science.gov (United States)

    Islam, Julie; Talebi, Soheila; Cativo, Eder; Mushiyev, Savi; Pekler, Gerald; Visco, Ferdinand

    2016-01-01

    Presentation of pericardial disease is diverse, with the viral aetiology being the most common cause; however, when haemorrhagic pericardial effusion is present, these causes are narrowed to few aetiologies. We present a case of a young female of African descent who presented with diffuse abdominal pain and vomiting. Initial work-up showed pericardial effusion with impending echocardiographic findings of cardiac tamponade and bilateral pleural effusions. Procedures included a left video-assisted thoracoscopic surgery (VATS) with pericardial window. We consider that it is important for all physicians to be aware of not only typical presentation but also atypical and unusual clinical picture of pericardial disease.

  4. Estudo comparativo in vitro entre biopróteses de pericárdio bovino e porcinas In vitro comparative study between bovine pericardial and porcine bioprosthesis

    Directory of Open Access Journals (Sweden)

    Domingo M Braile

    1996-12-01

    Full Text Available A maioria dos implantes valvulares cardíacos realizados no Brasil é representada pelas válvulas de pericárdio bovino, seguidas por próteses porcinas. Na avaliação de válvulas biológicas, deve-se considerar: desempenho hidrodinámico, resistência à fadiga e processo de calcificação. No presente estudo, foi avaliado o desempenho hidrodinámico de biopróteses de pericárdio bovino (Biopro-PB-Braile Biomédica comparativamente às válvulas porcinas (Biopro-PP-Braile Biomédica através do gradiente médio transvalvular. Os testes hidrodinámicos foram realizados em próteses de diâmetros variando de 19 a 35 mm, submetidas ao Sistema Duplicador de Pulsos Shelhigh (Shelhigh Inc.. O volume de ejeção foi mantido constante em 90 ml, com freqüência de pulso de 60, 70,80, 90 e 100 ciclos por minuto, possibilitando fluxos entre 5 e 9 litros por minuto, equivalentes a fluxos contínuos aproximados de 8 a 18 litros por minuto. Houve tendência à diminuição dos gradientes pressóricos à medida em que aumenta o diâmetro externo das próteses. O gradiente pressórico médio encontrado em próteses de pericárdio bovino foi significativamente menor que o de próteses porcinas (pMost of the cardiac valve implantations in Brazil are represented by bovine pericardial valves, followed by the porcine prostheses. In the evaluation of biological valves, the following should be taken into consideration: hydrodynamic performance resistance to fatigue and calcification process. In this study, the hydrodynamic performance of bovine pericardial bioprostheses (Biopro-BP-Braile Biomedica was evaluated comparatively to porcine valves (Biopro-PP-Braile Biomedica, through the transvalvular medium gradient. The hydrodynamic tests were made on prostheses varying from 19 to 35 mm in diameter, which underwent the pulse duplicator system Shelhigh (Shelligh Inc.. The ejection volume was constantly kept at 90 ml. The pulse frequencies varied between 60 and 100

  5. Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: a position statement of the ESC working group on myocardial and pericardial diseases.

    Science.gov (United States)

    Pinto, Yigal M; Elliott, Perry M; Arbustini, Eloisa; Adler, Yehuda; Anastasakis, Aris; Böhm, Michael; Duboc, Denis; Gimeno, Juan; de Groote, Pascal; Imazio, Massimo; Heymans, Stephane; Klingel, Karin; Komajda, Michel; Limongelli, Giuseppe; Linhart, Ales; Mogensen, Jens; Moon, James; Pieper, Petronella G; Seferovic, Petar M; Schueler, Stephan; Zamorano, Jose L; Caforio, Alida L P; Charron, Philippe

    2016-06-14

    In this paper the Working Group on Myocardial and Pericardial Disease proposes a revised definition of dilated cardiomyopathy (DCM) in an attempt to bridge the gap between our recent understanding of the disease spectrum and its clinical presentation in relatives, which is key for early diagnosis and the institution of potential preventative measures. We also provide practical hints to identify subsets of the DCM syndrome where aetiology directed management has great clinical relevance. PMID:26792875

  6. AMP-Activated Kinase (AMPK Activation by AICAR in Human White Adipocytes Derived from Pericardial White Adipose Tissue Stem Cells Induces a Partial Beige-Like Phenotype.

    Directory of Open Access Journals (Sweden)

    Omar Abdul-Rahman

    Full Text Available Beige adipocytes are special cells situated in the white adipose tissue. Beige adipocytes, lacking thermogenic cues, morphologically look quite similar to regular white adipocytes, but with a markedly different response to adrenalin. White adipocytes respond to adrenergic stimuli by enhancing lipolysis, while in beige adipocytes adrenalin induces mitochondrial biogenesis too. A key step in the differentiation and function of beige adipocytes is the deacetylation of peroxisome proliferator-activated receptor (PPARγ by SIRT1 and the consequent mitochondrial biogenesis. AMP-activated protein kinase (AMPK is an upstream activator of SIRT1, therefore we set out to investigate the role of AMPK in beige adipocyte differentiation using human adipose-derived mesenchymal stem cells (hADMSCs from pericardial adipose tissue. hADMSCs were differentiated to white and beige adipocytes and the differentiation medium of the white adipocytes was supplemented with 100 μM [(2R,3S,4R,5R-5-(4-Carbamoyl-5-aminoimidazol-1-yl-3,4-dihydroxyoxolan-2-yl]methyl dihydrogen phosphate (AICAR, a known activator of AMPK. The activation of AMPK with AICAR led to the appearance of beige-like morphological properties in differentiated white adipocytes. Namely, smaller lipid droplets appeared in AICAR-treated white adipocytes in a similar fashion as in beige cells. Moreover, in AICAR-treated white adipocytes the mitochondrial network was more fused than in white adipocytes; a fused mitochondrial system was characteristic to beige adipocytes. Despite the morphological similarities between AICAR-treated white adipocytes and beige cells, functionally AICAR-treated white adipocytes were similar to white adipocytes. We were unable to detect increases in basal or cAMP-induced oxygen consumption rate (a marker of mitochondrial biogenesis when comparing control and AICAR-treated white adipocytes. Similarly, markers of beige adipocytes such as TBX1, UCP1, CIDEA, PRDM16 and TMEM26 remained

  7. AMP-Activated Kinase (AMPK) Activation by AICAR in Human White Adipocytes Derived from Pericardial White Adipose Tissue Stem Cells Induces a Partial Beige-Like Phenotype

    Science.gov (United States)

    Abdul-Rahman, Omar; Kristóf, Endre; Doan-Xuan, Quang-Minh; Vida, András; Nagy, Lilla; Horváth, Ambrus; Simon, József; Maros, Tamás; Szentkirályi, István; Palotás, Lehel; Debreceni, Tamás; Csizmadia, Péter; Szerafin, Tamás; Fodor, Tamás; Szántó, Magdolna; Tóth, Attila; Kiss, Borbála; Bacsó, Zsolt; Bai, Péter

    2016-01-01

    Beige adipocytes are special cells situated in the white adipose tissue. Beige adipocytes, lacking thermogenic cues, morphologically look quite similar to regular white adipocytes, but with a markedly different response to adrenalin. White adipocytes respond to adrenergic stimuli by enhancing lipolysis, while in beige adipocytes adrenalin induces mitochondrial biogenesis too. A key step in the differentiation and function of beige adipocytes is the deacetylation of peroxisome proliferator-activated receptor (PPARγ) by SIRT1 and the consequent mitochondrial biogenesis. AMP-activated protein kinase (AMPK) is an upstream activator of SIRT1, therefore we set out to investigate the role of AMPK in beige adipocyte differentiation using human adipose-derived mesenchymal stem cells (hADMSCs) from pericardial adipose tissue. hADMSCs were differentiated to white and beige adipocytes and the differentiation medium of the white adipocytes was supplemented with 100 μM [(2R,3S,4R,5R)-5-(4-Carbamoyl-5-aminoimidazol-1-yl)-3,4-dihydroxyoxolan-2-yl]methyl dihydrogen phosphate (AICAR), a known activator of AMPK. The activation of AMPK with AICAR led to the appearance of beige-like morphological properties in differentiated white adipocytes. Namely, smaller lipid droplets appeared in AICAR-treated white adipocytes in a similar fashion as in beige cells. Moreover, in AICAR-treated white adipocytes the mitochondrial network was more fused than in white adipocytes; a fused mitochondrial system was characteristic to beige adipocytes. Despite the morphological similarities between AICAR-treated white adipocytes and beige cells, functionally AICAR-treated white adipocytes were similar to white adipocytes. We were unable to detect increases in basal or cAMP-induced oxygen consumption rate (a marker of mitochondrial biogenesis) when comparing control and AICAR-treated white adipocytes. Similarly, markers of beige adipocytes such as TBX1, UCP1, CIDEA, PRDM16 and TMEM26 remained the same when

  8. Report on the 2nd Florence International Symposium on Advances in Cardiomyopathies: 9th meeting of the European Myocardial and Pericardial Diseases WG of the ESC

    Directory of Open Access Journals (Sweden)

    Franco Cecchi

    2012-12-01

    Full Text Available A bridge between clinical and basic science aiming at cross fertilization, with leading experts presenting alongside junior investigators, is the key feature of the “2nd Florence International Symposium on Advances in Cardiomyopathies” , 9th Meeting of the Myocardial and Pericardial Diseases Working Group of the European Society of Cardiology, which was held in Florence, Italy on 26-­-28th September 2012. Patients with cardiomyopathies, with an estimated 3 per thousand prevalence in the general population, constitute an increasingly large proportion of patients seen by most cardiologists. This class of diseases, which are mostly genetically determined with different transmission modalities, can cause important and often unsolved management problems, despite rapid advances in the field. On the other hand, few other areas of cardiology have seen such an impressive contribution from basic science and translational research to the understanding of their pathophysiology and clinical management. The course was designed to constantly promote close interaction between basic science and clinical practice and highlight the top scientific and translational discoveries in this field in 10 scientific sessions. It was preceded by two mini-­-courses, which included the basic concepts of cardiomyocyte mechanical and electrophysiological properties and mechanisms, how-­-to sessions for clinical diagnosis and management and illustrative case study presentations of different cardiomyopathies.

  9. Dispnéia por compressão de estruturas mediastinais por cisto pericárdico Dyspnea through compression of mediastinal structures due to pericardial cyst

    Directory of Open Access Journals (Sweden)

    Jeanine Eggers Caramori

    2005-06-01

    Full Text Available Caso de uma paciente com 65 anos, apresentando dispnéia aos esforços e dor torácica lateral direita como principais sintomas de um cisto no pericárdio, de aproximadamente 8 cm. Os exames físico, bioquímico e eletrocardiográfico não evidenciaram alterações. O resultado dos exames de radiografia de tórax, tomografia computadorizada e ecocardiograma foi sugestivo de cisto pericádico. Com base nessas evidências clínicas a paciente foi submetida à toracotomia em região torácica lateral direita e realizada excisão completa da massa mediastinal com remissão total dos sintomas.A case of a 65-year-old patient, showing dyspnea to strains and right side pain as main symptoms of an approximately 8 cm cyst in the pericardium. The physical, biochemical and electrocardiographic examinations did not evince any changes. The results from the thoracic radiography, CT scan and echocardiogram suggested pericardial cyst. Based on those clinical evidences, the patient was submitted to a thoracotomy in the right side thoracic region and a complete excision of the mediastinal mass was performed, with complete remission of the symptoms.

  10. Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval.

    Science.gov (United States)

    Chen, Jian-Hua; Inamori-Kawamoto, Osamu; Michiue, Tomomi; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

    2015-09-01

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of forensic autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) PMI of <48h. CSF cTnI and CK-MB showed similar findings. There was no difference between myocardial infarction and other causes of death to be discriminated, including asphyxiation, drowning and fire fatality. These findings are similar to clinical observations in critical ill patients, suggesting that elevated cardiac biomarkers cannot be a specific finding for death from acute ischemic heart disease, but indicate the severity of myocardial injury in postmortem investigation. PMID:26052007

  11. Plant lignan secoisolariciresinol suppresses pericardial edema caused by dioxin-like compounds in developing zebrafish: Implications for suppression of morphological abnormalities.

    Science.gov (United States)

    Tokunaga, Saimi; Woodin, Bruce R; Stegeman, John J

    2016-10-01

    Dioxins and dioxin-like compounds (DLCs) enter the body mainly through diet and cause various toxicological effects through activation of the aryl hydrocarbon receptor (AhR), a ligand activated transcription factor. Some plant extracts and phytochemicals are reported to suppress this transformation. However, most of these reports have been from in vitro experiments and few reports have been from in vivo experiments. In addition, there has been no report of foodstuffs that effectively prevent AhR-associated morphological abnormalities such as deformities caused by dioxins and DLCs in vivo. In this study, we show that secoisolariciresinol (SECO), a natural lignan-type polyphenolic phytochemical found mainly in flaxseed, has a rescuing effect, actually suppressing morphological abnormalities (pericardial edema) in zebrafish embryos exposed to 3,3',4,4',5-pentachlorobiphenyl (PCB126), a dioxin-like PCB congener. Importantly, the rescuing effect of SECO was still evident when it was applied 16 h after the beginning of exposure to PCB126. This study suggests that SECO may be useful as a natural suppressive agent for morphological abnormalities caused by dioxins and DLCs. PMID:27427306

  12. Severe Left Ventricular Hypertrophy, Small Pericardial Effusion, and Diffuse Late Gadolinium Enhancement by Cardiac Magnetic Resonance Suspecting Cardiac Amyloidosis: Endomyocardial Biopsy Reveals an Unexpected Diagnosis

    Directory of Open Access Journals (Sweden)

    Nina P. Hofmann

    2016-01-01

    Full Text Available Left ventricular (LV hypertrophy can be related to a multitude of cardiac disorders, such as hypertrophic cardiomyopathy (HCM, cardiac amyloidosis, and hypertensive heart disease. Although the presence of LV hypertrophy is generally associated with poorer cardiac outcomes, the early differentiation between these pathologies is crucial due to the presence of specific treatment options. The diagnostic process with LV hypertrophy requires the integration of clinical evaluation, electrocardiography (ECG, echocardiography, biochemical markers, and if required CMR and endomyocardial biopsy in order to reach the correct diagnosis. Here, we present a case of a patient with severe LV hypertrophy (septal wall thickness of 23 mm, LV mass of 264 g, and LV mass index of 147 g/m2, severely impaired longitudinal function, and preserved radial contractility (ejection fraction = 55%, accompanied by small pericardial effusion and diffuse late gadolinium enhancement (LGE by cardiac magnetic resonance (CMR. Due to the imaging findings, an infiltrative cardiomyopathy, such as cardiac amyloidosis, was suspected. However, amyloid accumulation was excluded by endomyocardial biopsy, which revealed the presence of diffuse myocardial fibrosis in an advanced hypertensive heart disease.

  13. 心周脂肪组织与冠心病及代谢综合征的关系%The relationship of pericardial adipose tissue volume with coronary artery disease and metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    刘瑛琪; 费军; 刘莉; 刘军华; 王晓非; 郑冬; 张朝利

    2011-01-01

    摘要:目的 探讨心周脂肪组织(pericardial adipose tissue,PAT)容量与冠心病及代谢综合征(metabolic syndrome,MS)的关系.方法 回顾性分析1102例患者的双源CT冠状动脉造影资料,采用平扫图像测定PAT容量.根据代谢危险因素的数量和冠状动脉狭窄程度,将患者分为MS组338例和无MS组764例及≥50%狭窄组492例和<50%狭窄组610例.结果 MS组PAT容量较无MS组明显增多,≥50%狭窄组PAT容量较<50%狭窄组明显增多(P<0.01).随着代谢危险因素数目的增加,PAT容量呈上升趋势,差异有统计学意义(P<0.01).多元回归分析显示,PAT容量与≥50%狭窄(回归系数=17.78,P<0.01)、体重指数(回归系数=7.32,P<0.01)、腹围(回归系数=2.51,P<0.01)和LDL-C(回归系数=16.94,P< 0.05)相关.结论 多层螺旋CT测定PAT容量是提示患者冠心痛和代谢风险的方法 之一.%Objective To study the relationship of volume of pericardial adipose tissue(PAT) with coronary artery disease and metabolic syndrome(MS). Methods The computed tomography angi-ography data of 1102 consecutive patients were analyzed retrospectively. Pericardial adipose tissue volume was measured using non-enhanced image. According to the number of metabolic risk factors and the extent of coronary stenosis,the patients were divided into MS group (n = 338)and non-MS group (w = 764),and ≥50% stenosis group (n = 492)or <50% stenosis group( n = 610). Results Pericardial adipose tissue volume increased significantly in MS group compared with non-MS group. It also increased significantly in ≥50% stenosis group compared with <50% stenosis group. As the number of metabolic risk factors increased, the volume of pericardial adipose tissue increased correspondingly. Multiple regression analysis showed that 2≥50% stenosis (coefficient=17. 78, P < 0. 01) ,BMI(coefficient = 7. 32, P < 0. 01) ,waist circumference(coeffi-cient = 2. 51, P < 0. 01) and LDL-C level(coefficient = 16. 94

  14. Reconstrução arterial com tubo de pericárdio bovino corrugado Arterial reconstruction with crimped bovine pericardial conduit

    Directory of Open Access Journals (Sweden)

    Cláudio A Salles

    1992-06-01

    Full Text Available No período de agosto de 1989 a fevereiro de 1992, 32 pacientes foram submetidos a reconstruções vasculares utilizando-se condutos de pericárdio bovino corrugado preservado em glutaraldeído. A incorporação do principio crimping utilizado nas próteses vasculares sintéticas proporcionou tubos que mantêm sua forma cilíndrica, mesmo quando submetidos a curvaturas. Vinte e nove pacientes (Grupo I eram portadores de doenças da aorta torácica e/ou abdominal, incluindo aneurismas, dissecções agudas, coarctação da aorta e lesão oclusiva aorto-ilíaca. A reconstrução da aorta torácica foi realizada em 25 pacientes (incluindo a substituição da valva aórtica em 10, da aorta abdominal em 2 e aorto-ilíaca em 2. Três pacientes (Grupo II, portadores de cardiopatias congênitas complexas, foram submetidos a reconstrução da via de saída do ventrículo direito em 2 e a operação de Fontan em 1. A mortalidade hospitalar no Grupo I foi 24% (7 pacientes, causada por baixo débito cardíaco em 4, recidiva precoce da dissecção em dois e infecção respiratória em 1. Seis destes óbitos ocorreram em pacientes operados na fase aguda de dissecção aórtica. Não houve nenhum óbito no Grupo II. Houve um óbito tardio no Grupo I devido a complicações metabólicas relacionadas a diabetes e insuficiência renal crônica. Esta experiência clínica inicial registrou um seguimento médico de 16 meses por paciente, com um máximo de 32 meses e não se verificou nenhuma complicação tardia relacionada ao conduto de pericárdio bovino corrugado.From August 1989 to February 1992, 32 patients underwent vascular reconstructions using crimped bovine pericardial conduits processed in glutaraldehyde. The introduction of the crimping process used for synthetic vascular prosthesis provided circular tubes, which retain their shape with bending and avoid kinking. Twenty-nine patients (Group I presented vascular lesions involving the thoracic and

  15. Fatores de risco hospitalar para implante de bioprótese valvar de pericárdio bovino Hospital risk factors for bovine pericardial bioprosthesis valve implantation

    Directory of Open Access Journals (Sweden)

    Mateus W. De Bacco

    2007-08-01

    Full Text Available FUNDAMENTO: Identificação de fatores de risco pré-operatórios na cirurgia cardíaca valvar visa melhor resultado cirúrgico pela possível neutralização de condições relacionadas com morbi-mortalidade aumentada. OBJETIVO: Este estudo objetiva identificar fatores de risco hospitalar em pacientes submetidos a implante de bioprótese de pericárdio bovino. MÉTODOS: Estudo retrospectivo incluindo 703 pacientes consecutivos submetidos a implante de pelo menos uma bioprótese de pericárdio bovino St. Jude Medical-Biocor® de setembro de 1991 a dezembro de 2005 no Instituto de Cardiologia do RS, sendo 392 aórticos, 250 mitrais e 61 mitro-aórticos. Analisadas as características sexo, idade, índice de massa corporal, classe funcional (New York Heart Association - NYHA, fração de ejeção, lesão valvar, hipertensão arterial sistêmica, diabete melito, função renal, arritmias cardíacas, cirurgia cardíaca prévia, revascularização miocárdica, plastia tricúspide e caráter eletivo, de urgência ou de emergência da cirurgia. Desfecho primordial foi mortalidade hospitalar. Utilizou-se regressão logística para examinar relação entre fatores de risco e mortalidade hospitalar. RESULTADOS: Ocorreram 101 (14,3% óbitos hospitalares. Características significativamente relacionadas à mortalidade aumentada foram sexo feminino (p 2,4mg/dl (p=0,004, classe funcional IV (pBACKGROUND: Identification of preoperative heart valve surgery risk factors aim to improve surgical outcomes with the possibility to offset conditions related to increased morbidity and mortality. OBJECTIVE: Intent of this study is to identify hospital risk factors in patients undergoing bovine pericardial bioprosthesis implantation. METHODS: Retrospective study including 703 consecutive patients who underwent implantation of at least one St. Jude Medical-Biocor™ bovine pericardial bioprosthesis between September 1991 and December 2005 at the Rio Grande do Sul

  16. Trophic effect of human pericardial fluid on adult cardiac myocytes. Differential role of fibroblast growth factor-2 and factors related to ventricular hypertrophy.

    Science.gov (United States)

    Corda, S; Mebazaa, A; Gandolfini, M P; Fitting, C; Marotte, F; Peynet, J; Charlemagne, D; Cavaillon, J M; Payen, D; Rappaport, L; Samuel, J L

    1997-11-01

    Pericardial fluid (PF) may contain myocardial growth factors that exert paracrine actions on cardiac myocytes. The aims of this study were (1) to investigate the effects of human PF and serum, collected from patients undergoing cardiac surgery, on the growth of cultured adult rat cardiac myocytes and (2) to relate the growth activity of both fluids to the adaptive changes in overloaded human hearts. Both PF and serum increased the rate of protein synthesis, measured by [14C]phenylalanine incorporation in adult rat cardiomyocytes (PF, +71.9 +/- 8.2% [n = 17]; serum, +14.9 +/- 6.5% [n = 13]; both P < .01 versus control medium). The effects of both PF and serum on cardiomyocyte growth correlated positively with the respective left ventricular (LV) mass. However, the magnitude of change with PF was 3-fold greater than with serum (P < .01). These trophic effects of PF were mimicked by exogenous basic fibroblast growth factor (FGF2) and inhibited by anti-FGF2 antibodies and transforming growth factor-beta (TGF-beta), suggesting a relationship to FGF2. In addition, FGF2 concentration in PF was 20 times greater than in serum. On the other hand, the LV mass-dependent trophic effect, present in both fluids, was independent of FGF2 concentration or other factors, such as angiotensin II, atrial natriuretic factor, and TGF-beta. These data suggest that FGF2 in human PF is a major determining factor in normal myocyte growth, whereas unidentified LV mass-dependent factor(s), present in both PF and serum, participates in the development of ventricular hypertrophy. PMID:9351441

  17. The Use of Bovine Pericardial Buttress on Linear Stapler Fails to Reduce Pancreatic Fistula Incidence in a Porcine Pancreatic Transection Model

    Directory of Open Access Journals (Sweden)

    A. Maciver

    2011-01-01

    Full Text Available We investigate the effectiveness of buttressing the surgical stapler to reduce postoperative pancreatic fistulae in a porcine model. As a pilot study, pigs (n=6 underwent laparoscopic distal pancreatectomy using a standard stapler. Daily drain output and lipase were measured postoperative day 5 and 14. In a second study, pancreatic transection was performed to occlude the proximal and distal duct at the pancreatic neck using a standard stapler (n=6, or stapler with bovine pericardial strip buttress (n=6. Results. In pilot study, 3/6 animals had drain lipase greater than 3x serum on day 14. In the second series, drain volumes were not significantly different between buttressed and control groups on day 5 (55.3 ± 31.6 and 29.3 ± 14.2 cc, resp., nor on day 14 (9.5 ± 4.2 cc and 2.5 ± 0.8 cc, resp., P=0.13. Drain lipase was not statistically significant on day 5 (3,166 ± 1,433 and 6,063 ± 1,872 U/L, resp., P=0.25 or day 14 (924 ± 541 and 360 ± 250 U/L. By definition, 3/6 developed pancreatic fistula; only one (control demonstrating a contained collection arising from the staple line. Conclusion. Buttressed stapler failed to protect against pancreatic fistula in this rigorous surgical model.

  18. Pericardial cavity chemotherapy combined with external high frequency thermotherapy in the treatment of malignant pericardial effusion caused by lung cancer%心包腔化疗联合体外高频热疗治疗肺癌伴心包积液

    Institute of Scientific and Technical Information of China (English)

    张江灵; 赖灿辉; 陈少谊; 郑维斌; 陈云萍

    2013-01-01

    Objective To evaluate the efficacy of cisplatin chemotherapy combined with external high frequency thermotherapy in the treatment of patients with malignant pericardial effusion caused by lung cancer. Methods All of the patients were treated with intra-cavitary paracentesis and drainage at first, and then they were injected with 60 mg of cisplatin and 10 mg of dexamethasone on the first and eighth days. Then they were divided into the group A ( n = 30 ) and the group B ( n = 33 ). After the eighth days, the group A were given external high frequency thermotherapy additionally every 3 days. Results The clinical objective response was 90% ( 70% CR and 20% PR ) in the group A, and the clinical objective response was 75. 8% ( 51. 5% CR and 24. 2% PR ) in the group B. The difference of the total effective rate between the two groups was significant ( P < 0. 05 ). Conclusion On the basis of intracavitary injection of cisplatin chemotherapy, the external high frequency thermotherapy can significantly improve the curative effect in treatment of malignant pericardial effusion caused by lung cancer.%目的 探讨心包腔灌注顺铂化疗联合体外高频热疗治疗肺癌伴恶性心包积液的疗效.方法 63例患者分成甲组30例、乙组33例,甲组先行心包腔穿刺引流,再向心包腔内灌注顺铂60 mg+地塞米松10 mg,第1、8天.第8天灌注药物后即拔除引流管,然后行心包区域体外深部热疗,隔3天1次,共热疗2次.乙组除不进行热疗外,其余治疗均与甲组相同.结果 甲组CR21例、PR6例、NC3例,总有效率90.0%;乙组CR17例、PR8例、NC8例,总有效率75.8%,P<0.05.结论 心包腔灌注顺铂治疗肺癌伴恶性心包积液有效,在此基础上联合体外高频热疗可以提高疗效.

  19. Infantile pericardial round cell tumor

    International Nuclear Information System (INIS)

    Cardiac malignancies presenting in infancy are rare. Desmoplastic small round cell tumor (DSRCT) is a rare occurrence in this age group. No case of intrapericardial DSRCT has been reported in the literature in infants

  20. 玻璃体切除硅油填充术后高眼压临床分析%Clinical analysis of intraocular pressure(IOP) elevation after vitrectomy and silicon oil tamponade

    Institute of Scientific and Technical Information of China (English)

    黄庆; 张军军

    2012-01-01

    Objective To investigate the causes and measurements of intraocular pressure (IOP) elevation after vitrectomy. Methods To retrospectively analyze clinical data of thirty-one eyes out of one hundred and sixty patients (one hundred and seventy-eight eyes) which had IOP elevation in early period after vitrectomy from January,2010 to December, 2010. Results The causes of postoperative IOP elevation ate uveitic inflammation (eighteen eyes, 58. 1% ), aphakia (four eyes, 12.9%), steroids ((our eyes, 12.9%), silicon oil tamponade excess (three eyes, 9.7%) and endoph-thalmitis (two eyes, 6.5%). After various treatments such as IOP-lowering medication, stop using of steroids, taken-out part of silicon oil, paracentesis of anterior chamber and change to hign-grade antibiotics, the IOP of all eyes returned to normal. Conclusion The incidence of IOP elevation after vitrectomy is 17.4% and uveitic inflammation is the common cause. Timely prevention and proper measurement can reduce visual damage.%目的 探讨玻璃体切除硅油填充术后高眼压的原因及处理.方法 回顾性分析2010年1月到2010年12月本院160例(178只眼)玻璃体切除硅油填充术后早期发生高眼压31例(31只眼)的临床资料.结果 术后高眼压发生原因如下:葡萄膜炎症反应(18只眼,58.1%)、无晶状体眼(4只眼,12.9%)、激素引发(4只眼,129%)、硅油填充过量(3只眼,9.7%)、眼内炎(2只眼,6.5%).给予降眼压药物、停用激素类药物、硅油部分取出、前房穿刺或换用敏感抗生素等治疗后,眼压均降至正常.结论 玻璃体切除硅油填充术后高眼压在本研究的发生率为17.4%,术后葡萄膜炎症反应为常见原因,及时的预防和处理能减少视功能的损害.

  1. Perioperative management of a patient with Dandy Walker malformation with tetralogy of Fallot undergoing total correction and fresh homologous pericardial pulmonary valve conduit implantation: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Vishnu Datt

    2015-01-01

    Full Text Available Perioperative management of a patient with Dandy-Walker malformation (DWM with tetralogy of Fallot (TOF, patent ductus arteriosus, and pulmonary artery stenosis is a great challenge to the anesthesiologist. Anesthetic management in such patients can trigger tet spells that might rapidly increase intracranial pressure (ICP, conning and even death. The increase in ICP can precipitate tet spells and further brain hypoxia. To avoid an increase in ICP during TOF corrective surgery ventriculo-peritoneal (VP shunt should be performed before cardiac surgery. We present the first case report of a 11-month-old male baby afflicted with DWM and TOF who underwent successful TOF total corrective surgery and fresh autologous pericardial pulmonary valve conduit implantation under cardiopulmonary bypass after 1 week of VP shunt insertion.

  2. Research progress and clinical application value of pericardial adipose volume%心包脂肪体积的研究进展及临床应用价值

    Institute of Scientific and Technical Information of China (English)

    李江

    2013-01-01

    Pericardial adipose tissue,a special anatomical distribution of complex physiological and biochemical characteristics,as well as its relation to coronary atherosclerosis,has become a global hotspot.Increasing of the PAT volume has been recognized as an important risk factor for atherosclerotic disease and metabolic syndrome.PAT volume is closely related to the development of coronary atherosclerosis,identification and evaluation of visceral adipose tissue is critical.So the risk prediction and diagnosis of coronary atherosclerotic heart disease by PAT volume have high clinical value,which may be a therapeutic target for coronary heart disease.%心包脂肪组织(pericardial adipose tissue,PAT)特殊的解剖学分布、复杂的生理生化特性以及与冠状动脉粥样硬化的密切相关性使其成为世界性研究热点.PAT体积增加已被公认是动脉粥样硬化性疾病和代谢综合征的一个重要危险因素.PAT体积与冠状动脉粥样硬化的发生发展密切相关,对内脏脂肪组织的鉴别和评价至关重要,故PAT体积对冠状动脉粥样硬化性心脏病的风险预测及诊断具有极高的临床应用价值,并可能成为冠心病的治疗靶点.

  3. 心脏介入术中并发急性心脏压塞的抢救与护理%Rescue and nursing of complicated acute cardiac tamponade cardiac in patients with cardiac interventional operation

    Institute of Scientific and Technical Information of China (English)

    杨福梅

    2015-01-01

    Objective To explore the rescue and nursing of complicated acute cardiac tam-ponade (ACT)in patients with cardiac interventional operation (CIO).Methods A total of 64 CIO patients with complicated ACT were randomly divided into observation group and control group,32 cases in each group.Both groups were conducted with emergency treatment for ACT, and on this basis the control group was treated with routine nursing,while the observation group was treated with comprehensive nursing.Discovery rate of ACT,success rate of rescue as well as satisfactory degree toward nursing and HDL score were compared between two groups.Results In the observation group,the discovery rate of ACT and success rate of rescue were significantly higher than those in the control group (P <0.05).Satisfactory degree toward nursing in the ob-servation group was significantly better than that in the control group (P <0.05).After nursing, scores of anxiety and depression as well as total score of HDL in the observation group were signifi-cantly lower than those before treatment and the control group (P <0.05).Conclusion For CIO patients with complicated ACT,rescue measures and comprehensive nursing can significantly im-prove the success rate of rescue and satisfactory degree toward nursing,reduce the HDL score and reduce medical disputes.%目的:研究心脏介入术(CIO)中并发急性心脏压塞(ACT)的抢救与护理。方法将64例患者实施 CIO 时并发ACT,以数字法随机分成观察组及对照组各32例,2组均实施 ACT 抢救措施,对照组在此基础上另实施常规护理,而观察组则实施综合护理。对比 2组 ACT 发现率及抢救成功率,2组护理满意情况以及 HDL 评分情况。结果观察组 ACT 发现率及抢救成功率均显著高于对照组,差异均有统计学意义(P <0.05);观察组的护理满意情况显著优于对照组,差异有统计学意义(P <0.05);观察组护理后的焦虑、抑郁评分及总

  4. Comparative study on anti-infection ability of pericardial and polyester patch against staphylococcus aureus%心包片和涤纶片抗金黄色葡萄球菌感染能力比较研究

    Institute of Scientific and Technical Information of China (English)

    许赓; 马震

    2016-01-01

    目的:通过对心包片和涤纶片两种生物膜抵抗金黄色葡萄球菌感染能力进行比较分析,从而判断两种材料的可用性。方法通过观察金黄色葡萄球菌于6h、12h、18h、24h四个时间点在心包片和涤纶片表面形成生物膜的数量和厚度,比较二者对金黄色葡萄球菌感染的抵抗能力。结果心包片表面金黄色葡萄球菌生物膜数量和厚度均小于涤纶片,且金黄色葡萄球菌在心包片的生长速度也低于其在涤纶片的生长速度。结论与涤纶片相比,心包片具有更好的抗感染能力。%Objective Comparative antibacterial properties of the two kinds of biological membranes of the pericardial and polyester film for Staphylococcus aureus, so as to judge the availability of the two material.Methods To compare the infection ability of staphylococcus aureus on pericardium and polyester film through observe the density and thickness of the staphylococcus aureu biofilm on the surface of the pericardium and polyester film in 6h ,12h, 18h, 24h.Results The density and thickness of Staphylococcus aureus biofilms on the pericardium surface was less than the polyester film surface, and the growth rate of Staphylococcus aureus in the pericardial patch was also lower than that in the polyester chip.Conclusion The pericardium had better anti-infection ability than the polyester film.

  5. Expert consensus on technical specifications of pericardial devascularization (2013 edition)%贲门周围血管离断术技术规范专家共识(2013版)

    Institute of Scientific and Technical Information of China (English)

    卫生和计划生育委员会卫生公益性行业科研专项专家组

    2014-01-01

    There are many operation methods in the surgical treatment of portal hypertension with esophageal gastric varices bleeding,and the technical levels vary significantly in different areas.Therefore,the consensus on technical specifications of pericardial devascularization (2013 edition) is made by experts group from the Ministry of Health Special Fund for Research in the Public Interest "Reasonable choice and application of treatment of portal hypertension".The surgical indications of pericardial devascularization is portal hypertension with esophageal and gastric varices bleeding.Laboratory and imaging examinations,surgical risk assessment and preoperative preparation should be done before operation.The decision of choosing selective or non-selective paraesophagogastric devascularization depends on the patient's actual situation.Controversial still exits on simultaneous splenectomy.The idea of in situ splenectomy and possible side effects of devascularization on subsequent liver transplantation are specially emphasized in the experts consensus.%有关外科治疗肝硬化门静脉高压症食管胃静脉曲张破裂出血的手术方法很多,且不同地区技术水平存在一定差别.为此,卫生和计划生育委员会卫生公益性行业科研专项“门静脉高压症治疗方法的合理选择和推广应用”专家组就贲门周围血管离断术规范化等相关临床问题进行充分研讨,形成以下共识:贲门周围血管离断术的手术适应证为肝硬化门静脉高压症伴有食管胃静脉曲张破裂出血,手术前应完善实验室和影像学检查,做好风险评估和术前准备,根据患者实际情况采用选择性或非选择性贲门周围血管离断术,对于是否切除脾脏尚存在争议.该专家共识特别探讨了原位脾切除技术及断流术有可能影响以后肝移植等问题.

  6. Pseudo-aneurisma em tubo valvulado de pericárdio bovino corrugado após reconstrução da aorta ascendente: relato de caso False aneurysm of crimped bovine pericardial conduit after reconstruction of the ascending aorta: case report

    Directory of Open Access Journals (Sweden)

    Noedir A. G. STOLF

    1999-10-01

    Full Text Available Os autores descrevem o caso de paciente que, 9 anos após a correção cirúrgica de um aneurisma de aorta ascendente com tubo valvulado de pericárdio bovino corrugado, evoluiu com a formação de um pseudo-aneurisma de aorta localizado, posteriormente, sobre a linha de sutura do tubo de pericárdio bovino. Foi realizada substituição do tubo de pericárdio bovino por tubo de Dacron valvulado (com prótese mecânica e reimplante dos óstios coronários utilizando-se a técnica de hemi-Cabrol. O tempo de seguimento pós-operatório do paciente é de 12 meses, permanecendo assintomático.The authors describe the case of a patient who had an aneurysm of the ascending aorta repaired with biologic valved crimped bovine pericardial conduit. Nine years after the surgery he presented a false aneurysm of the ascending aorta, located posteriorly on the suture line of the pericardial tube. The patient was reoperated and the pericardial tube was replaced by a valved Dacron composite graft using the hemi- Cabrol technique for the reimplantation of the coronary ostia. At 12 months follow-up the patient remains free of symptoms.

  7. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection.

    Science.gov (United States)

    Zingg, Walter; Cartier, Vanessa; Inan, Cigdem; Touveneau, Sylvie; Theriault, Michel; Gayet-Ageron, Angèle; Clergue, François; Pittet, Didier; Walder, Bernhard

    2014-01-01

    Central line-associated bloodstream infection (CLABSI) is the major complication of central venous catheters (CVC). The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88-0.96]; P<0.001) after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days) in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22). Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI. PMID:24714418

  8. Does antibiotic lock therapy prevent catheter-associated bacteremia in hemodialysis?

    Directory of Open Access Journals (Sweden)

    Macarena Jiménez

    2015-01-01

    Full Text Available Central venous catheter-related blood stream infection is a major cause of morbidity and mortality in patients with renal disease treated with hemodialysis. Antibiotic lock solutions can be effective in preventing this complication in patients with hemodialysis. Searching in Epistemonikos database, which is maintained by screening more than twenty databases, we identified eight systematic reviews including seventeen randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that antibiotic lock solutions probably decrease catheter-related blood stream infection in hemodialysis patients.

  9. Catheter Removal versus Retention in the Management of Catheter-Associated Enterococcal Bloodstream Infections

    Directory of Open Access Journals (Sweden)

    Jonas Marschall

    2013-01-01

    Full Text Available BACKGROUND: Enterococci are an important cause of central venous catheter (CVC-associated bloodstream infections (CA-BSI. It is unclear whether CVC removal is necessary to successfully manage enterococcal CA-BSI.

  10. Kocuria Kristinae in Catheter Associated Urinary Tract Infection: A Case Report

    OpenAIRE

    Tewari, Rachna; Dudeja, Mridu; Das, Ayan K.; Nandy, Shyamasree

    2013-01-01

    Kocuria kristinae is a gram positive coccus of the family of Micrococcacae. It inhabits the skin and mucous membranes, but it has rarely been isolated from clinical specimens and is thus considered to be a non-pathogenic commensal. However, it may cause opportunistic infections in patients with indwelling devices and severe underlying diseases. We are reporting an unusual case of a Kocuria kristinae urinary tract infection in a catheterized, 20-years old male. To the best of our knowledge, th...

  11. Specific selection for virulent urinary tract infectious Escherichia coli strains during catheter-associated biofilm formation

    DEFF Research Database (Denmark)

    Ferrieres, Lionel; Hancock, Viktoria; Klemm, Per

    2007-01-01

    microorganisms can attach. Urinary tract infectious (UTI) Escherichia coli range in pathogenicity and the damage they cause - from benign asymptomatic bacteriuria (ABU) strains, which inflict no or few problems to the host, to uropathogenic E. coli (UPEC) strains, which are virulent and often cause severe...... symptoms and complications. We have found that whereas ABU strains produce better biofilms on polystyrene and glass, UPEC strains have a clear competitive advantage during biofilm growth on catheter surfaces. Our results indicate that some silicone and silicone-latex catheters actually select...

  12. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Fonseca Andrade

    2016-01-01

    Full Text Available Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r, Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r, Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

  13. Value of Artisanal Simulators to Train Veterinary Students in Performing Invasive Ultrasound-Guided Procedures

    Science.gov (United States)

    Hage, Maria Cristina F. N. S.; Massaferro, Ana Beatriz; Lopes, Érika Rondon; Beraldo, Carolina Mariano; Daniel, Jéssika

    2016-01-01

    Pericardial effusion can lead to cardiac tamponade, which endangers an animal's life. Ultrasound-guided pericardiocentesis is used to remove abnormal liquid; however, it requires technical expertise. In veterinary medical education, the opportunity to teach this procedure to save lives during emergencies is rare; therefore, simulators are…

  14. 眼外导光照明视网膜光凝联合前房注气在白内障玻璃体视网膜术中应用%Microscopically eye light illumination, retinal laser photocoagulation combined with gas anterior chamber tamponade in cataract joint vitreoretinal surgery

    Institute of Scientific and Technical Information of China (English)

    刘鹏飞

    2016-01-01

    目的 探讨显微镜下眼外导光照明、视网膜激光光凝联合前房注气在白内障联合玻璃体视网膜手术中的疗效及可行性.方法 回顾性分析2010年1月至2014年7月在唐山市眼科医院就治的47例(47只眼)合并晶状体后囊破裂的眼内异物患者实施白内障联合玻璃体视网膜手术.其中周边视网膜格子样变性39只眼,视网膜裂孔者7只眼,玻璃体积血30只眼,视网膜脱离7只眼,锯齿缘解离2只眼.实施白内障摘除、玻璃体切除、视网膜光凝、人工晶状体植入、眼内注气术,术中显微镜下眼外导光照明、视网膜激光光凝联合前房注气.术后观察视力、人工晶状体、视网膜情况及并发症.术后随访6~11个月,平均(6.14±2.15)月.结果 47例患者中,42只眼充填C3F8,5只眼充填硅油.44只眼视力不同程度改善.41只眼人工晶状体正位,1只眼人工晶状体略偏斜.3只眼发生孔源性视网膜脱离.8只眼继发性青光眼,药物治疗1周至2周眼压恢复正常.2只眼角膜内皮面增生膜生长.结论 显微镜下眼外导光照明、视网膜激光光凝联合前房注气在白内障联合玻璃体视网膜手术中操作方便,安全可靠,减少了手术并发症发生,有很好的实用价值.此术式是白内障玻璃体视网膜联合手术的有力补充.%Objective To study the clinical efficacy and feasibility associated with microscopically eye light illumination,retinal laser photocoagulation combined with gas anterior chamber tamponade in the cataract joint vitreoretinal surgery.Methods It was a retrospective analysis of 47 cases (47 eyes) with intraocular foreign bodies and lens capsule rupture was performed cataract joint vitreoretinal surgery.Among 47 cases,peripheral lattice retinal degeneration in 39 eyes,peripheral retinal tear in 7 eyes,vitreous hemorrhage in 30 eyes,retinal detachment in 7 eyes,retinal serrated edge disintegrate in 2 eyes.The patients were performed cataract

  15. 射频消融治疗心房颤动并发急性心脏压塞行心包穿刺引流治疗的临床分析%Clinical Analysis of Radiofrequency Ablation for Atrial Fibrillation Concurrent Acute Cardiac Tamponade Line the Pericardiocentesis Treatment

    Institute of Scientific and Technical Information of China (English)

    张大鹏; 王祖禄

    2012-01-01

      Objective To analyze the diagnosis,cause and experience during the treatment of acute cardiac Tamponade (ACT) in radiofrequency catheter ablation in atrial fibrillation. Methods In a retrospective analysis,we investigated the cause and summarized the process of diagnosis and treatment of ACT in 178 consecutive patients with radiofrequency ablation in atrial fibrillation from March 2005 to June 2010.Results There were 9 cases complicated with ACT in 294 patients with incidence. All were performed emergency pericardiocentesis. None of them died. Conclusion Incidence of ACT is low in RFCA in AF. Earlier discovery and appropriate management can stabilize hemodynamics and avoid operation.%  目的分析和探讨经导管射频消融(Radiofrequency Catheter Ablation,RFCA)治疗心房颤动(Atrial Fibrillation,AF)并发急性心脏压塞(Acute Cardiac Tamponade,ACT)的原因、诊断及处理方法.方法回顾性分析309例AF患者行RFCA术中急性心脏压塞ACT的诊断、发生的原因及处理方法.结果在309例行RFCA术的AF患者中,根据临床表现及超声心动图检查,证实有11例并发ACT,发生率为3.06%.其中2例经快速补液和多巴胺治疗血压难以维持及纠正,经用阿托品后心率无明显提升,9例全部行急诊心包穿刺引流,无一例死亡.结论在AF的RFCA中应尽早期发现发ACT,并及时行心包穿刺及持续引流,可以稳定患者的血液动力学,并避免开胸手术治疗.

  16. 优化腹腔镜脾切除和贲门周围血管离断术的临床研究%Modified laparoscopic splenectomy plus pericardial devascularization for the treatment of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    成剑; 洪德飞; 沈国樑; 谢志杰; 孙晓东; 王知非; 张远标; 黄东胜

    2014-01-01

    Objective To evaluate a modified totally laparoscopic splenectomy plus pericardial devascularization (LSPD) for the treatment of portal hypertension.Methods We applied the technique of ligating the splenic artery in advance followed by the establishment of a tunnel underneath the splenic hilum and the consecutive transection of secondary splenic pedicles and gastric coronary vein with Endo-GIA during the process of splenectomy.Results Totally laparoscopic procedures were performed successfully in 28 cases.Procedure was converted to open surgery in one case because of uncontrollable splenic bleeding.Of the 28 patients that received the total LSPD,the operation time was (207.2 ± 59.3) min,intraoperative blood loss was (287.7 ± 212) ml,intraoperative blood transfusion volume was (106.7 ± 98.3) ml,postoperative passing gas time was (4.6 ± 1.7) d,postoperative hospital stay was (11.8 ± 2.9) d.Abdominal infection,postoperative portal vein thrombosis and liver failure were found in 1,1,2 cases respectively.There were no pancreatic fistula,intraabdominal hemorrhage,postoperative upper gastrointestinal hemorrhage cases.One patient died of liver failure,the other was cured by artificial liver therapy.Conclusions The technique of modified LSPD could reduce the conversion rate of laparoscopic splenectomy and intraoperative blood loss.%目的 探讨完全腹腔镜脾切除、贲门周围血管离断术(laparoscopic splenectomy plus pericardial devascularization,LSPD)的优化技术.方法 应用预先结扎脾动脉,建立脾门后隧道,根据脾门形态应用直线或可转弯切割闭合器分次离断二级脾蒂、应用直线切割闭合器离断胃冠状曲张静脉丛的方法优化LSPD来治疗门静脉高压症及脾功能亢进.结果 29例患者手术均顺利完成,1例中转开腹.28例腹腔镜手术时间(207.2±59.3)min,术中出血量(287.7 ±212) ml,术中输血量(106.7 ±98.3) ml.术后肛门排气时间(4.6±1.7)d,术后住院时间(11.8±2.9)d

  17. Bioprótese valvar de pericárdio bovino St Jude Medical-Biocor: sobrevida tardia St Jude Medical-Biocor bovine pericardial bioprosthesis: long-term survival

    Directory of Open Access Journals (Sweden)

    Felipe W. de Bacco

    2005-12-01

    Full Text Available OBJETIVO: Nosso objetivo é apresentar resultados a longo prazo da subsituição valvar por bioprótese de pericárdio bovino SJM-BiocorTM. MÉTODO: Entre 1992 e 2000, tiveram alta hospitalar, após substituição valvar por bioprótese de pericárdio bovino SJM-BiocorTM 304 pacientes. Idades eram de 15 a 83 anos (média: 60,6±14,3, sendo 50,3% do sexo masculino. Pacientes tiveram situação clínica atualizada e análise atuarial foi empregada no cálculo da sobrevida simples e livre de eventos. RESULTADOS: Em um seguimento total de 931,0 pacientes-ano, ocorreram 28 (9,2% óbitos tardios, sendo cinco (1,6% relacionados à bioprótese, sete (2,3% cardíacos, quatro (1,3% não-cardíacos e 12 (3,9% de causa desconhecida. Eventos de bioprótese foram: endocardite: 18 (5,9%, degeneração fibrocálcica: 15 (4,9%, tromboembolismo: três (1,0%, hemólise: um (0,3%. Disfunção de bioprótese resultou em 16 (5,2% reoperações, por degeneração fibrocálcica (nove, endocardite (seis e tromboembolismo (um. Probabilidade de sobrevida foi 86,3±3,4%, no 5º, e 69,3±9,0%, no 10º ano pós-operatório. Idade jovem (60 anos, n=187: 82,0±13,3% vs 58,8±13,6%, no 9º ano. Sobrevida livre de eventos foi 77,5±3,7%, no 5º, e 40,2±9,0%, no 10º ano. Probabilidade de falência estrutural de bioprótese foi 5%, no 5º ano, e 20%, no 10º; em aórticos, zero e 8%, respectivamente. A classe funcional (NYHA atual é I para 88,5%, II para 9,1% e III para 2,4% dos pacientes. CONCLUSÃO: Implante de bioprótese de pericárdio bovino SJM-BiocorTM resulta em satisfatória perspectiva de sobrevida dos pacientes com doença valvar e apresenta baixa prevalência de disfunção de prótese.OBJECTIVE: The objective of this work is to present long-term results of valve replacement using SJM-BiocorTM bovine pericardial bioprostheses. METHODS: From 1992 to 2000, 304 patients were discharged from hospital after bioprosthesis implantation. Ages ranged from 15 to 83 years

  18. Perfluoroctano líquido como tamponante vitreorretiniano de curta duração no pós-operatório de portadores de descolamento de retina por ruptura gigante Perfluoroctane liquid as a short-term vitreous-retinal tamponade in the postoperative period in patients with retinal detachment due to giant tears

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    Marcelo Carvalho Ventura

    2007-06-01

    Full Text Available OBJETIVOS: Relatar os resultados de vitrectomia via pars plana com utilização de perfluocarbono líquido (Perfluoroctano-Ophtalmos®, como tamponante vítreo-retiniano de curta duração, no pós-operatório de portadores de descolamento de retina, por ruptura gigante. MÉTODOS: Estudaram-se dez desses pacientes. Todos os casos eram complicados por vitreorretinopatia proliferativa grau B ou pior com rupturas que variavam em extensão de 90º a 210º. O perfluorocarbono líquido foi introduzido, por via pars plana, com o volume necessário para ultrapassar o limite posterior da ruptura, permanecendo no pós-operatório por cinco dias, estando os pacientes em decúbito dorsal. Após esse período submetiam-se a segunda intervenção para troca do perfluorocarbono líquido para gás ou óleo de silicone. RESULTADOS: Após período de acompanhamento médio de 16,2 ± 12,4 meses (2 a 43 meses, 80% das retinas estavam aplicadas, sendo necessária a repetição desta técnica em 1 caso (10% caso e em 2 casos (20% não houve reaplicação da retina por vitreorretinopatia avançada. Houve melhora da acuidade visual em 5 casos (50%. CONCLUSÃO: Observaram-se bons resultados quanto à aplicação da retina (80% e melhora da acuidade visual (50% quando do uso do perfluorocarbono líquido como tamponante vitreorretiniano de curta duração no pós-operatório de cirurgias de descolamento de retina por rupturas gigantes.PURPOSE: To report pars plana vitrectomy results of intravitreous use of liquid perfluorocarbon as a short-term postoperative tamponade in retinal detachment due to giant tears in a series of patients. METHODS: Ten of those patients, all of them complicated by proliferative vitreoretinopathy grade B or worse, with tear extension varying from 90º to 210º were studied. Perfluorocarbon liquid was injected via pars plana until the posterior tear limit, remaining in the postoperative period during five days, with the patients in supine position

  19. The effect of transbronchoscopic double-lumen balloon tamponading for the management of haemoptysis in bronchiectasis%经纤维支气管镜气道内置入双腔球囊导管 治疗支气管扩张咯血

    Institute of Scientific and Technical Information of China (English)

    王首红; 陈正贤; 高兴林; 郭纪全; 李静; 李惠英

    2001-01-01

    Objective To evaluate the efficacy of managing haemoptysis caused by bronchiectasis with the double-lumen, bronchus-blocking catheter that can be introduced through the working channel of a standard fibrobronchoscope to the location of bleeding. Methods Fifteen patients suffered from bronchiectasis with haemoptysis were studied. The positions of catheters, duration of tamponade, outcome and complications were observed. Result Sixteen catheters were inserted and were left in position for 2~4 days. Bleeding stopped immediately after the balloons were inflated. The blocking procedure took only several minutes. There were hardly any complications due to the balloon. Conclusion This procedure is practical, simple and well-tolerated by the patients in controlling haemoptysis caused by bronchiectasis.%目的 观察经纤维支气管镜(纤支镜)气道内置入双腔球囊导管治疗支气管扩张咯血的疗效。方法 支气管扩张咯血经常规内科治疗无效者15例,经纤支镜于出血部位置入新型气道内双腔球囊导管,压迫出血的支气管,观察球囊内注入的液体量、止血时间、停留导管时间、停留导管的副作用等。结果 15例患者均顺利置入导管,出血立即停止,停留导管时间为2~4 d不等,无明显副作用。结论 该技术操作简便、疗效迅速可靠,患者容易耐受。

  20. 无眼内填充的玻璃体切割手术联合内界膜剥除治疗高度近视黄斑劈裂疗效观察%Evaluation of effectiveness of vitrectomy associated with internal limiting membrane peeling without tamponade for myopic foveoschisis

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    朱丽; 陈晓; 宋艳萍; 晏颖; 洪玲; 曾苗

    2015-01-01

    目的 观察无眼内填充的玻璃体切割手术联合内界膜(ILM)剥除治疗高度近视黄斑劈裂的疗效.方法 回顾性病例分析.临床检查确诊的高度近视黄斑劈裂患者23例23只眼纳入研究.行最佳矫正视力(BCVA)、眼压、裂隙灯显微镜、间接检眼镜、眼底彩色照相、A型和(或)B型超声、光相干断层扫描检查.患眼BCVA 0.02~0.4.平均屈光度(-14.1±3.8)D;平均眼轴长度(28.8±1.5) mm;平均黄斑中心凹视网膜厚度(CFT) (573.2±142.8) μm.采用经睫状体平坦部三切口25G玻璃体切割手术联合ILM剥除,手术结束时未填充气体或硅油,仅保留玻璃体灌注液.手术后随访6~28个月,观察患眼BCVA、CFT变化、黄斑区视网膜复位情况以及手术并发症发生情况.结果 末次随访时,23只眼中,劈裂腔消失,视网膜完全复位者16只眼,占69.6%;劈裂腔高度不同程度下降,视网膜部分复位者4只眼,占17.4%;视网膜未复位者3只眼,占13.0%.视力提高者12只眼,占52.2%;视力稳定者9只眼,占39.1%;视力下降者2只眼,占8.7%.随访期间未见黄斑裂孔、眼底出血、低眼压以及眼内炎等并发症发生.结论 无跟内填充的璃体切割手术联合ILM剥除治疗高度近视黄斑劈裂可获得较好疗效;未见手术相关并发症发生.%Objective To evaluate the efficacy of vitrectomy with internal limiting membrane peeling without intraocular tamponade in the treatment of myopic foveoschisis.Methods Twenty-three eyes of 23 patients with myopic foveoschisis underwent vitreoretinal surgery were analyzed retrospectively.All the patients had undergone the examinations of best corrected visual acuity (BCVA),intraocular pressure,slit lamp microscope,direct ophthalmoscope,A or B ultrasonic scan and optical coherence tomography(OCT).The mean BCVA was 0.02-0.4,mean diopter was (-14.1 ±3.8) D,mean axial length was (28.8± 1.5) mm,mean central fovea thickness (CFT) was (573.2± 142.8)

  1. 前后段联合手术及硅油填充治疗高度近视黄斑孔视网膜脱离的疗效观察%The therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia

    Institute of Scientific and Technical Information of China (English)

    陈伟奇; 张责华; 胡一骏; 郑建龙

    2009-01-01

    Objective To observe the therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia. Methods The clinical data of 48 high myopia patients (48 eyes) with macular hole retinal detachment were retrospectively analyzed. Retinal detachment was mainly at the posterior pole; macular hole was confirmed by non-contact Hruby lens and optical coherence tomography (OCT). Phacoemulsification combined with pars plana vitrectomy and silicon oil tamponade were performed to all patients, of which 41 had undergone internal limiting membrane peeling, and 23 had intraocular lens implanting. The oil had been removed 3.5-48.0 months after the first surgery and OCT had been performed before the removal. The follow-up period after the removal of the silicon oil was more than 1 year. Results The edge of the macular hole could not be seen under the non-contact Hruby lens 1 week after the surgery in all but 5 patients, and the visual acuity improved. The silicon oil had been removed in all of the 48 patients; the OCT scan before the removal showed that the closed macular holes can be in U shape (8 eyes), V shape (6 eyes) or W shape (23 eyes). About 13-38 months after the oil removal, retinal detachment recurred in 2 patients with the W-shaped holes. At the end of the follow-up period, 16 patients (33.3%) had U or V-shaped macular holes, and 32 patients (66.7%) had W-shaped macular holes. The rate of retinal reattachment was 100%. Conclusion Combined surgery of anterior and posterior segment and silicon oil tamponade is effective on macular hole retinal detachment in eyes with high myopia.%目的 观察前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离临床疗效.方法 回顾分析前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离患者48例48只眼的临床资料.患者均有高度近视史,视网膜脱离以后极部为主.裂隙灯

  2. Changes of photoreceptor layer on spectral domain optical coherence tomography in idiopathic macular hole after vitreous surgery combined with air tamponade%相干光断层扫描观察玻璃体手术联合空气填充治疗特发性黄斑裂孔术后的光感受器细胞层改变

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    贺峰; 于伟泓; 郑霖; 董方田

    2012-01-01

    目的 研究玻璃体切除手术联合空气填充治疗特发性黄斑裂孔的手术效果及其术后光感受器细胞层的改变.方法 回顾性病例系列研究.选择2009年1月至2011年5月行玻璃体切除手术联合空气填充治疗的45例(45只眼)特发性黄斑裂孔患者,采用频域相干光断层扫描测量患者黄斑裂孔直径及光感受器细胞层破坏直径.术前与术后最佳矫正视力和黄斑裂孔闭合率的相关性分析,采用Bivariate过程的Pearson相关分析法.结果 45例(45只眼)患者的术前最佳矫正视力为0.4至眼前手动,平均0.08;黄斑裂孔直径204~1616 μm,平均827.4 μm;光感受器细胞层破坏直径792~ 3444 μm,平均1988.9 μm.术后1个月,45例(45只眼)患者的黄斑裂孔闭合率为75.6%;最佳矫正视力为0.5至光感,平均0.13;光感受器细胞层破坏直径166~2553 μm,平均1285.1μm.患者术后视力较术前显著提高,光感受器细胞层破坏直径显著减小.术前的黄斑裂孔直径和术后的光感受器细胞层破坏直径与术后视力显著相关(r =0.526,0.628,P<0.05).结论 玻璃体切除手术联合空气填充治疗特发性黄斑裂孔安全有效.术前的黄斑裂孔直径和术后的光感受器细胞层破坏直径是预测术后视力的最敏感指标之一.%Objective To evaluate the tamponade effect of sterilized air in vitrectomy for idiopathic macular hole (IMH) as well as changes of photoreceptor layer after surgery.Methods Forty-five eyes of 45 consecutive cases underwent vitrectomy and air tamponade.Surgical outcomes were retrospectively analyzed,consisting of logarithm of the minimal angle of resolution (logMAR) and SD-OCT findings including the size of IMH and the photoreceptor layer defect.Results Preoperatively,mean BCVA was 0.08 (range,0.4 to HM),mean hole diameter was 827.4 μm (range,204 to 1616 μm),and mean diameter of photoreceptor layer defect was 1988.9 μm (range,792 to 3444 μm).The primary closure rate

  3. Vitrectomy and internal limiting membrane peeling with different vitreous tamponade for idiopathic macular epiretinal membrane%玻璃体切割联合内界膜剥离术治疗IMEM不同眼内填充物的临床观察

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    董洁; 张含; 孙鹏; 谷峰; 王欢; 傅博; 刘哲丽

    2013-01-01

    AIM: To compare visual outcomes, central foveal thickness ( CFT), and postoperative complications after vitrectomy and internal limiting membrane ( ILM ) peeling, with balanced salt solution ( BSS ) or gas tamponade, for the treatment of idiopathic macular epiretinal membrane(IMEM).METHODS: Retrospective clinical study. 44 patients with IMEM were included in this study. All patients had undergone vitrectomy and ILM peeling. Eyes were divided into two groups: 20 eyes in group A with BSS tamponade. 24 patients in group B with gas tamponade (11 eyes were injected with filtered air and 13 eyes with perfluoropropane,100mL/L C3F8). The follow-up period was 12-16( mean 13) months. The following parameters were collected and compared: best - corrected visual acuity(BCVA) and CFT (at baseline and 1, 3, 6 and 12 months postoperatively), intraocular pressure(IOP) (at baseline and on the 1th ,7th day, 1, 3 months postoperatively).RESULTS: BCVA significantly improved, and 29 of 44 eyes (65. 9%) achieved visual recovery ≥0. 2 logMAR. There were no significant differences between group A and group B in mean baseline logMAR BCVA (0. 53±0.18 vs 0.52±0.14; P>0.05) and final logMAR BCVA(0.31 ±0.14 vs 0.28±0.09; P>0.05). With respect to OCT parameters, the mean CFT at 12 months (285. 25 ± 70. 07μm) was significantly decreased from that of the baseline (407. 82± 97. 00μm), (Z=4.29, P 0.05) and final CFT (287.60±66. 94μm vs 283.29±73.95μm; P>0. 05). With respect to IOP, there were no significant differences between group A and group B at mean baseline and on the 7th day, 1, 3 months postoperatively (P>0.05). The IOP in group A was significant lower at 1th postoperative day compared with group B (Z=3.12, P0.05).末次随访时A、B组患眼CFT较术前明显降低,从407.82±97.00μm下降到285.25±70.07μm(Z=4.29,P0.05).术后1d,A组眼压(14.25±3.06mmHg)低于B组(17.71±3.20mmHg),差异有统计学意义(Z=3.12,P<0.05),但两组眼压均值均未超过正常范围(10

  4. 玻璃体切割联合C3F8气体填充术治疗孔源性视网膜脱离的疗效分析%Observation on vitrectomy with C3F8 gas tamponade for the treatment of rhegmatogenous retinal detachment

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    关健; 刘蕊; 万超; 赵宁; 才娜

    2015-01-01

    目的 观察玻璃体切割联合C3F8气体填充术治疗孔源性视网膜脱离的疗效,评价该术式的安全性及有效性.方法 对2012年9月至2013年9月在中国医科大学附属第一医院眼科随访观察孔源性视网膜脱离病人40例40只眼,均行标准三切口经睫状体平坦部玻璃体切割联合惰性气体填充,观察患者最佳矫正视力恢复情况;眼部B超、眼底照片示视网膜复位情况;采集低视力生存质量量表.结果 术后定期随访,通过眼底检查,术眼脱离的视网膜全部复位,至随访结束,视网膜复位良好,术前BCVA的平均值为(1.51±0.64) LogMAR,术后1个月(0.87±0.26) LogMAR,术后3个月和6个月为(0.62±0.25) LogMAR.术后1、3、6个月BCVA的LogMAR与术前比较,差别均有统计学意义(P<0.05).术前量表总分为88.36±36.38,术后量表总分为110.47±45.28,手术前后总分差值为22.11±9.45,手术前后量表总分及平均分比较,差别有统计学意义(P<0.05).结论 玻璃体切割联合惰性气体C3F8玻璃体腔内填充术治疗孔源性视网膜脱离疗效确切,同时减轻了患者长期面朝下体位的痛苦,并能提高患者生存质量.%Objective To observe the effectiveness and safety of the vitrectomy combined with C3F8 gas tamponade on treatment of rhegmatogenous retinal detachment.Methods Forty cases (40 eyes) of rhegmatogenous retinal detachment were followed up and observed after underwent vitrectomy combined with inert gas tamponade combined with laser photocoagulation.The visual acuity recovery,eye fundus photographs were observed,and B ultrasound checked retinal reattachment.Low vision quality of life questionnaire were collected.Results After the operation,through fundus examination the detached retina were reattached.Average value of the best corrected visual acuity(Log-MAR):preoperative was 1.51±0.64;1 month after the operation was 0.87±0.26;3 months and 6 months after the operation was 0.62±0.25.Compared with the

  5. Prevenção de aderências pericárdicas pós-operatórias com uso de carboximetilquitosana termoestéril Prevention of postoperative pericardial adhesions using thermal sterile carboxymethyl chitosan

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    Luiz Renato Dias Daroz

    2008-12-01

    Full Text Available OBJETIVO: Este trabalho tem como objetivo avaliar alterações físico-químicas da carboximetilquitosana após termoesterilização e sua eficácia na prevenção de aderências pericárdicas pós-esternotomia. MÉTODOS: Após ser submetida a termoesterilização em autoclave, a carboximetilquitosana termoestéril (CMQte foi submetida a análises físico-químicas. Doze animais foram divididos em dois grupos e submetidos à pericardiotomia e a protocolo de indução de aderências. A seguir, foi aplicada de forma tópica a CMQte ou solução salina. Após 8 semanas, foi realizada esternotomia e avaliação macroscópica do grau de aderências, tempo de dissecção e quantidade do uso de dissecção cruenta e avaliação microscópica. RESULTADOS: As análises físico-químicas não mostraram diferença entre a CMQ e CMQte. A avaliação macroscópica mostrou que a intensidade das aderências foi significantemente menor no grupo CMQte (P=0,007. O tempo de dissecção e o uso de dissecção cruenta também apresentaram reduções significativas (P=0,007, P=0,008; respectivamente. CONCLUSÃO: O método de esterilização empregado não alterou as propriedades físico-químicas da carboximetilquitosana. O uso de biopolímeros de barreira como a CMQte pode reduzir a intensidade das aderências pós-cirúrgicas no pericárdio, diminuindo as complicações da esternotomia em reoperações cardiovasculares.OBJECTIVE: The aim of this study is to evaluate CMC physical-chemical alterations after thermal sterilization and its efficacy in preventing poststernotomy pericardial adhesions. METHODS: After autoclaving thermal sterilization, thermal sterile Carboxymethyl Chitosan (CMCts was submitted to physical-chemical analysis. Twelve animals were divided into two groups and underwent pericardiotomy and adhesion induction protocol. Afterward, topic CMCts or saline solution was administered. After 8 weeks, a sternotomy was performed for adhesion score

  6. Efficacies of splenic artery ligation plus pericardial devascularization for hypersplenic patients with portal hypertension%脾动脉结扎联合贲门周围血管离断术治疗门静脉高压症脾功能亢进

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    徐锋; 戴朝六; 卜献民; 贾昌俊; 彭松林; 赵阳; 许永庆

    2014-01-01

    目的:探讨脾动脉结扎联合贲门周围血管离断术治疗门静脉高压症脾功能亢进的安全性和有效性。方法2012年2月至2014年1月前瞻性研究对比脾动脉结扎和脾切除联合贲门周围血管离断术治疗42例脾功能亢进患者的疗效。结果术前两组白细胞计数、血小板计数、白蛋白计数、总胆红素、凝血酶原时间、平均年龄和术中平均出血量差异均无统计学意义。术后两组白细胞计数和血小板计数均有改善,脾动脉结扎组上升速度相对平缓;术后门静脉压力下降程度类似;脾动脉结扎组门静脉系统血栓形成概率小于脾切除组(4/19与11/23,P <0.05),脾动脉结扎组出现3例局灶性脾梗死,经保守治疗后均好转。两组均无死亡病例。结论脾动脉结扎联合贲门周围血管离断术可以作为脾功能亢进的一种安全有效的治疗手段,但其长期效果仍有待进一步观察。%Objective To assess the safety and efficacies of splenic artery ligation plus pericardial devascularization in improving hypersplenism in patients with portal hypertension.Methods Between February 2012 and January 2014,42 patients with cirrhotic hypersplenism caused by portal hyperten-sion were divided non- randomly into 2 groups.Nineteen (male 13,female 6)patients underwent splenic artery ligation plus pericardial devascularization (SAL group)while another 23 (male 1 5,fe-male 8)splenectomy plus pericardial devascularization (SE group).And the outcomes of two groups were compared.Results Preoperative white blood cell (WBC),platelet counts (PLT),albumin,total bilirubin,prothrombin time,mean age and intraoperative blood loss volume were similar in two groups.The postoperative levels of WBC and PLT in SAL group increased more gently than that of SE group.Portal vein pressure decreased analogously in two groups.The incidence of portal venous system thrombosis in SAL group was lower than that of SE group (4/19 vs 1 1/23,P

  7. Morganella morganii Pericarditis in a Patient with Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Takafumi Nakao

    2013-01-01

    Full Text Available Purulent pericarditis caused by Morganella morganii is extremely rare. We report herein a case of a 61-year-old man who presented with chest pain and dyspnea fourteen days after chemotherapy for multiple myeloma. Echocardiogram and computed tomography revealed a massive pericardial effusion and associated cardiac tamponade. Pericardiocentesis was performed. Pericardial fluid was found to be purulent, and Morganella morganii was isolated from the fluid. The patient was successfully treated with antibiotic therapy and surgical drainage of the fluid. Morganella morganii should be considered a possible pathogen when immunocompromised patients develop purulent pericarditis.

  8. Morganella morganii Pericarditis in a Patient with Multiple Myeloma.

    Science.gov (United States)

    Nakao, Takafumi; Yoshida, Masahiro; Kanashima, Hiroshi; Yamane, Takahisa

    2013-01-01

    Purulent pericarditis caused by Morganella morganii is extremely rare. We report herein a case of a 61-year-old man who presented with chest pain and dyspnea fourteen days after chemotherapy for multiple myeloma. Echocardiogram and computed tomography revealed a massive pericardial effusion and associated cardiac tamponade. Pericardiocentesis was performed. Pericardial fluid was found to be purulent, and Morganella morganii was isolated from the fluid. The patient was successfully treated with antibiotic therapy and surgical drainage of the fluid. Morganella morganii should be considered a possible pathogen when immunocompromised patients develop purulent pericarditis.

  9. Pharmacokinetic/Pharmacodynamic Correlation of Cefquinome against Experimental Catheter-associated Biofilm Infection due to Staphylococcus aureus

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    Yu-Feng eZhou

    2016-01-01

    Full Text Available Biofilm formations play an important role in Staphylococcus aureus pathogenesis and contribute to antibiotic treatment failures in biofilm-associated infections. The aim of this study was to evaluate the pharmacokinetic/pharmacodynamic (PK/PD profiles of cefquinome against an experimental catheter-related biofilm model due to S. aureus, including three clinical isolates and one non-clinical isolate. The minimal inhibitory concentration (MIC, minimal biofilm inhibitory concentration (MBIC, biofilm bactericidal concentration (BBC, minimal biofilm eradication concentration (MBEC and biofilm prevention concentration (BPC and in vitro time-kill curves of cefquinome were studied in both planktonic and biofilm cells of study S. aureus strains. The in vivo post-antibiotic effects (PAEs, PK profiles and efficacy of cefquinome were performed in the catheter-related biofilm infection model in murine. A sigmoid Emax model was utilized to determine the PK/PD index that best described the dose-response profiles in the model.The MICs and MBICs of cefquinome for the four S. aureus strains were 0.5 and 16μg/mL, respectively. The BBCs (32-64 μg/mL and MBECs (64-256 μg/mL of these study strains were much higher than their corresponding BPC values (1-2 μg/mL. Cefquinome showed time-dependent killing both on planktonic and biofilm cells, but produced much shorter PAEs in biofilm infections. The best-correlated PK/PD parameters of cefquinome for planktonic and biofilm cells were the duration of time that the free drug level exceeded the MIC (fT>MIC, R2=96.2% and the MBIC (fT>MBIC, R2=94.7%, respectively. In addition, the AUC24h/MBIC of cefquinome also significantly correlated with the anti-biofilm outcome in this model (R2=93.1%. The values of AUC24h/MBIC for biofilm-static and 1-log10-unit biofilm-cidal activity were 22.8 h and 35.6 h; respectively. These results indicate that the PK/PD profiles of cefquinome could be used as valuable guidance for effective dosing regimens treating S. aureus biofilm-related infections.

  10. A case report of vascular catheter-associated bacteremia caused by Mycobacterium tuberculosis in a non-immunosuppressed patient

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    PETRILLO Victor Flávio

    1999-01-01

    Full Text Available Mycobacterium tuberculosis was isolated from a central venous catheter in a non-immunosuppressed patient with systemic tuberculosis. This case report represents a very uncommon form of isolation of Mycobacterium tuberculosis. A total improvement was obtained after treatment.

  11. Bacteriemia relacionada a catéter por Ochrobactrum anthropi Catheter-associated bacteremia caused by Ochrobactrum anthropi

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    Rolando Soloaga

    2009-12-01

    Full Text Available Ochrobactrum anthtropi es un bacilo gram negativo aeróbico, no fermentador de la glucosa, anteriormente conocido como Achromobacter sp o CDC grupo Vd. Ha sido aislado del medio ambiente y de infecciones en seres humanos que generalmente presentaban algún tipo de inmunocompromiso. Las infecciones por este microorganismo fueron bacteriemias relacionadas a catéteres y en ocasiones endoftalmitis, infecciones urinarias, meningitis, endocarditis, absceso hepático, osteocondritis, absceso pelviano y absceso pancreático. Se presenta el caso de un paciente de sexo masculino, de 69 años de edad, que consultó a la guardia por hipotensión sostenida y síndrome febril de cuatro días de evolución, escalofrío, sudoración profusa y deterioro del sensorio. El paciente tenía diabetes de tipo 2 y antecedente de accidente cerebrovascular. Debido a insuficiencia renal crónica presentaba un catéter de doble lumen para la diálisis. Se documentó una bacteriemia relacionada a catéter por cultivo de sangre a través de catéter y de vena periférica, utilizando el sistema automatizado de hemocultivos Bact-Alert y la metodología de tiempo diferencial (>120min. La confirmación se realizó, una vez removido el catéter, por la técnica semicuantitativa de Maki (> 15 UFC. El microorganismo fue identificado por API 20NE y Vitek 1 como Ochrobactrum anthropi.Ochrobactrum anthropi is a non-glucose fermentative, aerobic gram-negative bacillus, formerly known as Achromobacter sp or CDC group Vd. It has been isolated from the environment and from infections in usually immunocompromised human beings. The documented infections frequently involved catheter related bacteremia whereas endophthalmitis, urinary infections, meningitis, endocarditis, hepatic abscess, osteochondritis, pelvic abscess and pancreatic abscess were rarely involved. Here it is presented the case of a male patient aged 69 years with sustained hypotension, four day febrile syndrome, chill, lavish perspiration and sensorium deterioration. He had type 2 diabetes and antecedent of cerebrovascular accident. A double-lumen dialysis catheter was present due to chronic renal insufficiency. An episode of catheter-related bloodstream infection was documented by using Bact-Alert Blood Culture System and Differential-Time-to-Positivity Method for central venous catheter versus peripheral blood cultures (>120 min. Once removed, it was confirmed through Maki semi quantitative technique (>15 FCU. The microorganism was identified by API 20NE and Vitek 1 as Ochrobactrum anthropi.

  12. Cardiac surgery in a patient with immunological thrombocytopenic purpura: Complications and precautions

    Directory of Open Access Journals (Sweden)

    Vivek Chowdhry

    2013-01-01

    Full Text Available Immune thrombocytopenic purpura (ITP patients are at high-risk for bleeding complications during and after cardiac surgeries involving cardiopulmonary bypass. We report a patient with ITP with severe coronary artery disease and mitral valve regurgitation who underwent uncomplicated coronary artery bypass grafting and mitral valve replacement. Three weeks later, the patient was readmitted in a very low general condition with signs of pericardial tamponade. We describe our experience of managing the case.

  13. Double heart rupture after acute myocardial infarction: A case report

    OpenAIRE

    Ivanov Igor; Lovrenski Aleksandra; Dejanović Jadranka; Petrović Milovan; Jung Robert; Raffay Violetta

    2014-01-01

    Introduction. Double heart rupture is a rare complication of acute myocardial infarction with high mortality. Case report. We presented a 67-year-old female patient with symptoms and signs of myocardial infarction, diagnosed with echocardiography, rupture of the septum, the presence of a thrombus and a small pericardial effusion. Soon after admission the patient died. Autopsy revealed tamponade and double myocardial rupture, free wall rupture and ventricula...

  14. Regional blood flow distribution in dog during induced hypotension and low cardiac output. Spontaneous breathing versus artificial ventilation.

    OpenAIRE

    Viires, N; Sillye, G; Aubier, M.; Rassidakis, A; Roussos, C

    1983-01-01

    Respiratory muscle blood flow and organ blood flow was studied in two groups of dogs with radioactively labeled microspheres to assess the influence of the working respiratory muscles on the regional distribution of blood flow when arterial pressure and cardiac output were lowered by pericardial tamponade. In one group (n = 6), the dogs were paralyzed and mechanically ventilated (Mv), while in the other (n = 6), they were left to breathe spontaneously (Sb). Cardiac output fell to 30% of contr...

  15. Injury to the coronary arteries and related structures by implantation of cardiac implantable electronic devices.

    Science.gov (United States)

    Pang, Benjamin J; Barold, S Serge; Mond, Harry G

    2015-04-01

    Damage to the coronary arteries and related structures from pacemaker and implantable cardioverter-defibrillator lead implantation is a rarely reported complication that can lead to myocardial infarction and pericardial tamponade that may occur acutely or even years later. We summarize the reported cases of injury to coronary arteries and related structures and review the causes of troponin elevation in the setting of cardiac implantable electronic device implantation. PMID:25564549

  16. Hjertetamponade hos et praematurt barn med perkutant anlagt centralt venekateter

    DEFF Research Database (Denmark)

    Callesen, Michael T; Nielsen, Peter Ehlert

    2008-01-01

    We report a case of a premature girl born with a gestational age of 26 weeks who developed cardiac tamponade after displacement of a peripheral inserted central catheter. She recovered completely after an acutely performed pericardiocentesis. The pericardial fluid was consistent with parental...... nutrition. Pericardiac effusion must be suspected in children with central catheters and sudden cardiovascular decompensation. This article discusses recommended positioning of peripherally inserted central catheters....

  17. Pneumopericardium, pneumomediastinum, pneumothorax and pneumoretroperitoneum complicating pulmonary metastatic carcinoma in a cat.

    Science.gov (United States)

    Greci, V; Baio, A; Bibbiani, L; Caggiano, E; Borgonovo, S; Olivero, D; Rocchi, P M; Raiano, V

    2015-11-01

    This report describes a case of severe spontaneous tension pneumopericardium with concurrent pneumomediastinum, pneumothorax and retropneumoperitoneum in a cat presenting with dyspnoea and signs of cardiac tamponade secondary to metastatic pulmonary carcinoma. Spontaneous pneumopericardium is an extremely uncommon condition consisting of pericardial gas in the absence of iatrogenic/traumatic causes. In humans, it has been described secondary to pneumonia or lung abscess and very rarely secondary to pulmonary neoplasia.

  18. Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer%射频透热联合化疗治疗肺癌恶性心包积液的近期疗效

    Institute of Scientific and Technical Information of China (English)

    罗鹏飞; 曹培国; 姚志平

    2011-01-01

    背景与目的恶性心包积液为肺癌严重并发症之一,有效治疗方法不多.本研究旨在评价射频透热联合化疗治疗恶性心包积液的近期疗效.方法回顾性分析中南大学湘雅三医院肿瘤科2000年10月-2010年10月收治的肺癌并恶性心包积液的患者55例,分为射频透热联合化疗组(热化组)和化疗组,热化组采用心包穿刺引流心包积液后,给予心包腔内注射顺铂20 mg+地塞米松5 mg,然后进行局部射频透热治疗,患者一般情况改善后行全身化疗,腔内化疗1次-6次,平均3次,热疗每周2次平均6次,腔内温度控制在40.5℃-41.5℃左右并维持60min;化疗组只给予腔内注药和全身化疗.全身化疗方案为长春瑞滨+顺铂,长春瑞滨总量50 mg/m2,顺铂总量75 mg/m2.结果热化组心包积液完全缓解率为54.3%,总有效率为91.4%,化疗组分别为25.0%、70.0%,两组比较有统计学差异(P<0.05);治疗后两组生活质量均明显提高,但热化组生活质量的改善优于化疗组,两组KPS评分的变化有统计学差异(P<0.05);化疗不良反应主要为消化道毒性和骨髓抑制,两组比较无统计学差异(P>0.05);与热疗相关的主要副反应为局部皮肤疼痛(8.6%)和皮下脂肪硬结(5.7%).结论射频透热联合化疗治疗肺癌恶性心包积液近期疗效确切,能显著改善患者生活质量,不增加全身化疗毒副反应,安全性高.%Background and objective Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyper-thermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer. Methods Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group) and chemotherapy group. The

  19. 肝硬化门静脉高压症断流术后贲门失迟缓的诊治%Diagnosis and treatment of post-operative achalasia after pericardial devascularization in patients with portal hypertension from liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    罗大勇; 李恒; 王润之; 张伟; 肖国丰

    2014-01-01

    Objective:To investigate the diagnosis and surgical approach to post operative achalasia after pericardial devasculatirzation in patients with por-tal hypertension resulted from liver cirrhosis.Methods:The clinical data were retrospectively examined in 43 of 282 patients undergone conventional sple-nectomy plus pericardial vessel devascularization complicated with post-oerative achalasia to a certain degree.Results: After operation,43 patients com-plained of catch sensation of food intake and dysphagia.By symptomatic treatment and psychological intervention,remission occurred in 34,and 9 were giv-en enteral nutrition via nasojejunal tube,in which 4 were relieved and 5 remained no remission.The clinical picture included vomiting after food intake due to thread-like stenosis of cardia by the findings of barium meal X-ray for the upper digestive tract.Endoscopic balloon dilation was applied to the 5 cases, and remission occurred in 4 by one intervention and in 1 by twice.No relapse occurred in the follow-up period.Conclusion:Esophageal stenosis after peri-cardial devascularization is closely associated with gender,devascularization position,preoperative intravascular interventional therapy of repeated bleeding, intraoperative esophagus muscular injury and spraying esophageal mucosal surface with non-absorbing chemical glue.Early detection and treatment should be necessary for this disease,and interventional treatment or endoscopic balloon dilation is effective and recommended to the failure of conservative treat-ment.%目的:探讨肝硬化门静脉高压症行贲门周围血管离断术后发生贲门失迟缓的诊治方法。方法:对我院2008年1月~2013年5月共行脾切除+贲门周围血管离断术282例术后发生不同程度的贲门失迟缓的43例(15.2%)病例资料进行分析总结。结果:43例在术后出现进食梗咽感、吞咽困难,给予心理安慰、对症治疗缓解34例;另9例经鼻肠管给

  20. Chemically modified chitosan anti-adhesion membrane preventing postoperative pericardial adhesions in rabbit myocardial infarction model%改性壳聚糖防粘连膜防止心肌梗死模型兔心脏与周围组织粘连

    Institute of Scientific and Technical Information of China (English)

    李连东; 张存泰; 阮磊; 龚良庚; 李治群; 倪明科

    2010-01-01

    Objective To evaluate the efficacy of a chemically modified chitosan anti-adhesion membrane for preventing postoperative pericardial adhesions in rabbit myocardial infarction model. Methods Twenty-five Japanese white rabbits underwent myocardial infarction by ligation of coronary artery after thoracotomy, and devided into treatment and control groups randomly. The treatment group had a chitosan anti-adhesion membrane placed between the heart and retrostemal injured surfaces, while control group received nothing. Then Chest was subsequently closed. Eleven rabbits survived the operation in each group. After a period of 3 months, there were 8 rabbits alive in control group and 9 rabbits alive in treatment group. The animals were examined by Cine magnetic resonance imaging. sacrificed under anesthesia, and independent observers, blinded to treatment, graded the formation of pericardial adhesions by magnetic resonance cinema and histologioal anatomy respectively. Data were analyzed by Wilcoxon' s rank test. Results Cine magnetic resonance imaging revealed that there were 2,2,4 cases of mild adhesion, moderate adhesion,and severe adhesion in group, and 7, 2, 0 respectively (P<0.05). Thoracotomy indicated there were 1,1,2,4 cases of adhesions, mild adhesions, moderate adhesions, and severe adhesions in group A, and 3, 4, 2, 0 in group B respectively (P < 0. 05). Conclusion Placement of a chemically modified chitosan anti-adhesion membrane between injured surfaces effectively reduced the formation of postoperative pericardial adhesion in rabbits of myocardial infarction model.%目的 观察改性壳聚糖防粘连膜对心肌梗死兔心脏与周围组织粘连程度的影响.方法 25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分为对照组(A组)和改性壳聚糖防粘连膜组(B组),A组正常关胸,B组关胸前在心脏和胸壁间置入改性壳聚糖防粘连膜.每组造模型成功各11只.术后3个月A组存活8

  1. Right ventricular hydatid cyst ruptured to pericardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-01-01

    Full Text Available Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

  2. Purulent Pericarditis after Liver Abscess: A Case Report

    Directory of Open Access Journals (Sweden)

    María Fidalgo García

    2014-01-01

    Full Text Available We present the case of a 49-year-old woman, with previous clinical antecedents of recent hepatic metastasis, who was admitted to the ICU due to respiratory failure and hemodynamic instability. She was found to have purulent pericarditis complicated by pericardial tamponade and pleural effusion, as well as surgical site infection, which was the origin of the disease. Cultures of the surgical wound and the pericardial effusion were positive for Enterococcus faecalis and Escherichia coli. A pericardial tap was performed and the intra-abdominal abscess was surgically drained. Pleural effusion was also evacuated. She received antibiotic treatment and recovered successfully. The only after-effect was a well-tolerated effusive-constrictive pericarditis.

  3. Acute Effusive Pericarditis due to Horse Chestnut Consumption.

    Science.gov (United States)

    Edem, Efe; Kahyaoğlu, Behlül; Çakar, Mehmet Akif

    2016-01-01

    BACKGROUND There are many well-known causes of pericardial effusion, such as cancer metastasis, bacterial or viral pericarditis, and uremic pericarditis; however, no reports exist in the literature demonstrating a pericardial effusion that led to cardiac tamponade following consumption of an herbal remedy. CASE REPORT A 32-year-old male patient was referred to our cardiology outpatient clinic with a complaint of dyspnea. The patient's medical history was unremarkable; however, he had consumed 3 boxes of horse chestnut (Aesculus hippocastanum L) paste over the previous 1.5 months. His chest x-ray examination revealed an enlarged cardiac shadow and bilateral pleural effusion. On transthoracic echocardiographic examination, his ejection fraction was found to be 55% with circumferentially extended pericardial effusion that reached 3.9 cm at its maximal thickness. No growth had been detected in the pericardial and pleural biopsies or blood samples; there was no evidence of an infectious process in the physical examination. Based on this information, we diagnosed pericarditis resulting from the use of herbal remedies. This is the first report to demonstrate that herbal remedy consumption may cause this type of clinical condition. CONCLUSIONS Besides other well-known causes, pericardial effusion related to the consumption of herbal remedies should always be considered when treating patients with pericardial effusion caused by unclear etiologies. PMID:27141926

  4. CT-guided pericardiocenteses: Clinical profile, practice patterns and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Eichler, Katrin, E-mail: k.eichler@em.uni-frankfurt.d [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany); Zangos, Stephan; Thalhammer, Axel; Jacobi, Volkmar [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany); Walcher, Felix; Marzi, Ingo [Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Frankfurt (Germany); Moritz, Anton [Department of Thoracic and Cardiovascular Surgery, University of Frankfurt, Frankfurt (Germany); Vogl, Thomas J.; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt (Germany)

    2010-07-15

    Objective: To assess the effectiveness and clinical outcome and technique of CT-guided pericardiocenteses in the treatment of pericardial effusions in adults and children. Methods: 20 drainages were performed in Seldinger-technique under CT-guidance on 20 patients suffering from pericardial effusions and haematomas. In 85%, the etiology of effusion was postoperative. The mean age of the patients was 59 years (minimum 9 years, maximum 86 years).There were 12 male and eight female patients. The inclusion criterion was an echocardiographically relevant proved pericardial effusion. Results: All catheters could be placed successfully (20/20) in the pericardial effusion and allowed for draining of the effusion in all cases under CT-guidance. The overall 30-day mortality rate was 0%. CT-guided pericardiocentesis was successful for withdrawing pericardial fluid and/or relieving tamponade in 100% of all procedures. No major complication was occurred. A total of one minor complication (5%) occurred that required no specific interventions, except for monitoring and appropriate follow-up. We observed one pneumothorax as a minor complication. Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with CT-guided pericardiocenteses in adults and children. The ventrolateral entry side for the puncture should be preferred to reach the whole effusion and avoid complications, like a pneumothorax.

  5. Seguimento de 9 anos da bioprótese valvular cardíaca de pericárdio bovino IMC-Biomédica: estudo multicêntrico Nine year follow-up of the bovine pericardial prosthetic valve IMC-Biomedica: a multicenter study

    Directory of Open Access Journals (Sweden)

    Alexandre V Brick

    1987-12-01

    Full Text Available De dezembro de 1977 a novembro de 1986, foi usado o bioenxerto valvular cardíaco de pericárdio bovino IMC-Biomédica na posição mitral, em 798 pacientes, com idade média de 42 anos. Os 722 pacientes sobreviventes foram observados por um período de até 9 anos, representando 27036 meses, ou 2253 anos. O estudo indicou um índice de sobrevida de 66% para os adultos e 69% para os jovens, sendo de 94% e 80% o índice de sobrevida para os adultos e jovens, respectivamente, com pós-operatório de 5 anos. A freqüência das complicações diante da amostra analisada foi: 0,4% de rotura do tecido; 0,4% de vazamento paravalvular; 2,7% de acidente vascular cerebral; 3,2% de endocardite infecciosa; 4,4% de calcificação. A curva atuarial de calcificação entre os anos de 1978 e 1982 (Grupo I mostrou 94% dos adultos e 12% dos jovens livres dessa complicação. Por outro lado, de 1982 a 1986 (Grupo II, esse índice subiu para 99,0% entre os adultos e 92,0% para os jovens. Deste modo, concluímos que a nossa opção pela bioprótese de pericárdio bovino foi apropriada, visto que 96% dos pacientes estiveram livres de complicações fatais relacionadas à bioprótese, o que significa que, em 9 anos, o potencial da bioprótese foi apenas de 4%.A mitral pericardial bioprosthetic valve IMC-Biomedica was implanted in a consecutive series of 798 patients with mean age of 52 years, from December 1977 to November 1978. The 722 patients who survived operation were observed during a period of 9 years (mean 27036 months or 2253 years. Actuarial studies indicated an expected survived rate at 9 years of 66% for adult patients and 68% for younger patients. The probability of complications were the following: rupture 0.4; perivalvar leak 0.4%; thromboembolysm 2.7%; endocarditis 3.2%; calcification 4.4%. The actuarial freedom from calcification between 1977 to 1982 (Group I was 94.0% to adults and 12.0% to younger patients. On the other hand, between 1982 to 1986

  6. Acute Effusive Pericarditis due to Horse Chestnut Consumption

    Science.gov (United States)

    Edem, Efe; Kahyaoğlu, Behlül; Çakar, Mehmet Akif

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Pericardial effusion related to the consumption of herbal product Symptoms: Dyspnea Medication: Horse chestnut (Aesculus hippocastanum L) Clinical Procedure: Pericardial and pleural effusions were drained through a pericardiopleural window Specialty: Cardiology Objective: Unusual clinical course Background: There are many well-known causes of pericardial effusion, such as cancer metastasis, bacterial or viral pericarditis, and uremic pericarditis; however, no reports exist in the literature demonstrating a pericardial effusion that led to cardiac tamponade following consumption of an herbal remedy. Case Report: A 32-year-old male patient was referred to our cardiology outpatient clinic with a complaint of dyspnea. The patient’s medical history was unremarkable; however, he had consumed 3 boxes of horse chestnut (Aesculus hippocastanum L) paste over the previous 1.5 months. His chest x-ray examination revealed an enlarged cardiac shadow and bilateral pleural effusion. On transthoracic echocardiographic examination, his ejection fraction was found to be 55% with circumferentially extended pericardial effusion that reached 3.9 cm at its maximal thickness. No growth had been detected in the pericardial and pleural biopsies or blood samples; there was no evidence of an infectious process in the physical examination. Based on this information, we diagnosed pericarditis resulting from the use of herbal remedies. This is the first report to demonstrate that herbal remedy consumption may cause this type of clinical condition. Conclusions: Besides other well-known causes, pericardial effusion related to the consumption of herbal remedies should always be considered when treating patients with pericardial effusion caused by unclear etiologies. PMID:27141926

  7. Perforation of the Right Ventricle as a Complication of Pericardiocentesis: A Case report

    Directory of Open Access Journals (Sweden)

    Stojanović Milovan

    2016-06-01

    Full Text Available Pericardial effusion represents the accumulation of larger amounts of fluid in the pericardial cavity. If not timely diagnosed and adequately treated, it can lead to cardiac tamponade. The treatment of pericardial effusion includes primarily the use of drugs like aspirin, NSAIDs, corticosteroids, and/or colchicine followed by invasive procedures such as pericardiocentesis or pericardiectomy. Pericardiocentesis complications are extremely rare but very serious especially in the case of the rupture of the right ventricle or the coronary arteries. Patient S.V, born in 1938, from Svrljig, was examined because of suffocating and swollen shin. The medical reports showed that the patient previously had had a permanent pacemaker implanted and that he had undergone a triple coronary artery bridging. Medical reports also showed that two months before the examination he was hospitalized due to pericardial effusion at the reference institution. The ultrasonographic examination registered large circular effusion with the motion of the right ventricle and the patient underwent urgent pericardiocentesis. During pericardiocentesis, the rupture of the right ventricle occurred and the patient was sent to the cardiac surgery clinic where he had catheter extraction performed. The control ultrasound examination of the heart showed no pericardial effusion, and no signs of damage to the right ventricle.

  8. Diagnosis and Treatment of Penetrating Cardiac Injury One Year after Thoracic Stab Wound

    Directory of Open Access Journals (Sweden)

    MH Soltani

    2005-10-01

    Full Text Available In any patient with a history of penetrating thoracic trauma, cardiac injury must be kept in mind. Here, we describe a 36 years-old female referred to this hospital with severe chest pain and hypotension. After primary evaluation and suggestion of AMI, streptokinase was started for the patient and because of deterioration of vital signs, cardiac surgery consultation was requested. After performing urgent echocardiography, massive pericardial tamponade was detected. Visualization of a knife blade on C.X.R and past medical history of thoracic stab injury led to a diagnosis of delayed cardiac tamponade and urgent sternotomy was performed. The blade that had penetrated the right ventricular chamber was extracted. Six days after operation, patient was discharged without any problem. This case study suggests the importance of high suspicion to cardiac injury in any patient with chest pain and a history of chest trauma.

  9. Prevention of central venous catheter-associated bloodstream infections: A questionnaire evaluating the knowledge of the selected 11 evidence-based guidelines by Polish nurses.

    Science.gov (United States)

    Dedunska, Karina; Dyk, Danuta

    2015-12-01

    This study evaluated the questionnaire testing nurses' knowledge about the maintenance of a central venous catheter (CVC) and assessed it with regard to age, work experience, type of ward, frequency of trainings, and postgraduate education. There were 1,180 questionnaires (N = 784; 66.4% of the total sample) distributed in several regions of Poland for a period of 7 months. The difficulty level for each question ranged from 0.22-0.88.

  10. Preliminary study on serum paraoxonase-1 status and chemokine (C-C motif) ligand 2 in hospitalized elderly patients with catheter-associated asymptomatic bacteriuria.

    Science.gov (United States)

    Iftimie, S; García-Heredia, A; Pujol, I; Ballester, F; Fort-Gallifa, I; Simó, J M; Joven, J; Camps, J; Castro, A

    2016-09-01

    Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient's immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection. PMID:27334497

  11. CT imaging of complications of catheter ablation for atrial fibrillation

    International Nuclear Information System (INIS)

    The complication rate following radiofrequency catheter ablation for atrial fibrillation is low (<5%). Complications include pericardial effusion, cardiac tamponade, pulmonary vein stenosis, oesophageal ulceration or perforation, atrio-oesophageal fistula formation, stroke/transient ischaemic attack, phrenic nerve injury, haematoma at the puncture site, and femoral arteriovenous fistula. Among available imaging tools, computed tomography (CT) can be very useful in diagnosing complications of the procedure, particularly in the subacute and delayed stages after ablation. This review illustrates CT imaging of several of the common and uncommon complications of radiofrequency catheter ablation

  12. Taponamiento cardíaco por hipotiroidismo: descripción de 2 casos

    Directory of Open Access Journals (Sweden)

    José Rafael Rojas-Solano

    2005-07-01

    Full Text Available Rara vez el derrame pericárdico en el hipotiroidismo evoluciona al taponamiento cardíaco, complicación que es mortal si no se diagnostica y trata a tiempo. En este artículo describimos dos singulares casos y discutimos aspectos importantes de la fisiopatología, diagnóstico y manejo de esta enfermedad.Pericardial effusion in hypothyroidism seldom evolves to cardiac tamponade, a fatal complication if diagnosis and treatment are delayed. In this article, we describe 2 singular cases and discuss important facts about the pathophysiology, diagnosis and management of this disease.

  13. Purulent pericarditis in a dog administered immune-suppressing drugs

    International Nuclear Information System (INIS)

    A 5-year-old castrated mongrel dog was brought to our hospital with anorexia and vomiting. Laboratory testing revealed immune-mediated hemolytic anemia (IMHA), and so treatment was initiated with multiple immune-suppressing drugs, achieving partial remission from IMHA. However, cardiac tamponade due to purulent pericarditis was identified as a secondary disease. Culture of pericardial fluid yielded numerous Candida albicans and multidrug-resistant Acinetobacter sp. Pericardiocentesis was performed, and the condition of the dog improved. However, the dog died the next day

  14. Percutaneous atrial appendage occlusion for stroke prevention in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Munkholm-Larsen, Stine; Cao, Christopher; Yan, Tristan D;

    2012-01-01

    databases. Fourteen studies were identified for evaluation. Overall, implantation was successful in 93% of all cases. Periprocedural mortality and stroke rates were 1.1% and 0.6%, respectively. The incidences of pericardial effusion/cardiac tamponade and device embolisation were 4% and 0.7%, respectively....... At the time of the latest follow-up (up to 40 months), the overall incidence of stroke among all studies was 1.4% per annum. Existing evidence suggests that PLAAO is a relatively safe treatment for patients with AF. However, there is a need for further evaluation of its efficacy in the form of large and well...

  15. Pleuritic Chest Pain in a Young Female: A Reminder for Acute Health Care Providers

    Science.gov (United States)

    Ali, Alaa M.; Stroncek, Carolyn

    2014-01-01

    Chest pain is one of the most common reasons for emergency department visits. Emergency medicine doctors should focus their initial assessment on patients' stability. History, physical examination, and ancillary testing should exclude serious causes such as acute coronary syndrome, acute aortic syndromes, pulmonary embolism, pneumothorax, esophageal perforation, and rupture as well as pericardial tamponade. Young age should not be used alone as a predictor of a benign condition. Below we present a case of a 24-year-old female who was found to have ascending aortic dissection and was sent for emergent surgery. PMID:25247097

  16. The management of acute pericarditis.

    Science.gov (United States)

    Wells, T A; Curzen, N P

    2005-01-01

    Acute pericarditis is usually a benign self-limiting condition, often of unexplained or viral aetiology, involving inflammation of the pericardial layers. It is often part of the differential diagnosis in patients admitted with acute chest pain and can be confused with acute myocardial infarction, acute pulmonary embolism and pleurisy. Occasionally it can result in cardiac tamponade and, if associated with myocarditis, in heart failure. This article sets out how to diagnose acute pericarditis, the common underlying causes, the possible treatment options and outcomes. PMID:21655516

  17. Fatal secondary pulmonary hypertension due to cardiac involvement in AIDS-associated Burkitt′s lymphoma

    Directory of Open Access Journals (Sweden)

    Singh Ashutosh

    2006-09-01

    Full Text Available Primary cardiac lymphomas are rare lesions in children with acquired immunodeficiency syndrome (AIDS. Most of them are high-grade Burkitt′s or Burkitt-like lymphomas. They usually present with congestive cardiac failure, pericardial effusion or tamponade, arrhythmias, with predominant systemic ′B′ symptoms and often with widespread extranodal involvement. The clinical profile and operative and pathological findings of a 4-year-old boy with AIDS-associated Burkitt′s lymphoma of the heart presenting with acute right heart failure and fatal secondary pulmonary hypertension is reported.

  18. Periaortic haemangiosarcoma in an African wild dog (Lycaon pictus : clinical communication

    Directory of Open Access Journals (Sweden)

    A. Newell-Fugate

    2009-05-01

    Full Text Available A 9-year-old apparently healthy male African wild dog (Lycaon pictus was found dead in its enclosure at the De Wildt Cheetah and Wildlife Centre. Necropsy revealed a pericardium distended by approximately 250mℓ of thick blood. A soft, red, lobulated mass was attached to the periaortic fat between the level of the aortic valves and the pericardial reflection. Histologically, the mass was consistent with a haemangiosarcoma. Other findings in the heart included mild to moderate ventricular hypertrophy and moderate, acute perivascular myocardial necrosis. Sudden death was attributed to acute heart failure precipitated by cardiac tamponade.

  19. Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection

    DEFF Research Database (Denmark)

    Bonser, Robert S; Ranasinghe, Aaron M; Loubani, Mahmoud;

    2011-01-01

    Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for...... malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection......-related complications in the proximal and downstream aorta. No randomized trials of treatment or techniques have ever been performed, and novel therapies-particularly with regard to extent of surgery-are being devised and implemented, but their role needs to be defined. Overall, except in highly specialized centers...

  20. [Pyopneumopericardium caused by perforation of gastric ulcer; report of a case].

    Science.gov (United States)

    Segawa, Masataka; Kusajima, Y

    2005-05-01

    Pyopneumopericardium caused by transdiaphragmatic perforation of gastric ulcer is very rare. A 60-year-old man was admitted to our hospital because of chest pain with high fever. The chest computed tomography (CT) revealed hydropneumopericardium. The patient was diagnosed as purulent pericarditis. So emergent pericardiectomy and pericardial drainage were performed to relieve cardiac tamponade. Two findings enabled us to diagnose the causation of pyopneumopericardium as gastropericardial fistura. The first finding was that endoscopic examination of upper gastrointestinal tract revealed a deep peptic ulcer in the dome of gastric fundus. The second finding was that a dye solution which was injected into the pericardial cavity via the drainage tube leaked out into the gastric cavity through the ulcer. This patient improved successfully by the treatment of intravenous hyperalimentation including antibiotics and omeprazole. We think that expedient diagnosis and surgical drainage are essential for successful patient outcome.

  1. Retalho de pericárdio pediculado vascularizado autógeno para aortoplastia e correção da coarctação simples de aorta torácica, ou associada à hipoplasia, atresia ou interrupção do arco aórtico Pediculated autologous vascularized pericardial flap aortoplasty for correction of simple aortic coarctation or associated with hypoplasia, atresia or interruption of aortic arch

    Directory of Open Access Journals (Sweden)

    Paulo Rodrigues da Silva

    2006-12-01

    . CONCLUSÃO: A técnica do emprego do retalho pericárdico pediculado, vascularizado e autógeno é a mais adequada e a mais completa em comparação com todas as outras técnicas cirúrgicas existentes para correção dos diferentes tipos de coarctação da aorta torácica, nas suas formas simples ou associadas a outras lesões aórticas. É indicada em todas as faixas etárias, inclusive em recém-natos.OBJECTIVE: Eighteen years ago, two young male patients of 8 months and 13 years with aortic coarctation associated to aortic hypoplasia between the left subclavian artery and the coarctated area, were submitted to surgical correction using a new world-pioneering surgical technique developed in our service. METHOD: This technique consists of sectioning the patent ductus arteriosus, followed by resection of all the coarctated tissue in the aortic wall and aortoplasty correction by means of the lengthwise implantation of a pediculated autogenous pericardial flap. This flap is inserted into the thoracic aorta, from the root of the left subclavian artery to 2.0 cm below the coarctated area. RESULTS: For both patients, the blood pressure and arterial pulses of both arms and legs have been normal since the surgery until the present moment. Clinical examination and Doppler evaluation evidenced no pressure gradient between arms and legs, normal blood flow and no pressure gradient through the coarctated area. Both patients were submitted to other evaluations 18 years after surgery, including cardiac and thoracic aortic catheterization followed by aortography. These evaluations demonstrated normal aortic configuration, with normal diameter, including the areas above and below the coarctated site. There was no evidence of any kind of degenerative lesions of the vascularized pericardial flap or re-coarctation of the lesion and no signs of aneurysms forming or the presence of atherosclerosis of the flap. Moreover, and very importantly, it was evident that the pediculated completely

  2. Resultados a médio prazo de anuloplastia com órtese maleável de pericárdio bovino na insuficiência mitral reumática Midterm results of annuloplasty repair with bovine pericardial orthesis in rheumatic mitral insufficiency

    Directory of Open Access Journals (Sweden)

    Orlando PETRUCCI JÚNIOR

    1999-04-01

    with rheumatic valve disease underwent mitral valve repair. There were 17 females (73.9% and 6 males (26.1%, all patients with mitral insufficiency or double mitral dysfunction. All of them had no rheumatic activity at time of surgery. Eleven patients (47.8% were in NYHA class III or IV. All patients underwent annuloplasty with bovine pericardial ring, and were evaluated with trans-thoracic echocardiography before surgery and at each six months after sugery. Results: There were no peri-operative deaths. Follow-up time was 25.8 ± 7.8 months, 83.9% patients were free from reoperation in 36.09 ± 1.2 months (confidence interval 33.7 to 38.48 months. Statistically, an improvement occurred in left ventricle and diastolic volume (from 58.52 ± 12.87 to 53 ± 12.15 mm (p = 0.001, and functional class (p = 0.0001. Ejection fraction and left ventricle systolic volume showed no significant improvement. Two patients were reoperated at 22.7 and 28.5 months of follow-up. One patient presented moderate mitral insufficiency and all others showed satisfactory results (mild insufficiency or none. Conclusions: We conclude that mitral valve annuloplasty repair presents good results at mid-term, with improvement of clinical and echocardiographic variables. Reoperation incidence was very low.

  3. Extramedullary Cardiac Multiple Myeloma-A Case Report and Contemporary Review of the Literature.

    Science.gov (United States)

    Coakley, Maria; Yeneneh, Beeletsega; Rosenthal, Allison; Fonseca, Rafael; Mookadam, Farouk

    2016-05-01

    Multiple myeloma (MM) is characterized by a clonal proliferation of plasma cells. Although the bone marrow is the usual site of involvement, extramedullary plasmacytomas (EMPs) also occur, affecting any tissue. Cardiac and pericardial involvement, although described, have been rare occurrences. We present the case of a 61-year-old female patient 47 days after autologous stem cell transplant for MM who developed cardiac tamponade owing to extramedullary recurrence of myeloma, pulmonary embolism, and takotsubo cardiomyopathy. We performed a review of the published studies of all cases of MM presenting at diagnosis or relapse with cardiac or pericardial involvement in the past 25 years. Including our patient, 34 patients with plasmacytoma involving cardiac or pericardial structures were identified from the literature search. Approximately equal numbers of patients were male and female (42% and 57%, respectively). The mean age was 62 years. Primary plasmacytomas accounted for 12% of the cases. A history of MM, EMP, or monoclonal gammopathy of uncertain significance was noted in two thirds of the cases (66.6%). Treatment included chemotherapy and/or high-dose corticosteroids in 81.1% of cases and 27% underwent radiation therapy. The reporting of all cases to date has focused on unusual findings, rather than treatment approaches or new therapeutic strategies that might benefit patients. We suggest the formation of a database of all cases of cardiac and pericardial EMPs, with a focus on predictive disease variables, standardized staging, outcomes, and survival, to ensure that patients are optimally treated in the modern era. PMID:27009538

  4. Acute pulmonary embolism in helical computed tomography

    International Nuclear Information System (INIS)

    Pulmonary embolism is a common condition in which diagnostic and therapeutic delays contribute to substantial morbidity and mortality. Clinical diagnosis is difficult because the signs and symptoms re unspecific, and a differential diagnosis is extensive, including pneumonia or bronchitis, asthma, myocardial infraction, pulmonary edema, anxiety, dissection of the aorta, pericardial tamponade, lung cancer, primary pulmonary hypertension, rib fracture, and pneumothorax. The purpose of the study was to present the use of CT in diagnosing acute pulmonary embolism. A group of 23 patients with clinically suspected pulmonary embolism underwent CT examination with a helical CT scanner (Somatom Emotion, Siemens) before and after administration of 150 ml of Ultravist. Pulmonary embolism was found in the CT examinations of 13 patients. In two of these it was a central filling defect. Amputation of the artery was found in one. Parietal filling defect in three patients formed an acute angle with the vessel walls. Saddle emboli appearing as filling defects in the contrast column that hung over vessel bifurcations was found in two patients. In five patients,emboli were found in small segmental arteries. CT provides information not only on the pulmonary arteries, but also on the lung parenchyma, hila, mediastinum, and the heart. Alternative findings may be identified by CT chest examination, stablishing alternative diagnoses, including pulmonary disorders (such as pneumonia or fibrosis), pleural abnormalities, and cardiovascular disease (such as aortic dissection or pericardial tamponade). Another advantage of the CT is its widespread availability.(author)

  5. Evaluating condom catheter balloon tamponade in non-traumatic postpartum haemorrhage resistant to medical management

    Directory of Open Access Journals (Sweden)

    Syed Nawaz Ahmad

    2016-06-01

    Conclusions: Placement of a condom catheter balloon can successfully treat non-traumatic PPH refractory to medical management. It is simple, inexpensive, easily, available and in those with successful placement no procedure related morbidity was observed. The potential for it to be used by inexperienced operators in areas with limited resources makes it a useful tool in management of PPH. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1874-1878

  6. Coronary perforation with tamponade successfully managed by retrograde and antegrade coil embolization

    OpenAIRE

    Boukhris, Marouane; Tomasello, Salvatore Davide; Azzarelli, Salvatore; Elhadj, Zied Ibn; Marzà, Francesco; Galassi, Alfredo Ruggero

    2015-01-01

    In recent years, retrograde approach for chronic total occlusions has rapidly evolved, enabling a higher rate of revascularization success. Compared to septal channels, epicardial collaterals tend to be more tortuous, more difficult to negotiate, and more prone to rupture. Coronary perforation is a rare but potentially life-threatening complication of coronary angioplasty, often leading to emergency cardiac surgery. We report a case of a retrograde chronic total occlusion revascularization th...

  7. [A man with candida pyopneumopericarditis and cardiac tamponade in conjunction with gastric tube infection

    NARCIS (Netherlands)

    Beek, L.M. van; Landman, J.J.; Verheugt, F.W.A.

    2005-01-01

    A 55-year-old man who had undergone oesophagectomy with retrosternal gastric tube reconstruction for oesophageal carcinoma several years before, presented with retrosternal pain, fever and chills. He appeared to have Candida glabratarelated pyopneumopericarditis and a fungal infection in the gastric

  8. Cardiac Tamponade following Mitral Valve Replacement for Active Infective Endocarditis with Ring Abscess

    Directory of Open Access Journals (Sweden)

    R. Ranjan

    2015-01-01

    Full Text Available Periannular extension and abscess formation are rare but deadly complications of infective endocarditis (IE with high mortality. Multimodality cardiac imaging, invasive and noninvasive, is needed to accurately define the extent of the disease. Debridement, reconstruction, and valve replacement, often performed in an emergent setting, remain the treatment of choice. Here we present a case of severe IE in a 29-year-old intravenous drug user who after undergoing debridement of the abscess, annular reconstruction, and mitral valve replacement (MVR presented with recurrence of shortness of breath and pedal edema. Transthoracic echocardiogram (TTE showed a 6.2×5.5 cm cavity, posterior to and communicating with the left ventricle through a 3 cm wide fistulous opening, in proximity of the reconstructed mitral annulus. The patient underwent a redo MVR with patch closure of the fistulous opening, with good clinical outcome. This case highlights the classic TTE findings and the necessity for close follow-up in the perioperative period in patients undergoing surgery for periannular extension of infection. A cardiac magnetic resonance imaging can be considered, preoperatively, in such cases to identify the extent of myocardial involvement and surgical planning.

  9. Probable Hydrochlorothiazide-Induced Myopericarditis: First Case Reported

    Directory of Open Access Journals (Sweden)

    Toufik Mahfood Haddad

    2015-01-01

    Full Text Available Hydrochlorothiazide has never been reported as a reason for myopericarditis. An African American female, with past history of hypertension, coronary artery disease, and sulfa allergy, presented with indolent onset and retrosternal chest pain which was positional, pleuritic, and unresponsive to sublingual nitroglycerin. Her medications included hydrochlorothiazide (HCTZ which was started three months ago for uncontrolled hypertension. Significant laboratory parameters included erythrocyte sedimentation rate (ESR of 47 mm/hr and peak troponin of 0.26 ng/mL. Transthoracic echocardiogram (TTE revealed preserved ejection fraction with no segmental wall motion abnormalities; however, it showed moderate pericardial effusion without tamponade physiology. We hypothesize that this myopericarditis could be due to HCTZ allergic reaction after all other common etiologies have been ruled out. There is a scarcity of the literature regarding HCTZ as an etiology for pericardial disease, with only one case reported as presumed hydrochlorothiazide-induced pericardial effusion. Management involves discontinuation of HCTZ and starting anti-inflammatory therapy.

  10. Effusive-constrictive calcific pericarditis associated with Streptococcus salivarius. Case report and review of the literature.

    Science.gov (United States)

    Rafailidis, Petros I; Prapas, Sotirios N; Kasiakou, Sofia K; Costeas, Xenofon F; Falagas, Matthew E

    2005-01-01

    We report the case of a 40-year-old patient presenting with a 6-month history of dyspnea and edema, with significant worsening of his clinical manifestations for the 2 weeks before admission to our department. During this 14-day preadmission period, continuous positive airway pressure (CPAP) was prescribed elsewhere for management of a working diagnosis of obstructive sleep apnea. The patient presented to us hemodynamically compromised. Management of the patient included emergency cardiac surgery for tamponade caused by effusive-constrictive, calcific pericarditis in addition to antimicrobial treatment as a result of the growth of Streptococcus salivarius from the pericardial fluid. This is the first report in the literature of association of this microorganism with pericarditis. The use of CPAP made the patient's symptoms worse as a result of an increase of the intrathoracic pressure, which was a pathophysiological mechanism, added to the interference of the localized pericardial effusion and the effect of the pericardial constriction. In an era of rapidly increasing use of CPAP systems, clinicians should be aware of their possible detrimental effects on patients with some types of cardiopulmonary diseases. PMID:15831142

  11. Implementation of the updated 2015 Commission for Hospital Hygiene and Infection Prevention (KRINKO) recommendations "Prevention and control of catheter-associated urinary tract infections" in the hospitals in Frankfurt/Main, Germany.

    Science.gov (United States)

    Heudorf, Ursel; Grünewald, Miriam; Otto, Ulla

    2016-01-01

    Ziel: Zur Prävention von Katheter-assoziierten Harnwegsinfektionen hat die Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) im Jahr 2015 neue Empfehlungen publiziert. In diesem Beitrag wird über die Umsetzung dieser Empfehlungen in Frankfurter Krankenhäusern im Herbst 2015 berichtet.Material und Methode: In jedem der 17 Krankenhäuser der Stadt fanden auf jeweils zwei peripheren Stationen (keine Intensivstationen) anhand einer auf Grundlage der neuen KRINKO-Empfehlung erarbeiteten Checkliste Überprüfungen statt, in einer großen Klinik wurden insgesamt 5 Stationen überprüft. Die Überprüfung umfasste die Struktur- und Prozessqualität (Arbeitsanweisungen, Schulungen, Indikation, das Legen und die Pflege von Kathetern) und die Demonstration des Legens eines Katheters an einem fiktiven Patienten oder einem Modell. Ergebnisse: Alle Stationen verfügten über einschlägige Arbeitsanweisungen, in etwa der Hälfte der Stationen fanden auch regelmäßige Schulungen statt. Die Indikationen entsprachen weitgehend den Empfehlungen der KRINKO. Alternativen zum Harnwegskatheter (HWK) waren vorhanden und wurden häufiger eingesetzt als Harnwegskatheter selbst (15,9% vs. 13,5%). Auf eine Antibiotika-Prophylaxe beim Legen des Katheters, die Instillationen antiseptischer oder antimikrobieller Substanzen oder Spülungen wurde in Übereinstimmung mit den Empfehlungen verzichtet. Auch die Demonstration des Katheter-Legens war fachgerecht. Verbesserungsbedarf wurde bei der Dokumentation der täglichen Überprüfung des Fortbestehens der Indikation für den HWK sowie bei dem „regelmäßigen“ Katheterwechsel gesehen. Schlussfolgerung: Insgesamt wurde eine gute Umsetzung der Empfehlungen der KRINKO zur Prävention von Katheter-assoziierten Harnwegsinfektionen vorgefunden. Es ist aber nicht auszuschließen, dass in Situationen mit Zeitdruck und bei Personalknappheit der Umgang mit Harnwegskathetern weniger positiv verläuft, als wie es im Rahmen der Begehung beobachtet wurde. Vor diesem Hintergrund erscheinen – neben ausreichendem Fachpersonal auf den Stationen – regelmäßige Visiten des Hygienefachpersonals auf den Stationen empfehlenswert.

  12. 预防使用抗菌药物对导尿管相关性尿路感染影响的meta分析%Meta-analysis of antibiotics prophylaxis for catheter-associated urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    纪翠芳; 鲁琼; 刘艺平; 彭文兴

    2014-01-01

    目的 系统评价预防使用抗菌药物对降低导尿管相关性尿路感染发生的影响.方法 检索PubMed、Cochrane library、Wiley Online Library、CNKI和万方数字化期刊全文数据库,收集2014年3月以前发表的关于预防使用抗菌药物对导尿管相关性尿路感染影响的随机对照试验,按照纳入标准和排除标准对入选文献进行资料提取、方法学质量评价后,用RevMan 5.2软件进行meta分析,依据研究的异质性与偏倚进行敏感性分析,并采用GRADE系统评价证据质量和推荐等级.结果 最终纳入13个研究,meta分析结果显示:抗菌药物组在拔除导尿管48 h内菌尿症、预防用药结束后7d内菌尿症、单剂量干预结束后菌尿症、预防用药结束后脓尿、预防用药结束后尿培养阳性方面与对照组比较,合并效应量的异质性小且有显著性差异.基于结局指标的GRADE系统的证据推荐等级评价显示:抗菌药物组与对照组比较的12个结局指标中,除留置期间菌尿症、预防用药结束后发热和随访期间脓尿这3个结局指标为低级证据外,其余均为高级证据.抗菌药物组可有效降低拔除导尿管48 h内菌尿症、预防用药结束后7d的菌尿症、单剂量干预后菌尿症、预防用药结束后脓尿、预防用药结束后尿培养阳性等发生.结论 目前有效证据支持术前无尿路感染患者(如糖尿病患者或免疫缺陷患者等)围手术期后短期留置导尿管时,拔除导尿管前或后48 h内预防使用单剂量抗菌药物可有效减少继发尿路感染的发生.该结论还需要更多高质量大样本随机对照试验加以证明.

  13. Rationale and design of the HEALTHY-CATH trial: A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2009-08-01

    Full Text Available Abstract Background Catheter-related bacteraemias (CRBs contribute significantly to morbidity, mortality and health care costs in dialysis populations. Despite international guidelines recommending avoidance of catheters for haemodialysis access, hospital admissions for CRBs have doubled in the last decade. The primary aim of the study is to determine whether weekly instillation of 70% ethanol prevents CRBs compared with standard heparin saline. Methods/design The study will follow a prospective, open-label, randomized controlled design. Inclusion criteria are adult patients with incident or prevalent tunneled intravenous dialysis catheters on three times weekly haemodialysis, with no current evidence of catheter infection and no personal, cultural or religious objection to ethanol use, who are on adequate contraception and are able to give informed consent. Patients will be randomized 1:1 to receive 3 mL of intravenous-grade 70% ethanol into each lumen of the catheter once a week and standard heparin locks for other dialysis days, or to receive heparin locks only. The primary outcome measure will be time to the first episode of CRB, which will be defined using standard objective criteria. Secondary outcomes will include adverse reactions, incidence of CRB caused by different pathogens, time to infection-related catheter removal, time to exit site infections and costs. Prospective power calculations indicate that the study will have 80% statistical power to detect a clinically significant increase in median infection-free survival from 200 days to 400 days if 56 patients are recruited into each arm. Discussion This investigator-initiated study has been designed to provide evidence to help nephrologists reduce the incidence of CRBs in haemodialysis patients with tunnelled intravenous catheters. Trial Registration Australian New Zealand Clinical Trials Registry Number: ACTRN12609000493246

  14. The prevention and management of complications during and immediately after percutaneous balloon mitral valvuloplasty

    International Nuclear Information System (INIS)

    Objective: To approach the cause and treatment of complication during and immediately after percutaneous balloon mitral valvuloplasty. Methods: One thousand three hundred and eleven patients with mitral stenosis were treated by percutaneous transseptal balloon mitral valvuloplasty. Among them, 42 patients with complications were retrospectively analyzed. Results: The overall complications rate was 3.2% (42/1311) including atrial fibrillation 0.8% (10/1311), acute pericardial tamponade 0.31% (4/1311), severe mitral insufficiency 0.46% (6/1311), femoral arterial venous fistula 0.69% (9/1311), acute pulmonary edema and iatrogenic atrial septal defect 0.23% (3/1311), respectively. Coronary air embolism, arterial thrombosis and transient cerebrovascular accident was 0.15% (2/1311) for every other one. Balloon rupture was 0.08%(1/1311). Conclusions: The complications of percutaneous balloon mitral valvuloplasty rarely occur. It is a safe and efficient nonsurgical method for treating rheumatic mitral stenosis

  15. Percutaneous left atrial appendage closure: Technical aspects and prevention of periprocedural complications with the watchman device

    Institute of Scientific and Technical Information of China (English)

    Sven; M?bius-Winkler; Nicolas; Majunke; Marcus; Sandri; Norman; Mangner; Axel; Linke; Gregg; W; Stone; Ingo; D?hnert; Gerhard; Schuler; Peter; B; Sick

    2015-01-01

    Transcatheter closure of the left atrial appendage has been developed as an alternative to chronic oral anticoagulation for stroke prevention in patients with atrial fibrillation, and as a primary therapy for patients with contraindications to chronic oral anticoagulation. The promise of this new intervention compared with warfarin has been supported by several, small studies and two pivotal randomized trial with the Watchman Device. The results regarding risk reduction for stroke have been favourable although acute complications were not infrequent. Procedural complications, which are mainly related to transseptal puncture and device implantation, include air embolism, pericardial effusions/tamponade and device embolization. Knowledge of nature, management and prevention of complications should minimize the risk of complications and allow transcatheter left atrial appendage closure to emerge as a therapeutic option for patients with atrial fibrillation at risk for cardioembolic stroke.

  16. Successful resuscitation from two cardiac arrests in a female patient with critical aortic stenosis, severe mitral regurgitation and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Mijušković Dragan

    2012-01-01

    Full Text Available Introduction. The incidence of sudden cardiac death in patients with severe symptomatic aortic stenosis is up to 34% and resuscitation is described as highly unsuccessful. Case report. A 72-year-old female patient with severe aortic stenosis combined with severe mitral regurgitation and three-vessel coronary artery disease was successfully resuscitated following two in-hospital cardiac arrests. The first cardiac arrest occurred immediately after intraarterial injection of low osmolar iodinated agent during coronary angiography. Angiography revealed 90% occlusion of the proximal left main coronary artery and circumflex branch. The second arrest followed induction of anesthesia. Following successful open-chest resuscitation, aortic valve replacement, mitral valvuloplasty and three-vessel aortocoronary bypass were performed. Postoperative pericardial tamponade required surgical revision. The patient recovered completely. Conclusion. Decision to start resuscitation may be justified in selected patients with critical aortic stenosis, even though cardiopulmonary resuscitation in such cases is generally considered futile.

  17. Spontaneous aortic dissecting hematoma in two dogs.

    Science.gov (United States)

    Boulineau, Theresa Marie; Andrews-Jones, Lydia; Van Alstine, William

    2005-09-01

    This report describes 2 cases of spontaneous aortic dissecting hematoma in young Border Collie and Border Collie crossbred dogs. Histology was performed in one of the cases involving an unusual splitting of the elastin present within the wall of the aorta, consistent with elastin dysplasia as described in Marfan syndrome in humans. The first case involved a young purebred Border Collie that died suddenly and the second case involved a Border Collie crossbred dog that died after a 1-month history of seizures. Gross lesions included pericardial tamponade with dissection of the ascending aorta in the former case and thoracic cavity hemorrhage, mediastinal hematoma, and aortic dissection in the latter. Histologic lesions in the case of the Border Collie crossbred dog included a dissecting hematoma of the ascending aorta with elastin dysplasia and right axillary arterial intimal proliferation. PMID:16312247

  18. E-FAST:A propos of hemopericardium in the Emergency Department

    Institute of Scientific and Technical Information of China (English)

    Alejandro Cardozo; Federico Puerta; Libardo Valencia

    2016-01-01

    The extended-focused assessment with sonography in trauma is still recognized as a technique approach to patients whose trauma involves the chest and the abdomen, with the aim of ruling out conditions as pneumothorax, hemothorax, pericardial effusion/cardiac tamponade, and intraperitoneal free fluid. Although CT is the gold standard test, the inconvenience of moving unstable patients and the amount of time it takes to carry it out, makes it not always possible in the Emergency Department, which positions the ultrasound as an ideal tool in the evaluation of patients with trauma in the Emergency Department. In this case report, we presented the case of a patient who complains of multiple stab wounds, and the extended-focused assessment with sonography in trauma confirmed the diagnostic impressions.

  19. CT of left ventricular assist devices.

    Science.gov (United States)

    Carr, Carrie M; Jacob, Jaisy; Park, Soon J; Karon, Barry L; Williamson, Eric E; Araoz, Philip A

    2010-03-01

    Left ventricular assist devices (LVADs) have become an increasingly beneficial option for patients with heart failure, especially in light of the insufficient availability of donor hearts. LVADs have been used effectively in end-stage heart failure as a bridge to heart transplantation, as destination therapy for those ineligible for transplantation, or as a bridge to myocardial recovery. Presently, a wide variety of LVADs are being used therapeutically. Four different LVADs have been used at the authors' institution. The records of 42 patients who underwent implantation of 46 total LVADs during a 17-month period were reviewed; in 23 of these patients, computed tomography of the device was performed. Increased use of LVADs necessitates understanding of the normal positioning of a variety of these devices and recognition of potential complications, which include inflow and outflow cannula complications, postoperative hemorrhage, pericardial tamponade, thrombus formation, aortic valve stenosis, aortic valve insufficiency, right-sided heart failure, and infection. PMID:20228327

  20. Severe necrotizing myocarditis caused by serratia marcescens infection in an axolotl (Ambystoma mexicanum).

    Science.gov (United States)

    Del-Pozo, J; Girling, S; Pizzi, R; Mancinelli, E; Else, R W

    2011-05-01

    This report provides the first account of the pathological changes associated with infection by Serratia marcescens in an adult male axolotl. The infection resulted in septicaemia with severe multifocal necrotizing myocarditis. The latter lesion evolved to cardiac rupture, haemopericardium and death resulting from cardiac tamponade. This animal was exposed to higher than usual temperatures (24-25 °C) 2 weeks before the onset of disease and this may have resulted in immunocompromise and opportunistic bacterial infection. S. marcescens was isolated from the coelomic and pericardial cavity. Both isolates were identical and were resistant to β-lactam antibiotics, but not to aminoglycosides or fluoroquinolones. The production of red prodigiosin pigment by the bacterium suggested an environmental origin. Overall, the clinical and histopathological presentation suggests that S. marcescens should be included in the list of aetiological agents of the 'red-leg'/bacterial dermatosepticaemia syndrome of amphibians.

  1. Kidney allograft tolerance in diabetic patients after total lymphoid irradiation (TLI)

    Energy Technology Data Exchange (ETDEWEB)

    Ang, K.K.; Vanrenterighem, Y.; Waer, M.; Michielsen, P.; Schueren, E. van der (University Hospital St. Rafael, Leuven (Belgium)); Vandeputte, M. (Louvain Univ. (Belgium). Rega Institute for Medical Research)

    1985-04-01

    The value of total lymphoid irradiation (TLI) combined with low dose prednisone as sole immunosuppressive regimen in renal allograft transplantation in humans has been investigated. Seventeen patients with end-stage diabetic nephropathy received TLI to a cumulative dose of 20-30 Gy in fractions of 1 Gy. Cadaver kidneys were grafted as soon as they were available after completion of TLI. Profound and long-term immunosuppression has been achieved in 17 patients. Six patients live already more than one year and 7 for less than one year with a functioning kidney graft. One patient returned to chronic hemodialysis 11 months after transplantation and died of pericardial tamponade one month later. One patient had severe acute rejection for which cyclosporine A was administered; he died of septic shock as a consequence of immune deficiency a month later. The other two patients succumbed to other causes (myocardial infarction and hyperglycemia).

  2. Ultrasound for critical care physicians: hypotension after a MVA

    Directory of Open Access Journals (Sweden)

    Schmitz E

    2014-03-01

    Full Text Available No abstract available. Article truncated after first page. A 25 year old woman was a restrained driver in a rollover motor vehicle accident (MVA and suffered a C5-C6 fracture-dislocation with spinal cord injury. She was lucid and able to follow commands and could move her upper extremities but not her lower extremities. She was given approximately 6 liters of fluid but required vasopressors to maintain her blood pressure. Initial ECG revealed a normal sinus rhythm without significant ST changes (Figure 1. Upon initial evaluation her blood pressure was low. Bedside ultrasound of the left anterior second intercostal space revealed a sliding lung sign and a 4 chamber view of her heart was performed (Figure 2. Which of the following is the most likely cause of her hypotension? 1. Blunt cardiac injury; 2. Intravascular volume depletion; 3. Neurogenic stunned myocardium; 4. Pericardial tamponade; 5. Pneumothorax ...

  3. Thrombolytic-related complication in a case of misdiagnosed myocardial infarction.

    Science.gov (United States)

    Irivbogbe, Osereme; Mirrer, Brooks; Loarte, Pablo; Gale, Michael; Cohen, Ronny

    2014-06-01

    The importance of early thrombolysis in acute myocardial infarction has been highlighted in several large trials. The clinical decision is often taken by physicians who need to take a rapid action with the risk of misdiagnosing non-coronary events that mimic myocardial infarction. Here we describe a case of acute pericarditis in a 37-year-old man whom received thrombolysis and developed a sudden hemorrhagic pericardial effusion that evolved rapidly into a cardiac tamponade. These errors leading to lethal thrombolysis complications have been surprisingly rare; but a correct diagnosis of aortic dissection or hemorrhagic pericarditis needs to be stressed because even after obtaining the correct diagnosis, the prolonged disturbance of hemostasis prevents a rapid therapy being instigated. PMID:24749992

  4. In vitro properties and performance of glutaraldehyde-crosslinked bovine pericardial bioprostheses treated with glutamic acid.

    Science.gov (United States)

    Braile, Maria Christiane Valéria Braga; Carnevalli, Nelly Cristina; Goissis, Gilberto; Ramirez, Vladimir Aparecido; Braile, Domingo Marcolino

    2011-05-01

    Calcification is one of the major causes of failure of heart valve bioprostheses (HVBs) derived from glutaraldehyde (GA)-processed bovine pericardium (BP) or porcine aortic valves. New crosslinking reagent procedures are still far from giving satisfactory results, and this is the main reason why GA is still the reagent of choice for the fixation of native tissue intended for HVB manufacture. Nevertheless, two new findings with respect to GA processing may significantly improve HVB performance postimplantation: the finding that increasing concentrations of GA result in a decrease in calcification; the blocking of free aldehyde usually by nucleophyles or the treatment of processed material at low pH. This work investigates the in vitro properties of BP fixed with GA followed by the treatment with glutamic acid under alkaline conditions in order to prepare BP materials with lower calcification potential postimplantation. In comparison to conventional processing, except for the tensile strength that was slightly lower, elongation and toughness were higher than the accepted values. No significant differences were observed in the performance indexes (mean pressure gradient, mean effective area, regurgitant fraction, performance and efficiency indexes) with wear resistance over 150 × 10⁶ cycles. These results indicate that the processing of BP described in this work may be of potential use in the manufacture of HVBs. PMID:21595718

  5. Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

    Directory of Open Access Journals (Sweden)

    Johan S.J. Manshanden

    2015-09-01

    Conclusions: CPPF after cardiac surgery was found to be safe and feasible in this experimental setting. The clinically relevant effect on blood loss needs to be confirmed in a randomized clinical trial.

  6. Elastin and Mechanics of Pig Pericardial Resistance Arteries (pPRA)

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Leurgans, Thomas; Rosenstand, Kristoffer;

    Resistance arteries are remodeled in hypertension and diabetes. Elastin was reported to play a role herein. The parietal pericardium is opened during cardio-thoracic surgeries and might be a valuable biopsy for research in cardio-vascular diseases. We tested the hypothesis that resistance arterie...... can be isolated from the pericardium to study the micro-architecture of elastin and vascular wall mechanics. The pericardium of pigs served to test the hypothesis. pPRAs were microdissected. Their structure was examined using multiphoton excitation fluorescence microscopy. Diameter......-tension and pressure-diameter-length relationships were recorded in myographs. Findings are compared to rodent mesenteric resistance arteries and –basilar arteries (rMRA, rBA) with comparable lumen diameter (±300µm at 100mmHg). pPRA have no clear external elastic lamina (present in rMRA, but not rBA), scant elastin...... fibrils between their medial smooth muscle cells and a net-stocking-like internal elastic lamina underneath the endothelium (perforated sheet with fenestrae in rMRA and rBA). Isolated pPRA lengthen ~30% when pressurized to 100mmHg, like rMRA but not rBA (lumen is ~15% (

  7. An Echo-Dense Cap in the Pericardial Space After Acute Myocardial Infarction: A Case Report

    OpenAIRE

    Alizadehasl; Gholampour; Madani, MR; Peighambari; Pazouki; Kazem Mousavi

    2015-01-01

    Acute myocardial infarction can culminate in sudden cardiac death due to cardiogenic shock and ventricular fibrillation, and also rarely due to cardiac rupture. We present a case of post-infarction myocardial rupture after thrombolytic therapy diagnosed with transthoracic echocardiography and treated with direct closure and coronary artery bypass grafting.

  8. Forensic expertise of thoracic aorta, heart and pericardial injuries in car-occupant fatalities

    Directory of Open Access Journals (Sweden)

    Nikolić Slobodan

    2009-01-01

    Full Text Available Introduction. Forensic expertise has not specified with certainty any specific injury among fatally injured frontal car-occupants in frontal car collisions. Objective. To establish if blunt injuries of thoracic aorta, heart, and pericardium could be used as predictors where the fatally injured car-occupant was at the moment of car-collision. Methods. A retrospective autopsy study was performed. The subjects were fatally injured car-drivers, front-seat and rearseat passengers in head-on car collisions. In each of them we analyzed the injuries of thoracic aorta, heart and pericardium. Results. 492 subjects were analyzed (378 male and 104 female: 239 car-drivers, 194 front-seat and 49 rear-seat passengers. The isthmus of aorta was the commonest site of simple blunt rupture among car-drivers and front-seat passengers. Among more than half of the observed subject, there was aortic blunt rupture as concomitant injury with heart and pericardium injuries. Heart and pericardium ruptures were most common among fatally injured car-drivers. Most frequently injured part of the heart was the right atrium. Injuries of thoracic aorta, heart and pericardium indicated a higher probability that the fatally injured would be the car-driver (λ=0.818; df=2; p=0.011, λ=0.906; df=2; p=0.000, and λ=0.951; df=2; p=0.000; this was also pointed out by the rupture of the right atrium and multiple ruptures of the thoracic aorta (λ=0.966; df=2; p=0.000 and λ=0.918; df=2; p=0.009. The concomitant injuries of the thoracic aorta with thoracic spine, sternum and heart pointed out that the injured person was the car-driver (λ=0.971; df=4; p=0.007, λ=0.974; df=4; p=0.013 and λ=0.958; df=4; p=0.000, as well as the concomitant injuries of heart and sternal fracture (λ=0.960; df=4; p=0.001. The probability of about 80% that the fatally injured person in head-on collisions was a car-driver was pointed out by concomitant blunt thoracic aorta rupture with fractured sternum and ribs (Wald. coeff.=8.611; df=1; p=0.003, and Wald. coeff.=3.875; df=1; p=0.049. Conclusion. The basic mechanism of the injury of thoracic organs is deceleration, as well as anteroposterior compression with caudorostral hyperextension. That is why thoracic organ injuries are mostly concomitant. Fatally injured car-drivers suffered more often of these injuries than other car-occupants. The probability that the fatally injured was the car-driver rises with the number of concomitant injuries of thoracic aorta, heart and pericardium, as well as with the fractured thoracic-cage bones.

  9. Lymphangiopathy in neurofibromatosis 1 manifesting with chylothorax, pericardial effusion, and leg edema

    OpenAIRE

    Finsterer J; Stollberger C; Stubenberger E; Tschakoschian S

    2013-01-01

    Josef Finsterer,1 Claudia Stollberger,2 Elisabeth Stubenberger,3 Sasan Tschakoschian4 1Krankenanstalt Rudolfstiftung, Vienna, Austria; 2Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria; 3Thoracic Surgery Department, Vienna, Austria; 4Interne Lungenabt, Vienna, Austria Background: This case report documents the affliction of the lymph vessels as a phenotypic feature of neurofibromatosis-1 (NF-1). Methodology: Routine transthoracic echocardiography, computed tomography scan o...

  10. Diagnosis and treatment of type A dissection of the aorta - an interdisciplinary challenge

    International Nuclear Information System (INIS)

    Acute dissection of the ascending aorta is a life-threatening disease. Successful management requires close teamwork of internal medical specialist, radiologist and cardiovascular surgeon. The diagnostic and therapeutic approach is reviewed on the basis of 18 of our own cases - 15 men and 3 women aged from 42 to 88 years. Peculiarities of history, pain and ECG give valuable clues to the differentiation of aortic dissection from myocardial infarction and massive pulmonary embolism. As a non-invasive rapidly available diagnostic method echocardiography may yield decisive information about the aortic root and the presence of pericardial effusion. Definite confirmation of diagnosis is accomplished by aortography and/or computed tomography. Blood pressure and aortic flow must be decreased to the lowest level tolerated by the patient to prevent pericardial tamponade or rupture into the mediastinum. The urgency of surgical repair is underlined by a median survival time of 12 hours from onset of symptoms to death with conservative treatment. 7 of our patients were operated on. In 6 cases surgery was performed by means of extracorporeal circulation and the ascending aorta was replaced by a graft. 3 patients survived the operation (2 for over 2 years and three died in the postoperative period due to cerebral and pulmonary complications). In one case with inoperable dissection an axillo-femoral bypass was performed for relief of complete ischaemia of the left lower limb. Postoperatively, maintainance of the patient's blood pressure at the low normal level is mandatory. (Author)

  11. Immune reactions in tuberculous and chronic constrictive pericarditis. Clinical data and diagnostic significance of antimyocardial antibodies.

    Science.gov (United States)

    Maisch, B; Maisch, S; Kochsiek, K

    1982-11-01

    Humoral immune reactions were analyzed in 12 patients with exudative tuberculous pericarditis, 10 patients with constrictive pericarditis due to former tuberculosis, 10 patients with viral pericarditis, 20 patients with pulmonary tuberculosis, and 98 healthy donors. Pericarditis occurred in 12.5% of the patients with tuberculosis, whereas the incidence of tuberculosis in the 149 patients with pericarditis was 8%. Repeated pericardial puncture and pericardial effusions of greater than 500 ml with impending cardiac tamponade had to be performed in 4 patients. Clinical data indicated probable myocardial involvement in 4 of 12 patients. Antimyolemmal antibodies, which are a muscle-specific subtype of antisarcolemmal antibodies, were found in all patients with exudative tuberculous pericarditis and viral perimyocarditis, in only 1 of 12 patients with constrictive pericarditis, and in no patients with pulmonary tuberculosis. Antifibrillary antibodies--primarily of the antimyosin type--were missed in patients with viral heart disease but were demonstrated in 75% of patients with tuberculous pericarditis. Only sera with complement-fixing antimyolemmal antibodies of the IgG type in titers greater than 1:40 induced cytolysis of vital adult heterologous cardiocytes isolated and enriched by silica sol gradient centrifugation. These findings suggest not only that antimyolemmal antibodies are diagnostic indicators of perimyocardial involvement in tuberculous pericarditis, but also that they may play a significant role in its pathogenesis. PMID:6753555

  12. Extremely high ferritin level after an acute myocardial infarction in an end stage renal disease patient.

    Science.gov (United States)

    Sandhu, Gagangeet; Mankal, Pavan; Gupta, Isha; Tagani, Adrian; Ranade, Aditi; Jones, James; Bansal, Anip

    2014-07-01

    We present here a case of an asymptomatic end-stage renal disease (ESRD) patient, who had an unexplained persistent mild leukocytosis in the setting of an extremely high ferritin level (8,997 ng/ml; reference range: 12 - 300 ng/ml) 3 weeks after she suffered from a myocardial infarction (MI). Infection as the cause of these laboratory abnormalities was ruled out. A week later, the patient was noted to have asymptomatic hypotension (100/60 mmHg; her baseline blood pressure was 120/70 mmHg) during a maintenance hemodialysis session. An echocardiography revealed an interval development of moderate pericardial effusion when compared to her previous echocardiography 4 weeks before. In the setting of a recent MI with other laboratory markers suggesting an ongoing inflammatory process, a tentative diagnosis of Dressler's syndrome was made. A pericardial tap yielded exudative (bloody) fluid, thus, confirming our suspicion. Dressler's syndrome results from an inflammation of the pericardium as a consequence of an underlying autoimmune process few weeks to months after a myocardial infarction or post-cardiac surgery. Although it typically presents with pleuritic chest pain, fever, leukocytosis, and a friction rub; our case illustrates that the initial presentation may be asymptomatic in ESRD patients. For the same reason, it is likely an under-recognized entity in such patients. An unexplained elevated ferritin in an ESRD patient with recent history of MI should prompt an investigation for Dressler's syndrome. In those with associated significant pericardial effusion, daily HD should be initiated and anticoagulation should be avoided. Unlike other ESRD associated pericarditis, steroids and NSAIDs should be avoided in Dressler's syndrome as they may hamper cardiac remodeling in the immediate post-MI period. Colchicine may offer some benefit in patients with associated chest pain. For those failing medical management or manifesting overt signs of tamponade, surgical drainage

  13. Echokardiographie aktuell: Massiv tamponierender Perikarderguss?

    Directory of Open Access Journals (Sweden)

    Böck R

    2008-01-01

    beinhaltet in erster Linie folgende Parameter:br 1. Ausmaß des Ergussesbr 2. Vorhandensein von Tamponadezeichenbr 3. Entzündungszeichen: typ. Thoraxschmerz, Perikardreiben, Fieber 37 °C, diffuse ST-Hebungbr Hinweise für assoziierte spezifische Diagnosen sind:br • Entzündungszeichen: akute idiopathische Perikarditisbr • großer Erguss ohne Tamponade oder Entzündungszeichen: chronisch idiopathischer Perikardergussbr • Tamponade ohne Entzündungszeichen: Malignom [2]br Labortests v. a. im Hinblick auf klinische Verdachtsdiagnose sind zweckmäßig, liegen keine klinischen Hinweise vor, ist eine extensive Labortestung jedoch wenig sinnvoll. Routinemäßig sollte durchgeführt bzw. untersucht werden:br • komplettes Blutbildbr • Blutchemiebr • Nierenparameterbr • SD-Parameterbr • Lupusserologiebr • HIVbr • CT-Thoraxbr Aufgrund des geringen diagnostischen Gewinns ist eine routinemäßige Perikarddrainage nicht notwendig, sie sollte jedoch durchgeführt werden bei:br • Tamponadezeichenbr • Verdacht auf TB, purulentem oder malignem Ergussbr • größerem Erguss, nicht auf antiinflammatorische Therapie ansprechendbr Folgende Untersuchungen aus dem Perikardpunktat erscheinen sinnvoll:br Kultur, Zytologie, PCR, Adenosin-Deaminase (TB.p bLiteratur:/bbr 1. Atar S, Chiu J, Forrester JS, Siegel RJ. Bloody pericardial effusion in patients with cardiac tamponade: is the cause cancerous, tuberculous, or iatrogenic in the 1990s? Chest 1999; 116: 1564–9.br 2. Sagristà-Sauleda J, Mercé J, Permanyer-Miralda G, Soler-Soler. Clinical clues to the causes of large pericardial effusions. Am J Med 2000; 109: 95–101.br

  14. Decreased Bioenergetic Health Index in monocytes isolated from the pericardial fluid and blood of post-operative cardiac surgery patients

    OpenAIRE

    Kramer, Philip A.; Chacko, Balu K.; George, David J.; Zhi, Degui; Wei, Chih-Cheng; Dell'Italia, Louis J.; Melby, Spencer J.; George, James F.; Darley-Usmar, Victor M.

    2015-01-01

    Translational bioenergetics requires the measurement of mitochondrial function in clinically relevant samples and the integration of the data in a form that can be applied to personalized medicine. In the present study, we show the application of the measurement of the Bioenergetic Health Index (BHI) to cardiac surgery patients.

  15. Comparison between three types of stented pericardial aortic valves (Trivalve trial): study protocol for a randomized controlled trial

    OpenAIRE

    Azarnoush, Kasra; Pereira, Bruno; Dualé, Christian; Dorigo, Enrica; Farhat, Mehdi; Innorta, Andrea; Dauphin, Nicolas; Geoffroy, Etienne; Chabrot, Pascal; Camilleri, Lionel

    2013-01-01

    International audience BackgroundAortic valve stenosis is one of the most common heart diseases in older patients. Nowadays, surgical aortic valve replacement is the 'gold standard' treatment for this pathology and the most implanted prostheses are biological ones. The three most implanted bovine bioprostheses are the Trifecta valve (St. Jude Medical, Minneapolis, MN, USA), the Mitroflow valve (Sorin Group, Saluggia, Italy), and the Carpentier-Edwards Magna Ease valve (Edwards Lifesciences...

  16. A review of the safety aspects of radio frequency ablation

    Directory of Open Access Journals (Sweden)

    Abhishek Bhaskaran

    2015-09-01

    Full Text Available In light of recent reports showing high incidence of silent cerebral infarcts and organized atrial arrhythmias following radiofrequency (RF atrial fibrillation (AF ablation, a review of its safety aspects is timely. Serious complications do occur during supraventricular tachycardia (SVT ablations and knowledge of their incidence is important when deciding whether to proceed with ablation. Evidence is emerging for the probable role of prophylactic ischemic scar ablation to prevent VT. This might increase the number of procedures performed. Here we look at the various complications of RF ablation and also the methods to minimize them. Electronic database was searched for relevant articles from 1990 to 2015. With better awareness and technological advancements in RF ablation the incidence of complications has improved considerably. In AF ablation it has decreased from 6% to less than 4% comprising of vascular complications, cardiac tamponade, stroke, phrenic nerve injury, pulmonary vein stenosis, atrio-esophageal fistula (AEF and death. Safety of SVT ablation has also improved with less than 1% incidence of AV node injury in AVNRT ablation. In VT ablation the incidence of major complications was 5–11%, up to 3.4%, up to 1.8% and 4.1–8.8% in patients with structural heart disease, without structural heart disease, prophylactic ablations and epicardial ablations respectively. Vascular and pericardial complications dominated endocardial and epicardial VT ablations respectively. Up to 3% mortality and similar rates of tamponade were reported in endocardial VT ablation. Recent reports about the high incidence of asymptomatic cerebral embolism during AF ablation are concerning, warranting more research into its etiology and prevention.

  17. Echocardiography integrated ACLS protocol versus conventional cardiopulmonary resuscitation in patients with pulseless electrical activity cardiac arrest

    Institute of Scientific and Technical Information of China (English)

    Mojtaba Chardoli; Farhad Heidari; Helaleh Rabiee; Mahdi Sharif-Alhoseini; Hamid Shokoohi; Vafa Rahimi-Movaghar

    2012-01-01

    Objective: To examine the utility of bedside echocardiography in detecting the reversible causes of pulseless electrical activity (PEA) cardiac arrest and predicting the resuscitation outcomes.Methods: In this prospective interventional study,patients presenting with PEA cardiac arrest were randomized into two groups.In Group A,ultrasound trained emergency physicians performed echocardiography evaluating cardiac activity,right ventricle dilation,left ventricle function,pericardial effusion/tamponade and ⅣC size along with the advanced cardiac life support (ACLS) protocol.Patients in Group B solely underwent ACLS protocol without applying echocardiography.The presence or absence of mechanical ventricular activity (MVA) and evidences of PEA reversible causes were recorded.The return of spontaneous circulation (ROSC) and death were evaluated in both groups.Results: One hundred patients with the mean age of (58±6.1) years were enrolled in this study.Fifty patients (Group A) had echocardiography detected in parallel with cardiopulmonary resuscitation (CPR).Among them,7 patients (14%) had pericardial effusion,11 (22%) had hypovolemia,and 39 (78%) were revealed the presence of MVA.In the pseudo PEA subgroup (presence of MVA),43% had ROSC (positive predictive value) and in the true PEA subgroup with cardiac standstill (absence of MVA),there was no recorded ROSC (negative predictive value).Among patients in Group B,no reversible etiology was detected.There was no significant difference in resuscitation results between Groups A and B observed (P=0.52).Conclusion: Bedside echocardiography can identify some reversible causes of PEA.However,there are no significant changes in survival outcome between the echo group and those with traditional CPR.

  18. Intracardiac Leakage of Cement During Kyphoplasty and Vertebroplasty: A Case Report

    Science.gov (United States)

    Audat, Ziad A.; Alfawareh, Mohammad D.; Darwish, Fayeq T.; Alomari, Ali A.

    2016-01-01

    Patient: Male, 28 Final Diagnosis: Intracardial cortoss leak Symptoms: Back pain Medication: — Clinical Procedure: Kyphoplasty Specialty: Orthopedics and Traumatology Objective: Diagnostic/therapeutic accidents Background: Intracardiac leakage of bone cement after kyphoplasty and vertebroplasty is a rare and life-threatening complication. Cortoss, which is an injectable, non-absorbable, polymer composite that is designed to mimic cortical bone, can be used instead of cement. Here, we present the case of a patient with right intra-cardiac Cortoss embolization. Case Report: A 28-year-old man known to have ulcerative colitis since the age of 15 and treated with corticosteroids for more than 4 years and with anti-immune drugs presented to our hospital complaining of back pain and decreased body height due to osteomalacia with failed conservative treatment. Kyphoplasty and vertebroplasty of the thoracic 10–12 and first lumbar vertebrae were done with any complications. Three months later, the patient underwent kyphoplasty and vertebroplasty of lumbar 2–5 vertebrae by injecting Cortoss instead of cement, which was complicated with paravertebral intravascular leakage. We stopped surgery and transferred him to the recovery room, where he had slight chest pain that resolved spontaneously without neurological deficit. Two days later he developed severe chest pain and chest X-ray showed a large white shadow at the right side of the heart and another 2 small shadows just lateral to it. Sudden deterioration of patient status necessitated an emergency echocardiogram, which showed pericardial tamponade and a perforated right ventricle. Aspiration of pericardial blood and emergency open heart surgery were done. He was discharged 4 days later and was followed up at an outpatient clinic. Conclusions: Cardiac embolism is a serious condition that can complicate vertebral kyphoplasty; it requires a high level of suspicion and immediate action, and may need open heart surgery to

  19. Invasive and Ultrasound Based Monitoring of the Intracranial Pressure in an Experimental Model of Epidural Hematoma Progressing towards Brain Tamponade on Rabbits

    Directory of Open Access Journals (Sweden)

    Konstantinos Kasapas

    2014-01-01

    Full Text Available Introduction. An experimental epidural hematoma model was used to study the relation of ultrasound indices, namely, transcranial color-coded-Doppler (TCCD derived pulsatility index (PI, optic nerve sheath diameter (ONSD, and pupil constriction velocity (V which was derived from a consensual sonographic pupillary light reflex (PLR test with invasive intracranial pressure (ICP measurements. Material and Methods. Twenty rabbits participated in the study. An intraparenchymal ICP catheter and a 5F Swan-Ganz catheter (SG for the hematoma reproduction were used. We successively introduced 0.1 mL increments of autologous blood into the SG until the Cushing reaction occurred. Synchronous ICP and ultrasound measurements were performed accordingly. Results. A constant increase of PI and ONSD and a decrease of V values were observed with increased ICP values. The relationship between the ultrasound variables and ICP was exponential; thus curved prediction equations of ICP were used. PI, ONSD, and V were significantly correlated with ICP (r2=0.84±0.076, r2=0.62±0.119, and r2=0.78±0.09, resp. (all P<0.001. Conclusion. Although statistically significant prediction models of ICP were derived from ultrasound indices, the exponential relationship between the parameters underpins that results should be interpreted with caution and in the current experimental context.

  20. Effect of indomethacin on regulation of juxta-articular bone blood-flow during joint tamponade. An experimental study in puppies

    DEFF Research Database (Denmark)

    Ewald, Henrik Lykke; Holm, I E; Bülow, J;

    1989-01-01

    Prostaglandins are vasoactive substances which are assumed to play a major role in bone metabolism and bone repair. The purpose of the present study was to investigate the effect of indomethacin on the control of epiphyseal bone blood-flow. By means of simultaneous intra-osseous pressure (IOP) an...

  1. Infecção de corrente sanguínea relacionada a cateter venoso central (ICSRC em enfermarias: estudo prospectivo comparativo entre veia subclávia e veia jugular interna Catheter-associated bloodstream infections (CA-BSI in wards: a prospective comparative study between subclavian and jugular access

    Directory of Open Access Journals (Sweden)

    Gustavo Lopes Gomes Siqueira

    2011-09-01

    Full Text Available CONTEXTO: Hemocultura positiva associada a cateter venoso central tem sido estudada em unidades de terapia intensiva (UTI, mas ainda é controverso se o acesso jugular tem maior incidência de complicações infecciosas que o acesso na veia subclávia. OBJETIVO: Comparar índice de infecção entre os acessos na jugular interna e os na veia subclávia em pacientes internados nas enfermarias de cirurgia. MÉTODOS: Estudo prospectivo, descritivo e comparativo com 114 cateteres em 96 pacientes admitidos nas enfermarias de cirurgia de um Hospital Quaternário, tendo como variáveis o local de inserção, número de lumens, tempo de uso, comparando-os com o índice de complicações infecciosas. RESULTADOS: O índice de infecção foi de 9,64% (11 cateteres, sem significância estatística quando comparados o número de lumens (mono versus duplo e infecção (p=0,274; também sem significância estatística a comparação entre o tempo de uso (>14 dias e infecção (p=0,156. Comparando os acessos jugular e subclávia, encontramos significância estatística tendo infecção em 17,2% na subclávia e 1,8% na jugular, com p=0,005. Índice de Hemocultura positivo associado a cateter venoso central foi maior no acesso subclávia quando comparado com jugular interna, com OR 11,2, IC95% (1,4-90,9; p=0,023. CONCLUSÕES: O acesso venoso central na jugular interna tem menor risco de infecção se comparado com subclávia em enfermarias.BACKGROUND: Positive hemoculture associated with central venous catheters has been studied in intensive care units (ICU, but is still controversial if the internal jugular vein access has a higher incidence of infection than subclavian or femoral vein access. OBJECTIVE: To compare catheter-related bloodstream infection (CABSI rates between internal jugular and subclavian vein access in patients admitted to surgical wards. METHODS: This is a prospective, descriptive and comparative study of 114 central venous catheters placed in 96 patients admitted to the surgical wards of a tertiary-care hospital. The following parameters were studied: local of insertion of the catheter (internal jugular versus subclavian, number of lumens (single versus double and duration of use (longer or shorter than 14 days, in order to determine their influence in CABSI rates. RESULTS: The CABSI rate was 9,64% (11 catheters, with no significant statistical differences regarding the number of lumens (p=0.274, and duration of use (p=0.156. The CABSI rate was higher in the subclavian vein than in the internal jugular vein access (OR 11.2, 95%CI 1.4-90.8; p=0.023. CONCLUSIONS: The internal jugular vein access has a lesser incidence of CABSI than subclavian vein access in patients admitted to surgical wards.

  2. 肝素与抗菌药物封管预防中心静脉导管感染的临床对比研究%Comparative study of clinical effects of heparin and antibiotics sealed tubes on prevention of central venous catheter-associated infections

    Institute of Scientific and Technical Information of China (English)

    王红; 邓孝陵; 李小杰; 童峥慧

    2015-01-01

    OBJECTIVE To explore the clinical effects of heparin and antibiotics sealed tubes on prevention of cen‐tral venous catheter‐associated infections in the patients undergoing hemodialysis so as to seek the optimal method and improve the clinical treatment .METHODS A total of 70 patients who underwent central venous catheterization from Feb 2010 to Jan 2014 were recruited as the study objects and divided into the control group with 35 cases and the observation group with 35 cases .The control group was treated with single heparin sealed tube ,while the ob‐servation group was treated with antibiotics sealed tube ,and other treatments were the same .The clinical effects were observed after the treatments ,and the statistical analysis was performed with the use of SPSS 16 .0 software . RESULTS The incidence of central venous catheter‐associated infections was 22 .85% in the control group ,5 .72%in the observation group ;the total incidence of complications was 20 .00% in the control group ,2 .86% in the ob‐servation group ;the catheter indwelling time was (58 .9 ± 17 .8)days in the control group ,(50 .3 ± 15 .3)days in the observation group ,and there was statistically significant difference between the two groups (P<0 .05) .The Staphylococcus aureus ,Streptococcus spp ,and Klebsiella pneumoniae were the predominant pathogens isolated from the patient with infections in the two groups .CONCLUSION The antibiotics sealed tube can reduce the inci‐dence of central venous catheter‐associated infections in the patients undergoing hemodialysis ,with the incidence of complications lower .%目的:探讨肝素与抗菌药物封管预防血液透析患者中心静脉导管感染不同临床效果,以寻找最佳的方法,提高临床诊治水平。方法选取2010年2月-2014年1月70例中心静脉导管患者为研究对象,分为对照组35例,予单纯肝素封管;观察组35例,给予肝素与抗菌药物混合液封管,其余治疗相同,观察治疗后临床效果,数据采用SPSS16.0进行统计分析。结果中心静脉导管感染率对照组为22.85%、观察组为5.72%,并发症总发生率对照组为20.00%、观察组为2.86%,置管时间对照组为(58.9±17.8)d、观察组为(50.3±15.3)d,两组比较差异均有统计学意义(P<0.05);两组感染患者检出病原菌均以金黄色葡萄球菌、链球菌属和肺炎克雷伯菌为主。结论抗菌药物封管可降低血液透析患者中心静脉导管感染的发生,其并发症较低。

  3. Clinical study of catheter-associated urinary tract infections in elderly patients during perioperative period of endovascular interventional surgery%老年患者腔内介入治疗围术期留置尿管泌尿道感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘苏健; 银彩霞; 丁明超; 王意忠; 王斌; 王鸿

    2015-01-01

    OBJECTIVE To explore the risk factors for catheter‐associated urinary tract infections in elderly patients of vascular surgery department during perioperative period of endovascular interventional surgery and put forward the prevention measures so as to reduce the incidence of urinary tract infections .METHODS A total of 98 elderly patients who underwent the endovascular interventional surgery in the vascular surgery department from Jan 2010 to Dec 2012 were enrolled in the study and were randomly divided into the 24‐hour group with 32 cases ,48‐hour group with 33 cases ,and the 72‐hour group with 33 cases ;the risk factors for the catheter‐associated urinary tract infections were statistically analyzed .RESULTS The urinary tract infections occurred in 1 case in the 24‐hour group ,with the infection rate of 3 .1% ;the urinary tract infections occurred in 3 cases in the 48‐hour group ,with the infection rate of 9 .1% ;the urinary tract infections occurred in 5 cases in the no less than 72‐hour group ,with the infection rate of 15 .2% ,there was significant difference among the three groups (P<0 .05) .The Escherichia coli ,Enterococcus f aecalis ,and fungi were the most common pathogens .CONCLUSION It is an effective way to shorten the urinary catheter indwelling time so as to reduce the incidence of urinary tract infections in the elderly patients during the perioperative period .%目的:探讨血管外科老年患者腔内介入治疗围术期留置尿管导致泌尿道感染的危险因素并提出预防措施,以降低泌尿道感染发生率。方法对2010年1月-2013年12月血管外科行腔内介入治疗98例老年患者随机分为24、48、72 h组,分别为32、33、33例,对留置尿管致泌尿道感染的危险因素进行统计分析。结果术后24 h组有1例发生泌尿道感染,感染率为3.1%,术后48h组有3例发生泌尿道感染,感染率为9.1%,术后≥72h组有5例发生,感染率为15.2%,3组比较差异有统计学意义( P<0.05);最常见的病原菌是大肠埃希菌、粪肠球菌和真菌等。结论缩短尿管留置时间可有效降低围术期老年患者泌尿道感染的发生。

  4. Distribution of pathogens causing catheter-associated bloodstream infections in hemodialysis patients and analysis of risk factors%血液透析患者导管相关性血流感染病原菌分布与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    杨春琴; 黄敏; 翁明祥

    2015-01-01

    目的:探讨血液透析患者导管相关性血流感染的病原菌分布及相关危险因素,为制定相应的干预措施提供参考依据。方法回顾性分析286例行中心静脉留置透析导管透析患者的临床资料,记录透析患者的年龄、性别、基础疾病、置管种类及部位、导管留置时间、病原菌培养结果。结果286例留置中心静脉透析导管患者,发生CRBSI 28例,发生率为9.79%;共分离出病原菌28株,其中革兰阳性菌20株占71.44%,以表皮葡萄球菌、金黄色葡萄球菌为主,革兰阴性菌8株占28.56%,以铜绿假单胞菌、大肠埃希菌、褪色沙雷菌为主;年龄>60岁、原发病为糖尿病肾病、导管留置时间>2周、行股静脉置管与CRBSI的发生具有相关性(P<0.05)。结论 CRB‐SI感染病原菌以革兰阳性菌为主,高龄、糖尿病、导管留置时间长、股静脉置管为导管相关性血流感染的危险因素。%OBJECTIVE To explore the distribution of pathogens causing catheter‐associated bloodstream infections in the hemodialysis patients and analyze the related risk factors so as to put forward targeted interventions . METHODS The clinical data of 286 patients who underwent indwelling central venous catheter hemodialysis were retrospectively analyzed;the age ,genders ,underlying diseases ,types of indwelling catheter ,intubation sites , catheter indwelling time ,and result of cultures of pathogens were recorded and observed .RESULTS The catheter‐associated bloodstream infections occurred in 28 of 286 patients undergoing indwelling central venous catheter he‐modialysis ,with the incidence rate of 9 .79% .A total of 28 strains of pathogens have been isolated ,including 20 (71 .44% ) strains of gram‐positive bacteria and 8 (28 .56% ) strains of gram‐negative bacteria;the Staphylococcus epidermidis and Staphylococcus aureus were the predominant species of the gram‐positive bacteria;the Pseudo‐monas aeruginosa ,Escherichia coli ,and Serratia marcescens were dominant among the gram‐negative bacteria . The prevalence of the catheter‐associated bloodstream infections was associated with more than 60 years of age , primary disease of diabetic nephropathy ,catheter indwelling time more than 2 weeks ,and femoral venous cathe‐terization .CONCLUSION The gram‐positive bacteria are dominant among the pathogens causing the catheter‐asso‐ciated bloodstream infections .The risk factors for the catheter‐associated bloodstream infections include the ad‐vanced age ,diabetic mellitus ,long catheter indwelling time ,and femoral venous catheterization .

  5. Open Heart Surgery in a Newly Established Cardiovascular Department: The first 300 cases

    Directory of Open Access Journals (Sweden)

    Kemal Korkmaz

    2016-01-01

    Full Text Available Aim: Evaluation of the results of open heart surgery in a newly established cardiovascular clinic: Ankara Numune Education and Research Hospital. Material and Method: Between June 2012 and January 2014, 300 open heart surgeries were performed. Urgent operation was performed in 22 patients (7.3% because of ST-elevation myocardial infarction and in 1 patient because of left ventricular aneurysm rupture. Coronary artery bypass grafting was performed in 211 (70.3% patients. The other patients underwent various complex operations such as valve repair, Tirone-David procedure and repair of atrioventricular canal defect. Results: In 3 patients (1% hospital mortality was seen. Reoperation was performed in 8 patients (2.6% because of pericardial tamponade and in 9 patients (3% because of bleeding. Atrial fibrillation was developed in 28 patients (9.3% in the postoperative period and normal sinus rhythm was established with medical cardioversion. Intra-aortic balloon pump(IABP was used in 4 patients preoperatively and in 11 patients postoperatively, including 15 patients(%5. Discussion: In the current era, the patients who are consulted to cardiovascular surgery clinics become more chronic, high risk and patients with additional co-morbid diseases because of the developments in interventional cardiology. Our newly established center aims to be a nationally and internationally successful clinic which was proved by low mortality and morbidity rates with a team who follows the developments and constantly educate and trained.

  6. Two-Year Follow-Up after Contact Force Sensing Radiofrequency Catheter and Second-Generation Cryoballoon Ablation for Paroxysmal Atrial Fibrillation: A Comparative Single Centre Study.

    Science.gov (United States)

    Kardos, Attila; Kis, Zsuzsanna; Som, Zoltan; Nagy, Zsofia; Foldesi, Csaba

    2016-01-01

    Background. There are little comparative data on catheter ablation of paroxysmal atrial fibrillation (AF) using the contact force radiofrequency (CF-RF) catheter versus the second-generation cryoballoon (CB2). Methods and results. This is a single center, retrospective, nonrandomized study of 98 patients with symptomatic, drug-refractory paroxysmal AF who underwent their first PVI ablation using either the CB2 (n = 40) or CF-RF (n = 58). The mean age was 60 years with 63% men, a mean LA size of 42 mm. The procedure duration (74 ± 17 versus 120 ± 49 minutes p < 0.05) was shorter for CB2 group; the fluoroscopy time (14 ± 17 versus 16 ± 5 minutes, p = 0.45) was similar. Complete PVI was achieved in 96% of patients with RF-CF and 98% with CB2. Phrenic nerve palsies (2 transient and 1 persistent) occurred exclusively in the CB2 group and 1 severe, nonlethal complication (pericardial tamponade) occurred in the CF-RF group. At 24-month follow-up, the success rate, defined as freedom from AF/atrial tachycardia (AT) after a single procedure without antiarrhythmic drug, was comparable in CF-RF group and CB2 group (65.5% versus 67%, resp., log rank p = 0.54). Conclusion. Both the CB2 and the RF-CF ablation appeared safe; the success rate at 2 years was comparable between both technologies. PMID:27314032

  7. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives. PMID:26905825

  8. Cardiac Penetrating Injuries and Pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    CHEN Shifeng

    2002-01-01

    Objective To discuss the early diagnosis and treatment of cardiac penetrating injuries and pseudoaneurysm. Methods 18 cases of cardiac penetrating injuries, in which 2 cases were complicated with pseudoaneurysm, were diagnosed by emergency operation and color Doppler echocardiography between May 1973 and Dec. 2001 in our hospital. The basis for emergency operation is the injured path locating in cardiac dangerous zone, severe shock or pericardial tamponade. ResultsAmong 18 cases of this study, 17 cases underwent emergency operation. During the operation, 11 cases were found injured in right ventricle, 2 cases were found injured in right atrium, 1 case was found injured in pulmonary artery,4 cases were found injured in left ventricle, 2 cases were found complicated with pseudoaneurysm. 17cases underwent cardiac repair including 1 case of rupture of aneurysm. 1 case underwent elective aneurysm resection. In whole group, 15 cases survived(83.33% ), 3 cases died( 16.67%). The cause of death is mainly hemorrhagic shock. Conclusion Highly suspicious cardiac penetrating injuries or hemopericaridium should undergo direct operative exploration. Pseudoaneurysm should be resected early,which can prevent severe complications.

  9. Bedside emergency cardiac ultrasound in children

    Directory of Open Access Journals (Sweden)

    Doniger Stephanie

    2010-01-01

    Full Text Available Bedside emergency ultrasound has rapidly developed over the past several years and has now become part of the standard of care for several applications. While it has only recently been applied to critically ill pediatric patients, several of the well-established adult indications may be applied to pediatric patients. One of the most important and life-saving applications is bedside echocardiography. While bedside emergency ultrasonography does not serve to replace formal comprehensive studies, it serves as an extension of the physical examination. It is especially useful as a rapid and effective tool in the diagnosis of pericardial effusions, tamponade and in distinguishing potentially reversible causes of pulseless electrical activity from asystole. Most recently, left ventricular function and inferior vena cava measurements have proven helpful in the assessment of undifferentiated hypotension and shock in adults and children. Future research remains to be carried out in determining the efficacy of bedside ultrasonography in pediatric-specific pathology such as congenital heart disease. This article serves as a comprehensive review of the adult literature and a review of the recent applications in the pediatric emergency department. It also highlights the techniques of bedside ultrasonography with examples of normal and pathologic images.

  10. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives.

  11. Rare cardiovascular diseases in the context of occupational health care

    Directory of Open Access Journals (Sweden)

    Agata Salska

    2014-12-01

    Full Text Available In Poland like in other European countries a favorable trend towards reducing morbidity and mortality from cardiovascular disease has been observed. Nevertheless they are still one of the most important health problems in the population, responsible for nearly half of all deaths, including premature deaths. They also affect the quality of life in terms of health and socio-economic development, limiting the possibility of taking and/or continuing employment. Nowadays, cardiovascular diseases have become more common among young, professionally active people. Their professional activity, work organization and exposure to a broad range of occupational factors and environmental conditions may significantly influence the development and course of the cardiovascular disease. The aim of the study was to present the relationship between occupation and some rarer diseases and cardiovascular pathologies, as well as those in which this relationship has not as yet been fully evidenced, however, they may play an important role in workers’ health care. In this paper tako-tsubo cardiomyopathy, aortic aneurysm, aortic dissection, pericardial tamponade, Brugada syndrome and sudden cardiac death are discussed. In addition, the authors indicate new issues emerging along with the development of modern diagnostic and therapeutic techniques in cardiology, such as the care of patients with implanted pace-maker and the use of automated external defibrillators. These issues are presented in the context of their relationship with the occupation, taking into account the activities possibly to be undertaken under preventive care programs. Med Pr 2014;65(6:847–856

  12. PERICARDITIS CONSTRICTIVA EN UNA MUJER DE 36 AÑOS / Constrictive Pericarditis in a 36 year-old woman

    Directory of Open Access Journals (Sweden)

    Tessa Negrín Valdés

    2012-07-01

    Full Text Available ResumenPaciente femenina, de 36 años de edad, con antecedentes de dos gestaciones, dos partos y ningún aborto, que en el año 2003 tras su segundo parto, distócico por cesárea, desarrolla una pericarditis de causa no precisada que produjo un derrame pericárdico grave con signos de taponamiento cardíaco, y requirió ingreso hospitalario y pericardiocentesis. Siete años después se identifican, en la consulta de Cardiología, síntomas clínicos de una pericarditis constrictiva, corroborada por ecocardiograma y cateterismo derecho; actualmente ingresa para pericardiectomía, evaluada como alto riesgo quirúrgico. / Abstract36 year-old female patient, with a history of two pregnancies, two births and no abortion, who in 2003 after her second delivery (cesarean for dystocia she developed pericarditis of undetermined cause that produced a severe pericardial effusion with signs of cardiac tamponade and required hospital admission and pericardiocentesis. Seven years later, in the Cardiology service, clinical symptoms of constrictive pericarditis are identified and confirmed by echocardiography and right heart catheterization. This patient has been recently admitted for pericardiectomy, and evaluated as high surgical risk.

  13. Two-Year Follow-Up after Contact Force Sensing Radiofrequency Catheter and Second-Generation Cryoballoon Ablation for Paroxysmal Atrial Fibrillation: A Comparative Single Centre Study

    Directory of Open Access Journals (Sweden)

    Attila Kardos

    2016-01-01

    Full Text Available Background. There are little comparative data on catheter ablation of paroxysmal atrial fibrillation (AF using the contact force radiofrequency (CF-RF catheter versus the second-generation cryoballoon (CB2. Methods and results. This is a single center, retrospective, nonrandomized study of 98 patients with symptomatic, drug-refractory paroxysmal AF who underwent their first PVI ablation using either the CB2 (n=40 or CF-RF (n=58. The mean age was 60 years with 63% men, a mean LA size of 42 mm. The procedure duration (74±17 versus 120±49 minutes p<0.05 was shorter for CB2 group; the fluoroscopy time (14±17 versus 16±5 minutes, p=0.45 was similar. Complete PVI was achieved in 96% of patients with RF-CF and 98% with CB2. Phrenic nerve palsies (2 transient and 1 persistent occurred exclusively in the CB2 group and 1 severe, nonlethal complication (pericardial tamponade occurred in the CF-RF group. At 24-month follow-up, the success rate, defined as freedom from AF/atrial tachycardia (AT after a single procedure without antiarrhythmic drug, was comparable in CF-RF group and CB2 group (65.5% versus 67%, resp., log rank p=0.54. Conclusion. Both the CB2 and the RF-CF ablation appeared safe; the success rate at 2 years was comparable between both technologies.

  14. Mean platelet volume to platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection.

    Science.gov (United States)

    Li, Dong-Ze; Chen, Qing-Jie; Sun, Hui-Ping; Zeng, Rui; Zeng, Zhi; Gao, Xiao-Ming; Ma, Yi-Tong; Yang, Yi-Ning

    2016-09-01

    Type A acute aortic dissection is a life-threatening vascular emergency because of its high morbidity and mortality. Platelet is a pivotal ingredient involved in the development of acute aortic dissection. In this study, we aimed to investigate whether mean platelet volume (MPV)/platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection. In this single-center and prospective cohort study, 106 consecutive patients with Stanford type A acute aortic dissection admitted to the hospital within 12 h after onset were recruited. The best cut-off value of MPV/platelet count ratio predicting all-cause mortality was determined by the receiver operator characteristic analysis. Patients were divided into high (H-MPV/platelet count) and low (L-MPV/platelet count) groups based on the cut-off value of 7.49 (10 fl/10/l). Patients were followed up for 3.5 years. Of the 106 acute aortic dissection patients, 71 (67.0%) died during the study period, with a median follow-up duration of 570 days. Compared to the L-MPV/platelet count group, patients with H-MPV/platelet count had a higher risk of in-hospital complications including hypotension, hypoxemia, myocardial ischemia/infarction, conscious disturbance, pericardial tamponade, paraplegia, and poor survival (all P acute aortic dissection. PMID:26575495

  15. Mesothelioma in Two Nondomestic Felids: North American Cougar (Felis concolor and Cheetah (Acinonyx jubatus

    Directory of Open Access Journals (Sweden)

    Amanda Whiton

    2013-01-01

    Full Text Available A 15-year-old male North American cougar (Felis concolor presented with a 2-day history of anorexia, restlessness, and dyspnea. White blood cell count ( cells/μL and absolute segmented neutrophil count ( cells/μL were increased, and BUN (143 mg/dL, creatinine (6.3 mg/dL, and phosphorus (8.5 mg/dL concentrations indicated chronic renal disease. Thoracic radiographs showed severe pleural and pericardial effusion. During attempts to remove the fluid, cardiac tamponade developed and the cat died. At necropsy, nodular masses decorated the pericardium at the level of the base of the heart. The final microscopic diagnosis was mesothelioma of the pericardium, tunica adventitia of the main pulmonary artery, left auricle epicardium, and left ventricular epicardium. A 15-year-old female cheetah (Acinonyx jubatus was evaluated for acute respiratory distress. The white blood cell count ( cells/μL and absolute segmented neutrophil count ( cells/μL were increased. Radiographically pleural effusion and a cranial thoracic mass were seen. The cheetah was euthanized, and a gross diagnosis of disseminated pleural mesothelioma with thoracic effusion was made. Histologically, pleural mesothelioma was confirmed with local invasion of the lung and pulmonary arterial emboli and infarction. In both cases, a diagnosis of mesothelioma was made based on cellular morphology, microscopic architecture, and neoplastic cell coexpression of cytokeratin and vimentin.

  16. Bronchogenic Carcinoma with Cardiac Invasion Simulating Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Anirban Das

    2016-01-01

    Full Text Available Cardiac metastases in bronchogenic carcinoma may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells, but direct invasion of heart by adjacent malignant lung mass is very uncommon. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. But direct invasion of myocardium and endocardium is very uncommon. Left atrial endocardium is most commonly involved in such cases due to anatomical contiguity with pulmonary hilum through pulmonary veins, and in most cases left atrial involvement is asymptomatic. But myocardial compression and invasion by adjacent lung mass may result in myocardial ischemia and may present with retrosternal, oppressive chest pain which clinically may simulate with the acute myocardial infarction (AMI. As a result, it leads to misdiagnosis and delayed diagnosis of lung cancer. Here we report a case of non-small-cell carcinoma of right lung which was presented with asymptomatic invasion in left atrium and retrosternal chest pain simulating AMI due to myocardial compression by adjacent lung mass, in a seventy-four-year-old male smoker.

  17. Fatores de risco hospitalar para implante de bioprótese valvar de pericárdio bovino Hospital risk factors for bovine pericardial bioprosthesis valve implantation

    OpenAIRE

    Mateus W. de Bacco; João Ricardo M. Sant'Anna; Gustavo de Bacco; Roberto T. Sant'Anna; Marisa F. Santos; Edemar Pereira; Altamiro Reis da Costa; Paulo Roberto Prates; Renato A. K. Kalil; Ivo A NESRALLA

    2007-01-01

    FUNDAMENTO: Identificação de fatores de risco pré-operatórios na cirurgia cardíaca valvar visa melhor resultado cirúrgico pela possível neutralização de condições relacionadas com morbi-mortalidade aumentada. OBJETIVO: Este estudo objetiva identificar fatores de risco hospitalar em pacientes submetidos a implante de bioprótese de pericárdio bovino. MÉTODOS: Estudo retrospectivo incluindo 703 pacientes consecutivos submetidos a implante de pelo menos uma bioprótese de pericárdio bovino St. Jud...

  18. Dispnéia por compressão de estruturas mediastinais por cisto pericárdico Dyspnea through compression of mediastinal structures due to pericardial cyst

    OpenAIRE

    Jeanine Eggers Caramori; Luciane Miozzo; Maurice Formigheri; Cristiano Barcellos; Muriel Grando; Tiago Trentin

    2005-01-01

    Caso de uma paciente com 65 anos, apresentando dispnéia aos esforços e dor torácica lateral direita como principais sintomas de um cisto no pericárdio, de aproximadamente 8 cm. Os exames físico, bioquímico e eletrocardiográfico não evidenciaram alterações. O resultado dos exames de radiografia de tórax, tomografia computadorizada e ecocardiograma foi sugestivo de cisto pericádico. Com base nessas evidências clínicas a paciente foi submetida à toracotomia em região torácica lateral direita e r...

  19. The Improvement of Mixed Human Serum-induced Anaphylactic Reaction Death Model in Guinea Pigs%混合人血清诱发豚鼠过敏反应死亡模型的改良

    Institute of Scientific and Technical Information of China (English)

    陈炯垣; 赖跃; 李冬日; 岳霞; 王慧君

    2012-01-01

    Objective To increase the death rate of fatal anaphylaxis in guinea pigs and the detectable level of the tryptase of mast cell in blood serum. Methods Seventy-four guinea pigs were randomly divided into five groups: original model group, original model control group, improved model group, improved model control group, improved model with non-anaphylaxis group. Using mixed human serum as the allergen, the way of injection, sensitization and induction were improved. ELISA was used to detect the serum mast cell tryptase and total IgE in guinea pigs of each group. Results The death rate of fatal anaphylaxis in original model group was 54.2% with the different degree of hemopericardium. The severe pericardial tamponade appeared in 9 guinea pigs in original model group and original model control group. The death rate of fatal anaphylaxis in improved model group was 75% without pericardial tamponade. The concentration of the serum total IgE showed no statistically difference between original model group and original model control group (P>0.05), but the serum mast cell tryptase level was higher in the original model group than that in the original model control group (P<0.05). The concentration of the serum total IgE and the serum mast cell tryptase level were significantly higher in improved model group than that in the improved model control group (P<0.05). Conclusion The death rate of the improved model significantly increases, which can provide effective animal model for the study of serum total IgE and mast cell tryptase.%目的 提高豚鼠过敏反应死亡的发生率和血清肥大细胞类胰蛋白酶检出水平.方法 74只清洁级豚鼠随机分为原模型组、原模型对照组、改良模型组、改良模型对照组和改良模型非致敏组.混合人血清作为过敏原,对注射方式、致敏、发敏方式进行改良,ELISA法测定各组豚鼠血清肥大细胞类胰蛋白酶和总IgE含量.结果 原模型组过敏反应死亡发生率为54.2

  20. Analysis of common complications associated with interventional therapy of congenital heart disease%先天性心脏病介入治疗的常见并发症分析

    Institute of Scientific and Technical Information of China (English)

    张文泉; 王咏梅; 李贵双

    2011-01-01

    多年来外科手术一直是先天性心脏病(先心病)治疗的金标准.随着介入器材及技术的不断发展,先心病的介入治疗被广泛接受并成为很多患者的首选治疗方法.虽然大多情况下介入治疗能顺利完成,但并发症时有发生,介入手术仍存在相当大的风险.先心病介入治疗常见并发症有心脏、大血管穿孔、心包压塞、心律失常、封堵器脱落、瓣膜关闭不全、残余分流与溶血、血管并发症和拔管综合征等.该文分析了介入治疗常见并发症的发生原因、诊断、处理和预防.%Surgery has been considered to be the gold standard for the treatment of congenital heart disease.With the development of interventional equipment and technology, interventional therapy for congenital heart disease has been widely accepted and recognized as the preferred treatment option for a wide number of congenital cardiac conditions.Although most interventional therapy procedures are accomplished, complications, such as cardiac perforation, large vessels perforation, pericardial tamponade, arrhythmia, occluder off, valvular inadequacy, residual shunt with hemolysis and extubation syndrome, may occur.This review summarized the causes, diagnosis, treatment and prevention of common complications associated with interventional therapy of congenital heart disease.

  1. Myocardial uptake in HIV Lymphoma - A case study

    Energy Technology Data Exchange (ETDEWEB)

    Watson, T.N.; Hain, S.F.; Freund, J. [St Vincents Hospital, Sydney, NSW (Australia). Department of Nuclear Medicine

    1997-12-01

    Full text: A 25-year-old male presented to the HIV unit with acute abdominal pain, diarrhoea, malnutrition, dehydration, abdominal distension and haematokzia. CT followed by colonscopic cultures indicated large cell Iymphoma located in the sigmoid. Bone marrow biopsy showed no evidence of Iymphoma. There were no cardiac symptoms. The patient was then referred for a radionuclide gallium scan. The patient was injected with 370 MBq of {sup 67}Ga-citrate. At 72 hours post injection, anterior and posterior sweeps, right and left lateral skull views and a SPECT of the chest were performed. The following day, an anterior abdomen view was collected and a SPECT of the abdomen was performed. Diffuse {sup 67}Ga-citrate accumulation was seen in the myocardium and in the bowel. Radionuclide photopeaks were found to be consistent with gallium. Uptake in the liver was notably decreased, presumably due to concurrent massive blood transfusion for pancytopaenia. Further investigation of the heart was suggested. Owing to the tumour load of the bowel, the patient was immediately treated with chemotherapy without further investigation of the heart. The patient returned for a follow-up {sup 67}Ga-citrate scan three months later. Gallium-67-citrate uptake remained present in the myocardium and the bowel, with both being less intense than in the previous scan. The liver now appears normal. The patient re-presented to the Emergency Department two days post completion of chemotherapy with cardiac tamponade secondary to pericardial effusion, which was drained and cytology showed Iymphoma cells. Lymphoma of the myocardium is not unusual in HIV patients and should not be overlooked or left un investigated as a simple HIV infection

  2. Blunt traumatic cardiac rupture. A 5-year experience.

    Science.gov (United States)

    Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R

    1990-12-01

    Blunt traumatic cardiac rupture is associated with a high rate of mortality. A review of the computerized trauma registry (1983 to 1988) identified 32 patients with this injury (ages 19 to 65 years; mean age, 39.5 years; 21 men and 11 women). Twenty-one patients (65.6%) were injured in vehicular crashes, 3 (9.4%) in pedestrian accidents, 3 (9.4%) in motorcycle accidents; 3 (9.4%) sustained crush injury; 1 (3.1%) was injured by a fall; and 1 (3.1%) was kicked in the chest by a horse. Anatomic injuries included right atrial rupture (13[40.6%]), left atrial rupture (8 [25%]), right ventricular rupture (10[31.3%]), left ventricular rupture (4[12.5%]), and rupture of two cardiac chambers (3 [9.4%]). Diagnosis was made by thoracotomy in all 20 patients presenting in cardiac arrest. In the remaining 12 patients, the diagnosis was established in seven by emergency left anterolateral thoracotomy and in five by subxyphoid pericardial window. Seven of these 12 patients (58.3%) had clinical cardiac tamponade and significant upper torso cyanosis. The mean Injury Severity Score (ISS), Trauma Score (TS), and Glasgow Coma Scale (GCS) score were 33.8, 13.2, and 14.3, respectively, among survivors and 51.5, 8.3, and 7.0 for nonsurvivors. The overall mortality rate was 81.3% (26 of 32 patients), the only survivors being those presenting with vital signs (6 of 12 patients [50%]). All patients with rupture of two cardiac chambers or with ventricular rupture died. The mortality rate from myocardial rupture is very high. Rapid prehospital transportation, a high index of suspicion, and prompt surgical intervention contribute to survival in these patients. PMID:2256761

  3. Association of Atrial Fibrillation and Amino-terminal Pro-brain Natriuretic Peptide Concentrations in Patients After Off-Pump Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    Junquan Li; Qinghua Zhang; Weichen Tian; Hongyu Liu

    2008-01-01

    Objectives To investigate the possible role of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in the occurrence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG).Methods This study group included 70 consecutive patients scheduled for elective off-pump CABG.The patients with ejection fraction (EF) less than 0.30,history of AF,use of class Ⅰor Ⅲ antiarrhythmic drug,implanted pacemaker,postoperative myocardial infarction or chest reopening for pericardial tamponade were excluded.Preoperative and postoperative serum NT-proBNP levels were measured by radioimmunoassay technique.Results Postoperative AF occurred in 15 patients (21.4%);these patients had significantly higher median NT-proBNP levels when compared with those without AF after the operation (P<0.01).Using multivariate logistic regression analyses,an increase in NT-proBNP level after CABG was found to be independently associated with AF (OR=3.78,95% IC=1.81~4.89,P<0.01 ).Increased age,diabetes mellitus,preoperative use of β-blocker,proximal right coronary artery involvement,and longer operation time were also associated with AF.Conclusions These results indicated that AF was associated with higher NT-proBNP concentrations after off pump CABG;the increase in NT-proBNP after CABG may play an important role in the occurrence of AF after the operation.The further studies are needed to define the reason that lead to higher NT-proBNP concentrations among the patients who present AF after off pump CABG.

  4. Towards real-time cardiovascular magnetic resonance guided transarterial CoreValve implantation: in vivo evaluation in swine

    Directory of Open Access Journals (Sweden)

    Kahlert Philipp

    2012-03-01

    Full Text Available Abstract Background Real-time cardiovascular magnetic resonance (rtCMR is considered attractive for guiding TAVI. Owing to an unlimited scan plane orientation and an unsurpassed soft-tissue contrast with simultaneous device visualization, rtCMR is presumed to allow safe device navigation and to offer optimal orientation for precise axial positioning. We sought to evaluate the preclinical feasibility of rtCMR-guided transarterial aortic valve implatation (TAVI using the nitinol-based Medtronic CoreValve bioprosthesis. Methods rtCMR-guided transfemoral (n = 2 and transsubclavian (n = 6 TAVI was performed in 8 swine using the original CoreValve prosthesis and a modified, CMR-compatible delivery catheter without ferromagnetic components. Results rtCMR using TrueFISP sequences provided reliable imaging guidance during TAVI, which was successful in 6 swine. One transfemoral attempt failed due to unsuccessful aortic arch passage and one pericardial tamponade with subsequent death occurred as a result of ventricular perforation by the device tip due to an operating error, this complication being detected without delay by rtCMR. rtCMR allowed for a detailed, simultaneous visualization of the delivery system with the mounted stent-valve and the surrounding anatomy, resulting in improved visualization during navigation through the vasculature, passage of the aortic valve, and during placement and deployment of the stent-valve. Post-interventional success could be confirmed using ECG-triggered time-resolved cine-TrueFISP and flow-sensitive phase-contrast sequences. Intended valve position was confirmed by ex-vivo histology. Conclusions Our study shows that rtCMR-guided TAVI using the commercial CoreValve prosthesis in conjunction with a modified delivery system is feasible in swine, allowing improved procedural guidance including immediate detection of complications and direct functional assessment with reduction of radiation and omission of contrast media.

  5. Diagnóstico e tratamento cirúrgico do teratoma intrapericárdico Diagnosis and surgical treatment of intrapericardial teratoma

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1996-03-01

    Full Text Available Descrevemos 2 casos de teratoma intrapericárdico, tumor cardíaco primário raro, usualmente encontrado em neonatos e lactentes e que pode causar insuficiência respiratória, grande acúmulo de liqüido pericárdico e compressão cardíaca, levando à morte no período intra-uterino ou neonatal. Em ambos os casos, o diagnóstico foi estabelecido pelo ecocardiograma realizado em criança de 3 meses com sinais de tamponamento cardíaco e no feto de uma gestante no curso da 38º semana de gravidez. Ressecção cirúrgica com sucesso em ambos os pacientes foi realizada nas idades de 3 meses e 3 dias de vida, respectivamente. A histologia confirmou o diagnóstico de teratoma. Enfatiza-se a acurácia do diagnóstico ecocardiográfico nestes casos e a importância da indicação cirúrgica precoce.We report two cases of intrapericardial teratoma, a rare cardiac tumor, usually found in neonates and young infants, which may cause respiratory distress, large pericardial effusions and cardiac compression leading to intra-uterine or neonatal death. Both cases were diagnosed noninvasively by echocardiogram, in a 3 month-old girl with signs of cardiac tamponade, and by fetal echocardiography, in a 38 week pregnant woman. Successful surgical removal of the tumor was undertaken in both patients at the ages of 3 months and 3 days of life, respectively. Histology confirmed the diagnosis of teratoma. It is emphasized the diagnostic accuracy of achocardiography and the importance of early surgical treatment in the management of intrapericardial teratoma.

  6. Percutaneous occlusion of left atrial appendage in experimental canine models:the establishment of the delivery pathway%一种建立实验犬经皮左心耳封堵途径的方法

    Institute of Scientific and Technical Information of China (English)

    张志钢; 赵仙先; 吴弘; 秦永文; 李长永; 谭洪文; 储国俊; 朱玉峰; 白元; 许旭东; 熊文峰; 黄新苗

    2014-01-01

    into LA, a pigtail catheter was inserted into the ostium of the LAA and the sheath was then advanced over the pigtail into the LAA. LAA angiography was then performed through the delivery sheath to confirm the position of the delivery sheath. One hour after the procedure both electrocardiography (ECG) and transthoracic echocardiography (TTE) were carried out in five dogs to check the results, immediately after which the five dogs were sacrificed to macroscopically observe the damages of the puncture site of inter-atrial septum as well as inside the LA and LAA. One hour and 2 weeks after the procedure TTE was conducted in the remaining 7 dogs and these dogs were followed up for one month. Results One dog died of pericardial tamponade during the operation. In 8 dogs the LAA was clearly displayed in the projection position of right anterior oblique (RAO) 30°/cranial (CRA) 20°,while in 3 dogs the LAA was well visualized in the projection position of RAO 30° , and in one dog in the projection position of RAO 30°/caudal (CAU) 20°. The diameter of LAA neck was (13.6 ± 5.2) mm. The delivery sheath was safely advanced into the LAA along the pigtail catheter in all dogs, and no air embolism, thrombus or pericardial tamponade occurred. Hematoma at puncture point of groin occurred in 2 dogs, which was absorbed through pressure dressing. Macroscopic examination of the heart performed immediately after the operation showed that no bloody pericardial effusion was found, and mild hematoma at posterior wall of LA was seen in one dog and mild damage of the upper-margin intima of LAA was noted in 2 dogs. The mean fluoroscopy time was (10.1 ± 2.5) minutes and the mean operation time was (58 ± 12) minutes. TEE showed no pericardial effusion 2 weeks after the procedure. During the follow-up period of one month no sudden death, stroke or infection occurred. Conclusion This method of placing the delivery sheath into the LAA is clinically safe and effective, and it can reliably

  7. Disease: H01067 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available marily affects individuals with indwelling catheters or structural abnormalities ...Jacobsen SM, Shirtliff ME Proteus mirabilis biofilms and catheter-associated urinary tract infections. Virul...Jacobsen SM, Stickler DJ, Mobley HL, Shirtliff ME Complicated catheter-associated urinary tract infections d...theter-related urinary tract infection. Drugs Aging 22:627-39 (2005) PMID:19926986 Trautner BW Management of catheter

  8. Dialysate leakage into pericardium in an infant on long-term peritoneal dialysis.

    Science.gov (United States)

    Borzych, Dagmara; Ley, Sebastain; Schaefer, Franz; Billing, Heiko; Ley-Zaporozhan, Julia; Schenk, Jens; Schmitt, Claus Peter

    2008-02-01

    We report on a 2-year-old boy on automated peritoneal dialysis (PD) with a history of multiple hernias and dialysate leaks who developed pericardial effusion. Magnetic resonance imaging (MRI) demonstrated a peritoneo-pericardial fistula. Dialysis had to be discontinued, since head-down tilt reproducibly induced significant hypotension. In PD patients with pericardial effusion a peritoneo-pericardial leak should be considered. PMID:17922293

  9. Acute Effusive Pericarditis due to Horse Chestnut Consumption

    OpenAIRE

    Edem, Efe; Kahyaoğlu, Behlül; Çakar, Mehmet Akif

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Pericardial effusion related to the consumption of herbal product Symptoms: Dyspnea Medication: Horse chestnut (Aesculus hippocastanum L) Clinical Procedure: Pericardial and pleural effusions were drained through a pericardiopleural window Specialty: Cardiology Objective: Unusual clinical course Background: There are many well-known causes of pericardial effusion, such as cancer metastasis, bacterial or viral pericarditis, and uremic pericarditis; however, n...

  10. 先天性甲状腺功能减低症并心包积液2例%Report of 2 cases of congenital hypothyroidism complicated with pericardial effusion

    Institute of Scientific and Technical Information of China (English)

    冯锦玲; 罗云; 陶元

    2010-01-01

    @@ 先天性甲状腺功能减低症(congenital hypothyroidism,CH)是一种严重危害儿童健康,引起患儿生长发育迟缓、智力落后及生理功能低下的疾病;其散发性甲低发生率仅为14/10万~20/10万[1].

  11. Surgical application of fascia lata as a pericardial substitute in rabbits Aplicação cirúrgica de fascia lata como substituto do pericárdio em coelhos

    OpenAIRE

    Gholamreza Abedi; Peyman Shahzamani; Mehran Shahzamani; Pejman Mortazavi; Iraj Sohrabi Haghdost; Siyamak Mashhadi Rafiei; Kamran Ghods

    2012-01-01

    PURPOSE: To use fascia lata instead of pericardium and observe the presence of adhesions. METHODS: Twenty rabbits were divided into two group of ten. In group A, a 1×1 cm segment of pericardium was excised and resutured. In group B excised pericardium was substituted for autologous fascia lata. RESULTS: In the comparison of microscopic adhesion rate between two groups A, B after eight weeks, there was no significant statistical difference. CONCLUSION: Fascia lata is safe and it can be substit...

  12. Bioprótese valvar de pericárdio bovino St Jude Medical-Biocor: sobrevida tardia St Jude Medical-Biocor bovine pericardial bioprosthesis: long-term survival

    OpenAIRE

    Felipe W De Bacco; João Ricardo M. Sant'Anna; Roberto T. Sant'Anna; Paulo R. PRATES; Renato A. K. Kalil; Ivo A NESRALLA

    2005-01-01

    OBJETIVO: Nosso objetivo é apresentar resultados a longo prazo da subsituição valvar por bioprótese de pericárdio bovino SJM-BiocorTM. MÉTODO: Entre 1992 e 2000, tiveram alta hospitalar, após substituição valvar por bioprótese de pericárdio bovino SJM-BiocorTM 304 pacientes. Idades eram de 15 a 83 anos (média: 60,6±14,3), sendo 50,3% do sexo masculino. Pacientes tiveram situação clínica atualizada e análise atuarial foi empregada no cálculo da sobrevida simples e livre de eventos. RESU...

  13. Prevenção de aderências pericárdicas pós-operatórias com uso de carboximetilquitosana termoestéril Prevention of postoperative pericardial adhesions using thermal sterile carboxymethyl chitosan

    OpenAIRE

    Luiz Renato Dias Daroz; Jackson Brandão Lopes; Luis Alberto de Oliveira Dallan; Sérgio Paulo Campana-Filho; Luiz Felipe Pinho Moreira; Noedir Antônio Groppo Stolf

    2008-01-01

    OBJETIVO: Este trabalho tem como objetivo avaliar alterações físico-químicas da carboximetilquitosana após termoesterilização e sua eficácia na prevenção de aderências pericárdicas pós-esternotomia. MÉTODOS: Após ser submetida a termoesterilização em autoclave, a carboximetilquitosana termoestéril (CMQte) foi submetida a análises físico-químicas. Doze animais foram divididos em dois grupos e submetidos à pericardiotomia e a protocolo de indução de aderências. A seguir, foi aplicada de forma t...

  14. A case of catheter ablation of epicardial ventricular tachycardia using subxyphoid instrumentation of the pericardial space%经剑突心包穿刺射频消融心外膜室性心动过速一例

    Institute of Scientific and Technical Information of China (English)

    洪浪; 赖珩莉; 王洪; 尹秋林; 陈再华

    2009-01-01

    研究发现,一些异位激动点及室性心动过速(室速)折返环位于心肌内,靠近或位于心外膜,普通心内膜消融很难触及靶点。往往需要外科开胸、经胸腔镜或经冠状静脉窦途径接近心外膜达到消融目的。前两种方法创伤大,病人很难接受,不能作为常规治疗手段,而后一种方法只能用于消融冠状静脉窦周围的心外膜心动过速,且发生心脏压塞的风险较大。1996年,Sosa首先报道了经皮心包穿刺治疗心外膜心动过速的方法,应用该方法已治疗近300例病例,安全、有效。目前国内未见正式报道。

  15. Location of accessory pathways and its radiofrequency ablation in Wolf-Parkinson-White syndrome

    Directory of Open Access Journals (Sweden)

    Vukajlović Dejan

    2006-01-01

    Full Text Available Introduction: Radiofrequency ablation (RFA of accessory pathways (AP is the first line therapy in symptomatic patients with preexcitation syndrome, resistant to medical therapy. Objective: To evaluate the influence of AP location on RFA effectiveness. Method: The study compared RFA results of AP located on the left side, right side, and in septal area of the heart in the first 101 consecutive patients treated at Dedinje Cardiovascular Institute in Belgrade. Results: There was no significant difference between the right-, left- and septal-AP in relation to primary success rates (66.7%, 84.3%, 73.7%, respectively, p=0.285, recurrence rates (12.5%, 6.97%,14.3%, p=0.591, and final success rates (66%, 84.3%, 78.9%, p=0.37. Maximally achieved interface temperature was lowest at right-sided AP (49.8±1.9єC as compared to the left (53.0±3.5єC or septal AP (52.9±3.0єC (p<0.01. Fluoroscopy time did not differ significantly (p=0.062, while total procedure time and the number of applied RF pulses was higher in the left-sided AP as compared to other two (104.6±44.9 for the left, 98.9±47.5 for the right and 80.7±39.8 minutes for the septal AP, p<0.05; 11.0±8.8 pulses for the left, 6.5±3.8 for the right and 6.4±5.0 for septal AP, p<0.01. Two major complications developed: one third-degree AV block after ablation of midseptal AP, and one pericardial effusion without tamponade, with spontaneous regression. Conclusion: The success rate of RFA of the right-, left- and septal-AP was similar. Heating of the tissue was weakest during RFA of the right-sided AP.

  16. Emergency thoracotomies: Two center study

    Directory of Open Access Journals (Sweden)

    Sameh Ibrahim Sersar

    2013-01-01

    Full Text Available Introduction and Aim: Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors. Patients and Methods: Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis. Results: Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures. Conclusion: The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory

  17. Early and long-term results of combined cardiac surgery and neoplastic resection in patients with concomitant severe heart disease and neoplasms

    Institute of Scientific and Technical Information of China (English)

    FU Qiang; LI Quan-zheng; LIANG De-gang; RUAN Xin-hua; WANG Zan-xin; WEI Min-xin

    2011-01-01

    Background It is a surgical dilemma when patients present with both severe heart disease and neoplasms. The best surgical treatment remains controversial. This study aimed to analyze the early and long-term results of simultaneous surgical treatment of severe heart disease and neoplasms.Methods We reviewed the clinical records of 15 patients who underwent simultaneous neoplastic resection and cardiac surgery between September 2006 and January 2011. There were 5 male and 10 female patients. The mean age was (59.2±12.5) years and the mean left ventricular ejection fraction was (57.4±11.0)%. All patients were followed up completely for a period of 12 to 51 months (mean, (33.1±11.2) months).Results Fifteen patients underwent simultaneous cardiac surgery and neoplastic resection. Cardiac procedures consisted of off pump coronary artery bypass grafting (n=7), aortic valve replacement (n=3), mitral valve replacement (n=3), mitral valve replacement with coronary artery bypass grafting (n=1) and left atrial myxoma resection (n=1). Neoplastic resection consisted of lung cancer resection (n=5). colonic cancer resection (n=3), gallbladder resection (n=1), colonic cancer resection with gallbladder resection (n=1), hysterectomy (n=2), hysterectomy with bilateral salpingo-oophorectomy (n=2) and left ovariectomy (n=1). Pathological examination confirmed malignant disease in 10 patients and benign disease in 5 patients. There were no perioperative myocardial infarctions, stroke, pericardial tamponade, renal failure or hospital deaths. The most frequent complications were atrial fibrillation (33.3%), pneumonia (26.7%), low cardiac output syndrome (6.7%) and delayed healing of surgical wounds (6.7%). There was 1 late death 42 months after surgery for recurrent malignant disease. At 1 and 3 years, survival rates were 100% (Kaplan-Meier method).Conclusions Simultaneous cardiac surgery and neoplastic resection was not associated with increased early or late morbidity or mortality

  18. Long-Term Retrievability of IVC Filters: Should We Abandon Permanent Devices?

    International Nuclear Information System (INIS)

    Thromboembolic disease produces a considerable disease burden, with death from pulmonary embolism in the UK alone estimated at 30,000-40,000 per year. Whilst it is unproven whether filters actually improve longevity, the morbidity and mortality associated with thromboembolic disease in the presence of contraindications to anticoagulation is high. Thus complications associated with filter insertion, and whilst they remain in situ, must be balanced against the alternatives. Permanent filters remain in situ for the remainder of the patient's life and any complications from the filters are of significant concern. Filters that are not permanent are therefore attractive in these circumstances. Retrievable filters, to avoid or decrease long-term filter complications, appear to be a significant advance in the prevention of pulmonary embolism. In this review, we discuss the safety and effectiveness of both permanent and retrievable filters as well as the retrievability of retrievable inferior vena cava (IVC) filters, to explore whether the use of permanent IVC filters can be abandoned in favor of retrievable filters. Currently four types of retrievable filters are available: the Recovery filter (Bard Peripheral Vascular, Tempe, AZ, USA), the Guenther Tulip filter (Cook, Bloomington, IN, USA), the OptEase Filter (Cordis, Roden, The Netherlands), and the ALN filter (ALN Implants Chirurgicaux, Ghisonaccia, France). Efficacy and safety data for retrievable filters are as yet based on small series, with a total number of fewer than 1,000 insertions, and follow-up is mostly short term. Current long-term data are poor and insufficient to warrant the long-term implantation of these devices into humans. The case of fractured wire from a Recovery filter that migrated to the heart causing pericardial tamponade requiring open heart surgery is a reminder that any new endovascular device remaining in situ in the long term may produce unexpected problems. We should also bear in mind that

  19. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  20. Disease: H01350 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available g surgery. Morganella morganii can cause bacteremia and lead to major clinical problems, which are usually associated with common cau...ses of catheter-associated bacteriuria, infections of th

  1. Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle

    NARCIS (Netherlands)

    K. Helder MScN (Onno); R.F. Kornelisse (René); C. van der Starre (Cynthia); D. Tibboel (Dick); C.W.N. Looman (Caspar); R.M.H. Wijnen (Rene); M.J. Poley (Marten); E. Ista (Erwin)

    2013-01-01

    textabstractBackground: Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation requir

  2. Analysis of S. Epidermidis icaA and icaD genes by polymerase chain reaction and slime production: a case control study

    OpenAIRE

    Zhou, Shusheng; Chao, Xiaoguang; Fei, Mingming; Dai, Yuanyuan; Liu, Bao

    2013-01-01

    Background Staphylococcus epidermidis is a common pathogen in medical device-associated infections and have an ability to form adherent slime. We aimed to study the effects of icaA and icaD genes on the slime formation of Staphylococcus epidermidis associated with catheter-associated infections. Methods S. epidermidis isolates from the central venous catheter blood of patients with catheter-associated infections, and from the nasal vestibules of healthy volunteers, intensive care unit hospita...

  3. Total absence of the pericardium incidentally found during surgery for spontaneous pneumothorax.

    Science.gov (United States)

    Sugiyama, Ato; Izumi, Yotaro; Inoue, Yoshiaki; Aoki, Kohei; Fukuda, Hiroki; Gika, Masatoshi; Nakayama, Mitsuo

    2016-05-01

    Congenital absence of the pericardium is a rare malformation which is often found incidentally. We report a case of pericardial absence which was found during surgery for spontaneous pneumothorax. Image analyses suggested that the pericardial absence was bilateral and total. These findings were overlooked on CT, preoperatively. Although rare, the possibility of asymptomatic pericardial absence should be kept in mind when observing the chest images before performing thoracic interventions. PMID:25281370

  4. A case of prominent epicardial fat mimicking a tumor on echocardiography.

    OpenAIRE

    Ahn, Y. K.; Park, J. C.; Park, W S; Kim, N H; J.W. Kim; Kim, S H; Cho, J. H.; Jeong, M H; Cho, J. G.; Kang, J. C.

    1999-01-01

    Epicardial fat may anteriorly produce an echo-free space that can be mistaken for pericardial fluid. We recently experienced a 67-year-old woman with prominent epicardial fat which was presented as an echogenic tumor-like mass. She underwent open pericardiostomy to relieve large amount of pericardial effusion. Operative findings revealed only prominent epicardial fat. Biopsy of the pericardial and fat tissues revealed an inflammation and normal fat cells without any malignant cell infiltration.

  5. Immediate Postoperative Use of a Topical Agent to Prevent Intraocular Pressure Elevation After Pars Plana Vitrectomy With Gas Tamponade%睫状体平坦部玻璃体切除联合气体填充术后立即使用局部滴眼剂预防眼压升高的作用

    Institute of Scientific and Technical Information of China (English)

    Matthew S; Erika M.Escalona-Benz; Timothy G.Murray; Charles W.G.Eifrig; Daniel M.Yoder; Jeffrey K; Joyce C.Schiffman

    2004-01-01

    目的:决定单一的局部房水生成抑制剂应用于睫状体平坦部玻璃体切除联合长效气体填充术后对预防眼压升高是否有效.方法:50例患者符合接受睫状体平坦部玻璃体切除联合长效气体填充手术的入选标准,术后随机接受顺丁稀二酸盐噻吗心安与盐酸乙酰唑胺联合治疗、单独长效噻吗心安、单独乙酰唑胺,或安慰剂治疗.手术结束时和术后5h、1d、1周分别采用便携式手持眼压计(Tono-Pen)测量眼压.结果:各组眼压值在手术结束时差异无显著性.安慰剂组和噻吗心安和乙酰唑胺联合治疗组术后5h(27.0与17.4mm Hg,P<0.001)及术后1d(26.1与19.9mm Hg,P=0.01)的眼压显示安慰剂组和噻吗心安-乙酰唑胺组间差异有显著性.噻吗心安-乙酰唑胺组比单一的噻吗心安组或乙酰唑胺组,在术后5h显示出更大的眼压控制作用(P=0.04).结论:使用单一的局部房水生成抑制剂能有效预防睫状体平坦部玻璃体切除联合长效气体填充手术后5h及1d的眼压升高.

  6. Application of Enneagram in psychological care of patients undergoing vitrectomy combined with gas or silicone oil tamponade%九型人格在玻璃体切割联合气体或硅油填充术病人心理护理中的应用

    Institute of Scientific and Technical Information of China (English)

    何华; 吴净; 高军; 李美兰; 周丽霞

    2013-01-01

    [目的]探讨应用九型人格实施个性化心理护理对玻璃体切割联合气体或硅油填充术病人的影响.[方法]病人入院由责任护士随机分为试验组60例和对照组60例.对照组按一般常规护理,试验组进行海伦·帕尔默九型人格104题问卷测定,找出病人相应的人格类型及存在的心理问题,制定出临床护理路径,根据护理路径有计划地进行针对性心理护理.[结果]试验组病人负性情绪比对照组少,不良反应明显减轻,睡眠型态、饮食情况均较对照组有显著好转,强迫卧位舒适度、住院满意度较对照组明显提高.[结论]应用九型人格对病人进行个性化心理护理可提高病人生活质量.

  7. Acute Heart Failure Caused by Parvovirus B-19 Myocarditis Treated with Human Immunoglobulin

    OpenAIRE

    Luca Alberti; Marco Loffi; Gabriele Fragasso; Roberto Spoladore; Carlo Ballarotto; Alberto Margonato

    2012-01-01

    We describe the case of a 42-year-old woman developing cardiogenic shock with cardiac tamponade due to an acute myo-pericarditis caused by Parvovirus B19 (PVB19), successfully treated with intravenous (iv) immunoglobulin administration.

  8. [Rhegmatogenous retinal detachment in a patient with previous penetrating keratoplasty (clinical case)].

    Science.gov (United States)

    Burcea, M; Muşat, O; Gheorghe, Andreea; Mahdi, Labib; Colta, Diana; Cernat, Corina; Mansour, Agajani

    2014-01-01

    We present the case of a 54 year old patient diagnosed with rhegmatogenous retinal detachment and perforating keratoplasty. Surgery is recommended and we performed posterior vitrectomy, endolaser, and internal heavy oil tamponade. The post-operative course was favorable.

  9. Swan-Ganz - right heart catheterization

    Science.gov (United States)

    ... have: Abnormal pressures in the heart arteries Burns Congenital heart disease Heart failure Kidney disease Leaky heart valves (valvular ... 2011:chap 55. Read More Burns Cardiac tamponade Congenital heart disease Heart attack Heart failure - overview Pulmonary hypertension Restrictive ...

  10. Electrocardiogram

    Science.gov (United States)

    ... ASD) Cardiac tamponade Chest pain Coarctation of the aorta Coronary artery spasm Delirium tremens Digitalis toxicity Dilated ... of the great vessels Tricuspid regurgitation Type 2 diabetes Unstable angina Ventricular septal defect Ventricular tachycardia Wolff- ...

  11. Current surgery of retinal detachment recurrence. Review

    Directory of Open Access Journals (Sweden)

    V. D. Zakharov

    2012-01-01

    Full Text Available this review presents a detailed analysis and an experience of surgical treatment of retinal detachment recurrence associated with light silicone oil tamponade of vitreous cavity. Approaches and variants of treatment were described in the historical aspect and till now. there are considered general and particular issues in case of retinal detachment recurrence appearance, expediency and volume of intraoperative manipulations, time of operation and choice of temporary substitute of vitreous body for a purpose of postoperative tamponade of vitreous cavity.

  12. Paracardioscopic Ex-Maze

    Medline Plus

    Full Text Available ... defect in the diaphragm, it enters the pericardial space. Once it's inside the pericardial space, we can again place a camera through that ... as it leaves the pericardium into the pleural space on the left side. The pleural space is ...

  13. Management Of Fever And Suspected Infection In Pediatric Patients With Central Venous Catheters.

    Science.gov (United States)

    Brennan, Courtney; Wang, Vincent J

    2015-12-01

    The use of indwelling central venous catheters is essential for pediatric patients who require hemodialysis, parenteral nutrition, chemotherapy, or other medications. Fever is a common chief complaint in the emergency department, and fever in a patient with a central venous catheter may be related to a common cause of fever, or it may be due to a catheter-associated bloodstream infection. Catheter-associated bloodstream infections may also lead to additional complications such as sepsis, septic shock, or septic complications including suppurative thrombophlebitis, endocarditis, osteomyelitis, septic emboli, and abscesses. Early resuscitation as well as timely and appropriate antibiotic therapy have been shown to improve outcomes. This issue focuses on the approach to fever in pediatric patients with central venous catheters and the management and disposition of patients with possible catheter-associated bloodstream infections. PMID:26569627

  14. Management Of Fever And Suspected Infection In Pediatric Patients With Central Venous Catheters.

    Science.gov (United States)

    Brennan, Courtney; Wang, Vincent J

    2015-12-01

    The use of indwelling central venous catheters is essential for pediatric patients who require hemodialysis, parenteral nutrition, chemotherapy, or other medications. Fever is a common chief complaint in the emergency department, and fever in a patient with a central venous catheter may be related to a common cause of fever, or it may be due to a catheter-associated bloodstream infection. Catheter-associated bloodstream infections may also lead to additional complications such as sepsis, septic shock, or septic complications including suppurative thrombophlebitis, endocarditis, osteomyelitis, septic emboli, and abscesses. Early resuscitation as well as timely and appropriate antibiotic therapy have been shown to improve outcomes. This issue focuses on the approach to fever in pediatric patients with central venous catheters and the management and disposition of patients with possible catheter-associated bloodstream infections.

  15. Down 综合征患儿室间隔缺损的手术治疗%Surgical Treatment of Ventricular Septal Defect in Children with Down Syndrome

    Institute of Scientific and Technical Information of China (English)

    吴士强

    2014-01-01

    circulatory system and to reduce the incidence of pulmonary infection. Results Among the 48 children,ventilator-associated pneumonia occurred in 10,arrhythmia in 2, pneumothorax in 1,pericardial tamponade in 1,and low cardiac output in 1.These children had normal growth and development and no children died after 6 months to 6 years of follow-up.Con-clusion Early operation,appropriate surgery timing and reasonable and effective perioperative treatment can improve the success rate of operation and prolong the life of Down syndrome chil-dren with ventricular septal defect.

  16. 先天性心脏病术后漏斗胸行Nuss手术28例%Efficacy of Nuss procedure in treatment of pectus excavatum after congenital heart disease operation: 28cases of report

    Institute of Scientific and Technical Information of China (English)

    李帅; 汤绍涛; 余鋮; 黄欣; 阳历; 王勇; 童强松; 毛永忠; 阮庆兰

    2012-01-01

    Objective To explore the feasibility and efficacy in therapy of pectus excavatum using Nuss procedure after congenital heart disease operation.Methods A retrospective study was carried out for 28 cases of pectus’ excavatum undertaking Nuss procedure after congenital heart disease (CHD) operation.The operative time,hospital stay time,curative efficacy,issues for heart function in pre-and post-operation,as well postoperative complications were targeted for analysis.Children with congenital pectus excavatum were set as control and children in both group had comparable age.Results The average operation time was 61.1 min (ranging 55-75 min),hospital stay time was averagely 9.2 days (ranging from 7 13 days).1 case of children was complicated with hemopericardium and cardiac tamponade,and was effectively managed by pericardial puncture under ultrasound guidance,followed by transfusion of cold precipitation (due to combined coagulation dysfunction); Asymptomatic pneumothorax was found in 2 cases,and recovery in 1 week without intervention.The ejection fraction were improved significantly in comparison of pre-operation (58.4 ± 2.3) and post-operation (61.2 ± 3.6) (P<0.05).Conclusions Nuss procedure is a safe and effective procedure for pectus excavatum after CHD operation in children with satisfactory efficacy.%目的 探讨Nuss手术治疗先天性心脏病(CHD)术后漏斗胸的可行性和疗效.方法 回顾分析Nuss手术治疗CHD术后漏斗胸28例的病例资料.观察其手术时间、住院时间、手术效果、手术前后心功能指标及术后并发症.结果 CHD术后漏斗胸28例患儿行Nuss手术均顺利完成.手术时间55~75 min,平均(61.1±7.6)min;住院时间7~13 d,平均(9.2±1.5)d.术中出现心包积血、心脏压塞1例及时予以B超下心包穿刺同时输注冷沉淀控制了病情(因合并凝血功能障碍);气胸2例,准备出院复查时发现,无明显症状观察1周出院,1个月后复诊完全吸收.术后心脏

  17. 射频消融术治疗肝癌术中并发症的观察与护理%Care for Complications in Treatment of Liver Cancer by Radiofrequency Ablation

    Institute of Scientific and Technical Information of China (English)

    王春华; 郑加生; 孙健; 刘莉

    2009-01-01

    目的 针对射频消融术(radiofrequency ablation,RFA)对原发性肝细胞性肝癌治疗中出现的不同并发症,探讨护理规范和体会.方法 采用RFA对肝癌患者实施治疗,观察总结术中出现的各种并发症及术中护理配合要点.结果 对348例原发性肝癌患者,行RFA治疗733例次,术中共出现14种并发症172例次,最常见的并发症为恶心、呕吐,发生率为8.4%(62/172);头晕、头痛发生率为3.7%;右肩疼痛3.5%;肝被膜下出血2.9%;气胸1.2%;心绞痛1.0%;血压升高或下降0.8%;心率失常、胆汁瘤、低血糖发生率分别为0.4%;心包填塞、肠痿、皮肤灼伤、细电极断裂发生率分别占0.1%.由于护士对术中可能出现的并发症有充分认识,术中施以及时有效的护理配合,协助医师及早发现、预防和治疗,控制了术中并发症的进展.结论 护士及时有效的护理配合及护士的预见性,能更好地协助医师工作,99%的术中并发症都能得到及时的控制,减轻了患者的痛苦.%Objective To discuss the nursing norm of various complications in treatment of primary hepatocellular carcinoma (HCC) by radiofrequency ablation (RFA).Methods Totally 348 patients with HCC were treated by RFA,and various complications arising while performing RFA were observed and suitable nursing measures were summarized.Results RFA treatment for 348 HCC patients was applied for 733 case times,among which 14 types of complications developed for 172 case times.The most common complications were nausea and vomit with an incidence of 8.4%(62/172).The incidence for dizziness and headache was 3.7%; for right shoulder pain 3.5%; for subcapsular hemorrhage of liver 2.9%; for pneumothorax 1.2%; for angina pectoris 1.0%; for fluctuation of blood pressure 0.8%; for arrhythmia,cholesteatoma,and hypoglycemia 0.4%; and for pericardial tamponade,intestinal fistula,skin burning,breakdown of micro-electrode 0.1%.However,the nurses fully knew the possible complications

  18. 合并有主动脉弓及升主动脉倒撕裂的DeBakeyⅢ型主动脉夹层腔内介入治疗的时机和效果%Timing of TEVAR treatment in DeBakeyⅢtype aortic dissection associated with arch and ascending aorta anti-tearing

    Institute of Scientific and Technical Information of China (English)

    王志伟; 管生; 王稼祥; 李震

    2013-01-01

    Objective To explore the timing and the efficacy of TEVAR treatment in DeBakeyⅢtype aortic dissection associated with arch and ascending aorta anti-tearing. Methods Clinical data of 10 patients with DeBakeyⅢaortic dissection associated with arch and ascending aorta anti-tearing from January 2010 to January 2013 were retrospectively analyzed. All the patients had ifnally stepped stent therapy on the basis of conservative treatment, were erplored according to the follow up results. Results One case conducted TEVAR treatment three days after admission because of poor blood pressure control, but died of sudden pericardial tamponade postoperative two days. After 4 weeks’ conservative treatment all of 9 patients were performed TEVAR, the postoperative patients recovered well and were followed up for 6 to 30 months without adverse events. Conclusions False lumen thrombosis in ascending aorta and aortic arch are stable and partially absorbed after four weeks with conservative management in the patients who have DeBakeyⅢaortic dissection with arch and ascending aorta anti-tearing, and then the aortic arch can provide a relatively stable anchoring zone in the proximal end for TEVAR.%目的:探讨主动脉腔内修复术(TEVAR)治疗合并有主动脉弓和(或)升主动脉倒撕裂的DeBakeyⅢ型主动脉夹层的手术时机及疗效。方法对2010年1月至2013年1月郑州大学第一附属医院介入科收治的10例DeBakeyⅢ型主动脉夹层、同时合并有主动脉弓和(或)升主动脉逆向撕裂患者,在保守治疗的基础上行介入覆膜支架治疗,结合随访情况,探讨对该类患者行主动脉腔内修复术(TEVAR)的可行性、治疗时机及效果。结果1例患者血压控制差,入院后第3天行TEVAR治疗,术后第2天突发心包填塞而死亡;余9例患者在保守治疗4周,CT血管造影(CTA)显示逆向撕裂假腔内血栓稳定并部分吸收后,均安全实施了常规TEVAR,术

  19. Balloon pulmonary valvotomy as interim palliation for symptomatic young infants with tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Remadevi K

    2008-01-01

    Full Text Available Objectives: To describe the case selection, technique and immediate and short-term results of balloon pulmonary valvotomy (BPV in young infants with tetralogy of Fallot (TOF. Background: Symptomatic young infants with TOF can either undergo corrective surgery or Blalock-Taussig (BT shunt. Corrective surgery in early infancy is associated with significant morbidity and is not a realistic option in many centers. BT shunt carries the risk of branch pulmonary artery distortion and shunt occlusion. Methods : Infants less than three months with a significant valvar pulmonary stenosis (with or without associated infundibular and annular component and oxygen saturation ≤ 80% were offered BPV. The right ventricular outflow tract (RVOT was crossed with 4F Judkin′s right coronary catheter and the valve was crossed with 0.014" coronary guide wire. Serial balloon dilatations were done with over the wire coronary balloons (3-4 mm and Mini Tyshak balloons up to a balloon annulus ratio of 2:1, depending upon the improvement in saturation and formation of annular waist. Results : Seventeen infants less than three months of age with tetralogy of Fallot (median age: 33 days, range: 10-90 days, weight: 3.47 ± 0.87 kg, pulmonary annulus Z score: -5.59 ± 1.04 including eight neonates underwent palliative BPV between May 2004 and March 2007. The mean balloon annulus ratio was 1.4 ± 0.28 and fluoroscopy time was 26.18 ± 20.2 minutes. The mean oxygen saturation increased significantly from 73 ± 7% to 90 ± 3.68% following BPV (p = 0.0001. The only major complication was RVOT perforation and pericardial tamponade in one infant. The mean follow-up period was 23 ± 12 months. Two babies developed significant desaturation requiring surgery in the six months following BPV. There was a significant increase in pulmonary annulus. The z score for the pulmonary annulus improved from -5.59 ±1.04 before BPV to - 4.31 ± 1.9 at the time of last follow-up (p = 0.018. The

  20. Ruptura subaguda da parede livre do ventrículo esquerdo pós-infarto agudo do miocárdio: relato de caso e revisão de literatura Post-infarct sub-acute left ventricular free wall rupture: case report and review of the literature

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    Alexandre Siciliano Colafranceschi

    2006-03-01

    Full Text Available A ruptura da parede livre do ventrículo esquerdo é uma complicação potencialmente fatal e de tratamento essencialmente cirúrgico. A correção cirúrgica é o tratamento de escolha, mas o manejo pré-operatório e as técnicas de correção ainda não estão claramente definidos, sendo determinados conforme as condições clínicas do paciente. Há carência na literatura de grandes séries envolvendo este tipo de afecção e os relatos são baseados nas experiências individuais, com pequeno número de pacientes. São apresentados dois casos de ruptura subaguda da parede livre do ventrículo esquerdo como complicação da evolução do infarto agudo do miocárdio. Discute-se a abordagem cirúrgica completa, com revascularização miocárdica concomitante e a utilização de circulação extracorpórea. A opção de correção do defeito por meio da sutura epicárdica com retalho de pericárdio bovino e a revascularização completa do miocárdio, sobretudo sem circulação extracorpórea, parece ser a melhor estratégia para um grupo de pacientes que apresentam ruptura subaguda da parede livre do ventrículo esquerdo pós-infarto agudo do miocárdio.Post-infarction left ventricular free wall rupture is life threatening and not uncommon. Surgical experience is largely anecdotal with different techniques being used since the first successful surgical treatment was described. Here we present two patients with subacute left ventricular rupture that were managed using different perioperative strategies. Although the aim of surgical intervention is first and foremost to remove the threat to life by relieving of tamponade and closure of the ventricular defect, longer-term goals were those of conventional coronary operations, i.e., to prevent or limit the development of angina postoperatively and to improve the prognosis. These latter goals are controversial, and are discussed. The small number of patients involved prevent us to determine which

  1. 导丝贯穿技术在肝静脉型布加综合征介入治疗中的应用%The technique of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction

    Institute of Scientific and Technical Information of China (English)

    朱蕻潮; 徐浩; 祖茂衡; 崔艳峰; 魏宁; 许伟; 张庆桥

    2015-01-01

    目的 探讨导丝贯穿技术在肝静脉型布加综合征(BCS)介入治疗中的应用价值.方法 回顾性分析2011年5月至2014年8月收治的25例肝静脉型BCS患者的临床资料.所有患者均用导丝贯穿法行肝静脉成形术.介入治疗前后测量肝静脉压力,用t检验评价治疗前后肝静脉压力的变化.结果 25例患者均成功用导丝贯穿法行肝静脉成形术.术中无血管破裂出血、心包填塞及肝包膜破裂出血等并发症发生.治疗后肝静脉压力由(48.3±8.0)cmH2O降至(20.9±3.8)cmH2O(t=26.82,P<0.05),治疗前后差异有统计学意义.术后所有患者临床症状、体征均明显缓解或消失.随访期间有4例患者再次出现BCS相关症状.其中2例再次行球囊扩张治疗成功,1例因肝硬化失代偿改用经颈静脉肝内门体分流(TIPS)治疗,另1例因患强直性脊柱炎第三次症状复发行肝静脉开通治疗失败.结论 采用导丝贯穿技术行肝静脉成形术治疗肝静脉型BCS是一种安全、有效的补充治疗方法,能提高肝静脉型BCS的治疗成功率.%Objective To investigate the value of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction.Methods A retrospective study was conducted on 25 patients with Budd-Chiari syndrome (BCS) with hepatic vein obstruction treated from May 2011 to August 2014.The technique of guide-wire loop was used in these patients.The pressure of the hepatic vein was measured before and after treatment.The difference in the pressure was analyzed by the t test.Results All the patients were treated successfully using guide-wire loop angioplasty.No complications of bleeding,pericardial tamponade and liver capsule hemorrhage were observed.After treatment,the pressure of the hepatic vein reduced from (48.3± 8.0) cmH2O to (20.9 ± 3.8) cmH2O (t =26.82,P < 0.05);The symptoms and physical signs of the patients were relieved or disappeared.BCS-related symptoms

  2. Estudo comparativo das reações teciduais ao implante de pericárdio bovino e a inclusão de politetrafluoroetileno expandido em ratos A comparison of tissue reactions to bovine pericardial implants and expanded polytetrafluoroethylene inclusions in a rat model

    Directory of Open Access Journals (Sweden)

    Douglas Haddad Filho

    2004-04-01

    Full Text Available OBJETIVO: Comparar a reação tecidual à inclusão de politetrafluoroetileno-expandido com a reação tecidual ao implante de pericárdio bovino. MÉTODOS: Vinte ratos foram divididos em dois grupos iguais: 7 e 30 dias. Um disco de cada material foi introduzido no dorso de cada animal. As peças e o tecido reacional foram retirados 7 e 30 dias após a introdução, para a realização do estudo morfométrico. Para análise estatística foram aplicados os testes de Mann-Whitney e Wilcoxon. RESULTADOS: No PTFE-E, no grupo 30 dias, houve um aumento significante no número de fibroblastos e uma diminuição significante no número de neutrófilos, linfócitos e apilares. Em relação ao pericárdio bovino, ocorreu uma diminuição significante no número de fibroblastos. Quando os mesmos períodos foram comparados, o número de fibroblastos foi significativamente maior no PTFE-E, aos 30 dias, assim como o número de plasmócitos e linfócitos no grupo 30 dias , no pericárdio bovino. CONCLUSÕES: A reposta inflamatória foi menor e menos durável no PTFE-E; a reparação foi menor no PTFE-E e não houve reação de corpo estranho para ambos os materiais.PURPOSE: It is to compare tissue reactions of the expanded polytetrafluoroethyele (E-PTFE implantation and the tissue reaction of the bovine pericardium implants. METHODS: Twenty male rats were divided into two equal groups: 7 and 30 days. A disc-shaped specimen of test material was introduced into each animal's paraspinal region. The material and the tissue were resected 7 and 30 days after the introduction, for morphometric analysis. The Mann-Whitney and Wilcoxon tests were applied for statistical analysis of the results. RESULTS: E-PTFE demonstrated a significant increase in the number of fibroblast at 30 days. A significant drop was noted in the number of neutrophils, lymphocytes and porcentage of capilaries within the time periods. Bovine pericadium displayed a strinking drop in the number of fibroblasts. When the same periods were compared, the number of fibrolasts was greater in the E-PTFE at 30 days. The number of plasmocytes and lymphocytes was greater at 30 days compared to bovine pericardium. CONCLUSION: The inflammatory response was minor and less persistant over time in the E-PTFE; repair using the synthetic material was speedier and it did not produce a foreign body reaction.

  3. Ácido L-glutâmico na prevenção da calcificação de pericárdio bovino fixado em glutaraldeído: estudo em ratos L-glutamic acid in the prevention of the calcification of bovine pericardial fixed in glutaraldehyde: study in rats

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    Andrea Dumsch de Aragon Ferreira

    2007-09-01

    Full Text Available OBJETIVO: Avaliar a eficácia do ácido L-glutâmico na prevenção da calcificação do pericárdio bovino implantado no subcutâneo de ratos. MÉTODO: Utilizaram-se 54 ratos Wistar, distribuídos em seis grupos, de acordo com o segmento de pericárdio bovino implantado. Inicialmente, todos os pericárdios foram fixados com glutaraldeído 0,5% por 72h. No grupo I, após a fixação, o pericárdio foi preservado em glutaraldeído 0,2% até o implante. O grupo II foi estocado em solução de Paraben. No grupo III e IV, após a fixação inicial, os pericárdios foram tratados com ácido L-glutâmico 8% com pH 7,4 e 3,5, respectivamente, sendo em seguida estocados em Paraben. Os grupos V e VI foram semelhantes aos grupos III e IV, exceto pela concentração do ácido L-glutâmico que foi de 0,8%. Os explantes foram feitos com 15, 30 e 60 dias, e as amostras submetidas à análise histológica com hematoxilina-eosina e Von Kossa, além da mensuração de cálcio por espectofotometria de absorção atômica. RESULTADOS: A mensuração por espectofotometria de absorção atômica demonstrou aumento progressivo da calcificação nos grupos I, II e III, aos 15, 30 e 60 dias. Nos grupos IV, V e VI, os níveis de cálcio permaneceram sem alteração nos períodos estudados. A análise microscópica demonstrou calcificação progressiva nos grupos I, II e III. Nos grupos IV, V e VI, a calcificação, quando observada, foi focal e de grau leve. CONCLUSÃO: O uso do ácido L-glutâmico em segmentos de pericárdio bovino, fixados pelo glutaraldeído, foi efetivo na prevenção da calcificação, quando implantados no subcutâneo de ratos por até 60 dias.OBJECTIVE: To evaluate the efficiency of L-glutamic acid to prevent calcification of glutaraldehyde bovine pericardium implanted in rats' subcutaneous tissues. METHODS: Fifty four Wistar rats were divided in six groups according to the type of the bovine pericardium implanted. At first, all pericardia were initially cross-linked with 0.5% glutaraldehyd (GDA fixative for 72 h. In Group I, after the initial fixation, the pericardia were preserved in 0.2% GDA fixative until the implantation, whereas in Group II they were stocked in Paraben solution. In Groups III and IV, after the initial fixation in 0.5% GDA fixative, the pericardia were treated with 8% L-glutamic acid at pH 7.4 and 3.5, respectivelly, being subsequently stocked in Paraben solution. Groups V and VI were similar to III and IV, except for the concentration of L-Glutamic acid which was 0.8%. Explantation was done at 15, 30, and 60 days, and the specimens submitted to histological analysis with Hematoxylin and eosin (HE and Von Kossa stains, besides calcium quantification with atomic spectrofotometry. RESULTS: Microscopic analysis demonstrated severe and progressive calcification in groups I, II, and III, whereas in groups IV, V, and VI calcification, when present, was mild and focal. Spectrofotomety confirmed these findings, revealing calcium contents of 1.93µg/mg of tissue at 60 days in the control group. Groups IV and VI showed the least calcium contents (0.063 e 0.066, respectively. CONCLUSIONS: The use of L-glutamic acid in segments of bovine pericardium with glutaraldehyde fixative was effective in preventing the calcification when implanted in rats' subcutaneous up to 60 days.

  4. Analysis of portal vein thrombosis of portal hypertension after pericardial devascularization by prophylactic anticoagulation%门静脉高压症贲门周围血管离断术后预防性抗凝对门静脉系统血栓形成的影响

    Institute of Scientific and Technical Information of China (English)

    卢志坤; 吴永强; 杨进华; 何德谋; 张权锋

    2015-01-01

    目的 分析门静脉高压症患者实施贲门周围血管离断术后给予预防性抗凝对门静脉系统血栓形成(PVT)的影响.方法 选择我院2009年1月至2014年12月收治的乙型肝炎肝硬化门静脉高压症患者86例,均给予贲门周围血管离断术治疗,以是否术后给予预防性抗凝治疗将其分为观察组(给予抗凝治疗,46例)与对照组(未给予抗凝治疗,40例),对比两组术后并发PVT的情况及临床特征.结果 观察组术后PVT的发生率为10.9% (5/46),PVT分级中Ⅰ、Ⅱ、Ⅲ、Ⅳ级分别为2、3、0、0例;而对照组的发生率为32.5%(13/40),PVT分级中Ⅰ、Ⅱ、Ⅲ、Ⅳ级分别为4、7、2、0例,观察组发生率低于对照组(x2=9.735,P<0.05).两组患者中是否并发PVT,与年龄、性别构成、术中是否结扎脾动脉无关(P均>0.05);而与术后血小板峰值、门静脉血流方向有关(P均<0.05).PVT患者经溶栓治疗有效均顺利出院,其中血栓溶解2例,血运再通4例,无一例死于PVT.结论 门静脉高压症患者实施贲门周围血管离断术后给予预防性抗凝治疗能显著降低PVT,门静脉离肝血流及术后血小板峰值(300~499)×109/L是并发PVT的重要因素,早期发现、及时溶栓治疗是诊治PVT的关键.%Objective To explore the effect of pathogenesis,diagnosis,therapy and prevention of portal vein thrombosis(PVT) after devascularization.Methods Data of 86 patients who underwent devascularization because of cirrhotic portal hypertension between January 2009 and December 2014 were retrospectively analyzed.Patients were divided into preventive anticoagulant treatment group (46 cases) and nonpreventive anticoagulant treatment group (40 cases) according to whether or not to receive prophylactic anticoagulant therapy.Compared the causes of PVT and clinical characters.Results The occurrence of PVT was 10.9% (5/ 46) in preventive anticoagulant treatment group,PVT Ⅰ , Ⅱ, Ⅲ, Ⅳdegree were 2,3,0,0 cases,and that was 32.5% (13/40) in nonpreventive anticoagulant treatment group, PVT Ⅰ , Ⅱ , Ⅲ, Ⅳ degree were 4,7,2,0 cases, the incidence rate of treatment group was lower than control group (x2 =9.735, P < 0.05).There was no relationship in PVT with sex, age, and intraoperative ligation of splenic artery beforehand (P>0.05).There were apparent correlation in PVT with centrifugal-flow of portal vein and peak value of platelet count(P<0.05).All patients discharged uneventfully after anticoagulant treatment, including 2 cases of thrombolytic and 4 cases of blood supply recanalization, no case died from PVT.Conclusion The definite cause of PVT after devascularization is centrifugal-flow of portal vein and the peak value of platelet count (300-499) × 109/L is a pivotal risk factor.The key point of therapy is early diagnosis and early anticoagulant treatment.

  5. Oclusão do apêndice atrial esquerdo com o Amplatzer Cardiac Plug em pacientes com fibrilação atrial Left atrial appendage closure with the Amplatzer Cardiac Plug in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Ênio Eduardo Guérios

    2012-06-01

    immediate results and short- to medium-term clinical follow-up (FU of patients that underwent LAAC with Amplatzer Cardiac Plug (ACP implantation in a single reference center. METHODS: Eighty-six consecutive patients with NVAF, contraindication to OA, and CHADS2 score=2.6±1.2 underwent LAAC with ACP implantation. Clinical and echocardiographic FU was performed at least four months after the procedure. RESULTS: All implants were guided by angiography alone. Procedural success was 99% (one patient suffered a cardiac tamponade requiring pericardiocentesis, and the procedure was waived. There were four major complications (the already mentioned cardiac tamponade, two transient ischemic attacks and one device embolization with percutaneous retrieval and two minor complications (one pericardial effusion without clinical significance and one non-significant ASD evidenced at FU. There was one in-hospital death after six days, unrelated to the procedure. All other patients were discharged without OA. After 25.9 patient-years of FU (69 patients, there were no strokes and no late device embolization. The LAA was completely closed in 97% of the cases. Six patients showed evidence of thrombus formation on the device, which resolved after three months of OA. CONCLUSION: LAAC is associated with high success, acceptable complication rates, and promising FU results, and may be considered a valuable alternative or complement to OA for stroke prevention in patients with NVAF.

  6. 心脏穿透伤后生存过程:类型演变和分类救治的研究%Injury evolution and classified treatment in survival process of penetrating cardiac trauma

    Institute of Scientific and Technical Information of China (English)

    杨波; 杨建

    2013-01-01

    time point by survival analysis.Impacts of medical interventions on prognosis of those patients were analyzed,such as pericardial space exploration,emergency room thoracotomy (ERT),operating room thoracotomy (ORT).Results Some patients at sub-clinical phase were aggravated into clinical phase or agonal phase,as well as some patients at clinical phase were aggravated into agonal phase during in-hospital treatment.There were significance differences of posttraumatic suvival course among the four groups,namely sub-clinical type,cardiac tamponade type,hemorrhagic shock type and agonal type (P < 0.01).The differences of posttraumatic survival course were also significant among the three groups,namely sub-clinical phase,clinical phase and agonal phase (P < 0.01).Conclusion Clinical symptom classification (or pathogenesis phase) of PCT may not be always unchangeable,thus it is recommended that PCT patients should be treated based on their clinical symptom classification or patbogenesis phase at consultation.

  7. Spontaneous Bacterial Pericarditis and Coronary Sinus Endocarditis Caused by Oxacillin-Susceptible Staphylococcus aureus

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    Maurício N. Machado

    2010-01-01

    Full Text Available This paper describes a case of a 44-year-old male patient previously healthy admitted with an unusual spontaneous acute bacterial pericarditis associated with coronary sinus mass. Two-dimensional echocardiography showed large loculated pericardial effusion with signs of diastolic restriction and an image suggesting vegetation in topography of the right atrium coronary sinus. Pericardial drainage, coronary sinus vegetation resection, and antibiotic therapy with Oxacillin were performed due to Oxacillin-susceptible Staphylococcus aureus identified on the pericardial effusion and blood culture. This is a rare condition and a unique combination of a spontaneous acute bacterial pericarditis with coronary sinus endocarditis without cardiac valve compromise.

  8. Screening for genes involved in Klebsiella pneumoniae biofilm formation using a fosmid library

    DEFF Research Database (Denmark)

    Stahlhut, Steen G; Schroll, Casper; Harmsen, Morten;

    2010-01-01

    Klebsiella pneumoniae is a well-known opportunistic pathogen, often causing catheter-associated urinary tract infections. Biofilm formation on the catheter surfaces is an important step in the development of these infections. To identify the genes involved in the ability of K. pneumoniae to form...

  9. Transformational Teamwork: Exploring the Impact of Nursing Teamwork on Nurse-Sensitive Quality Indicators.

    Science.gov (United States)

    Rahn, Debbie J

    2016-01-01

    The purpose of this research was to investigate the relationship between nursing teamwork and NDNQI outcomes including pressure ulcers, falls, and catheter-associated urinary tract infections. Correlational analysis resulted in statistically significant relationships. Improving teamwork in medical-surgical acute care units can transform care and impact the occurrence of preventable adverse outcomes. PMID:26845422

  10. PREZIES: PREventie van ZIEkenhuisinfecties door Surveillance. Deelcomponent lijnsepsis, pilot 1999

    NARCIS (Netherlands)

    Talsma E; Mintjes-de Groot AJ; Batenburg LA; Geubbels ELPE; Berg JMJ van den; Boer AS de; Kwaliteitsinstituut voor de; CIE

    2000-01-01

    Objective: To evaluate the feasibility of the surveillance component catheter associated (CA) sepsis within the PREZIES-network of Dutch hospitals. The ultimate goal is the introduction of standardised surveillance of CA sepsis in hospitals and the generation of reference figures for individual hosp

  11. Effect of the adhesive antibiotic TA on adhesion and initial growth of E-coli on silicone rubber

    NARCIS (Netherlands)

    Simhi, E; van der Mei, HC; Ron, EZ; Rosenberg, E; Busscher, HJ

    2000-01-01

    Catheter-associated urinary tract infection is the most common nosocomial infection, and contributes to patient morbidity and mortality. We investigated the effect that the TA adhesive antibiotic had on adhesion and initial growth in urine of Escherichia coli on silicone rubber. The TA antibiotic ha

  12. The danger of chlorhexidine in lignocaine gel: A case report of anaphylaxis during urinary catheterisation

    OpenAIRE

    Stewart, Michael; Lenaghan, Daniel

    2015-01-01

    This article describes a case of anaphylaxis secondary to chlorhexidine during urethral catheterisation. Despite little evidence for the use of antiseptic lubricants in preventing catheter-associated urinary tract infections, the distribution and use of such products continues to be widespread. Chlorhexidine-free lubricating gel is widely available and should be used for urological procedures wherever possible.

  13. AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus

    Science.gov (United States)

    Abboud, Samir; Raparia, Kirtee; Ubago, Julianne M.; Resnick, Scott

    2016-01-01

    Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy. PMID:26509915

  14. Transformational Teamwork: Exploring the Impact of Nursing Teamwork on Nurse-Sensitive Quality Indicators.

    Science.gov (United States)

    Rahn, Debbie J

    2016-01-01

    The purpose of this research was to investigate the relationship between nursing teamwork and NDNQI outcomes including pressure ulcers, falls, and catheter-associated urinary tract infections. Correlational analysis resulted in statistically significant relationships. Improving teamwork in medical-surgical acute care units can transform care and impact the occurrence of preventable adverse outcomes.

  15. Is persistent hypotension after transient cardiogenic shock associated with an inflammatory response?

    Directory of Open Access Journals (Sweden)

    M. Park

    2008-08-01

    Full Text Available We evaluated the recovery of cardiovascular function after transient cardiogenic shock. Cardiac tamponade was performed for 1 h and post-shock data were collected in 5 domestic large white female pigs (43 ± 5 kg for 6 h. The control group (N = 5 was observed for 6 h after 1 h of resting. During 1 h of cardiac tamponade, experimental animals evolved a low perfusion status with a higher lactate level (8.0 ± 2.2 vs 1.9 ± 0.9 mEq/L, lower standard base excess (-7.3 ± 3.3 vs 2.0 ± 0.9 mEq/L, lower urinary output (0.9 ± 0.9 vs 3.0 ± 1.4 mL·kg-1·h-1, lower mixed venous saturation, higher ileum partial pressure of CO2-end tidal CO2 (EtCO2 gap and a lower cardiac index than the control group. Throughout the 6-h recovery phase after cardiac tamponade, tamponade animals developed significant tachycardia with preserved cardiac index, resulting in a lower left ventricular stroke work, suggesting possible myocardial dysfunction. Vascular dysfunction was present with persistent systemic hypotension as well as persistent pulmonary hypertension. In contrast, oliguria, hyperlactatemia and metabolic acidosis were corrected by the 6th hour. The inflammatory characteristics were an elevated core temperature and increased plasma levels of interleukin-6 in the tamponade group compared to the control group. We conclude that cardiovascular recovery after a transient and severe low flow systemic state was incomplete. Vascular dysfunction persisted up to 6 h after release of tamponade. These inflammatory characteristics may also indicate that inflammatory activation is a possible pathway involved in the pathogenesis of cardiogenic shock.

  16. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma.

    Science.gov (United States)

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-05-01

    Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patients whose condition is unstable in the setting of blunt thoracic trauma regardless of imaging conclusions. PMID:27106431

  17. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma

    OpenAIRE

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-01-01

    International audience Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patien...

  18. [Successful preclinical thoracotomy in a 17-year-old man].

    Science.gov (United States)

    Puchwein, P; Prenner, G; Fell, B; Sereinigg, M; Gumpert, R

    2014-09-01

    We report the case of a 17-year-old man who sustained multiple stab wounds after a knife attack. After arrival of the emergency medical team the patient suffered a cardiac arrest caused by cardiac tamponade. After emergency thoracotomy and open heart massage the patient developed ROSC and could be discharged 13 days later without neurological deficits. Prehospital thoracotomy is rarely performed in Austria but is the only realistic chance for survival in cases of hematopericardium and tamponade. Better training of emergency physicians in Austria concerning surgical resuscitation could increase survival rates especially after penetrating thoracic trauma.

  19. Erlotinib Hydrochloride With or Without Carboplatin and Paclitaxel in Treating Patients With Stage III-IV Non-small Cell Lung Cancer

    Science.gov (United States)

    2016-06-29

    Adenosquamous Lung Carcinoma; Bronchioloalveolar Carcinoma; Lung Adenocarcinoma; Malignant Pericardial Effusion; Malignant Pleural Effusion; Stage IIIB Non-Small Cell Lung Cancer; Stage IV Non-Small Cell Lung Cancer

  20. Disease: H01039 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available om the intravascular to the third space, which may result in ascites, pleural infusions, pericardial infus...ion, and even generalized edema. Majority of OHSS cases have been associated with t

  1. Pendulous Heart with Alternating Axis: A Suspicious Clue for Diagnosis of a Rare Disease

    Directory of Open Access Journals (Sweden)

    Abbas Ali Rafighdoust

    2015-03-01

    Full Text Available Absence of pericardium is a rare type of pericardial disorders. Left sided pericardial absence is more common than the right one. This disorder may present with a variety of signs and symptoms or abnormalities in electrocardiography and echocardiography. In this report, we discussed diagnosis of partial absence of pericardium in a 52-year-old man presented with a dull left-sided chest pain from 4 months ago with special electrocardiographic features. The axis deviations in his serial electrocardiograms led us to further evaluations with possible diagnosis of pericardial absence. His echocardiography and Magnetic Resonance Imaging (MRI confirmed the suspicion of pericardial absence. Suspicion of potentially life-threatening cardiac abnormalities should remain even while facing atypical chest pain or other non-specific symptoms. In this case, abnormal electrocardiographic and chest X-Ray findings together with echocardiography were all helpful in referring the patient for cardiac MRI as the imaging modality of choice in such cases.

  2. Peritoneal Fluid Analysis

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? Peritoneal Fluid Analysis Share this page: Was this page helpful? Formal name: Peritoneal Fluid Analysis Related tests: Pleural Fluid Analysis , Pericardial Fluid Analysis , ...

  3. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol.

    NARCIS (Netherlands)

    Corrado, D.; Pellicia, A.; Bjørnstad, H.; Vanhees, L.E.M.J.; Biffi, A.

    2005-01-01

    Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology.

  4. GETDB: 105176 [GETDB

    Lifescience Database Archive (English)

    Full Text Available ved from the National Institute of Genetics. CyUW14 Link to clone table - 1 750 Link to cluster table 750 1 Request - CNS, pericard... 1 Stock Request Request - Embryonic Expression CNS, pericardial cells? Larval GF

  5. Chylopericardium as a complication of cardiac surgery: Report of two cases and review of the literature

    OpenAIRE

    Velinović Miloš; Vraneš Mile; Kočica Mladen; Đukić Petar; Mikić Aleksandar; Vukomanović Vladislav; Kačar Saša; Putnik Svetozar; Divac Ivan; Marković Dejan; Seferović Petar M.; Ristić Arsen D.

    2007-01-01

    Chylopericardium refers to existing communication between the pericardial sac and the thoracic duct carrying the chyle. The objective of our report was to highlight the specificity of diagnosis and treatment of this rare but tedious condition through the analysis of two case reports. Male patient, aged 63 years, with chylopericardium was diagnosed perioperatively (implantation of artificial aortic - St. Jude No 21 and mitral valve - St. Jude No 29). Etiology of pericardial effusion was establ...

  6. Erdheim Chester Disease treated successfully with cladribine

    OpenAIRE

    Azadeh, Natalya; Tazelaar, Henry D.; Gotway, Michael B.; Mookadam, Farouk; Fonseca, Rafael

    2016-01-01

    A 61-year-old previously healthy male with a history of progressive fatigue, lower extremity edema, and dyspnea for 4 months was hospitalized with pericardial and pleural effusions (Figure 1A, B). Lung, pleural, and pericardial biopsies were consistent with Erdheim-Chester disease. He was treated with systemic steroids, and ultimately tried on PEG-interferon. He deteriorated clinically and the disease progressed to include CNS manifestations. Ultimately he was treated with Cladribine, at a do...

  7. Iatrogenic intrapericardial diaphragmatic hernia diagnosed by cardiovascular magnetic resonance

    OpenAIRE

    Entrikin Daniel W; Chughtai Haroon L; Drafts Brandon C

    2010-01-01

    Abstract Intrapericardial diaphragmatic hernias are very uncommon and are most typically caused by high-force blunt trauma. Other iatrogenic causes such as prior surgical formation of a pericardial window have been described, but are exceedingly rare. We present a case of an intrapericardial diaphragmatic hernia in a patient with a prior pericardial window in which the diagnosis was unclear using conventional imaging modalities, but was established using cardiovascular magnetic resonance.

  8. Atypical Presentation of Constrictive Pericarditis in a Holstein Heifer

    Directory of Open Access Journals (Sweden)

    Mohamed M. Elhanafy

    2012-01-01

    Full Text Available The field diagnosis of constrictive pericardial effusion is often established on the pertinent pathognomonic physical examination findings, but the condition cannot be ruled out based on absence of these cardinal signs. Constrictive pericardial effusion is not always manifested by bilateral jugular venous distention and pulsation, brisket edema, and muffled heart sounds, all of which are considered the key points in the field diagnosis of pericardial effusion and hardware disease. This case will also document that the outcomes of hematology, serum biochemistry panels, and blood gas analysis can be totally inconsistent with passive venous congestion and constrictive pericardial effusion in cattle. Chest radiographic findings revealed radio dense, wire-like objects; the findings were suggestive but not conclusive for pericardial or pleural effusions, due to indistinguishable diaphragmatic outline and cardiopulmonary silhouette. Cardiac ultrasonography was found to be an excellent paraclinical diagnostic procedure for cases that potentially have traumatic pericarditis and constrictive pericardial effusion. Ultrasound-guided pericardiocentesis was also a valuable diagnostic aid in establishing a definitive diagnosis.

  9. [Cardiac invasion of ATLL cells and therapeutic effects of local along with systemic treatments].

    Science.gov (United States)

    Imoto, S; Nakagawa, T; Ito, M

    1989-07-01

    We report a rare case of adult T cell leukemia/lymphoma (ATLL) in which cardiac invasion was clinically demonstrated and treated effectively. A 45-year-old female was admitted because of exertional dyspnea and cervical tumors. The leukocyte count was 19,100/microliters with 20% of flower cells. HTLV-I antibody was positive. She was diagnosed as ATLL and treated with VEPA. She got remission for a short duration which was followed by relapse. OPEC was started as salvage therapy. In the course, extensive pericardial effusion was found in chest X-P. Pericardial puncture demonstrated ATLL cells and high titer of free IL-2 receptor (57,400U/ml) in the effusion. It was diagnosed as pericardial invasion of ATLL cells. Chemotherapy was started with new combination of drugs (cisplatin, mitoxantrone, ifosfamide, and prednisolone). Concomitantly pericardial drainage was performed and the drugs were administered directly into the pericardial cavity. The clinical improvement was obtained and pericardial effusion did not appear thereafter. She died 4 months after the diagnosis of cardiac invasion. On autopsy myocardial invasion was identified. The pericardium widely adhered and effusion measured 42 ml. PMID:2810792

  10. Myocardial infarction and left ventricular free wall rupture in a patient with a prior pericardiectomy

    OpenAIRE

    Gosal, Tirath; Phillipp, Roger; Morris, Andrew L

    2008-01-01

    A 59-year-old man with an inferolateral myocardial infarction and cardiogenic shock was found to have extensive intrathoracic hemorrhage in communication with the left ventricle. His remote pericardiectomy precluded hemopericardium and tamponade, and permitted the establishment of an unusual diagnosis and subsequent closure of the site of myocardial perforation.

  11. [Retinal detachment with retinoschisis--case report].

    Science.gov (United States)

    Cristescu, R; Muşat, O; Toma, Oana; Coma, Corina; Gabej, Ioana; Burcea, M

    2013-01-01

    We present the case of a 43 year old patient diagnosed with rhegmatogenous retinal detachment and retinoschizis, a rare case of disease association. Surgery is recommended and we practice 23 gauge vitrectomy, laser retinopexy, criopexy in the periphery and internal heavy oil tamponade. Postoperatory evolution was favorable.

  12. Interplay of co-inherited diseases can turn benign syndromes in a deadly combination : haemoglobinopathy and bilirubin transport disorder

    NARCIS (Netherlands)

    Stolmeijer, T. M.; van den Berg, A. P.; Koeze, J.; Gouw, A. S. H.; Croles, F. N.; Sieders, E.; Zijlstra, J. G.

    2015-01-01

    We present a case about a 25-year-old male patient suffering from a rare genetic disorder called Mizuho haemoglobin. He was admitted to the Intensive Care Unit with acute liver and renal failure. During admission he also developed a cardiac tamponade twice. Finally he received a liver transplantatio

  13. Behandling af blødende øsofagusvaricer med selvekspanderende metalstenter

    DEFF Research Database (Denmark)

    Dahlerup, Jens F; Kruse, Aksel; Grønbaek, Henning;

    2007-01-01

    We report that haemostasis was obtained by the use of SEMS in two patients with bleeding oesophageal varices which failed conventional therapy (vasoactive drugs, antibiotics, endoscopy, and Sengstaken balloon tamponade). One patient subsequently died of sepsis; the other was treated with TIPS...

  14. Intraocular inflammation following endotamponade with high-density silicone oil.

    NARCIS (Netherlands)

    Theelen, T.; Tilanus, M.A.D.; Klevering, B.J.

    2004-01-01

    BACKGROUND: The use of a mixture of silicone oil and partially fluorinated alkanes (high-density silicone oil) has recently been suggested as intraocular tamponade in complicated retinal detachment of the inferior quadrants. We describe a series of patients who developed a clinical picture resemblin

  15. Surgical treatment of posttraumatic foreign bodies in the heart or great vessels

    Institute of Scientific and Technical Information of China (English)

    JIANG Chun-li; GU Tian-xiang; WANG Chun

    2006-01-01

    @@ Posttraumatic foreign bodies in the heart or great vessels is rare, which may cause cardiac tamponade, bleeding, shock, infection, embolism,arrhythmia, valve dysfunction, etc.1-3 The foreign bodies can be removed by surgery or percutaneous intervention.4 In this report we reviewed our experience in managing posttraumatic foreign bodies in 13 patients at our institution from 1992 to 2002.

  16. Sewing needle: a rare cause of intra-cardiac foreign body in a 3-year-old child.

    Science.gov (United States)

    Choudhary, Sandeep; Pujar Venkateshacharya, Suresh; Reddy, Chinnaswamy

    2016-10-01

    Sewing needles are rare causes of penetrating cardiac injury. Suicidal attempt, accidental penetration, domestic violence, and child abuse are likely causes for such injury. 1 Owing to their sharp nature, needles can rapidly migrate through the tissues. Fatalities are due to cardiac tamponade, infection, peripheral embolism, and valve dysfunction. PMID:27321856

  17. Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; La Cour, Morten

    2013-01-01

    a role in refraction, including measurement of the axial length, changes in the effective lens position and the anterior chamber depth, the use of intraocular gas tamponade, the formula for intraocular lens (IOL) power calculation, and the IOL type. Most phakic eyes with macular hole or epiretinal...

  18. Effect of intracapsular hyperpressure on femoral head blood flow. Laser Doppler flowmetry in dogs.

    Science.gov (United States)

    Vegter, J; Klopper, P J

    1991-08-01

    Intracapsular hyperpressure in the hip joint of dogs affected femoral head blood flow, especially in the juvenile animals. Graphic recording of the laser Doppler signal curve using rapid sampling time demonstrated venous hip joint tamponade in both juvenile and adult dogs. Laser Doppler flowmetry seems to be a sensitive and reproducible method to demonstrate femoral-head blood-flow changes.

  19. Pharmacokinetics of intravitreal 5-flurouracil prodrugs in silicone oil. Experimental studies in pigs

    DEFF Research Database (Denmark)

    Laugesen, Caroline S; Steffansen, Bente; Scherfig, Erik;

    2005-01-01

    PURPOSE: To examine the in vivo pharmacokinetics of intravitreal 5-Fluorouracil (5-FU) following tamponade with 5-FU prodrug silicone oil formulations. METHOD: Two different alkoxycarbonyl 5-FU prodrugs denoted C12 and C18 were synthesized and formulated as silicone oil suspensions. A total of 26...

  20. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

    2003-02-01

    To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)