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Sample records for permanent indwelling catheters

  1. Indwelling catheter care

    Science.gov (United States)

    Foley catheter ... You will need to make sure your indwelling catheter is working properly. You will also need to ... not get an infection or skin irritation. Make catheter and skin care part of your daily routine. ...

  2. Implantation port-catheter permanent indwelling of pulmonary artery in treating lung metastasis from HCC

    International Nuclear Information System (INIS)

    Cheng Jiemin; Wang Jianhua; Yan Zhiping; Wang Xiaolin; Gong Gaoquan; Liu Qingxin

    2000-01-01

    Objective: To observe the efficacy of a percutaneous implantation port-catheter permanent indwelling pulmonary artery for regional chemotherapy of the metastatic lung cancer from HCC. Methods: Between 1995 and 1999, 62 patients (42 males, 20 females; mean age 46 years) suffering from the metastatic lung cancer from HCC underwent percutaneous implantation of port-catheter permanent indwelling pulmonary artery using the right subclavian vein. In 19 patients with metastatic tumor located on one side of the lung, an indwelling catheter was placed into the ipsilateral side pulmonary artery. With metastasis of both sides, the catheter was inserted into the main trunk of pulmonary artery. The regimens of the chemotherapy were 5-FU + CDDP + MMC(FDM) or 5-FU + CDDP + MMC(FDA). Results: The interventional procedure was successfully completed in all 62 cases (100%). The complications occurred in 8% cases, including infections (3.2%), unhealed wound (1.6%) and pneumothorax (3.2%). The treatment effects of 3-months after the procedure were as follows: the obvious decrease of lung tumor size was 35.5%; stable disease (SD) 32.3% and progressive disease (PD) 32.3%. 6 months follow-up: 12 patients were dead (12/62) and the others are still doing well. The response rates were 22.6%, partial response (PR) 32.3%; stable disease (SD) 25.8% and progressive disease (PD) 32.3%. Conclusions: The percutaneous implantation techniques of pulmonary arterial port-catheter could be a good method in the treatment of metastatic lung cancer from HCC because of it is simple, with few complications and positive effect

  3. Prolonged use of indwelling urinary catheter following acute urinary ...

    African Journals Online (AJOL)

    J.O. Bello

    prolonged use of urinary catheters following acute urinary retention secondary to benign prostate enlarge- ment (BPE) and urethral ... indwelling urinary catheter for >3 months following acute urinary retention due to BPE or USD. The study .... the major health-care financing strategy in Nigeria and accounts for more than ...

  4. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration.

    Science.gov (United States)

    Pasalioglu, Kadriye Burcu; Kaya, Hatice

    2014-07-01

    Intravenous catheters have been indispensable tools of modern medicine. Although intravenous applications can be used for a multitude of purposes, these applications may cause complications, some of which have serious effects. Of these complications, the most commonly observed is phlebitis. This study was conducted to determine the effect of catheter indwell time on phlebitis development during peripheral intravenous catheter administration. This study determined the effect of catheter indwell time on phlebitis development during peripheral intravenous catheter administration. The study included a total of 103 individuals who were administered 439 catheters and satisfied the study enrollment criteria at one infectious diseases clinic in Istanbul/Turkey. Data were compiled from Patient Information Forms, Peripheral Intravenous Catheter and Therapy Information Forms, reported grades based on the Visual Infusion Phlebitis Assessment Scale, and Peripheral Intravenous Catheter Nurse Observation Forms. The data were analyzed using SPSS. Results : The mean patient age was 53.75±15.54 (standard deviation) years, and 59.2% of the study participants were men. Phlebitis was detected in 41.2% of peripheral intravenous catheters, and the rate decreased with increased catheter indwell time. Analyses showed that catheter indwell time, antibiotic usage, sex, and catheterization sites were significantly associated with development of phlebitis. The results of this study show that catheters can be used for longer periods of time when administered under optimal conditions and with appropriate surveillance.

  5. The relationship between peripheral intravenous catheter indwell time and the incidence of phlebitis.

    Science.gov (United States)

    Powell, Jessica; Tarnow, Karen Gahan; Perucca, Roxanne

    2008-01-01

    The purpose of this study was to determine any relationship between peripheral IV catheter indwell time and phlebitis in hospitalized adults. A retrospective review of quarterly quality assurance data-monitoring indwell time, phlebitis rating, and site and tubing labels-was performed. Of 1,161 sites, only 679 had documented indwell time to use. Average indwell time was 1.9 days, and overall phlebitis rate was 3.7%. Analysis of variance revealed a significant association between phlebitis and indwell time. However, asymptomatic peripheral IVs may not need to be removed at regular intervals because there were healthy, asymptomatic sites with indwell time up to 10 days.

  6. Managing malignant pleural effusion with an indwelling pleural catheter: factors associated with spontaneous pleurodesis.

    Science.gov (United States)

    Wong, W M; Tam, T Cc; Wong, M Ky; Lui, M Ms; Ip, M Sm; Lam, D Cl

    2016-08-01

    Malignant pleural effusion can be recurrent despite active anti-cancer treatment. Significant malignant pleural effusion leads to debilitating dyspnoea and worsening quality of life in patients with advanced cancer. An indwelling pleural catheter offers a novel means to manage recurrent malignant pleural effusion and may remove the need for repeated thoracocentesis. Spontaneous pleurodesis is another unique advantage of indwelling pleural catheter placement but the factors associated with its occurrence are not clearly established. The aims of this study were to explore the safety of an indwelling pleural catheter in the management of symptomatic recurrent malignant pleural effusion, and to identify the factors associated with spontaneous pleurodesis. This case series with internal comparisons was conducted in the Division of Respiratory Medicine, Department of Medicine, Queen Mary Hospital, Hong Kong. All patients who underwent insertion of an indwelling pleural catheter from the initiation of such service from January 2010 to December 2014 were included for data analysis. Patients were monitored until December 2014, with the last catheter inserted in July 2014. Between 2010 and 2014, a total of 23 indwelling pleural catheters were inserted in 22 consecutive patients with malignant pleural effusion, including 15 (65.2%) cases with malignant pleural effusion as a result of metastatic lung cancer. Ten (43.5%) cases achieved minimal output according to defined criteria, in five of whom the pleural catheter was removed without subsequent re-accumulation of effusion (ie spontaneous pleurodesis). Factors associated with minimal output were the absence of trapped lung (P=0.036), shorter time from first appearance of malignant pleural effusion to catheter insertion (P=0.017), and longer time from catheter insertion till patient's death or end of study (P=0.007). An indwelling pleural catheter provides a safe means to manage symptomatic malignant pleural effusion

  7. Nursing care of indwelling catheter thrombolysis for acute thrombosis in the arteriovenous fistula in hemodialysis patients

    International Nuclear Information System (INIS)

    Gao Peizhu; Ding Wenbin; Ming Zhibing; Sun Juyun

    2010-01-01

    Objective: To summarize the experience of the nursing care of indwelling catheter thrombolysis for acute thrombosis in the arteriovenous fistula in eight hemodialysis patients. Methods: After breaking thrombus through indwelling catheter, both bolus injection and micro-pump continuous infusion of urokinase was employed in eight hemodialysis patients with acute thrombosis in the arteriovenous fistula. The necessary nursing measures were carried out to assist the whole therapeutic procedure. Results: All the patients could well cooperate with the procedure of indwelling catheter thrombolysis and urokinase infusion. The reopening rate of the obstructed fistula was 100%. Conclusion: Indwelling catheter thrombolysis with urokinase infusion is a simple, effective and safe treatment for acute thrombosis in the arteriovenous fistula in hemodialysis patients. In order to obtain optimal results, necessary nursing measures must be carried out. (authors)

  8. Total parenteral alimentation via indwelling umbilical catheters in the newborn period.

    Science.gov (United States)

    Hall, R T; Rhodes, P G

    1976-01-01

    Total parenteral alimentation (TPA) was delivered to 80 infants via indwelling umbilical artery and to 9 via indwelling umbilical venous catheters. The primary indication for catheter placement and maintenance was monitoring of arterial blood gases (umbilical venous catheter tip in left atrium) in a group of sick neonates requiring increased inspired oxygen or assisted ventilation. Results were compared with those from 23 infants who had tunnelled jugular catheters for a variety of chronic medical and surgical problems preventing gastric or intestinal feeding. A mean weight gain was achieved in both groups. Mortality and morbidity rates were similar in both groups. The most common complications were infection and thrombotic phenomena. Metabolic complications were few. It is concluded that infusing TPA solutions via indwelling umbilical catheters presents no greater risk than infusion via tunnelled jugular catheters, and provides a method for supplying adequate caloric intake for growth during the acute stage of illness. PMID:827978

  9. Nursing care for patients carrying indwelling catheter in target vessel for continuous chemotherapy

    International Nuclear Information System (INIS)

    Wen Lihong

    2009-01-01

    Objective: To reduce the occurrence of undesirable catheter-related events in patients with indwelling catheter during the course of continuous chemotherapy. Methods: (1)To enhance the propaganda,education and guidance to patients. (2) To standardize the nursing care operations. (3) To establish the reasonable care rules and procedures. (4) The nurses should take the daily nursing care,observations and recording work seriously. Results: Through the analysis of a variety of problems occurred in patients with indwelling catheter during the course of continuous chemotherapy the nursing care experience was summed up. Conclusion: Proper and effective care can reduce the occurrence of undesirable catheter-related events in patients with indwelling catheter during the course of continuous chemotherapy. (authors)

  10. Large-volume paracentesis with indwelling peritoneal catheter and albumin infusion: a community hospital study

    Directory of Open Access Journals (Sweden)

    Daniel K. Martin

    2016-10-01

    Full Text Available Background: The management of ascites can be problematic. This is especially true in patients with diuretic refractory ascites who develop a tense abdomen. This often results in hypotension and decreased venous return with resulting renal failure. In this paper, we further examine the risks and benefits of utilizing an indwelling peritoneal catheter to remove large-volume ascites over a 72-h period while maintaining intravascular volume and preventing renal failure. Methods: We retrospectively reviewed charts and identified 36 consecutive patients undergoing continuous large-volume paracentesis with an indwelling peritoneal catheter. At the time of drain placement, no patients had signs or laboratory parameters suggestive of spontaneous bacterial peritonitis. The patients underwent ascitic fluid removal through an indwelling peritoneal catheter and were supported with scheduled albumin throughout the duration. The catheter was used to remove up to 3 L every 8 h for a maximum of 72 h. Regular laboratory and ascitic fluid testing was performed. All patients had a clinical follow-up within 3 months after the drain placement. Results: An average of 16.5 L was removed over the 72-h time frame of indwelling peritoneal catheter maintenance. The albumin infusion utilized correlated to 12 mg/L removed. The average creatinine trend improved in a statistically significant manner from 1.37 on the day of admission to 1.21 on the day of drain removal. No patients developed renal failure during the hospital course. There were no documented episodes of neutrocytic ascites or bacterial peritonitis throughout the study review. Conclusion: Large-volume peritoneal drainage with an indwelling peritoneal catheter is safe and effective for patients with tense ascites. Concomitant albumin infusion allows for maintenance of renal function, and no increase in infectious complications was noted.

  11. Intraperitoneal Urinary Bladder Perforation with Pneumoperitoneum in Association with Indwelling Foley Catheter Diagnosed in Emergency Department.

    Science.gov (United States)

    Zhan, Chenyang; Maria, Pedro P; Dym, R Joshua

    2017-11-01

    Indwelling Foley catheter is a rare cause of urinary bladder perforation, a serious injury with high mortality that demands accurate and prompt diagnosis. While the gold standard for diagnosis of bladder injury is computed tomography (CT) cystography, few bladder ruptures associated with Foley catheter have been reported to be diagnosed in the emergency department (ED). An 83-year-old man with indwelling Foley catheter presented to the ED for hematuria and altered mental status. He was diagnosed to have intraperitoneal rupture of the urinary bladder in the ED using abdominal and pelvic CT without contrast, which demonstrated bladder wall discontinuity, intraperitoneal free fluid, and pneumoperitoneum. The patient was treated successfully with medical management and bladder drainage. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: To our knowledge, this is the first report of intraperitoneal urinary bladder perforation associated with Foley catheter diagnosed in the ED by CT without contrast. Pneumoperitoneum found in this case was a clue to the diagnosis and is a benign finding that does not necessitate urgent surgical intervention. The early and accurate diagnosis in this case allowed for effective management with good clinical outcome. The use of indwelling Foley catheter has a high prevalence, especially in long-term care facility residents, who are frequent visitors in the ED. Therefore, emergency physicians and radiologists should be familiar with the presentation and imaging findings of this potential injury associated with Foley catheters. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Using an indwelling catheter for the domiciliary management of malignant effusions

    Directory of Open Access Journals (Sweden)

    Ramkumar P

    2003-01-01

    Full Text Available Background: Many patients with malignant pleural effusions and ascites require repeated hospital visits for paracentesis. Materials and Methods: Patients and caregivers were taught to drain malignant effusions at home, using an indwelling catheter inserted into the pleural/ peritoneal cavity. The catheter, (ARROW 14 wire gauge with three additional side holes made to prevent blockage was inserted using the Seldenger technique for central venous cannulation and secured with a stitch. A three way stopcock was used to regulate fluid drainage. The caregiver was taught to do biweekly dressings with antiseptic ointment. Results: The catheter has been used in 200 patients over a period of five years. Two patients developed infections in the pleural cavity, which were managed with antibiotics. Two patients needed catheter change because of blockage. Other patients retained the catheter till last follow up or death. The procedure can be carried out as a day case. This article describes practical guidelines for inserting and maintaining the catheter.

  13. A guideline for adults with an indwelling urinary catheter in different health care Settings - methodological procedures

    Science.gov (United States)

    Barbezat, Isabelle; Willener, Rita; Jenni, Giovanna; Hürlimann, Barbara; Geese, Franziska; Spichiger, Elisabeth

    2017-07-01

    Background: People with an indwelling urinary catheter often suffer from complications and health care professionals are regularly confronted with questions about catheter management. Clinical guidelines are widely accepted to promote evidence-based practice. In the literature, the adaptation of a guideline is described as a valid alternative to the development of a new one. Aim: To translate a guideline for the care for adults with an indwelling urinary catheter in the acute and long term care setting as well as for home care. To adapt the guideline to the Swiss context. Method: In a systematic and pragmatic process, clinical questions were identified, guidelines were searched and evaluated regarding clinical relevance and quality. After each step, the next steps were defined. Results: An English guideline was translated, adapted to the local context and supplemented. The adapted guideline was reviewed by experts, adapted again and approved. After 34 months and an investment of a total of 145 man working days, a guideline for the care for people with an indwelling urinary catheter is available for both institutions. Conclusions: Translation and adaptation of a guideline was a valuable alternative to the development of a new one; nevertheless, the efforts necessary should not be underestimated. For such a project, sufficient professional and methodological resources should be made available to achieve efficient guideline work by a constant team.

  14. Stuck long-term indwelling central venous catheters in adolescents: three cases and a short topical review

    DEFF Research Database (Denmark)

    Mortensen, A; Afshari, A; Henneberg, S W

    2010-01-01

    We present three cases of fixated vascular injection ports. Two patients had cystic fibrosis and one had an immunological defect. All catheters were made from polyurethane and implanted in adolescent patients. Indwelling time were 6-8 years. One patient's catheter was entirely integrated in the v......We present three cases of fixated vascular injection ports. Two patients had cystic fibrosis and one had an immunological defect. All catheters were made from polyurethane and implanted in adolescent patients. Indwelling time were 6-8 years. One patient's catheter was entirely integrated...

  15. Exploring relationships of catheter-associated urinary tract infection and blockage in people with long-term indwelling urinary catheters.

    Science.gov (United States)

    Wilde, Mary H; McMahon, James M; Crean, Hugh F; Brasch, Judith

    2017-09-01

    To describe and explore relationships among catheter problems in long-term indwelling urinary catheter users, including excess healthcare use for treating catheter problems. Long-term urinary catheter users experience repeated problems with catheter-related urinary tract infection and blockage of the device, yet little has been reported of the patterns and relationships among relevant catheter variables. Secondary data analysis was conducted from a sample in a randomised clinical trial, using data from the entire sample of 202 persons over 12 months' participation. Descriptive statistics were used to characterise the sample over time. Zero-inflated negative binomial models were employed for logistic regressions to evaluate predictor variables of the presence/absence and frequencies of catheter-related urinary tract infection and blockage. Catheter-related urinary tract infection was marginally associated with catheter blockage. Problems reported at least once per person in the 12 months were as follows: catheter-related urinary tract infection 57%, blockage 34%, accidental dislodgment 28%, sediment 87%, leakage (bypassing) 67%, bladder spasms 59%, kinks/twists 42% and catheter pain 49%. Regression analysis demonstrated that bladder spasms were significantly related to catheter-related urinary tract infection and sediment amount, and catheter leakages were marginally significantly and positively related to catheter-related urinary tract infection. Frequencies of higher levels of sediment and catheter leakage were significantly associated with higher levels of blockage, and being female was associated with fewer blockages. Persons who need help with eating (more disabled) were also more likely to have blockages. Catheter-related urinary tract infection and blockage appear to be related and both are associated with additional healthcare expenditures. More research is needed to better understand how to prevent adverse catheter outcomes and patterns of problems in

  16. Urinary catheters

    Science.gov (United States)

    Catheter - urine; Foley catheter; Indwelling catheter; Suprapubic catheters ... stones Blood infections ( septicemia ) Blood in the urine (hematuria) Kidney damage (usually only with long-term, indwelling ...

  17. Outpatient unicompartment knee arthroplasty with indwelling femoral nerve catheter.

    Science.gov (United States)

    Dervin, Geoffrey F; Madden, Susan M; Crawford-Newton, Barbara A; Lane, Alan T; Evans, Holly C

    2012-06-01

    Contemporary multimodal anesthesia regimens allow the performance of unicompartment knee arthroplasty (UKA) on an outpatient basis. Our initial pilot experience is presented using a continuous femoral nerve block as an adjunct for 24 patients classified as American Society of Anesthesiology class 1 (14 men, 10 women; median age, 56 years; range, 46-72 years). After minimally invasive UKA, patients documented their pain and oral medication use while at home for the first 5 days. Adverse events, medication adverse effects, and the amount of infused ropivacaine were recorded. Median pain scores for the first 3 days were 1, 2, and 2 (at rest) and 4, 5, and 3 (during physical therapy). Eighteen patients (75%) required less than 4 mg oral hydromorphone/d. Of the 18, 10 (42%) did not require supplemental oral opioids. The median catheter use was 3 days. Our results suggest that with careful patient selection and adequate teaching, continuous femoral nerve blocks may be used as part of a multimodal pain regimen to assist the delivery of outpatient UKA with high patient satisfaction. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Comparison of two indwelling central venous access catheters in dogs undergoing fractionated radiotherapy

    International Nuclear Information System (INIS)

    Evans, K.L.; Smeak, D.D.; Couto, C.G.; Hammer, A.S.; Gaynor, J.S.

    1994-01-01

    Twenty dogs with neoplasms requiring multiple radiation treatments received either percutaneous vascular access catheters (PVACs; Cook, Bloomington, IN) or subcutaneous vascular access ports (SVAPs; Vascular-Access-Ports, Norfolk Medical Products, Inc., Skokie, IL); 10 dogs were entered in each group. All catheters were implanted and removed aseptically and the catheter tips were cultured during implant removal. Complications with PVACs included mild incisional swelling and redness and accidental severance or rupture of the catheter. Complications with SVAPs included incisional or port swelling, bruising or redness, hematoma formation, and pain. Ports in 4 of these dogs could not be used for 1 to 3 days after surgery because of swelling and pain. Surgical wound complications, when pooled for comparison, occurred significantly more frequently with the SVAPs (P = .023). Wound complications associated with both catheters were self-limiting and resolved within 7 days. Bacterial cultures were positive in two PVACs and four SVAP tips, however, none of these dogs had clinical signs of infection or sepsis. Although both types of indwelling catheters were functional in a clinical setting, PVACs were preferred to SVAPs for dogs undergoing radiation therapy because of decreased time for implantation and fewer overall complications

  19. A Rare Cause of Death in a Woman: Iatrogenic Bladder Rupture in a Patient With an Indwelling Foley Catheter.

    Science.gov (United States)

    Paul, Anthea B Mahesan; Simms, Lary; Paul, Abraham E; Mahesan, Andrew A; Ramzanali, Ammani

    2016-05-01

    The CDC estimates that 12-25% of all hospitalized patients receive a urinary catheter during their hospital stay. Foley catheter failure is uncommon and Foley catheter failure associated with iatrogenic urinary bladder rupture (IUBR) is extremely rare. Symptoms are often nonspecific and thus misdiagnosis and delayed treatment is common. In this case report, we present a case of IUBR in a woman from Foley catheter failure, which ultimately led to her demise. This case adds to the literature the importance of suspicion for IUBR in patients with indwelling Foley catheters presenting with lower abdominal pain, hematuria, and decreased urine output.

  20. Improvement in Knowledge Level of Associate Degree Nursing Students in Zarqa University College Regarding Care for Patients With Indwelling Urinary Catheters After Joining an Educational Session.

    Science.gov (United States)

    Najjar, Yahya W; Hdaib, Maha T; Al-Momany, Siham M

    2015-03-25

    Care for patients with indwelling urinary catheter is one of the most important factors in preventing problems associated with indwelling urinary catheters. Caregiver education about caring of indwelling urinary catheters is important the same as patient education to prevent urinary catheters problems. A pre test post test control group design was used with nursing students of Zarqa University College. Data were collected through self-administered questionnaire. Experimental group did not do better in the posttest than the control group after they joined an educational session about caring for patients with indwelling urinary catheter. Level of student (first year vs. second year) has been identified as a covariate that may have distorted the results. One educational session is insufficient to change level of knowledge regarding caring for patients with indwelling urinary catheter, in addition to considering the level of nursing student when conducting the educational session.

  1. Transvaginal closure of urethra and correction of uterovaginal prolapse in neurologically impaired patient with chronic indwelling catheter.

    Science.gov (United States)

    Kubal, U; Arunkalaivanan, A S; Baptiste, M

    2009-08-01

    We report the case of a 38-year-old neurologically impaired woman with continuous urinary incontinence as a result of a chronic indwelling catheter for neurogenic bladder. Long-term catheter resulted in dilatation of urethra and pressure necrosis of urethra, with subsequent incontinence despite the catheter. She also had a stage 3 uterovaginal prolapse. She underwent cystoscopy, closure of urethra and bladder neck by transvaginal route (Feneley procedure), insertion of a suprapubic catheter, sacrospinous fixation and posterior colporrhaphy with prolene mesh (Apogee). Vaginal hysterectomy was declined by the patient and her family. She remained dry at follow-up visit and is happy with the outcome.

  2. An Indwelling Urethral Catheter Knotted Around a Double-J Ureteral Stent: An Unusual Complication after Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    E. G. Warmerdam

    2011-01-01

    Full Text Available Urethral catheterization is a common procedure with a relatively low complication rate. Knotting of an indwelling urethral catheter is a very rare complication, and there are only a few case reports on knotted catheters, most of them concerning children. We report an especially rare case where a urethral catheter formed a knot around a double-J ureteral stent after a kidney transplantation. We will discuss the various risk factors for knotting of a catheter and the methods to untangle a knot.

  3. Policies for replacing long-term indwelling urinary catheters in adults.

    Science.gov (United States)

    Cooper, Fergus P M; Alexander, Cameron Edwin; Sinha, Sanjay; Omar, Muhammad Imran

    2016-07-26

    Long-term indwelling catheters are used commonly in people with lower urinary tract problems in home, hospital and specialised health-care settings. There are many potential complications and adverse effects associated with long-term catheter use. The effect of health-care policies related to the replacement of long-term urinary catheters on patient outcomes is unclear. To determine the effectiveness of different policies for replacing long-term indwelling urinary catheters in adults. We searched the Cochrane Incontinence Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, CINAHL, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 19 May 2016), and the reference lists of relevant articles. All randomised controlled trials investigating policies for replacing long-term indwelling urinary catheters in adults were included. At least two review authors independently performed data extraction and assessed risk of bias of all the included trials. Quality of evidence was assessed by adopting the GRADE approach. Any discrepancies were resolved by discussion between the review authors or an independent arbitrator. We contacted the authors of included trials to seek clarification where required. Three trials met the inclusion criteria, with a total of 107 participants in three different health-care settings: A USA veterans administration nursing home; a geriatric centre in Israel; and a community nursing service in Hong Kong. Data were available for three of the pre-stated comparisons. Priefer and colleagues evaluated different time intervals between catheter replacement (n = 17); Firestein and colleagues evaluated the use of antibiotic prophylaxis at the time of replacement (n = 70); and Cheung and colleagues compared two different types of cleaning solutions (n = 20).All the included trials were

  4. Changing Behavior among Nurses to Track Indwelling Urinary Catheters in Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Bona Yoon

    2013-01-01

    Full Text Available Catheter-associated urinary tract infections (CAUTIs are preventable complications of hospitalization. An interdisciplinary team developed a curriculum to increase awareness of the presence of indwelling urinary catheters (IUCs in hospitalized patients, addressed practical, primarily nurse-controlled inpatient risk-reduction interventions, and promoted the use of the IUC labels (“tags”. Five thirty-minute educational sessions were cycled over three daily nursing shifts on two inpatient medical floors over a 1-year period; participants were surveyed (n=152 to elicit feedback and provide real-time insight on the learning objectives. Nurse self-reported IUC tagging was early and sustained; after the IUC tag was introduced, there was a significant increase in tagging reported by the end of the block of educational sessions (from 46.2% to 84.6%, P=0.001. Early engagement combined with a targeted educational initiative led to increased knowledge, changes in behavior, and renewed CAUTI awareness in hospitalized patients with IUCs. The processes employed in this small-scale project can be applied to broader, hospitalwide initiatives and to large-scale initiatives for healthcare interventions. As first-line providers with responsibility for the placement and daily maintenance of IUCs, nurses are ideally positioned to implement efforts addressing CAUTIs in the hospital setting.

  5. Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion.

    Science.gov (United States)

    Olfert, Jordan A P; Penz, Erika D; Manns, Braden J; Mishra, Eleanor K; Davies, Helen E; Miller, Robert F; Luengo-Fernandez, Ramon; Gao, Song; Rahman, Najib M

    2017-05-01

    Malignant pleural effusion is associated with morbidity and mortality. A randomized controlled trial previously compared clinical outcomes and resource use with indwelling pleural catheter (IPC) and talc pleurodesis in this population. Using unpublished quality of life data, we estimate the cost-effectiveness of IPC compared with talc pleurodesis. Healthcare utilization and costs were captured during the trial. Utility weights produced by the EuroQol Group five-dimensional three-level questionnaire and survival were used to determine quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness ratio (ICER) was calculated over the 1-year trial period. Sensitivity analysis used patient survival data and modelled additional nursing time required per week for catheter drainage. Utility scores, cost and QALYs gained did not differ significantly between groups. The ICER for IPC compared with talc was favorable at $US10 870 per QALY gained. IPC was less costly with a probability exceeding 95% of being cost-effective when survival was pleural effusion in patients without history of prior pleurodesis, with consideration for patient survival, support and preferences. © 2016 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

  6. Cervical esophagostomy using indwelling catheter for analysis of gastric physiology in dogs

    Directory of Open Access Journals (Sweden)

    Cavalcanti Carlos Augusto de Oliveira

    2005-01-01

    Full Text Available PURPOSE: To describe the technique of cervical esophagostomy with indwelling catheter for the collection of secretions and study of gastric emptying. METHODS: Esophagostomy was performed in 14 dogs, and a tube was introduced into the animals' stomachs and maintained pervious for eight weeks. The technique consisted of opening the left lateral surface of the neck for insertion of the tube, with the aid of a Mixter forceps, and the subsequent subcutaneous tunneling and exteriorization of the catheter on the dorsum of the animals. RESULTS: Successful use of the tube and its total permeability were observed in 13 animals (92.8%. In one animal, the tube was obstructed by hair, and it was replaced. Formation of a small abscess occurred in 3 animals (21.4%, followed by spontaneous drainage. No accidents occurred, and the bleeding was minimal. No deaths were registered. CONCLUSION: The described technique can be used in similar researches, as well as for animal feeding in investigations of the upper digestive tract, after esophageal resection and in major neck surgeries.

  7. [Impact of an intervention to improve indwelling urinary catheter use and reduce urinary tract infections].

    Science.gov (United States)

    Smithson, A; Bosch, L; Ramos, X; Martínez-Santana, V

    2016-01-01

    To evaluate the impact of an intervention regarding the adequate use and improvement in the care of indwelling urinary catheters (IUC) and the frequency of catheter-associated urinary tract infections (CAUTI) in hospitalised patients. A quasi-experimental study was performed. Basic data on the use of IUC were recorded before and after the intervention, which consisted of training on IUC use and the implementation of reminders for their removal. There were 197 patients in the pre-intervention period and 194 in the post-intervention period. There was a non-significant decrease in the prevalence (17.3% versus 15.3%) and days with IUC (4.8±5.8 versus 4.3±4.2). There was an increase in adequately prescribed (41.1% versus 61.9%; P<.001) and attached IUC (0% vs 38.1%; P<.001), and a decrease in the urine collection bags on the floor (26.4% vs 6,2%; P<.001). The increase in the appropriate indications for IUC (86.8% vs 92.3%) and the decrease in CAUTI incidence density (2.1 vs 1.2 episodes/1,000 catheter days) were not significant, although above the standards. After the intervention there was a significant increase in the number of adequately prescribed and attached IUC, and a decrease in the number of urine collection bags on the floor. Improvement in IUC indication and frequency of CAUTI reached the quality standards. Educational activities and the use of reminders improve safety of hospitalised patients with IUC. Copyright © 2015 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. SU-F-J-131: Reproducibility of Positioning Error Due to Temporarily Indwelled Urethral Catheter for Urethra-Sparing Prostate IMRT

    International Nuclear Information System (INIS)

    Hirose, K; Takai, Y; Sato, M; Hatayama, Y; Kawaguchi, H; Aoki, M; Akimoto, H; Komai, F; Souma, M; Obara, H; Suzuki, M

    2016-01-01

    Purpose: The purpose of this study was to prospectively assess the reproducibility of positioning errors due to temporarily indwelled catheter in urethra-sparing image-guided (IG) IMRT. Methods: Ten patients received urethra-sparing prostate IG-IMRT with implanted fiducials. After the first CT scan was performed in supine position, 6-Fr catheter was indwelled into urethra, and the second CT images were taken for planning. While the PTV received 80 Gy, 5% dose reduction was applied for the urethral PRV along the catheter. Additional CT scans were also performed at 5th and 30th fraction. Positions of interests (POIs) were set on posterior edge of prostate at beam isocenter level (POI1) and cranial and caudal edge of prostatic urethra on the post-indwelled CT images. POIs were copied into the pre-indwelled, 5th and 30th fraction’s CT images after fiducial matching on these CT images. The deviation of each POI between pre- and post-indwelled CT and the reproducibility of prostate displacement due to catheter were evaluated. Results: The deviation of POI1 caused by the indwelled catheter to the directions of RL/AP/SI (mm) was 0.20±0.27/−0.64±2.43/1.02±2.31, respectively, and the absolute distances (mm) were 3.15±1.41. The deviation tends to be larger if closer to the caudal edge of prostate. Compared with the pre-indwelled CT scan, a median displacement of all POIs (mm) were 0.3±0.2/2.2±1.1/2.0±2.6 in the post-indwelled, 0.4±0.4/3.4±2.1/2.3±2.6 in 5th, and 0.5±0.5/1.7±2.2/1.9±3.1 in 30th fraction’s CT scan with a similar data distribution. There were 6 patients with 5-mm-over displacement in AP and/or CC directions. Conclusion: Reproducibility of positioning errors due to temporarily indwelling catheter was observed. Especially in case of patients with unusually large shifts by indwelling catheter at the planning process, treatment planning should be performed by using the pre-indwelled CT images with transferred contour of the urethra identified by

  9. SU-F-J-131: Reproducibility of Positioning Error Due to Temporarily Indwelled Urethral Catheter for Urethra-Sparing Prostate IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, K; Takai, Y [Hirosaki University, Hirosaki (Japan); Southern Tohoku BNCT Research Center, Koriyama (Japan); Sato, M; Hatayama, Y; Kawaguchi, H; Aoki, M; Akimoto, H [Hirosaki University, Hirosaki (Japan); Komai, F; Souma, M; Obara, H; Suzuki, M [Hirosaki University Hospital, Hirosaki (Japan)

    2016-06-15

    Purpose: The purpose of this study was to prospectively assess the reproducibility of positioning errors due to temporarily indwelled catheter in urethra-sparing image-guided (IG) IMRT. Methods: Ten patients received urethra-sparing prostate IG-IMRT with implanted fiducials. After the first CT scan was performed in supine position, 6-Fr catheter was indwelled into urethra, and the second CT images were taken for planning. While the PTV received 80 Gy, 5% dose reduction was applied for the urethral PRV along the catheter. Additional CT scans were also performed at 5th and 30th fraction. Positions of interests (POIs) were set on posterior edge of prostate at beam isocenter level (POI1) and cranial and caudal edge of prostatic urethra on the post-indwelled CT images. POIs were copied into the pre-indwelled, 5th and 30th fraction’s CT images after fiducial matching on these CT images. The deviation of each POI between pre- and post-indwelled CT and the reproducibility of prostate displacement due to catheter were evaluated. Results: The deviation of POI1 caused by the indwelled catheter to the directions of RL/AP/SI (mm) was 0.20±0.27/−0.64±2.43/1.02±2.31, respectively, and the absolute distances (mm) were 3.15±1.41. The deviation tends to be larger if closer to the caudal edge of prostate. Compared with the pre-indwelled CT scan, a median displacement of all POIs (mm) were 0.3±0.2/2.2±1.1/2.0±2.6 in the post-indwelled, 0.4±0.4/3.4±2.1/2.3±2.6 in 5th, and 0.5±0.5/1.7±2.2/1.9±3.1 in 30th fraction’s CT scan with a similar data distribution. There were 6 patients with 5-mm-over displacement in AP and/or CC directions. Conclusion: Reproducibility of positioning errors due to temporarily indwelling catheter was observed. Especially in case of patients with unusually large shifts by indwelling catheter at the planning process, treatment planning should be performed by using the pre-indwelled CT images with transferred contour of the urethra identified by

  10. FACTORS AND COMPLICATIONS AFFECTING CATHETER AND TECHNIQUE SURVIVAL WITH PERMANENT SINGLE-LUMEN DIALYSIS CATHETERS

    NARCIS (Netherlands)

    DEMEESTER, J; VANHOLDER, R; DEROOSE, J; RINGOIR, S

    1994-01-01

    This long-term study on the outcome of permanent silicone single-lumen dialysis catheters consisted of 43 surgically inserted catheters in 33 patients. All catheters were attached to a pressure-pressure single-cannula dialysis system. Technique and catheter survival were 80 and 59% at 1 year, and 63

  11. Discontinuation of peri-operative gentamicin use for indwelling urinary catheter manipulation in orthopaedic surgery.

    Science.gov (United States)

    Bond, Stuart E; Boutlis, Craig S; Jansen, Stuart G; Miyakis, Spiros

    2017-11-01

    Gentamicin has historically been used prior to insertion and removal of indwelling urinary catheters (IDCs) around elective joint replacement surgery to prevent infection; however, this indication is not recognized in the Australian Therapeutic Guidelines: Antibiotic and the paradigm for safe use of gentamicin has shifted. The antimicrobial stewardship team of a 500 bed tertiary regional hospital performed a retrospective clinical study of gentamicin IDC prophylaxis around total hip and knee arthroplasties. Results were presented to the orthopaedic surgeons. A literature review identified no guidelines to support gentamicin prophylaxis and only a very low risk of bacteraemia associated with IDC insertion/removal in patients with established bacteriuria. Consensus was reached with the surgeons to discontinue this practice. Subsequent prospective data collection was commenced to determine effectiveness, with weekly feedback to the Department Head of Orthopaedics. Data from 137 operations pre-intervention (6 months) were compared with 205 operations post-intervention (12 months). The median patient age was 72 years in both groups. Following the intervention, reductions in gentamicin use were demonstrated for IDC insertion (59/137 (42%) to 4/205 (2%), P < 0.01) and removal (39/137 (28%) to 6/205 (3%), P < 0.01). No gentamicin use was observed during the final 40 weeks of the post-intervention period. There were no significant differences between the groups for pre-operative bacteriuria, surgical site infections or acute kidney injury. A collaborative approach using quality improvement methodology can lead to an evidence-based reappraisal of established practice. Regular rolling audits and timely feedback were useful in sustaining change. © 2016 Royal Australasian College of Surgeons.

  12. Comparing cost of indwelling pleural catheter vs talc pleurodesis for malignant pleural effusion.

    Science.gov (United States)

    Penz, Erika D; Mishra, Eleanor K; Davies, Helen E; Manns, Braden J; Miller, Robert F; Rahman, Najib M

    2014-10-01

    Malignant pleural effusion is associated with short life expectancy and significant morbidity. A randomized controlled trial comparing indwelling pleural catheters (IPCs) with talc pleurodesis found that IPCs reduced in-hospital time and the need for additional procedures but were associated with excess adverse events. Using data from the clinical trial, we compared costs associated with use of IPCs and with talc pleurodesis. Resource use and adverse events were captured through case report forms over the 1-year trial follow-up. Costs for outpatient and inpatient visits, diagnostic imaging, nursing, and doctor time were obtained from the UK National Health Service reference costs and University of Kent's Unit Costs of Health and Social Care 2011 and inflated to 2013 using the UK Consumer Price Index. Procedure supply costs were obtained from the manufacturer. Difference in mean costs was compared using nonparametric bootstrapping. All costs were converted to US dollars using the Organisation for Economic Co-operation and Development Purchasing Power Parity Index. Overall mean cost (SD) for managing patients with IPCs and talc pleurodesis was $4,993 ($5,529) and $4,581 ($4,359), respectively. The incremental mean cost difference was $401, with 95% CI of -$1,387 to $2,261. The mean cost related to ongoing drainage in the IPC group was $1,011 ($732) vs $57 ($213) in the talc pleurodesis group (P = .001). This included the cost of drainage bottles, dressing changes in the first month, and catheter removal. There was no significant difference in cost of the initial intervention or adverse events between the groups. For patients with survival < 14 weeks, IPC is significantly less costly than talc pleurodesis, with mean cost difference of -$1,719 (95% CI, -$3,376 to -$85). There is no significant difference in the mean cost of managing patients with IPCs compared with talc pleurodesis. For patients with limited survival, IPC appears less costly. isrctn.org; No.: ISRCTN

  13. Antibiotic resistance patterns of bacteria isolated from indwelling Foley catheters following tube cystostomy in goats with obstructive urolithiasis.

    Science.gov (United States)

    Chigerwe, Munashe; Mavangira, Vengai; Byrne, Barbara A; Angelos, John A

    2017-05-01

    Tube cystostomy is a surgical method used for managing obstructive urolithiasis and involves placement of a Foley catheter into the urinary bladder. We identified and evaluated the antibiotic resistance patterns of bacteria isolated from indwelling Foley catheters following tube cystostomy in goats with obstructive urolithiasis. Urine samples collected over a 10-y period from catheter tips at the time of removal were submitted for bacteriologic culture and antibiotic susceptibility testing. Resistance patterns to antibiotics, trends in the resistance patterns over the study period, and the probability of a bacterial isolate being resistant as a function of the identity of the isolate and antibiotic tested were determined. A total of 103 urine samples from 103 male goats with obstructive urolithiasis managed surgically with tube cystostomy were included in the study. Aerococcus (36.9%) and Enterococcus (30.1%) were isolated most frequently. The susceptibility patterns of all bacteria isolated did not change over the study period ( p > 0.05). Proportions of isolates resistant to 1, 2, and ≥3 antibiotics were 36.9%, 18.5%, and 23.3%, respectively. Thus, 41.8% of bacterial isolates were resistant to 2 or more antibiotics tested. The probability of Aerococcus spp., Escherichia coli, and Pseudomonas aeruginosa isolates to be resistant to ampicillin, ceftiofur, erythromycin, penicillin, or tetracycline ranged from 0.59 to 0.76.

  14. Renal vein to renal collecting system fistula: An extreme complication from central venous thrombosis secondary to indwelling catheter

    Directory of Open Access Journals (Sweden)

    Aditya Safaya

    2018-04-01

    Full Text Available Central venous catheters are routinely used for resuscitation, chemotherapy and nutrition but are not without risk. Central lines are the most common extrinsic cause of venous thrombosis in neonates and infants. We present an ex-36 week 1800g infant baby girl recovering after a staged repair of gastroschisis with ileostomy and mucous fistula formation. The patient was receiving parenteral nutrition through an indwelling saphenous vein tunneled catheter, with its tip in the inferior vena cava. The patient developed polyuria, with a characteristic odor of the parenteral nutrition and a urine analysis showed glucose and triglyceride levels consistent with the composition of the parenteral nutrition fluid. A fluoroscopic cysto-urogram and an inferior vena-cavogram showed a catheter-associated inferior vena cava thrombosis leading to backpressure changes, diverting all intravenous contrast into the right renal vein and to renal collecting system, thus elucidating the route of the parenteral nutrition fluid reaching the bladder. Our case represents an extreme case of complicated central venous thrombosis. We emphasize the importance of practicing a high index of suspicion for thrombotic complications in severely ill neonates with central venous access. An early diagnosis and aggressive management may prevent progression of the disease towards an overwhelming complication. Keywords: Central venous catheterization complications, Renal vein-collecting system connection, Renal vein- collecting system fistula

  15. Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals.

    Science.gov (United States)

    Fink, Regina; Gilmartin, Heather; Richard, Angela; Capezuti, Elizabeth; Boltz, Marie; Wald, Heidi

    2012-10-01

    Indwelling urinary catheters (IUCs) are commonly used in hospitalized patients, especially elders. Catheter-associated urinary tract infections (CAUTIs) account for 34% of all health care associated infections in the United States, associated with excess morbidity and health care costs. Adherence to CAUTI prevention practices has not been well described. This study used an electronic survey to examine IUC care practices for CAUTI prevention in 3 areas-(1) equipment and alternatives and insertion and maintenance techniques; (2) personnel, policies, training, and education; and (3) documentation, surveillance, and removal reminders-at 75 acute care hospitals in the Nurses Improving the Care of Healthsystem Elders (NICHE) system. CAUTI prevention practices commonly followed included wearing gloves (97%), handwashing (89%), maintaining a sterile barrier (81%), and using a no-touch insertion technique (73%). Silver-coated catheters were used to varying degrees in 59% of the hospitals; 4% reported never using a catheter-securing device. Urethral meatal care was provided daily by 43% of hospitals and more frequently that that by 41% of hospitals. Nurses were the most frequently reported IUC inserters. Training in aseptic technique and CAUTI prevention at the time of initial nursing hire was provided by 64% of hospitals; however, only 47% annually validated competency in IUC insertion. Systems for IUC removal were implemented in 56% of hospitals. IUC documentation and routine CAUTI surveillance practices varied widely. Although many CAUTI prevention practices at NICHE hospitals are in alignment with evidence-based guidelines, there is room for improvement. Further research is needed to identify the effect of enhanced compliance with CAUTI prevention practices on the prevalence of CAUTI in NICHE hospitals. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Clinical Application of a New Indwelling Catheter with a Side-Hole and Spirally Arranged Shape-Memory Alloy for Hepatic Arterial Infusion Chemotherapy

    International Nuclear Information System (INIS)

    Yagihashi, Kunihiro; Takizawa, Kenji; Ogawa, Yukihisa; Okamoto, Kyoko; Yoshimatsu, Misako; Fujikawa, Atsuko; Shimamoto, Hiroshi; Nakajima, Yasuo

    2010-01-01

    A new indwelling catheter, G-spiral (GSP), was developed for hepatic arterial infusion chemotherapy (HAIC) by way of an implanted catheter-port system (CPS). Here we evaluated its physical properties and the outcomes of its clinical use. The GSP vessel-fixing power and its ability to follow a guidewire were determined with a vascular in vitro model, and Student t test was used to determine statistical significance (P < 0.05). A retrospective analysis was performed to evaluate the technical success rate and to identify the clinical complications associated with radiologic CPS implantation with GSP in 65 patients with unresectable hepatic tumors. The mean vessel-fixing power of the GSP (14.4 g) significantly differed from that of a GSP with a cut shape-memory alloy (3.3 g). The mean resistance to following the guidewire displayed by the GSP (88.5 g) was significantly less than that for a 5F W-spiral (106.3 g) or 4F Cobra-type angiographic catheter (117.8 g). The CPS was placed successfully in 64 of 65 cases (98.5%). Hepatic artery occlusion was observed in one case. Occlusion, cracking, and infection of CPS were observed in one, two, and one case, respectively. The GSP is a highly useful indwelling catheter that can be used for HAIC.

  17. [Investigation of urinary management after removal of indwelling urethral catheters in a general hospital: associations between bedridden state and impaired bladder emptying].

    Science.gov (United States)

    Tsuchiyama, Katsuki; Ueki, Osamu; Minami, Hidero; Kawaguchi, Kouhei; Aoki, Yoshitaka; Yokoyama, Osamu

    2010-06-01

    In this study we investigated the influences of decreased levels of activities of daily living (ADL), especially in bedridden patients,on lower urinary tract dysfunction and urinary management during hospital care. All 1,106 non-urological inpatients (896 non-bedridden patients and 210 bedridden patients) with an indwelling urethral catheter treated at Noto General Hospital between April 2006 and October 2009 were retrospectively evaluated. Maximum bladder capacity and post-void residual urine volume (PVR) were evaluated with uroflowmetry or voiding cystourethrography at the time the catheter was removed. Clean intermittent catheterization (CIC) and drug administration were performed for patients who had a PVR of 100 ml or more. Bedridden patients required urinary interventions at a higher rate than did non-bedridden patients (bedridden : 29.0%,non-bedridden : 17.6%). Although indwelling urethral catheters were reinserted in 13 patients in the bedridden group and 16 patients in the non-bedridden group,many patients in both groups could be free from the catheter. Our results indicate that patients with low ADL are vulnerable to impaired bladder emptying,and early diagnosis of impaired bladder emptying and active urinary management are required to solve their urinary problems.

  18. Protocol of the Australasian Malignant Pleural Effusion (AMPLE) trial: a multicentre randomised study comparing indwelling pleural catheter versus talc pleurodesis

    Science.gov (United States)

    Fysh, Edward T H; Thomas, Rajesh; Read, Catherine A; Lam, Ben C H; Yap, Elaine; Horwood, Fiona C; Lee, Pyng; Piccolo, Francesco; Shrestha, Ranjan; Garske, Luke A; Lam, David C L; Rosenstengel, Andrew; Bint, Michael; Murray, Kevin; Smith, Nicola A; Lee, Y C Gary

    2014-01-01

    Introduction Malignant pleural effusion can complicate most cancers. It causes breathlessness and requires hospitalisation for invasive pleural drainages. Malignant effusions often herald advanced cancers and limited prognosis. Minimising time spent in hospital is of high priority to patients and their families. Various treatment strategies exist for the management of malignant effusions, though there is no consensus governing the best choice. Talc pleurodesis is the conventional management but requires hospitalisation (and substantial healthcare resources), can cause significant side effects, and has a suboptimal success rate. Indwelling pleural catheters (IPCs) allow ambulatory fluid drainage without hospitalisation, and are increasingly employed for management of malignant effusions. Previous studies have only investigated the length of hospital care immediately related to IPC insertion. Whether IPC management reduces time spent in hospital in the patients’ remaining lifespan is unknown. A strategy of malignant effusion management that reduces hospital admission days will allow patients to spend more time outside hospital, reduce costs and save healthcare resources. Methods and analysis The Australasian Malignant Pleural Effusion (AMPLE) trial is a multicentred, randomised trial designed to compare IPC with talc pleurodesis for the management of malignant pleural effusion. This study will randomise 146 adults with malignant pleural effusions (1:1) to IPC management or talc slurry pleurodesis. The primary end point is the total number of days spent in hospital (for any admissions) from treatment procedure to death or end of study follow-up. Secondary end points include hospital days specific to pleural effusion management, adverse events, self-reported symptom and quality-of-life scores. Ethics and dissemination The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study as have the ethics boards of all the participating hospitals. The

  19. Staphylococcus epidermidis recovered from indwelling catheters exhibit enhanced biofilm dispersal and "self-renewal" through downregulation of agr

    DEFF Research Database (Denmark)

    Dai, Lu; Yang, Liang; Parsons, Chris

    2012-01-01

    Background: In recent years, Staphylococcus epidermidis (Se) has become a major nosocomial pathogen and the most common cause of infections of implanted prostheses and other indwelling devices. This is due in part to avid biofilm formation by Se on device surfaces. However, it still remains unkno...

  20. Urinary incontinence and indwelling urinary catheters in acutely admitted elderly patients: relationship with mortality, institutionalization, and functional decline

    NARCIS (Netherlands)

    Bootsma, A. M. Jikke; Buurman, Bianca M.; Geerlings, Suzanne E.; de Rooij, Sophia E.

    2013-01-01

    To study differences in functional status at admission in acutely hospitalized elderly patients with urinary incontinence, a catheter, or without a catheter or incontinence (controls) and to determine whether incontinence or a catheter are independent risk factors for death, institutionalization, or

  1. Urinary Incontinence and Indwelling Urinary Catheters as Predictors of Death after New-Onset Stroke: A Report of the South London Stroke Register.

    Science.gov (United States)

    John, Gregor; Primmaz, Steve; Crichton, Siobhan; Wolfe, Charles

    2018-01-01

    To explore the relationship between indwelling urinary catheters (IUCs), urinary incontinence (UI), and death in the poststroke period and to determine when, after the neurological event, UI has the best ability to predict 1-year mortality. In a prospective observational study, 4477 patients were followed up for 1 year after a first-ever stroke. The impact of UI or urinary catheters on time to death was adjusted in a Cox model for age, sex, Glasgow Coma Scale, prestroke and poststroke Barthel Index, swallow test, motor deficit, diabetes, and year of inclusion. The predictive values of UI assessed at the maximal deficit or 7 days after a stroke were compared using receiver-operating curves. UI at the maximal neurological deficit and urinary catheters within the first week after the stroke were present in 43.9% and 31.2% patients, respectively. They were both associated with 1-year mortality in unadjusted and adjusted analysis (hazard ratio [HR], 1.78, 95% confidence interval [CI], 1.46-2.19, and HR, 1.84, 95% CI 1.54-2.19). Patients with UI and urinary catheters had twice the mortality rate of incontinent patients without urinary catheters (HR, 10.24; 95% CI, 8.72-12.03 versus HR, 4.70; 95% CI, 3.88-5.70; P year mortality than UI assessed at the maximal neurological deficit. IUCs in the poststroke period is associated with death, especially among incontinent patients. UI assessed at 1 week after the neurological event has the best predictive ability. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Comparison of two blood sampling techniques for the determination of coagulation parameters in the horse: Jugular venipuncture and indwelling intravenous catheter.

    Science.gov (United States)

    Mackenzie, C J; McGowan, C M; Pinchbeck, G; Carslake, H B

    2018-05-01

    Evaluation of coagulation status is an important component of critical care. Ongoing monitoring of coagulation status in hospitalised horses has previously been via serial venipuncture due to concerns that sampling directly from the intravenous catheter (IVC) may alter the accuracy of the results. Adverse effects such as patient anxiety and trauma to the sampled vessel could be avoided by the use of an indwelling IVC for repeat blood sampling. To compare coagulation parameters from blood obtained by jugular venipuncture with IVC sampling in critically ill horses. Prospective observational study. A single set of paired blood samples were obtained from horses (n = 55) admitted to an intensive care unit by direct jugular venipuncture and, following removal of a presample, via an indwelling IVC. The following coagulation parameters were measured on venipuncture and IVC samples: whole blood prothrombin time (PT), fresh plasma PT and activated partial thromboplastin time (aPTT) and stored plasma antithrombin activity (AT) and fibrinogen concentration. D-dimer concentration was also measured in some horses (n = 22). Comparison of venipuncture and IVC results was performed using Lin's concordance correlation coefficient. Agreement between paired results was assessed using Bland Altman analysis. Correlation was substantial and agreement was good between sample methods for all parameters except AT and D-dimers. Each coagulation parameter was tested using only one assay. Sampling was limited to a convenience sample and timing of sample collection was not standardised in relation to when the catheter was flushed with heparinised saline. With the exception of AT and D-dimers, coagulation parameters measured on blood samples obtained via an IVC have clinically equivalent values to those obtained by jugular venipuncture. © 2017 EVJ Ltd.

  3. Urinary tract infection after acute stroke: Impact of indwelling urinary catheterization and assessment of catheter-use practices in French stroke centers.

    Science.gov (United States)

    Net, P; Karnycheff, F; Vasse, M; Bourdain, F; Bonan, B; Lapergue, B

    2018-03-01

    Urinary catheterization and acute urinary retention increase the risk of urinary tract infection (UTI). Our study aimed to investigate the incidence of UTI following acute stroke at our stroke center (SC) and to assess urinary catheter-care practices among French SCs. Stroke patients hospitalized within 24h of stroke onset were prospectively enrolled between May and September 2013. Neurological deficit level was assessed on admission using the US National Institutes of Health Stroke Scale (NIHSS). Patients were followed-up until discharge. Indwelling urinary catheterization (IUC) was the only technique authorized during the study. An electronic survey was also conducted among French SCs to assess their practices regarding urinary catheterization in acute stroke patients. A total of 212 patients were included, with 45 (21.2%) receiving indwelling urinary catheters. The overall estimated incidence of UTI was 14.2%, and 18% among patients receiving IUC. On univariate analysis, IUC was significantly associated with older age, longer hospital stays and higher NIHSS scores. Of the 30 SCs that responded to our survey, 19 (63.3%) declared using IUC when urinary catheterization was needed. The main argument given to justify its use was that it was departmental policy to adopt this technique. Also, 27 participants (90%) stated that conducting a study to assess the impact of urinary catheterization techniques on UTI rates in acute stroke patients would be relevant. Our results are in accord with previously reported data and confirm the high burden of UTI among acute stroke subjects. However, no association was found between IUC and UTI on univariate analysis due to a lack of statistical power. Also, our survey showed high heterogeneity in catheter-use practices among French SCs, but offered no data to help determine the best urinary catheterization technique. Urinary catheterization is common after acute stroke and a well-known risk factor of UTI. However, as high

  4. OPTIMUM: a protocol for a multicentre randomised controlled trial comparing Out Patient Talc slurry via Indwelling pleural catheter for Malignant pleural effusion vs Usual inpatient Management.

    Science.gov (United States)

    Sivakumar, P; Douiri, A; West, A; Rao, D; Warwick, G; Chen, T; Ahmed, L

    2016-10-18

    The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis. OPTIMUM is currently open for any centres interested in collaborating in this study. OPTIMUM is a multicentre non-blinded randomised controlled trial. Patients with a diagnosis of MPE will be identified and screened for eligibility. Consenting participants will be randomised 1:1 either to an outpatient ambulatory pathway using IPCs and talc pleurodesis or standard inpatient treatment with chest drain and talc pleurodesis as per British Thoracic Society guidelines. The primary outcome measure is global health-related QoL at 30 days measured using the EORTC QLQ-C30 questionnaire. Secondary outcome measures include breathlessness and pain measured using a 100 mm Visual Analogue Scale and health-related QoL at 60 and 90 days. A sample size of 142 patients is needed to demonstrate a clinically significant difference of 8 points in global health status at 30 days, for an 80% power and a 5% significance level. The study has been approved by the NRES Committee South East Coast-Brighton and Sussex (reference 15/LO/1018). The trial results will be published in peer-reviewed journals and presented at scientific conferences. UKCRN19615 and ISRCTN15503522; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Effective flow performances and dialysis doses delivered with permanent catheters: a 24-month comparative study of permanent catheters versus arterio-venous vascular accesses.

    Science.gov (United States)

    Canaud, Bernard; Leray-Moragues, Hélène; Kerkeni, Nadia; Bosc, Jean-Yves; Martin, Katja

    2002-07-01

    Permanent venous catheters have emerged as a long-term vascular access option for renal replacement therapy in end-stage renal disease patients. The design and venous location of catheter devices bear intrinsic flow limitations that may negatively affect the adequacy of dialysis and the patient outcome. There is limited data comparing the long-term dialysis adequacy delivered with permanent catheters vs arterio-venous vascular accesses (AVA). To explore this problem, we conducted a prospective 24-month trial comparing the flow performances and dialysis dose (Kt/Vdp) deliveries of both access options in a group of 42 haemodialysis patients during two study phases. During the first 12 months the patients completed a treatment period by means of permanent dual silicone catheters (DualKT). Then they were transferred to an AVA (40 native arterio-venous fistulas and two PTFE grafts) and monitored for an additional 12-month period. Assessments of flow adequacy and dialysis quantification were performed monthly. Dialysis adequacy was achieved in all cases. No patient had to be transferred prematurely to the AVA because of catheter failure. Three catheters had to be replaced due to bacteraemia in three patients. The mean effective blood flow rates achieved were 316+/-3.5 ml/min and 340+/-3.3 ml/min with DualKT and AVA, respectively, for a pre-set machine blood flow of 348+/-2.2 ml/min. Recirculation rates evaluated with the 'slow blood flow' method were 8.6+/-0.6 and 12.1+/-0.8% for DualKT and AVA using mean values of the solute markers urea and creatinine. Due to the possibility of a comparison veno-venous vs arterio-venous blood circulation, a corrected arterio-venous access recirculation could be derived from the difference between the two, which was around 3%. The blood flow resistance of the DualKT was slightly higher than with AVA as indicated by venous pressure differences. Kt/Vdp delivered was 1.37+/-0.02 and 1.45+/-0.02 with DualKT and AVA access respectively. The

  6. [Fistulae or catheter for elderly who start hemodialysis without permanent vascular access?].

    Science.gov (United States)

    García Cortés, Ma J; Viedma, G; Sánchez Perales, M C; Borrego, F J; Borrego, J; Pérez del Barrio, P; Gil Cunquero, J M; Liébana, A; Pérez Bañasco, V

    2005-01-01

    Autologous access is the best vascular access for dialysis also in older patients and it should be mature when patient needs hemodialysis. It is not always possible. Surgeon availability and demographic characteristics of patients (age, diabetes, vascular disease...) are factors that determine primary vascular access. To analyse outcome and vascular access complications in elderly who start hemodialysis without vascular access. All patients older than 75 years who initiated hemodialysis without vascular access between January 2000 and June 2002 were included, They were divided en two groups depending on primary vascular access. GI: arterio-venous fistulae. GIIl: Tunnelled cuffed catheter. Epidemiological and analytical data, vascular access complications related, as well as patient and first permanent vascular access survival from their inclusion in dialysis up to December 2002 were analysed and compared in both groups. 32 patients were studied. GI: n = 17 (4 men) and GIIl: n =1 5 (8 men), age: 79.9 +/- 3.8 and 81.7 +/- 4 years respectively (ns). There were no differences in sex and comorbidity (diabetes, ischemic heart disease, peripheral vascular disease and hypertension). It took GI 3 months to get a permanent vascular access suitable for using, while it took GIIl 1.3 months (p catheters was higher in GI (3.35 vs 1.87 p central venous thrombosis happen in GI (I: 25 CVT/100 patients-year) vs 30% in GIIl (I = 14.4/100 patients-year) (ns). No significant differences neither in bleeding (66.7% vs 33.3%) nor ischemia (75% vs 25%) were found. Dialysis dose (Kt/V) as well as anaemia degree were similar in both groups. Permanent vascular access survival after 2 years was 45.8% in GI and 24% in GII (ns). Patient survival was similar in GI and GII (72% vs 51% ns). Elderly who start hemodialysis without vascular access took longer to get a suitable permanent vascular access when arterio-venous fistulae is placed than with a tunnelled cuffed hemodialysis catheter. As a

  7. Hickman catheter embolism in a child during stem cell transplantation

    International Nuclear Information System (INIS)

    Ahmed, P.; Khan, B.; Ullah, K.; Ahmed, W.; Hussain, I.; Khan, A.A.; Anwar, M.

    2003-01-01

    The majority of stem cell recipients rely on indwelling central venous catheters situated in superior vena cava or right atrium. Semi-permanent tunneled silicone rubber Hickman catheters are widely used to provide durable central venous access for patients undergoing stem cell transplantation. A case of 5 years old child with diagnosis of severe aplastic anemia is reported. The patient received peripheral blood stem cells (PBSC) and had successful engraftment with complete hematological recovery. He had Hickman catheter embolism in the pulmonary circulation following unsuccessful attempt to remove the line. The catherter was successfully removed by midsternostomy operation. The child is normal with sustained remission on day +218 post stem cell transplant. (author)

  8. Mitral and aortic valve endocarditis together with mitral cleft developing due to an incorrectly inserted permanent hemodialysis catheter

    Directory of Open Access Journals (Sweden)

    Oktay Şenöz

    2015-06-01

    Full Text Available Infective endocarditis (IE usually affects the right-sided valves in hemodialysis (HD patients. Hemodialysis catheter-related left-sided endocarditis is a very rare condition and has a high mortality. A 58-year-old male patient who had been inserted a permanent HD catheter from the right subclavian vein 6 months ago was admitted with fever and dyspnea. Transesophageal echocardiography (TEE revealed that the HD catheter extended to the left atrium by passing from interatrial septum (IAS. A vegetation in the interatrial septum, aortic valve, which formed a perforation in the mitral valve and leading to severe valve insufficiency was observed. The patient was planned to undergo an operation however he died as a result of impaired hemodynamic stability. Catheter site should be confirmed through an imaging method performed during or after the procedure in order to prevent catheter malposition. A proper antibiotic treatment should be started as soon as a catheter-related endocarditis is detected, a surgical decision should be done in the shortest and the most proper time.

  9. High dose urokinase for restoration of patency of occluded permanent central venous catheters in hemodialysis patients.

    Science.gov (United States)

    Shavit, L; Lifschitz, M; Plaksin, J; Grenader, T; Slotki, I

    2010-10-01

    Catheter thrombosis is common and results in inadequate dialysis treatment and, frequently, in catheter loss. Since dialysis treatment runs on a strict schedule, occluded catheters need to be restored in a timely and cost effective manner. We present a new shortened protocol of urokinase infusion that allows hemodialysis to be performed within 90 minutes. To chronic hemodialysis patients, who developed complete catheter occlusion, urokinase was infused simultaneously through both lumens of the catheter (125,000 units to each lumen) over 90 minutes. Technical success was defined as restoring blood pump speed to at least 250 ml/min. We determined the average time from catheter placement to first clot event (primary patency PP), recurrent clot event after urokinase treatment (secondary patency SP), catheter salvage rate and cause for removal. 37 catheters developed total thrombosis and urokinase was used to restore patency one or more times (total 47 treatments). Catheter salvage rate was 97 %. The average time of PP was 152 ± 56 days (7 - 784 days). Nine patients (30%) developed recurrent occlusion and the average time of SP was 64 ± 34 days (2 - 364 days). One catheter was removed because of dysfunction due to thrombosis. Other catheters were removed due to infection, fistula maturation or fell out spontaneously. Hemodialysis was performed immediately after treatment with blood speed of 250 ml/min in all patients. Our protocol is highly effective, short, and allows to restore patency of totally occluded central venous catheters with minimal disruption of the dialysis session.

  10. Permanent catheters for recurrent ascites-a critical and systematic review of study methodology

    DEFF Research Database (Denmark)

    Christensen, Lars; Wildgaard, Lorna Elizabeth; Wildgaard, Kim

    2016-01-01

    fulfilled the inclusion criteria. Only three studies reported technical success less than 100 %. Data on complications and treatment were not available in all papers; peritonitis (48 %), cellulitis (41 %), prophylactic antibiotics (48 %) and complications to catheter insertion were difficult to distinguish...

  11. The effects of indwelling transurethral catheterization and tube cystostomy on urethral anastomoses in dogs.

    Science.gov (United States)

    Cooley, A J; Waldron, D R; Smith, M M; Saunders, G K; Troy, G C; Barber, D L

    1999-01-01

    The influence of urinary diversion procedures on urethral healing was studied in 15 male dogs following transection and anastomosis of the intrapelvic portions of their urethras. Dogs were randomly assigned to one of three treatment groups and had urine diverted from the surgical site by indwelling transurethral catheter, cystostomy catheter, or a combination of transurethral catheter and cystostomy catheter. There were no statistically significant differences in urethral healing when considering the different diversion methods, based on clinical, radiographic, and urodynamic parameters evaluated.

  12. Complications of central venous stenosis due to permanent central venous catheters in children on hemodialysis.

    Science.gov (United States)

    Rinat, Choni; Ben-Shalom, Efrat; Becker-Cohen, Rachel; Feinstein, Sofia; Frishberg, Yaacov

    2014-11-01

    Central venous catheters are frequently used as access for hemodialysis (HD) in children. One of the known complications is central venous stenosis. Although this complication is not rare, it is often asymptomatic and therefore unacknowledged. Superior vena cava (SVC) stenosis is obviously suspected in the presence of upper body edema, but several other signs and symptoms are often unrecognized as being part of this syndrome. We describe four patients with various manifestations of central venous stenosis and SVC syndrome. These sometimes life- or organ-threatening conditions include obstructive sleep apnea, unresolving stridor, increased intracranial pressure, increased intraocular pressure, right-sided pleural effusion, protein-losing enteropathy and lymphadenopathy. The temporal relationship of these complications associated with the use of central venous catheters and documentation of venous stenosis, together with their resolution after alleviation of high venous pressure, points to a causal role. We suggest pathophysiological mechanisms for the formation of each of these complications. In patients with occlusion of the SVC, various unexpected clinical entities can be caused by high central venous pressure. As often the etiology is not obvious, a high index of suspicion is needed as in some cases prompt alleviation of the high pressure is mandatory.

  13. Severe Ventral Erosion of Penis Caused by Indwelling Urethral Catheter and Inflation of Foley Balloon in Urethra—Need to Create List of “Never Events in Spinal Cord Injury” in order to Prevent These Complications from Happening in Paraplegic and Tetraplegic Patients

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2010-01-01

    Full Text Available Never Events are serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented. We propose that a list of “Never Events” is created for spinal cord injury patients in order to improve the quality of care. To begin with, following two preventable complications related to management of neuropathic bladder may be included in this list of “Never Events.” (i Severe ventral erosion of glans penis and penile shaft caused by indwelling urethral catheter; (ii incorrect placement of a Foley catheter leading to inflation of Foley balloon in urethra. If a Never Event occurs, health professionals should report the incident through hospital risk management system to National Patient Safety Agency's Reporting and Learning System, communicate with the patient, family, and their carer as soon as possible about the incident, undertake a comprehensive root cause analysis of what went wrong, how, and why, and implement the changes that have been identified and agreed following the root cause analysis.

  14. Difficult OptEase Filter Retrievals After Prolonged Indwelling Times

    Energy Technology Data Exchange (ETDEWEB)

    Van Ha, Thuong G., E-mail: tgvanha@radiology.bsd.uchicago.edu; Kang, Lisa; Lorenz, Jonathan; Zangan, Steven; Navuluri, Rakesh; Straus, Christopher; Funaki, Brian [University of Chicago, Section of Interventional Radiology, Department of Radiology (United States)

    2013-08-01

    PurposeThe OptEase vena cave filter (Cordis, Piscataway, NJ) is commercially available as a retrievable or permanent filter with short recommended indwelling time, presumably due to extensive contact of the filter side struts with the inferior vena cava wall and subsequent neointimal hyperplasia leading to incorporation. Our purpose was to evaluate OptEase filter retrievals with a long indwelling time period that required unconventional retrieval techniques.Materials and MethodsWe retrospectively reviewed patients who underwent OptEase filter retrieval with long undwelling times requiring additional maneuvers for retrieval. Techniques used included rigid endobronchial forceps dissection and wire-through-loop snare. Each patient underwent postretrieval venogram to evaluate for possible complications. In addition, patients had clinical follow-up 2 weeks after the retrieval procedure.ResultsThere were three patients (2 women, 1 man; average age 64 years) who underwent OptEase filter retrieval. The mean indwelling time was 6.4 months. The indwelling filters were successfully retrieved. There were no complications. Postprocedural follow-up showed no clinical pathology.ConclusionUnconventional techniques aided in the retrieval of OptEase filters with long indwelling times.

  15. Difficult OptEase Filter Retrievals After Prolonged Indwelling Times

    International Nuclear Information System (INIS)

    Van Ha, Thuong G.; Kang, Lisa; Lorenz, Jonathan; Zangan, Steven; Navuluri, Rakesh; Straus, Christopher; Funaki, Brian

    2013-01-01

    PurposeThe OptEase vena cave filter (Cordis, Piscataway, NJ) is commercially available as a retrievable or permanent filter with short recommended indwelling time, presumably due to extensive contact of the filter side struts with the inferior vena cava wall and subsequent neointimal hyperplasia leading to incorporation. Our purpose was to evaluate OptEase filter retrievals with a long indwelling time period that required unconventional retrieval techniques.Materials and MethodsWe retrospectively reviewed patients who underwent OptEase filter retrieval with long undwelling times requiring additional maneuvers for retrieval. Techniques used included rigid endobronchial forceps dissection and wire-through-loop snare. Each patient underwent postretrieval venogram to evaluate for possible complications. In addition, patients had clinical follow-up 2 weeks after the retrieval procedure.ResultsThere were three patients (2 women, 1 man; average age 64 years) who underwent OptEase filter retrieval. The mean indwelling time was 6.4 months. The indwelling filters were successfully retrieved. There were no complications. Postprocedural follow-up showed no clinical pathology.ConclusionUnconventional techniques aided in the retrieval of OptEase filters with long indwelling times

  16. Urethral catheters: can we reduce use?

    NARCIS (Netherlands)

    Broek, P.J. van den; Wille, J.C.; Benthem, B.H.B. van; Perenboom, R.J.M.; Akker-van Marle, M.E. van den; Nielen, A.M.A.

    2011-01-01

    Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection. The efficacy of an intervention programme to improve adherence to

  17. Uso de cateteres venosos totalmente implantados para nutrição parenteral: cuidados, tempo de permanência e ocorrência de complicações infecciosas Long-term central venous catheter for total parenteral nutrition: catheter care, permanence period, and incidence of infections

    Directory of Open Access Journals (Sweden)

    Maria do Rosário Del Lama de Unamuno

    2005-04-01

    Full Text Available Cateteres venosos totalmente implantados são utilizados em pacientes com síndrome do intestino curto, para realizar o suporte nutricional parenteral, o qual mantém estes pacientes vivos, pois fornece-lhes nutrientes que são absorvidos pela via digestiva. No entanto, estes cateteres não são isentos de complicações. As infecções relacionadas aos cateteres venosos são as complicações mais temidas e sua incidência varia de 3% a 20%, aumentando em pacientes mais graves. O objetivo do presente estudo é descrever as complicações infecciosas em pacientes recebendo nutrição parenteral por meio de cateteres venosos totalmente implantados. Tais cateteres são utilizados pela Divisão de Nutrição Clínica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, para realizar o suporte nutricional parenteral em pacientes submetidos a ressecções extensas de intestino delgado. Foram avaliadas as complicações infecciosas ocorridas com 21 cateteres, implantados em 16 pacientes. O tempo de permanência dos cateteres foi de 768±664,3 dias (mediana 529 dias e a taxa de infecção foi de 0,029 infecções/paciente/ano, resultados que se comparam às taxas de infecção observadas em países desenvolvidos. Concluiu-se que os cuidados observados no manuseio destes cateteres foram de fundamental importância para diminuir a incidência de infecção nestes pacientes.Long-term venous catheters are used for the total parenteral nutrition infusion, which is essential for feeding short-bowel syndrome patients. However, complications are likely to occur. The incidence of catheter related infections ranges from 3 to 20% in hospitalized patients. The Divisão de Nutrição Clínica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Brazil, has been providing nutrition support to short-bowel syndrome patients, using totally implantable venous catheters. This is a

  18. Indwelling bladder catheterisation as part of intraoperative and postoperative care for caesarean section.

    Science.gov (United States)

    Abdel-Aleem, Hany; Aboelnasr, Mohamad Fathallah; Jayousi, Tameem M; Habib, Fawzia A

    2014-04-11

    Caesarean section (CS) is the most common obstetric surgical procedure, with more than one-third of pregnant women having lower-segment CS. Bladder evacuation is carried out as a preoperative procedure prior to CS. Emerging evidence suggests that omitting the use of urinary catheters during and after CS could reduce the associated increased risk of urinary tract infections (UTIs), catheter-associated pain/discomfort to the woman, and could lead to earlier ambulation and a shorter stay in hospital. To assess the effectiveness and safety of indwelling bladder catheterisation for intraoperative and postoperative care in women undergoing CS. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2013) and reference lists of retrieved studies. Randomised controlled trials (RCTs) comparing indwelling bladder catheter versus no catheter or bladder drainage in women undergoing CS (planned or emergency), regardless of the type of anaesthesia used. Quasi-randomised trials, cluster-randomised trials were not eligible for inclusion. Studies presented as abstracts were eligible for inclusion providing there was sufficient information to assess the study design and outcomes. Two review authors independently assessed studies for eligibility and trial quality, and extracted data. Data were checked for accuracy. The search retrieved 16 studies (from 17 reports). Ten studies were excluded and one study is awaiting assessment. We included five studies involving 1065 women (1090 recruited). The five included studies were at moderate risk of bias.Data relating to one of our primary outcomes (UTI) was reported in four studies but did not meet our definition of UTI (as prespecified in our protocol). The included studies did not report on our other primary outcome - intraoperative bladder injury (this outcome was not prespecified in our protocol). Two secondary outcomes were not reported in the included studies: need for postoperative analgesia and women

  19. Catheter Angiography

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    Full Text Available ... News Physician Resources Professions Site Index A-Z Catheter Angiography Catheter angiography uses a catheter, x-ray ... are the limitations of Catheter Angiography? What is Catheter Angiography? Angiography is a minimally invasive medical test ...

  20. Innovating urinary catheter design: An introduction to the engineering challenge.

    Science.gov (United States)

    Murphy, Cathy

    2018-05-01

    Every day, people around the world rely on intermittent and indwelling urinary catheters to manage bladder dysfunction, but the potential or actual harm caused by these devices is well-recognised. Current catheter designs can cause urinary tract infection and septicaemia, bladder and urethral trauma and indwelling devices frequently become blocked. Furthermore, the devices can severely disrupt users' lives, limiting their daily activities and can be costly to manage for healthcare providers. Despite this, little significant design innovation has taken place in the last 80 years. In this article current catheter designs and their limitations are reviewed, common catheter-associated problems are outlined and areas of design ripe for improvement proposed. The potential to relieve the individual and economic burden of catheter use is high.

  1. Catheter Angiography

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    Full Text Available ... of a catheter makes it possible to combine diagnosis and treatment in a single procedure. Catheter angiography ... of a catheter makes it possible to combine diagnosis and treatment in a single procedure. An example ...

  2. Catheter Angiography

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    Full Text Available ... few millimeters) in the skin where the catheter can be inserted into an artery. The catheter is ... need for surgery. If surgery remains necessary, it can be performed more accurately. Catheter angiography presents a ...

  3. Catheter Angiography

    Medline Plus

    Full Text Available ... resonance imaging (MRI) In catheter angiography, a thin plastic tube, called a catheter , is inserted into an ... The catheter used in angiography is a long plastic tube about as thick as a strand of ...

  4. Catheter Angiography

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    Full Text Available ... using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a thin plastic ... called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of a catheter makes it ...

  5. Longitudinal cleavage of the penis, a rare catheter complication seen in paraplegic patients

    DEFF Research Database (Denmark)

    Larsen, T; Hansen, B J

    1989-01-01

    Two cases of total necrosis of the penile urethra and overlying ventral structures are described in paraplegic male patients treated with indwelling urethral catheters. The lesions were apparently caused by an inexpedient pull on the catheter causing ischaemic necrosis of the urethral wall....

  6. Catheter Angiography

    Medline Plus

    Full Text Available ... Z Catheter Angiography Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material ... vessels in the body. Angiography is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging ( ...

  7. Relato de caso: implante transparietohepático de cateter de longa permanência para diálise Case report: transhepatic insertion of long-term dialysis catheter

    Directory of Open Access Journals (Sweden)

    Felipe Nasser

    2007-12-01

    Full Text Available O implante transhepático de cateteres de diálise de longa permanência é um procedimento de exceção, utilizado para obter um acesso em pacientes com oclusão de veias centrais de membros superiores e inferiores. O caso descrito relata um paciente jovem, com história de 15 anos de diálise, que foi submetido no passado a um transplante renal sem sucesso. Esse paciente encontrava-se em urgência dialítica e oclusão comprovada de veias centrais de membros superiores e de veias ilíacas. Foi realizado o implante do cateter de longa permanência pelo acesso transparietohepático sob anestesia geral. A ponta do cateter foi posicionada ao nível do átrio direito. A diálise foi realizada satisfatoriamente no mesmo dia.Transhepatic insertion of long-term dialysis catheter is an exception procedure used to obtain access in patients with central vein occlusion of lower and upper limbs. We report on a case of a young patient with history of dialysis for 15 years, who was submitted to an unsuccessful renal transplantation. This patient was in dialytic emergency and had confirmed occlusion of upper limb central veins and iliac veins. Transhepatic insertion of a long-term catheter was performed under general anesthesia. The catheter tip was placed at the level of the right atrium. Dialysis was satisfactorily performed on the same day.

  8. Limited utility of plain abdominal radiographs in evaluating intussusceptions secondary to long indwelling feeding tubes

    Directory of Open Access Journals (Sweden)

    Albert Yang

    2013-01-01

    Full Text Available Adult intussusception (AI is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.

  9. A Targeted Infection Prevention Intervention in Nursing Home Residents With Indwelling Devices

    Science.gov (United States)

    Mody, Lona; Krein, Sarah L.; Saint, Sanjay K.; Min, Lillian C.; Montoya, Ana; Lansing, Bonnie; McNamara, Sara E.; Symons, Kathleen; Fisch, Jay; Koo, Evonne; Rye, Ruth Anne; Galecki, Andrzej; Kabeto, Mohammed U.; Fitzgerald, James T.; Olmsted, Russell N.; Kauffman, Carol A.; Bradley, Suzanne F.

    2015-01-01

    IMPORTANCE Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs. OBJECTIVE To test whether a multimodal targeted infection program (TIP) reduces the prevalence of MDROs and incident device-related infections. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial at 12 community-based NHs from May 2010 to April 2013. Participants were high-risk NH residents with urinary catheters, feeding tubes, or both. INTERVENTIONS Multimodal, including preemptive barrier precautions, active surveillance for MDROs and infections, and NH staff education. MAIN OUTCOMES AND MEASURES The primary outcome was the prevalence density rate of MDROs, defined as the total number of MDROs isolated per visit averaged over the duration of a resident's participation. Secondary outcomes included new MDRO acquisitions and new clinically defined device-associated infections. Data were analyzed using a mixed-effects multilevel Poisson regression model (primary outcome) and a Cox proportional hazards model (secondary outcome), adjusting for facility-level clustering and resident-level variables. RESULTS In total, 418 NH residents with indwelling devices were enrolled, with 34 174 device-days and 6557 anatomic sites sampled. Intervention NHs had a decrease in the overall MDRO prevalence density (rate ratio, 0.77; 95% CI, 0.62–0.94). The rate of new methicillin-resistant Staphylococcus aureus acquisitions was lower in the intervention group than in the control group (rate ratio, 0.78; 95% CI, 0.64–0.96). Hazard ratios for the first and all (including recurrent) clinically defined catheter-associated urinary tract infections were 0.54 (95% CI, 0.30–0.97) and 0.69 (95% CI, 0.49–0.99), respectively, in the intervention group and the control group. There were no reductions in new vancomycin

  10. Catheter Angiography

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    Full Text Available ... incision in the skin. Once the catheter is guided to the area being examined, a contrast material ... inserted into an artery. The catheter is then guided through the arteries to the area to be ...

  11. Catheter Angiography

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    Full Text Available ... it will make the rest of the procedure pain-free. You will not feel the catheter in ... nurse if you notice any bleeding, swelling or pain at the site where the catheter entered the ...

  12. Catheter Angiography

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    Full Text Available ... an artery through a small incision in the skin. Once the catheter is guided to the area ... small incision (usually a few millimeters) in the skin where the catheter can be inserted into an ...

  13. Catheter Angiography

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    Full Text Available ... should inform the nurse if you notice any bleeding, swelling or pain at the site where the ... Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter tip ...

  14. Catheter Angiography

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    Full Text Available ... catheter , is inserted into an artery through a small incision in the skin. Once the catheter is ... the tube and images are captured using a small dose of ionizing radiation ( x-rays ). top of ...

  15. Catheter Angiography

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    Full Text Available ... imaging (MRI) In catheter angiography, a thin plastic tube, called a catheter , is inserted into an artery ... examined, a contrast material is injected through the tube and images are captured using a small dose ...

  16. Catheter Angiography

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    Full Text Available ... or other procedures such as chemoembolization or selective internal radiation therapy. identify dissection or splitting in the ... days. Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter ...

  17. Catheter Angiography

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    Full Text Available ... is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, ... tumor; this is called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of ...

  18. Catheter Angiography

    Medline Plus

    Full Text Available ... is performed using: x-rays with catheters computed tomography (CT) magnetic resonance imaging (MRI) In catheter angiography, a ... tumor; this is called superselective angiography. Unlike computed tomography (CT) or magnetic resonance (MR) angiography , use of a ...

  19. Catheter Angiography

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    Full Text Available ... Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material to examine ... removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x- ...

  20. Catheter Angiography

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    Full Text Available ... most cases, the kidneys will regain their normal function within five to seven days. Rarely, the catheter ... limitations of Catheter Angiography? Patients with impaired kidney function, especially those who also have diabetes, are not ...

  1. Catheter Angiography

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    Full Text Available ... lies. The catheter used in angiography is a long plastic tube about as thick as a strand of spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ...

  2. Optimizing logistics for balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices by doing away with the indwelling balloon: concept and techniques.

    Science.gov (United States)

    Saad, Wael E; Nicholson, David B

    2013-06-01

    Since the conception of balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices 25 years ago, the placement of an indwelling balloon for hours has been central to the BRTO procedure. Numerous variables and variations of the BRTO procedure have been described, including methods to reduce sclerosant, combining percutaneous transhepatic obliteration, varying sclerosant, and using multiple sclerosants within the same procedure. However, the consistent feature of BRTO has always remained the indwelling balloon. Placing an indwelling balloon over hours for the BRTO procedure is a logistical burden that taxes the interventional radiology team and hospital resources. Substituting the balloon with hardware (coils or Amplatzer vascular plugs [AVPs] or both) is technically feasible and its risks most likely correlate with gastrorenal shunt (GRS) size. The current authors use packed 0.018- or 0.035-in coils or both for small gastric variceal systems (GRS size A and B) and AVPs for GRS sizes up to size E (from size A-E). The current authors recommend an indwelling balloon (no hardware substitute) for very large gastric variceal system (GRS size F). Substituting the indwelling balloon for hardware in size F and potentially size E GRS can also be risky. The current article describes the techniques of placing up to 16-mm AVPs through balloon occlusion guide catheters and then deflating the balloon once it has been substituted with the AVPs. In addition, 22-mm AVPs can be placed through sheaths once the balloon occlusion catheters are removed to further augment the 16-mm Amplatzer occlusion. To date, there are no studies describing, let alone evaluating, the clinical feasibility of performing BRTO without indwelling balloons. The described techniques have been successfully performed by the current authors. However, the long-term safety and effectiveness of these techniques is yet to be determined. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Catheter Angiography

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    Full Text Available ... lessen your anxiety during the procedure. The area of the groin or arm where the catheter will be inserted is shaved, ... contrast material is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is ...

  4. Complete eversion and prolapse of bladder following pulling out of a Foley catheter concurrent with uterine prolapse

    Directory of Open Access Journals (Sweden)

    Amulya M Acharya

    2007-01-01

    Full Text Available Complete eversion and transurethral prolapse of the urinary bladder is rare. We report a case of complete eversion and prolapse of bladder that occurred due to self pulling out of an indwelling Foley catheter in a 72-year-old woman. She presented with retention of urine concurrent with complete uterine procidentia. An indwelling Foley catheter was given to relieve the retention. The senile lady pulled out the catheter resulting in complete transurethral prolapse with bladder eversion. Under injection Midazolam sedation and with application of xylocain jelly the prolapsed bladder could be reduced manually back through the urethra. Definite corrective surgery was done later for the uterine prolapse.

  5. Percutaneous transvenous retrieval of CVP catheter emboli in S. V. C.-A case report-

    International Nuclear Information System (INIS)

    Zeon, Seok Kil; Lee, Deock Hee; Kim, Hong; Kim, Ok Bae

    1987-01-01

    The increasing use of the indwelling venous catheters and cardiovascular catheters has led to many iatrogenic complications. One of the most serious complications is catheter embolization, caused by inadvertent fracture of a fragment of catheter remaining within cardiovascular systems. In the catheter embolization, there are serious consequence such as thromboembolism, sepsis, cardiac arrhythmia and others. Fisher and Ferreyro (1978) reported a 71% incidence of serious morbidity or death following to intravascular foreign bodies in patients without removal. The authors experienced a case of retained central venous pressure monitoring catheter (CVP catheter) fragment extending from superior vena cava to hepatic segment of inferior vena cava. CVP catheter wa introduced into right subclavian venous route for hyperalimentation, because of poor general condition for operation of afferent loop syndrome following to resection of the gastric carcinoma with Billoth II operation (5 years age). On attempting removal of CVP catheter on recovery from afferent loop syndrome, a large portion of the CVP catheter was cut off in S.V.C. Percutaneous puncture of right femoral vein with Seldinger technique was done and 9F introducer sheath was indwelled. The helical basket of Dotter intravascular retriever set was advance through the sheath up to retained CVP catheter, and it was grasped. The retrieved CVP catheter fragment showed several tiny blood clots on surface. The patient was uneventfully recovered and was discharged asymptomatic on second day of the procedure.

  6. The importance of effective catheter securement.

    Science.gov (United States)

    Fisher, Jayne

    This article examines the importance of securing/fixing indwelling urinary catheters. The Oxford English dictionary interlinks the two words-'secure' and 'fix'-as having the same meaning. To secure the catheter should not be confused with 'support', whereby the weight of the urine drainage bag is supported with the use of velcro straps or a sleeve. The author introduces the need for the concept of this practice to be at the forefront of nurses' minds in all settings, and this is demonstrated through the use of case studies. Current guidance in this area is reviewed, as well as the problems that can arise when catheters are not secured properly and the available products for health professionals to use.

  7. Catheter Angiography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Catheter Angiography Catheter angiography ...

  8. Catheter Angiography

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    Full Text Available ... is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is removed and the incision site is closed by applying pressure on the area for approximately 10 to 20 ...

  9. Urinary catheter - infants

    Science.gov (United States)

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... A urinary catheter is a small, soft tube placed in the bladder. This article addresses urinary catheters in babies. WHY IS ...

  10. Tsukamurella catheter-related bloodstream infection in a pediatric patient with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Kristen A. Wendorf

    2010-03-01

    Full Text Available Catheter-related bloodstream infections (CR-BSI are important complications in patients with long-term indwelling central venous catheters. In this report, we present the case of a 14-year-old male with pulmonary hypertension treated with continuous treprostinil infusion, who presented with a CR-BSI caused by a Tsukamurella species. This case highlights the potential for this unusual organism to cause infection in immunocompetent patients.

  11. Catheter Angiography

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    Full Text Available ... the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available ... will regain their normal function within five to seven days. Rarely, the catheter punctures the artery, causing ...

  12. Catheter Angiography

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    Full Text Available ... diagnosis and treatment in a single procedure. An example is finding an area of severe arterial narrowing, ... contrast material, your radiologist may advise that you take special medication for 24 hours before catheter angiography ...

  13. Catheter Angiography

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    Full Text Available ... possible to combine diagnosis and treatment in a single procedure. Catheter angiography produces very detailed, clear and ... possible to combine diagnosis and treatment in a single procedure. An example is finding an area of ...

  14. Catheter Angiography

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    Full Text Available ... you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking and allergies, especially ... is Catheter Angiography? Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical ...

  15. Catheter Angiography

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    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... angiogram may be performed in less than an hour; however, it may last several hours. top of ...

  16. Catheter Angiography

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    Full Text Available ... a catheter, x-ray imaging guidance and an injection of contrast material to examine blood vessels in ... technologies and, in most cases, a contrast material injection is needed to produce pictures of blood vessels ...

  17. Catheter Angiography

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    Full Text Available ... far outweighs the risk. If you have a history of allergy to x-ray contrast material, your ... Angiography (CTA) X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Catheter Angiography Sponsored ...

  18. Catheter Angiography

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    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... and x-rays. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  19. Catheter Angiography

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    Full Text Available ... atherosclerosis (plaque). The use of a catheter makes it possible to combine diagnosis and treatment in a ... the aorta in the chest or abdomen or its major branches. show the extent and severity of ...

  20. Catheter Angiography

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    Full Text Available ... story about radiology? Share your patient story here Images × Image Gallery Interventional radiologist performing an angiography exam View ... ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Catheter Angiography Sponsored by Please note ...

  1. Catheter Angiography

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    Full Text Available ... examine blood vessels in key areas of the body for abnormalities such as aneurysms and disease such ... to produce pictures of blood vessels in the body. Angiography is performed using: x-rays with catheters ...

  2. Catheter Angiography

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    Full Text Available ... 20 minutes (or by using a special closure device). When the examination is complete, you may be ... contrast material, your radiologist may advise that you take special medication for 24 hours before catheter angiography ...

  3. Catheter Angiography

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    Full Text Available ... rays ). top of page What are some common uses of the procedure? Catheter angiography is used to ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  4. Catheter Angiography

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    Full Text Available ... spaghetti. top of page How does the procedure work? Catheter angiography works much the same as a ... possible to combine diagnosis and treatment in a single procedure. An example is finding an area of ...

  5. Catheter Angiography

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    Full Text Available ... Once the catheter is guided to the area being examined, a contrast material is injected through the ... You should inform your physician of any medications being taken and if there are any allergies, especially ...

  6. Catheter Angiography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Catheter Angiography ...

  7. Fecal containment in bedridden patients: economic impact of 2 commercial bowel catheter systems.

    Science.gov (United States)

    Kowal-Vem, Areta; Poulakidas, Stathis; Barnett, Barbara; Conway, Deborah; Culver, Daniel; Ferrari, Michelle; Potenza, Bruce; Koenig, Michael; Mah, John; Majewski, Mary; Morris, Linda; Powers, Jan; Stokes, Elizabeth; Tan, Michael; Salstrom, Sara-Jane; Zaletel, Cindy; Ambutas, Shirley; Casey, Kathleen; Stein, Jayne; DeSane, Mary; Berry, Kathy; Konz, Elizabeth C; Riemer, Michael R; Cullum, Malford E

    2009-05-01

    Fecal contamination is a major challenge in patients in acute/critical care settings that is associated with increased cost of care and supplies and with development of pressure ulcers, incontinence dermatitis, skin and soft tissue infections, and urinary tract infections. To assess the economic impact of fecal containment in bedridden patients using 2 different indwelling bowel catheters and to compare infection rates between groups. A multicenter, observational study was done at 12 US sites (7 that use catheter A, 5 that use catheter B). Patients were followed from insertion of an indwelling bowel catheter system until the patient left the acute/critical care unit or until 29 days after enrollment, whichever came first. Demographic data, frequency of bedding/dressing changes, incidence of infection, and Braden scores (risk of pressure ulcers) were recorded. The study included 146 bedridden patients (76 with catheter A, 70 with catheter B) who had similar Braden scores at enrollment. The rate of bedding/dressing changes per day differed significantly between groups (1.20 for catheter A vs 1.71 for catheter B; P = .004). According to a formula that accounted for personnel resources and laundry cycle costs, catheter A cost $13.94 less per patient per day to use than did catheter B. Catheter A was less likely than was catheter B to be removed during the observational period (P = .03). Observed infection rates were low. Catheter A may be more cost-effective than catheter B because it requires fewer unscheduled linen changes per patient day.

  8. An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: Direct observation of catheter insertion procedure.

    Science.gov (United States)

    Galiczewski, Janet M; Shurpin, Kathleen M

    2017-06-01

    Healthcare associated infections from indwelling urinary catheters lead to increased patient morbidity and mortality. The purpose of this study was to determine if direct observation of the urinary catheter insertion procedure, as compared to the standard process, decreased catheter utilization and urinary tract infection rates. This case control study was conducted in a medical intensive care unit. During phase I, a retrospective data review was conducted on utilsiation and urinary catheter infection rates when practitioners followed the institution's standard insertion algorithm. During phase II, an intervention of direct observation was added to the standard insertion procedure. The results demonstrated no change in utilization rates, however, CAUTI rates decreased from 2.24 to 0 per 1000 catheter days. The findings from this study may promote changes in clinical practice guidelines leading to a reduction in urinary catheter utilization and infection rates and improved patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. 21 CFR 868.1200 - Indwelling blood oxygen partial pressure (PO2) analyzer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Indwelling blood oxygen partial pressure (PO2... Indwelling blood oxygen partial pressure (PO2) analyzer. (a) Identification. An indwelling blood oxygen... electrode) and that is used to measure, in vivo, the partial pressure of oxygen in blood to aid in...

  10. Catheter Angiography

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    Full Text Available ... rare, and radiology departments are well-equipped to deal with them. There is a small risk that ... standard x-ray contrast. Catheter angiography should be done very cautiously—if at all—in patients who ...

  11. Catheter Angiography

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    Full Text Available ... key areas of the body for abnormalities such as aneurysms and disease such as atherosclerosis (plaque). The use of a catheter makes ... including the: brain neck heart chest abdomen (such as the kidneys and liver) pelvis legs and feet ...

  12. Catheter Angiography

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... Catheter Angiography? Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical conditions. ...

  13. Value of Micronester coils in port-catheter implantation for continuous hepatic arterial infusion chemotherapy with fixed catheter tip method

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko; White, Robert I.

    2008-01-01

    To retrospectively evaluate the use of Micronester coils in port-catheter implantation with the fixed catheter tip method in comparison with other previously used coils. The cohort of this study was 143 consecutive patients with unresectable advanced liver cancer for whom a port-catheter system was percutaneously implanted. In the most recent 32 patients, Micronester coils were used for catheter tip fixation. Details of embolic agents for fixation, persistent blood flow beyond the distal end of the indwelling catheter, and complications were compared between cases without and with Micronester coils. In all, percutaneous port-catheter placement was successful. Mean number of coils used for fixation was 4.2 without Micronester coils vs. 2.5 with Micronester coils. N-butyl cyanoacrylate (NBCA)-Lipiodol was additionally used for catheter tip fixation in 85.6% of 111 procedures without Micronester coils and in 50% of 32 using Micronester coils. The gastroduodenal artery beyond the distal end was not detected at the final examination after any procedure. Catheter dislocation occurred in five and hepatic arterial obstruction or severe stenosis in eight. The number of coils used and necessity of NBCA-Lipiodol could be decreased with usage of Micronester coils without decreasing fixation ability compared to other coils. (orig.)

  14. [Transurethral electroresection--an alternative to the indwelling catheter of old patients with prostatic hypertrophy].

    Science.gov (United States)

    Thiel, U; Krebs, W

    1978-01-01

    The people become elder in this time, everywhere. The number of patients with adenoma of the prostate is increasing. Most of them have other diseases, too. A retrospective study (2646 cases in 8 years, exactly specially analysed 469 cases from 1975/1976) was done, comparing the results of TUR and open surgery. Well known is the lower risk of TUR, the lower blood loss, the lower discomfort, the lower nursing in the postoperative period ect. There are not news in this study. But it is important, to recall some things, because it's more and more difficult, to classify an old man as an "inoperable case". Nobody knows, where he should stay. The family does not like him at home (his "dripping", his incontinence etc.) In the veterans house it's the same problem, and from the hospital he is removed, because he is an "inoperable case". The situation of this old man is very bad, because he feels there isn't a place for him and nobody likes him. Each man, also if it's the strongest one, will be broken psychically and physically after a short time. Concerning these aspects, must be enlarged the indication of removal the bladder neck obstruction per transurethral resection, more and more.

  15. Optease Vena Cava Filter Optimal Indwelling Time and Retrievability

    International Nuclear Information System (INIS)

    Rimon, Uri; Bensaid, Paul; Golan, Gil; Garniek, Alexander; Khaitovich, Boris; Dotan, Zohar; Konen, Eli

    2011-01-01

    The purpose of this study was to assess the indwelling time and retrievability of the Optease IVC filter. Between 2002 and 2009, a total of 811 Optease filters were inserted: 382 for prophylaxis in multitrauma patients and 429 for patients with venous thromboembolic (VTE) disease. In 139 patients [97 men and 42 women; mean age, 36 (range, 17–82) years], filter retrieval was attempted. They were divided into two groups to compare change in retrieval policy during the years: group A, 60 patients with filter retrievals performed before December 31 2006; and group B, 79 patients with filter retrievals from January 2007 to October 2009. A total of 128 filters were successfully removed (57 in group A, and 71 in group B). The mean filter indwelling time in the study group was 25 (range, 3–122) days. In group A the mean indwelling time was 18 (range, 7–55) days and in group B 31 days (range, 8–122). There were 11 retrieval failures: 4 for inability to engage the filter hook and 7 for inability to sheathe the filter due to intimal overgrowth. The mean indwelling time of group A retrieval failures was 16 (range, 15–18) days and in group B 54 (range, 17–122) days. Mean fluoroscopy time for successful retrieval was 3.5 (range, 1–16.6) min and for retrieval failures 25.2 (range, 7.2–62) min. Attempts to retrieve the Optease filter can be performed up to 60 days, but more failures will be encountered with this approach.

  16. Penile gangrene following condom catheter urinary drainage : A case report

    Directory of Open Access Journals (Sweden)

    Sandhya Gupta

    2016-04-01

    Full Text Available External urine collecting devices have been a boon to patients of urinary incontinence since their invention in late 90s. They have replaced the need for uncomfortable indwelling catheters in these patients. As safe as they may be, ghastly complications have occurred infrequently, mostly due to their inappropriate application. Such penile and urethral complications add to the morbidity of the patients significantly. They can be easily avoided by following few simple steps of catheter care, thus emphasizing the need to aware clinicians and health care workers about the correct application methods. Here we discuss a case of 60 year old male who developed penile skin necrosis and urethral fistula due to chronic use of condom catheter.

  17. Biofilms on Indwelling Urologic Devices: Microbes and Antimicrobial ...

    African Journals Online (AJOL)

    hanumantp

    Results: Both single and multi‑species BFs were formed on catheters, whereas mono‑bacterial BFs were exclusive on stents. Predominant organisms were. Pseudomonas ..... of biofouling until the colonized device is removed. Even after removal of a BF colonized-catheter, persistent organisms may re-colonize on the new ...

  18. The dangers of long-term catheter drainage.

    Science.gov (United States)

    Lowthian, P

    There are many dangers associated with long-term urinary bladder drainage by catheter. For various reasons, the choice of catheter is important, and its initial insertion can be particularly hazardous. All catheterizations should, however, be safer when there is some urine (or other fluid) in the bladder. The appropriate choice of drainage system attached to the catheter can delay bacterial invasion of the bladder. Great care is needed to prevent blockage of the system, particularly when bacteriuria is present. Recent evidence indicates that some bacteria encourage the development of encrustations, so that, in some circumstances, catheters may become blocked within 24 hours. This, together with other considerations, strongly suggests that indwelling catheters should be changed at intervals of not more than 5 days. The practical implications of this are considered, as are the benefits that may accrue. Accidental catheter traction is another danger, and some possible methods of avoiding this are discussed. Finally, the need for a new kind of drainage-bag support is highlighted.

  19. Evaluation of temperature rise and bonding strength in cements used for permanent head attachments in rats and mice

    NARCIS (Netherlands)

    Agterberg, Martijn J. H.; Spoelstra, Edwin N.; van der Wijst, Suzanne; Brakkee, Jan H.; Wiegant, Victor M.; Hamelink, Ralph; Brouns, Kim; Westerink, Ben H.; Remie, Rene

    In animal models, devices such as indwelling catheters and intracranial cannulae are often fixed on the skull to allow sampling or injection in the freely moving animal. The most commonly used method to fixate these devices is by embedding them in a 'helmet' of cement which is fixed to the skull

  20. Novel Method for Exchange of Impella Circulatory Assist Catheter: The "Trojan Horse" Technique.

    Science.gov (United States)

    Phillips, Colin T; Tamez, Hector; Tu, Thomas M; Yeh, Robert W; Pinto, Duane S

    2017-07-01

    Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.

  1. Using optical coherence tomography to detect bacterial biofilms on foley catheters (Conference Presentation)

    Science.gov (United States)

    Heidari, Andrew E.; Oh, Kyungjin; Chen, Zhongping

    2017-02-01

    Urinary tract infections(UTI) pose a serious problem for hospital patients accounting for 33% of all hospital acquired(nosocomial) infections with indwelling foley catheters. The presence of an indwelling foley catheter provides a scaffolding for circulating planktonic bacteria to adhere to and to form microbial biofilm communities that would typically be hindered by the body's innate immune system response. It is these biofilm communities that form on the inner lumen of foley catheters that provide a reservoir of pathogenic bacteria that could dislodge or disperse from the biofilm and infect urethra or bladder mucosal tissue in the urinary tract. Current diagnostic techniques of urine microbiological cultures are lacking in differentiating asymptomatic bacteriuria and symptomatic catheter-associated urinary tract infection(CAUTI) since almost all patients with chronic indwelling catheters are almost universally bacteriuruic. There is an unmet need of a diagnostic tool to assess the difference between the pathogenesis of asymptomatic bacteriuria and CAUTI, specifically at the site of the native biofilm formation. Optical Coherence Tomography(OCT) is an emerging high resolution, minimally invasive tomographic imaging technique that has shown promise in imaging biofilm structures previously in an endoscopic setting of the airway in-vivo and in microfluidic chambers. OCT can be adapted to image various sized biological surfaces and orifices such as airway branches and blood vessels by using a variety of minature endoscopic probes. In this work OCT will be used to image biofilm structure in-vitro on the inner lumen of extravasated critical care patient's foley catheters. Scanning electron microscopy will be conducted post OCT to confirm the presence of bacterial biofilm in OCT images.

  2. Early catheter removal after radical retropubic prostatectomy: long-term followup.

    Science.gov (United States)

    Koch, Michael O; Nayee, Anish H; Sloan, James; Gardner, Thomas; Wahle, Greg R; Bihrle, Richard; Foster, Richard S

    2003-06-01

    We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. The catheter was removed on postoperative day 3 or 4 in 263 patients (72%). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21%), extensive bladder neck reconstruction (1%) and prolonged hospitalization because of an ileus or other complicating factor (6%). Thirteen patients (3.6%) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11%) had either an early or late complication (excluding incontinence). There were 3 complications (0.8%) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2%) and 14 (8.9%) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95% to 98% of patients at 6 and 12 months. This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach

  3. Inhibition and Inactivation of Uropathogenic Escherichia coli Biofilms on Urinary Catheters by Sodium Selenite

    Directory of Open Access Journals (Sweden)

    Amoolya Narayanan

    2018-06-01

    Full Text Available Urinary tract infections (UTI are the most common hospital-acquired infections in humans and are caused primarily by uropathogenic Escherichia coli (UPEC. Indwelling urinary catheters become encrusted with UPEC biofilms that are resistant to common antibiotics, resulting in chronic infections. Therefore, it is important to control UPEC biofilms on catheters to reduce the risk for UTIs. This study investigated the efficacy of selenium for inhibiting and inactivating UPEC biofilms on urinary catheters. Urinary catheters were inoculated with UPEC and treated with 0 and 35 mM selenium at 37 °C for 5 days for the biofilm inhibition assay. In addition, catheters with preformed UPEC biofilms were treated with 0, 45, 60, and 85 mM selenium and incubated at 37 °C. Biofilm-associated UPEC counts on catheters were enumerated on days 0, 1, 3, and 5 of incubation. Additionally, the effect of selenium on exopolysacchride (EPS production and expression of UPEC biofilm-associated genes was evaluated. Selenium at 35 mM concentration was effective in preventing UPEC biofilm formation on catheters compared to controls (p < 0.05. Further, this inhibitory effect was associated with a reduction in EPS production and UPEC gene expression. Moreover, at higher concentrations, selenium was effective in inactivating preformed UPEC biofilms on catheters as early as day 3 of incubation. Results suggest that selenium could be potentially used in the control of UPEC biofilms on urinary catheters.

  4. Urethral catheters: can we reduce use?

    Directory of Open Access Journals (Sweden)

    van den Akker-van Marle M Elske

    2011-05-01

    Full Text Available Abstract Background Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection. Methods The efficacy of an intervention programme to improve adherence to recommendations to reduce the use of urethral catheters was studied in a before-after comparison in ten Dutch hospitals. The programme detected barriers and facilitators and each individual facility was supported with developing their own intervention strategy. Outcome was evaluated by the prevalence of catheters, alternatives such as diapers, numbers of urinary tract infections, the percentage of correct indications and the duration of catheterization. The costs of the implementation as well as the catheterization were evaluated. Results Of a population of 16,495 hospitalized patients 3335 patients of whom 2943 were evaluable for the study, had a urethral catheter. The prevalence of urethral catheters decreased insignificantly in neurology (OR 0.93; 95% CI 0.77 - 1.13 and internal medicine wards (OR 0.97; 95% CI 0.83 - 1.13, decreased significantly in surgical wards (OR 0.84; 95% CI 0.75 - 0.96, but increased significantly in intensive care (IC and coronary care (CC units (OR 1.48; 95% CI 1.01 - 2.17. The use of alternatives was limited and remained so after the intervention. Duration of catheterization decreased insignificantly in IC/CC units (ratio after/before 0.95; 95% CI 0.78 - 1.16 and neurology (ratio 0.97; 95% CI 0.80 - 1.18 and significantly in internal medicine (ratio 0.81; 95% CI 0.69 - 0.96 and surgery wards (ratio 0.80; 95% CI 0.71 - 0.90. The percentage of correct indications on the day of inclusion increased from 50 to 67% (p Conclusion Targeted implementation of recommendations from an existing guideline can lead to better adherence and cost savings. Especially, hospitals which use a lot of urethral catheters or

  5. Development of an Infection-Responsive Fluorescent Sensor for the Early Detection of Urinary Catheter Blockage.

    Science.gov (United States)

    Milo, Scarlet; Acosta, Florianne B; Hathaway, Hollie J; Wallace, Laura A; Thet, Naing T; Jenkins, A Toby A

    2018-03-23

    Formation of crystalline biofilms following infection by Proteus mirabilis can lead to encrustation and blockage of long-term indwelling catheters, with serious clinical consequences. We describe a simple sensor, placed within the catheter drainage bag, to alert of impending blockage via a urinary color change. The pH-responsive sensor is a dual-layered polymeric "lozenge", able to release the self-quenching dye 5(6)-carboxyfluorescein in response to the alkaline urine generated by the expression of bacterial urease. Sensor performance was evaluated within a laboratory model of the catheterized urinary tract, infected with both urease positive and negative bacterial strains under conditions of established infection, achieving an average "early warning" of catheter blockage of 14.5 h. Signaling only occurred following infection with urease positive bacteria. Translation of these sensors into a clinical environment would allow appropriate intervention before the occurrence of catheter blockage, a problem for which there is currently no effective control method.

  6. Rhodococcus bacteremia in cancer patients is mostly catheter related and associated with biofilm formation.

    Directory of Open Access Journals (Sweden)

    Fadi Al Akhrass

    Full Text Available Rhodococcus is an emerging cause of opportunistic infection in immunocompromised patients, most commonly causing cavitary pneumonia. It has rarely been reported as a cause of isolated bacteremia. However, the relationship between bacteremia and central venous catheter is unknown. Between 2002 and 2010, the characteristics and outcomes of seventeen cancer patients with Rhodococcus bacteremia and indwelling central venous catheters were evaluated. Rhodococcus bacteremias were for the most part (94% central line-associated bloodstream infection (CLABSI. Most of the bacteremia isolates were Rhodococcus equi (82%. Rhodococcus isolates formed heavy microbial biofilm on the surface of polyurethane catheters, which was reduced completely or partially by antimicrobial lock solution. All CLABSI patients had successful response to catheter removal and antimicrobial therapy. Rhodococcus species should be added to the list of biofilm forming organisms in immunocompromised hosts and most of the Rhodococcus bacteremias in cancer patients are central line associated.

  7. A prospective interventional study to examine the effect of a silver alloy and hydrogel-coated catheter on the incidence of catheter-associated urinary tract infection.

    Science.gov (United States)

    Chung, P Hy; Wong, C Wy; Lai, C Kc; Siu, H K; Tsang, D Nc; Yeung, K Y; Ip, D Km; Tam, P Kh

    2017-06-01

    Catheter-associated urinary tract infection is a major hospital-acquired infection. This study aimed to analyse the effect of a silver alloy and hydrogel-coated catheter on the occurrence of catheter-associated urinary tract infection. This was a 1-year prospective study conducted at a single centre in Hong Kong. Adult patients with an indwelling urinary catheter for longer than 24 hours were recruited. The incidence of catheter-associated urinary tract infection in patients with a conventional latex Foley catheter without hydrogel was compared with that in patients with a silver alloy and hydrogel-coated catheter. The most recent definition of urinary tract infection was based on the latest surveillance definition of the National Healthcare Safety Network managed by Centers for Disease Control and Prevention. A total of 306 patients were recruited with a similar ratio between males and females. The mean (standard deviation) age was 81.1 (10.5) years. The total numbers of catheter-days were 4352 and 7474 in the silver-coated and conventional groups, respectively. The incidences of catheter-associated urinary tract infection per 1000 catheter-days were 6.4 and 9.4, respectively (P=0.095). There was a 31% reduction in the incidence of catheter-associated urinary tract infection per 1000 catheter-days in the silver-coated group. Escherichia coli was the most commonly involved pathogen (36.7%) of all cases. Subgroup analysis revealed that the protective effect of silver-coated catheter was more pronounced in long-term users as well as female patients with a respective 48% (P=0.027) and 42% (P=0.108) reduction in incidence of catheter-associated urinary tract infection. The mean catheterisation time per person was the longest in patients using a silver-coated catheter (17.0 days) compared with those using a conventional (10.8 days) or both types of catheter (13.6 days) [P=0.01]. Silver alloy and hydrogel-coated catheters appear to be effective in preventing catheter

  8. Bacterial Biofilms and Catheters: A Key to Understanding Bacterial Strategies in Catheter-Associated Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    J Curtis Nickel

    1992-01-01

    Full Text Available Despite major technological improvements in catheter drainage systems, the indwelling Foley catheter remains the most common cause of nosocomial infection in medical practice. By approaching this common complicated urinary tract infection from the perspective of the biofilm strategy bacteria appear to use to overcome obstacles to produce bacteriuria, one appreciates a new understanding of these infections. An adherent biofilm of bacteria in their secretory products ascends the luminal and external surface of the catheter and drainage system from a contaminated drainage spigot or urethral meatus into the bladder. If the intraluminal route of bacterial ascent is delayed by strict sterile closed drainage or addition of internal modifications to the system, the extraluminal or urethral route assumes greater importance in the development of bacteriuria, but takes significantly longer. Bacterial growth within these thick coherent biofilms confers a large measure of relative resistance to antibiotics even though the individual bacterium remains sensitive, thus accounting for the failure of antibiotic therapy. With disruption of the protective mucous layer of the bladder by mechanical irritation, the bacteria colonizing the catheter can adhere to the bladder’s mucosal surface and cause infection. An appreciation of the role of bacterial biofilms in these infections should suggest future directions for research that may ultimately reduce the risk of catheter-associated infection.

  9. A Comparative Study of Blood Culture Sampling from Umbilical Catheter Line versus Peripheral Site

    Directory of Open Access Journals (Sweden)

    Abdolkarim Hamedi

    2010-08-01

    Full Text Available Neonatal sepsis is an important cause of death and morbidity in newborns and is diagnosed by isolation of organism in blood culture. In several reports,reliablity of blood cultures were done from umbi lical catheters,have been demonstrated. The objective of the present study was to determine,wether an inde welling umbilical catheter, could be an alternative site for blood culture. In a prospective study over 6 months during 2006,141 paired blood cultures from 134 infant,were done simultaneously from peripheral site and umbilical catheter (mostly U. V. C,during the first four days of life. Majority of these infants were preterm and admitted to NICU for special care. these infants had indwelling umbilical line and had indication of sepsis workup. A total of 141 pairs of blood cultures were obtained from 134 infants. In 16 infants blood culture pairs were positive for one organism in both peripheral vein and umbilical site. 71. 6% of total cultures (n=11pairs were negative in boths site. A total of 22 pairs were positive in one site only,with 5 positive from peripheral vein only and the other 17 from umblical site. Two pairs were positve in boths site with two different organism. In over all 16 infant (11%of blood were considered to be contaminated. Contamination rate were 2. 4% and 9. 2% for peripheral and umbilical catheter site. Contamination rate increased after 48 hours of age in umbilical catheter. The result showed that after 2 days contamination rate for blood culture taken from catheter line increased and specifity decreased. We recommended that blood culture via umblical catheter in first 2 days in sick neonates with indwelling catheter can be a alternate site of blood culture sampelling.

  10. Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial.

    Science.gov (United States)

    Chambers, S T; Sanders, J; Patton, W N; Ganly, P; Birch, M; Crump, J A; Spearing, R L

    2005-09-01

    Exit-site and tunnel infections of tunnelled central intravascular catheters are a frequent source of morbidity among neutropenic patients and may necessitate catheter removal. They require antimicrobial therapy that increases healthcare costs and is associated with adverse drug reactions. A prospective randomized clinical trial was conducted among adult patients undergoing chemotherapy in a haematology unit. Tunnelled intravascular catheters were randomized to receive the control of a standard dressing regimen as recommended by the British Committee for Standards in Haematology, or to receive the intervention of a sustained-release chlorhexidine dressing. Follow-up data were available in 112 of 114 tunnelled intravascular catheters which were randomized. Exit-site or combined exit-site/tunnel infections occurred in 23 (43%) of 54 catheters in the control group, and five (9%) of 58 catheters in the intervention group [odds ratio (OR) for intervention group compared with control group =0.13, 95% confidence intervals (CI) 0.04-0.37, P<0.001]. More tunnelled intravascular catheters were prematurely removed from the control group than the intervention group for documented infections [20/54 (37%) vs 6/58 (10%), OR=0.20, 95%CI 0.53-0.07]. However, there was no difference in the numbers of tunnelled intravascular catheters removed for all proven and suspected intravascular catheter-related infections [21/54 (39%) vs 19/58 (33%)], or in the time to removal of catheters for any reason other than death or end of treatment for underlying disease. Thus chlorhexidine dressings reduced the incidence of exit-site/tunnel infections of indwelling tunnelled intravascular catheters without prolonging catheter survival in neutropenic patients, and could be considered as part of the routine management of indwelling tunnelled intravascular catheters among neutropenic patients.

  11. Dose requirements for UVC disinfection of catheter biofilms

    DEFF Research Database (Denmark)

    Bak, Jimmy; Ladefoged, Søren D.; Tvede, Michael

    2009-01-01

    Bacterial biofilms on permanent catheters are the major sources of infection. Exposure to ultraviolet-C (UVC) light has been proposed as a method for disinfecting the inner surface of catheters. Specification of a UVC-based device for in vivo disinfection is based on the knowledge of the required...... doses to kill catheter biofilm. Given these doses and the power of available UVC light sources, calculation of the necessary treatment times is then possible. To determine the required doses, contaminated urinary catheters were used as test samples and UVC treated in vitro. Patient catheters (n = 67......) were collected and cut into segments of equal size and treated with various UVC doses. After treatment, the biofilm was removed by scraping and quantified by counting colony forming units. Percentage killing rates were determined by calculating ratios between UVC-treated samples and controls (no UVC...

  12. Experimental research on preventing mechanical phlebitis arising from indwelling needles in intravenous therapy by external application of mirabilite.

    Science.gov (United States)

    Lu, Yanyan; Hao, Chunyan; He, Wubin; Tang, Can; Shao, Zhenya

    2018-01-01

    Various types of complications arising from intravenous indwelling needles have become a challenge in clinical care. It is urgent to seek a simple and cost-effective method for prevention and treatment of phlebitis. We investigated the roles of mirabilite in preventing and treating phlebitis caused by intravenous indwelling needles and provide guidance for prevention and treatment of mechanical phlebitis caused by intravenous indwelling needles. A total of 57 healthy congeneric big-eared New Zealand rabbits were randomly divided into 3 groups: blank control, indwelling needle, and group with external application of mirabilite. The ear vein of each rabbit was punctured with an intravenous indwelling needle. The ear vein specimens were taken at 3, 5, and 7 days after indwelling. The hematoxylin and eosin stained pathological tissue sections of the ear veins of the rabbits in each group were observed. The expression levels of IL-1 and IL-6, and tumour necrosis factor-α (TNF-α) in the vascular tissue of the ear veins of the rabbits in each group were detected with the immunofluorescence method. In the blank control group, there was no inflammatory cellular infiltration and no proliferation of fibrous tissue around the vascular wall. With the increase of the indwelling time, proliferation of fibrous tissue in vascular wall, increased inflammatory cellular infiltration and organized thrombus in the vascular tissue occurred in the ear veins of the rabbits in the indwelling needle group and group with external application of mirabilite. Compared with the indwelling needle group, the group with external application of mirabilite had significantly decreased fibrous tissue in the vascular wall and significantly decreased inflammatory cellular infiltration. At the same point in indwelling time, the expression levels of IL-1, IL-6, and TNF-α in the indwelling needle and group with external application of mirabilite were significantly higher than that in the blank control

  13. Central venous catheters: detection of catheter complications and therapeutical options

    International Nuclear Information System (INIS)

    Gebauer, B.; Beck, A.; Wagner, H.J.; Vivantes-Kliniken, Hellersdorf und Prenzlauer Berg

    2008-01-01

    For modern medicine central venous catheters play an important role for diagnostic and therapeutic options. Catheter implantation, complication detection and therapy of catheter complications are an increasing demand for the radiologist. The review article provides an overview of different catheter types, their indications, advantages and disadvantages. Catheter malpositions are usually detectable in conventional X-ray. Most malpositions are correctable using interventional-radiological techniques. In addition therapeutical options for thrombotic complications (venous thrombosis, catheter occlusion, fibrin sheath) are discussed. In case of an infectious catheter complication, usually a catheter extraction and re-implantation is necessary

  14. Combined ultrasound and fluoroscopy guided port catheter implantation-High success and low complication rate

    International Nuclear Information System (INIS)

    Gebauer, Bernhard; El-Sheik, Michael; Vogt, Michael; Wagner, Hans-Joachim

    2009-01-01

    Purpose: To evaluate peri-procedural, early and late complications as well as patients' acceptance of combined ultrasound and fluoroscopy guided radiological port catheter implantation. Materials and methods: In a retrospective analysis, all consecutive radiological port catheter implantations (n = 299) between August 2002 and December 2004 were analyzed. All implantations were performed in an angio suite under analgosedation and antibiotic prophylaxis. Port insertion was guided by ultrasonographic puncture of the jugular (n = 298) or subclavian (n = 1) vein and fluoroscopic guidance of catheter placement. All data of the port implantation had been prospectively entered into a database for interventional radiological procedures. To assess long-term results, patients, relatives or primary physicians were interviewed by telephone; additional data were generated from the hospital information system. Patients and/or the relatives were asked about their satisfaction with the port implantion procedure and long-term results. Results: The technical success rate was 99% (298/299). There were no major complications according to the grading system of SIR. A total of 23 (0.33 per 1000 catheter days) complications (early (n = 4), late (n = 19)) were recorded in the follow-period of a total of 72,727 indwelling catheter days. Infectious complications accounted for 0.15, thrombotic for 0.07 and migration for 0.04 complications per 1000 catheter days. Most complications were successfully treated by interventional measures. Twelve port catheters had to be explanted due to complications, mainly because of infection (n = 9). Patients' and relatives' satisfaction with the port catheter system was very high, even if complications occurred. Conclusion: Combined ultrasound and fluoroscopy guided port catheter implantation is a very safe and reliable procedure with low peri-procedural, early and late complication rate. The intervention achieves very high acceptance by the patients and

  15. Risk factors for reinsertion of urinary catheter after early removal in thoracic surgical patients.

    Science.gov (United States)

    Young, John; Geraci, Travis; Milman, Steven; Maslow, Andrew; Jones, Richard N; Ng, Thomas

    2018-03-08

    To reduce the incidence of urinary tract infection, Surgical Care Improvement Project 9 mandates the removal of urinary catheters within 48 hours postoperatively. In patients with thoracic epidural anesthesia, we sought to determine the rate of catheter reinsertion, the complications of reinsertion, and the factors associated with reinsertion. We conducted a prospective observational study of consecutive patients undergoing major pulmonary or esophageal resection with thoracic epidural analgesia over a 2-year period. As per Surgical Care Improvement Project 9, all urinary catheters were removed within 48 hours postoperatively. Excluded were patients with chronic indwelling catheter, patients with urostomy, and patients requiring continued strict urine output monitoring. Multivariable logistic regression analysis was used to identify independent risk factors for urinary catheter reinsertion. Thirteen patients met exclusion criteria. Of the 275 patients evaluated, 60 (21.8%) required reinsertion of urinary catheter. There was no difference in the urinary tract infection rate between patients requiring reinsertion (1/60 [1.7%]) versus patients not requiring reinsertion (1/215 [0.5%], P = .389). Urethral trauma during reinsertion was seen in 1 of 60 patients (1.7%). After reinsertion, discharge with urinary catheter was required in 4 of 60 patients (6.7%). Multivariable logistic regression analysis found esophagectomy, lower body mass index, and benign prostatic hypertrophy to be independent risk factors associated with catheter reinsertion after early removal in the presence of thoracic epidural analgesia. When applying Surgical Care Improvement Project 9 to patients undergoing thoracic procedures with thoracic epidural analgesia, consideration to delayed removal of urinary catheter may be warranted in patients with multiple risk factors for reinsertion. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  16. Permanent education

    International Nuclear Information System (INIS)

    Gardien, S.; Kirsch, R.

    1998-01-01

    The permanent education of the IPN-Lyon inscribes itself completely in the priorities of the tri-annual plan of education of CNRS. These priorities contribute to evolution of research, evaluation of the professions, integration during the professional carriers of the personnel and form the frame for new management practice implementation

  17. Kocuria kristinae in catheter associated urinary tract infection: a case report.

    Science.gov (United States)

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

    2013-08-01

    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, this is the first reported case of a catheter related urinary tract infection which was caused by Kocuria kristinae.

  18. Colonization of a Central Venous Catheter by the Hyaline Fungus Fusarium solani Species Complex: A Case Report and SEM Imaging

    Directory of Open Access Journals (Sweden)

    Alberto Colombo

    2013-01-01

    Full Text Available The incidence of opportunistic infections by filamentous fungi is increasing partly due to the widespread use of central venous catheters (CVC, indwelling medical devices, and antineoplastic/immunosuppressive drugs. The case of a 13-year-old boy under treatment for acute lymphoblastic leukemia is presented. The boy was readmitted to the Pediatric Ward for intermittent fever of unknown origin. Results of blood cultures drawn from peripheral venous sites or through the CVC were compared. CVC-derived bottles (but not those from peripheral veins yielded hyaline fungi that, based on morphology, were identified as belonging to the Fusarium solani species complex. Gene amplification and direct sequencing of the fungal ITS1 rRNA region and the EF-1alpha gene confirmed the isolate as belonging to the Fusarium solani species complex. Portions of the CVC were analyzed by scanning electron microscopy. Fungi mycelia with long protruding hyphae were seen into the lumen. The firm adhesion of the fungal formation to the inner surface of the catheter was evident. In the absence of systemic infection, catheter removal and prophylactic voriconazole therapy were followed by disappearance of febrile events and recovery. Thus, indwelling catheters are prone to contamination by environmental fungi.

  19. Suprapubic catheter care

    Science.gov (United States)

    ... going back into your bladder. Try not to disconnect the catheter more than you need to. Keeping ... Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for EHRs For Developers U.S. National Library of ...

  20. [Prospective evaluation of pain associated with indwelling JJ stents following ureterorenoscopic lithotripsy].

    Science.gov (United States)

    Dudek, Przemysław; Gołabek, Tomasz; Jaskulski, Jarosław; Orłowski, Paweł; Bukowczan, Jakub; Szopiński, Tomasz; Chłosta, Piotr

    2013-01-01

    Routine placement of JJ ure teric stents, following uncomplicated endoscopic removal of a ureteral stone, still remains debatable. Indwelling JJ stents are not without any risks. They often can cause marked discomfort, or even pain. The aim of this study was to prospectively evaluate patient's perceived pain due to renal colic and indwelling JJ stent left following ure terorenoscopic lithotripsy (URSL). 54 patients with colicky pain due to distal ureteric stone, and who underwent uncompli cated ureterorenoscopic lithotripsy, were included in the study. Follow ing URSL, patients were randomly selected to have either JJ stent left in situ (Group I), or remain without a stent (Group II). Among all study par ticipants levels of pain prior, as well as 14 days after the procedure were evalu ated with the use of a visual analogue pain scale. Pain perception at the time of colic did not vary between men and women (6.30 +/- 1.33 and 6.38 +/- 1.11, respectively, p=0.293). Similarly, no differences in perceived pain were noted 14 days following URSL. Mean pain score in patients with indwelling JJ stent was 2.12 +/- 1.23 as compared to 2.15 +/- 0.67 in those without it (p=0.148). No increase in pain levels due to indwelling JJ stent could be observed. Further research to allow for better assessment of discomfort and pain caused by an indwelling JJ stent on a larger cohort, and which could also discriminate patients' psy chosomatic symptoms, is needed.

  1. Dedicated radial ventriculography pigtail catheter

    Energy Technology Data Exchange (ETDEWEB)

    Vidovich, Mladen I., E-mail: miv@uic.edu

    2013-05-15

    A new dedicated cardiac ventriculography catheter was specifically designed for radial and upper arm arterial access approach. Two catheter configurations have been developed to facilitate retrograde crossing of the aortic valve and to conform to various subclavian, ascending aortic and left ventricular anatomies. The “short” dedicated radial ventriculography catheter is suited for horizontal ascending aortas, obese body habitus, short stature and small ventricular cavities. The “long” dedicated radial ventriculography catheter is suited for vertical ascending aortas, thin body habitus, tall stature and larger ventricular cavities. This new design allows for improved performance, faster and simpler insertion in the left ventricle which can reduce procedure time, radiation exposure and propensity for radial artery spasm due to excessive catheter manipulation. Two different catheter configurations allow for optimal catheter selection in a broad range of patient anatomies. The catheter is exceptionally stable during contrast power injection and provides equivalent cavity opacification to traditional femoral ventriculography catheter designs.

  2. Acute Urinary Obstruction in a Tetraplegic Patient from Misplacement of Catheter in Urethra.

    Science.gov (United States)

    Vaidyanathan, Subramanian; Singh, Gurpreet; Hughes, Peter L; Soni, Bakul M

    2016-01-01

    A male tetraplegic patient attended accident and emergency with a blocked catheter; on removing the catheter, he passed bloody urine. After three unsuccessful attempts were made to insert a catheter by nursing staff, a junior doctor inserted a three-way Foley catheter with a 30-mL balloon but inflated the balloon with 10 mL of water to commence the bladder irrigation. The creatinine level was mostly 19 µmol/L (range: 0-135 µmol/L) but increased to 46 µmol/L on day 7. Computerized tomography urogram revealed that the bilateral hydronephrosis with hydroureter was extended down to urinary bladder, the bladder was distended, prostatic urethra was dilated and filled with urine, and although the balloon of Foley catheter was not seen in the bladder, the tip of the catheter was seen lying in the urethra. Following the re-catheterization, the creatinine level decreased to 21 µmol/L. A follow-up ultrasound scan revealed no evidence of hydronephrosis in both kidneys. Flexible cystoscopy revealed inflamed bladder mucosa, catheter reaction, and tiny stones. There was no bladder tumor. This case report concludes that the cause of bilateral hydronephrosis, hydroureter, and distended bladder was inadequate drainage of urinary bladder as the Foley balloon that was under-filled slipped into the urethra resulting in an obstruction to urine flow. Urethral catheterization in tetraplegic patients should be performed by senior, experienced staff in order to avoid trauma and incorrect positioning. Tetraplegic subjects with decreased muscle mass have low creatinine level. Increase in creatinine level (>1.5 times the basal level) indicates acute kidney injury, although peak creatinine level may still be within laboratory reference range. While scanning the urinary tract of spinal cord injury patients with indwelling urinary catheter, if Foley balloon is not seen within the bladder, urethra should be scanned to locate the Foley balloon.

  3. Virtual Breakthrough Series, Part 1: Preventing Catheter-Associated Urinary Tract Infection and Hospital-Acquired Pressure Ulcers in the Veterans Health Administration.

    Science.gov (United States)

    Zubkoff, Lisa; Neily, Julia; King, Beth J; Dellefield, Mary Ellen; Krein, Sarah; Young-Xu, Yinong; Boar, Shoshana; Mills, Peter D

    2016-11-01

    In 2014 the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help VHA facilities prevent hospital-acquired conditions: catheter-associated urinary tract infection (CAUTI) and hospital-acquired pressure ulcers (HAPUs). During the prework phase, participating facilities assembled a multidisciplinary team, assessed their current system for CAUTI or HAPU prevention, and examined baseline data to set improvement aims. The action phase consisted of educational conference calls, coaching, and monthly team reports. Learning was conducted via phone, web-based options, and e-mail. The CAUTI bundle focused on four key principles: (1) avoidance of indwelling urinary catheters, (2) proper insertion technique, (3) proper catheter maintenance, and (4) timely removal of the indwelling catheter. The HAPU bundle focused on assessment and inspection, pressure-relieving surfaces, turning and repositioning, incontinence management, and nutrition/hydration assessment and intervention. For the 18 participating units, the mean aggregated CAUTI rate decreased from 2.37 during the prework phase to 1.06 per 1,000 catheter-days during the action (implementation) phase (p model for implementing a virtual model for improvement. Copyright 2016 The Joint Commission.

  4. Successful treatment of central venous catheter induced superior vena cava syndrome with ultrasound accelerated catheter-directed thrombolysis.

    Science.gov (United States)

    Dumantepe, Mert; Tarhan, Arif; Ozler, Azmi

    2013-06-01

    Superior vena cava (SVC) syndrome results from obstruction of flow through the vessel either by external compression or thrombosis. External compression by intrathoracic neoplasms is the most common etiology, especially lung cancer and lymphoma. Thrombosis is becoming increasingly common due to the use of indwelling catheters and implantable central venous access devices. Most patients are unresponsive to anticoagulation alone which appears to be effective only in the mildest cases. However, recent advances in catheter-based interventions have led to the development of a variety of minimally invasive endovascular strategies to remove venous thrombus and accepted as an important first-line treatment given its high overall success rate and low morbidity as compared with medical and surgical treatments. Ultrasound accelerated catheter-directed thrombolysis (UACDT) has been developed to rapidly and completely resolve the existing thrombus. This technique integrates high frequency, low intensity ultrasound (US) with standard CDT in order to accelerate clot dissolution, reducing treatment time and the incidence of thrombolysis-related complications. An US wave enhances drug permeation through thrombus by disaggregating the fibrin matrix, exposing additional plasminogen receptor sites to the thrombolytic agent. The US energy affects thrombus in the entire venous segment, increasing the probability of complete thrombus clearing. We report the case of a 56-year-old man who presented with a 5 days history of SVC syndrome symptoms who had been receiving chemotherapy for colon cancer through a right subclavian vein port catheter. The patient successfully treated with UACDT with EkoSonic(®) Mach4e Endovascular device with an overnight infusion. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.

  5. Antibiotic prescribing practices for catheter urine culture results.

    Science.gov (United States)

    Chiu, Jonathan; Thompson, G William; Austin, Thomas W; Hussain, Zafar; John, Michael; Bombassaro, Anne Marie; Connelly, Sarah E; Elsayed, Sameer

    2013-01-01

    The literature suggests that positive results of catheter urine cultures frequently lead to unnecessary antimicrobial prescribing, which therefore represents an important target for stewardship. To assess the appropriateness of antibiotic prescribing in response to the results of urine cultures from patients with indwelling urinary catheters. This retrospective study was conducted at a tertiary care centre and involved adults with indwelling urinary catheters from whom urine specimens were obtained for culture. Patients with positive or negative culture results were identified from microbiology laboratory reports. The medical records of consecutive patients were screened to select a sample of 80 inpatients (40 per group). Abstracted patient histories were independently evaluated by an expert panel of 3 infectious diseases consultants blinded to the decisions of prescribers and of fellow panelists. The primary end point was concordance of each patient's treatment decision (with respect to the indication) between the expert panel (based on majority agreement, i.e., at least 2 of the 3 expert panelists) and the prescriber. The secondary end points were unnecessary days of therapy and selected outcomes over a predefined period after urine was obtained for culture. A total of 591 charts were screened to generate the targeted number of patients. Baseline demographic characteristics were comparable for the 2 groups, except antibiotic exposure before urine collection was significantly more frequent for the group with negative culture results. The treatment decision was concordant in 40% (16/40) of the patients with a positive culture result and 85% (34/40) of those with a negative culture result (p < 0.001). The most common reason for discordance was administration of antibiotics when not indicated (23 of 24 patients with a positive result and 5 of 6 patients with a negative result), which accounted for 165 and 32 unnecessary days of therapy per 1000 inpatient

  6. Catheter-associated UTI

    Science.gov (United States)

    ... UTI; Health care-associated UTI; Catheter-associated bacteriuria; Hospital acquired-UTI Images Bladder catheterization, female Bladder catheterization, male References Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  7. Catheter-related bloodstream infection.

    Science.gov (United States)

    Goede, Matthew R; Coopersmith, Craig M

    2009-04-01

    Catheter-related bloodstream infections (CR-BSIs) are a common, frequently preventable complication of central venous catheterization. CR-BSIs can be prevented by strict attention to insertion and maintenance of central venous catheters and removing unneeded catheters as soon as possible. Antiseptic- or antibiotic-impregnated catheters are also an effective tool to prevent infections. The diagnosis of CR-BSI is made largely based on culture results. CR-BSIs should always be treated with antibiotics, and except in rare circumstances the infected catheter needs to be removed.

  8. The efficacy of Jackson drain in the application to be a tunnel pleural catheter (TPC) in the management of malignant pleural effusion.

    Science.gov (United States)

    Tscheikuna, Jamsak; Thomrongpairoj, Preecha; Disayabutr, Suppareurg

    2011-06-01

    Malignant pleural effusion (MPE) is a common clinical problem in patients with advanced cancer and portends a poor prognosis, which means survival of less than six months. In June 1997, the US-FDA approved an indwelling TPC with a one-way drainage valve to be used in the management of MPE. Although popularity of this TPC has increased over the past few years, the experience with this device remains limited in Thai patients. One of the reasons is its high cost. Assess the efficacy and the safety of customary indwelling TPC by using Jackson drain in the management of patients with symptomatic MPE. Ten patients with symptomatic MPE were receiving these catheters (18 Fr Silicone catheters with 25 cm fenestrated length) to drain effusion via plastic vacuum bottles (250 ml) every other day or as needed to relieve dyspnea. The patient's dyspnic respiration, quality of life, and comfort during the catheter's application were quantified with a Borg score, the St. George Respiratory Disease Questionnaire (SGRQ), and the comfort's score, respectively. These parameters were recorded at initial (before insertion) and 2-week follow-up visit. Pain after 24 hours of each insertion was quantified by visual pain analogue scale (VPAS). Patients were followed until either death or catheter removal. The Borg score, SGRQ, and comfort's score showed significant improvement at 2-week visit (p drain was effective in the treatment of MPE as a TPC without early complications.

  9. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    International Nuclear Information System (INIS)

    Cantasdemir, M.; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F.

    2003-01-01

    AIM: To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses. MATERIALS AND METHODS: Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3). RESULTS: PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones. CONCLUSION: CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD

  10. Suicide by severing the arterio-venous subclavian dialysis catheter.

    Science.gov (United States)

    Edirisinghe, P A S; Busuttil, A

    2006-02-01

    Haemodialysis access is an essential requirement for haemodialysis treatment in end-stage renal disease. The common forms are arteriovenous fistula (AVF) and arteriovenous grafts in ante-cubital fossa, forearm and upper thigh. Sometimes temporary or immediate access is created via a subclavian catheter or internal jugular catheter. This report is on a 79-year-old man who was suffering from chronic renal failure with a non-functional peripheral AVF; he was being dialysed through a permanent subclavian catheter and he became depressed due to continuing deterioration of his health. He used the easily accessible haemodialysis site as the method of suicide by cutting the tube that connected with the main vessel in his chest and bled to death. This highlights the requirement to assess carefully the patient's mental state in those on chronic haemodialysis, even though very few similar fatal cases have been previously reported.

  11. Intravascular (catheter) MR imaging

    International Nuclear Information System (INIS)

    Cohen, A.M.; Hurst, G.C.; Katz, D.E.; Dverk, J.L.; Wiesen, E.J.; Czerski, L.W.; Malaya, R.; Bellon, E.M.

    1989-01-01

    Intravascular MR probes allow excellent spatial resolution and have the potential to detect arterial wall microstructure. Ultrasonic intravascular probes suggest that detailed morphologic information can assist clinical decision making. Catheter MR probes of 2--7 mm outside diameter (OD) were built of copper wire, Teflon, and parts from standard commercial catheters. The probes were connected to the surface coil receiver input of our Picker VISTA 2055HP 1.5-T imaging system. The extant (linear) body coil was used for transmit. Phantoms were constructed of coaxial glass MR tubes, filled with doped water. Watanabe rabbit aorta and human autopsy iliac artery specimens were examined within 4 hours of excision or stored by freezing. In vivo iliac arteries in dogs under general anesthesia were imaged, with percutaneous placement of the probe. Results are presented

  12. Torsades de Pointes associated with QT prolongation after catheter ablation of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Yae Min Park

    2017-09-01

    Full Text Available A 79-year-old woman who underwent catheter ablation for paroxysmal atrial fibrillation presented with Torsades de Pointes (TdP. Aggravation of prolonged QT interval which is most likely due to neural modulation by catheter ablation, played major role in the initiation of TdP. The patient was successfully treated with isoproterenol during acute stage and discharged after stabilization without implantation of permanent pacemaker or implantable cardioverter defibrillator.

  13. Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial.

    Science.gov (United States)

    Ahmed, Magdy R; Sayed Ahmed, Waleed A; Atwa, Khaled A; Metwally, Lobna

    2014-05-01

    To assess whether immediate (0h), intermediate (after 6h) or delayed (after 24h) removal of an indwelling urinary catheter after uncomplicated abdominal hysterectomy can affect the rate of re-catheterization due to urinary retention, rate of urinary tract infection, ambulation time and length of hospital stay. Prospective randomized controlled trial conducted at Suez Canal University Hospital, Egypt. Two hundred and twenty-one women underwent total abdominal hysterectomy for benign gynecological diseases and were randomly allocated into three groups. Women in group A (73 patients) had their urinary catheter removed immediately after surgery. Group B (81 patients) had the catheter removed 6h post-operatively while in group C (67 patients) the catheter was removed after 24h. The main outcome measures were the frequency of urinary retention, urinary tract infections, ambulation time and length of hospital stay. There was a significantly higher number of urinary retention episodes requiring re-catheterization in the immediate removal group compared to the intermediate and delayed removal groups (16.4% versus 2.5% and 0% respectively). Delayed urinary catheter removal was associated with a higher incidence of urinary tract infections (15%), delayed ambulation time (10.3h) and longer hospital stay (5.6 days) compared to the early (1.4%, 4.1h and 3.2 days respectively) and intermediate (3.7%, 6.8h and 3.4 days respectively) removal groups. Removal of the urinary catheter 6h postoperatively appears to be more advantageous than early or late removal in cases of uncomplicated total abdominal hysterectomy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Essure Permanent Birth Control

    Science.gov (United States)

    ... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  15. Cardiac pacemaker dysfunction in children after thoracic drainage catheter manipulation.

    Science.gov (United States)

    Lobdell, K W; Walters, H L; Hudson, C; Hakimi, M

    1997-05-01

    Two children underwent placement of permanent, epicardial-lead, dual-chamber, unipolar pacemaker systems for complete heart block. Postoperatively, both patients demonstrated subcutaneous emphysema-in the area of their pulse generators-temporally related to thoracic catheter manipulation. Acutely, each situation was managed with manual compression of the pulse generator, ascertaining appropriate pacemaker sensing and pacing. Maintenance of compression with pressure dressings, vigilant observation/monitoring, and education of the care givers resulted in satisfactory pacemaker function without invasive intervention.

  16. Impact of quality management monitoring and intervention on central venous catheter dysfunction in the outpatient chemotherapy infusion setting.

    Science.gov (United States)

    Bansal, Anu; Binkert, Christoph A; Robinson, Malcolm K; Shulman, Lawrence N; Pellerin, Linda; Davison, Brian

    2008-08-01

    To assess the utility of maintaining and analyzing a quality-management database while investigating a subjectively perceived increase in the incidence of tunneled catheter and port dysfunction in a cohort of oncology outpatients. All 152 patients undergoing lytic therapy (2-4 mg alteplase) of a malfunctioning indwelling central venous catheter (CVC) from January through June 2004 at a single cancer center in the United States were included in a quality-management database. Patients were categorized by time to device failure and the initial method of catheter placement (surgery vs interventional radiology). Data were analyzed after 3 months, and areas of possible improvement were identified and acted upon. Three months of follow-up data were then collected and similarly analyzed. In a 6-month period, 152 patients treated for catheter malfunction received a total of 276 doses of lytic therapy. A 3-month interim analysis revealed a disproportionately high rate (34%) of early catheter malfunction (ECM; <30 days from placement). Postplacement radiographs demonstrated suboptimal catheter positioning in 67% of these patients, all of whom had surgical catheter placement. There was a 50% absolute decrease in the number of patients presenting with catheter malfunction in the period from April through June (P < .001). Evaluation of postplacement radiographs in these patients demonstrated a 50% decrease in the incidence of suboptimal positioning (P < .05). Suboptimal positioning was likely responsible for some, but not all, cases of ECM. Maintenance of a quality-management database is a relatively simple intervention that can have a clear and important impact on the quality and cost of patient care.

  17. Echocardiography-guided Radiofrequency Catheter Ablation of Atrioventricular Node and VVI Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    T Guo

    2014-05-01

    Full Text Available Objective: This study is to evaluate the feasibility and safety of intracardiac radiofrequency catheter ablation (RFCA of the atrioventricular node (AVN and pacemaker implantation using transthoracic echocardiography. Methods: Eleven patients – six males and five females (mean age 66 years – with persistent or permanent atrial fibrillation/atrial flutter received RFCA of AVN and VVI pacemaker implantation (paces and senses the ventricle and is inhibited if it senses ventricular activity. Under transthoracic echocardiography, the electrode catheters were positioned intracardiac, and target ablation was performed, with the permanent pacemaking catheter in the left subclavian vein and the ablation catheter in the right femoral vein. The multi-view imaging and dynamic observation applied during the stable AV dissociation were successful. Results: Atrioventricular node ablation and permanent pacemaker implantation in 11 patients were completed successfully without X-ray exposure. The operation success rate was 100%. All patients recovered well within the follow-up period. Conclusions: Radiofrequency catheter ablation of AVN and VVI pacemaker implantation under transthoracic echocardiography guidance is a safe, easy and feasible approach. This procedure could be an important supplemental measure to catheter ablation of arrhythmia under routine X-ray fluoroscopy.

  18. Radiologic placement of Hickman catheters

    International Nuclear Information System (INIS)

    Robertson, L.J.; Mauro, M.A.; Jaques, P.F.

    1988-01-01

    Hickman catheter inserter has previously been predominantly accomplished surgically by means of venous cutdown or percutaneous placement in the operating room. The authors describe their method and results for 55 consecutive percutaneous placements of Hickman catheters in the interventional radiology suite. Complication rates were comparable to those for surgical techniques. Radiologic placement resulted in increased convenience, decreased time and cost of insertion, and super fluoroscopic control of catheter placement and any special manipulations. Modern angiographic materials provide safer access to the subclavian vein than traditional methods. The authors conclude that radiologic placement of Hickman catheters offers significant advantages over traditional surgical placement

  19. Agile and Bright Intracardiac Catheters

    NARCIS (Netherlands)

    M. Pekař (Martin)

    2017-01-01

    markdownabstractIntracardiac imaging catheters represent unique instruments to diagnose and treat a diseased heart. While there are imminent advances in medical innovation, many of the commercially available imaging catheters are outdated. Some of them have been designed more than 20 years and

  20. Runinal and Intermediary Metabolism of Propylene Glycol in Lactating Holstein Cows

    DEFF Research Database (Denmark)

    Kristensen, Niels Bastian; Raun, Birgitte Marie Løvendahl

    2007-01-01

    Four lactating Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the mesenteric artery, mesenteric vein, hepatic portal vein, and hepatic vein were used in a cross-over design to study the metabolism of propylene glycol (PG).......Four lactating Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the mesenteric artery, mesenteric vein, hepatic portal vein, and hepatic vein were used in a cross-over design to study the metabolism of propylene glycol (PG)....

  1. [Recurrent and catheter-associated urinary tract infections : Prophylaxis and prevention].

    Science.gov (United States)

    Piechota, H

    2017-06-01

    Urinay tract infection (UTI) as one of the most frequent bacterial infections in humans is of utmost relevance. Because of the rising prevalence of antimicrobial resistance, urinalysis should always include urine culture and a resistogram in order to avoid an unspecific selection and overuse of antibiotics. Prevention of recurrent UTI must first of all rule out predisposing uropathogenic conditions. Nowadays, a great variety of drugs, behavioral, and supportive treatment options can effectively minimize UTI recurrence. The growing importance of vaccines (immunotherapy), probiotics (lactobacilli), and standardized herbal preparations meets the need of reducing antibiotic use and the development of antimicrobial resistance. Around 80% of all nosocomial UTIs (nUTIs) are associated with indwelling urinary catheters. It is estimated that up to 70% of all nUTIs occurring in Germany may be avoided by using appropriate preventative measures. Therefore, profound knowledge about the basics of catheter-associated nUTIs and the correct management of urinary catheters are of utmost individual and socioeconomic importance.

  2. Biofilm Formation by Bacteria Isolated from Intravenous Catheters

    Directory of Open Access Journals (Sweden)

    Sina Hedayati

    2015-10-01

    Full Text Available Background: Reports on the association of nosocomial bacterial infections with indwelling medical devices such as intravenous catheters (IVC has increased in recent years. The potential to form biofilm on these devices seems to be the main reason for establishment of such infections. The aim of this study was to measure the potential of biofilm formation by bacterialisolates from IVCs.Methods: Seventy-one IVCs were collected from hospitalized patients in ICU, NICU, hematology and oncology wards at Taleghani Hospital from Jan 2010 to Jan 2011. The bacterial isolates were identified using the standard biochemical tests and the potential to form biofilms was determined by the microtiter plate assay method (MTP and colony morphology using Congo red agar plates (CRA.Results: Overall, 54 (71% IVCs were colonized and 76 bacteria were isolated among which, 64 (84.2% were coagulase negative staphylococci (CoNS, 3 (3.9% S. aureus, 3 (3.9% Enterococcus spp., 2 (2.6% E. coli and 4 (5.3% were miscellaneous isolates not further identified. Among the CoNS, biofilm formation was observed in 68.7% and 82.8% of bacteriausing MTP and CRA methods, respectively. S. aureus and E. coli isolates also were biofilm producers but Enterococcus and other unknown isolates were biofilm negative.Conclusions: Our results confirm that the prevalent biofilm forming bacteria on IVCs were CoNS and that was the reason for high rates of nosocomial infections.

  3. From Catheter to Kidney Stone: The Uropathogenic Lifestyle of Proteus mirabilis.

    Science.gov (United States)

    Norsworthy, Allison N; Pearson, Melanie M

    2017-04-01

    Proteus mirabilis is a model organism for urease-producing uropathogens. These diverse bacteria cause infection stones in the urinary tract and form crystalline biofilms on indwelling urinary catheters, frequently leading to polymicrobial infection. Recent work has elucidated how P. mirabilis causes all of these disease states. Particularly exciting is the discovery that this bacterium forms large clusters in the bladder lumen that are sites for stone formation. These clusters, and other steps of infection, require two virulence factors in particular: urease and MR/P fimbriae. Highlighting the importance of MR/P fimbriae is the cotranscribed regulator, MrpJ, which globally controls virulence. Overall, P. mirabilis exhibits an extraordinary lifestyle, and further probing will answer exciting basic microbiological and clinically relevant questions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Marxism as permanent revolution

    NARCIS (Netherlands)

    van Ree, E.

    2013-01-01

    This article argues that the 'permanent revolution' represented the dominant element in Karl Marx and Friedrich Engels' political discourse, and that it tended to overrule considerations encapsulated in 'historical materialism'. In Marx and Engels's understanding, permanent revolution did not

  5. Relationship between peripheral insertion site and catheter-related phlebitis in adult hospitalized patients: a systematic review.

    Science.gov (United States)

    Comparcini, Dania; Simonetti, Valentina; Blot, Stijn; Tomietto, Marco; Cicolini, Giancarlo

    2017-01-01

    To explore the relationship between the anatomical site of peripheral venous catheterization and risk of catheter-related phlebitis. Peripheral venous catheterization is frequently associated with phlebitis. Recent guidelines, recommend the use of an upper-extremity site for catheter insertion but no univocal consensus exists on the anatomical site with lower risk of phlebitis. Systematic review. We searched Medline (PubMed) and CINAHL (EBSCOhost) databases until the end of January 2017. We also reviewed the reference lists of retrieved articles and gray literature was excluded. Searches were limited to articles published in English with no restriction imposed to date of publication. The primary outcome was the incidence of phlebitis associated with anatomical site of peripheral catheterization. We included randomized controlled trials and observational studies on adult patients who required a peripheral catheter for the administration of medi- cation, intermittent or continuous fluid infusion. Antecubital fossa veins are associated with lower phlebitis rates, while hands veins are the most risky sites to develop phlebitis. There is no consensus regarding vein in forearm. Choosing the right anatomical site to insert a peripheral venous catheter is important to decrease phlebitis rate. Further studies should compare indwelling time in different anatomical sites with phlebitis rate. A more standardized approach in defining and assessing phlebitis among studies is recommended.

  6. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  7. Intracorporeal knotting of a femoral nerve catheter

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2015-01-01

    Full Text Available Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  8. Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients.

    Science.gov (United States)

    Fonseca, Igor Yoshio Imagawa; Krutman, Mariana; Nishinari, Kenji; Yazbek, Guilherme; Teivelis, Marcelo Passos; Bomfim, Guilherme André Zottele; Cavalcante, Rafael Noronha; Wolosker, Nelson

    2016-01-01

    To prospectively evaluate the perioperative safety, early complications and satisfaction of patients who underwent the implantation of central catheters peripherally inserted via basilic vein. Thirty-five consecutive patients with active oncologic disease requiring chemotherapy were prospectively followed up after undergoing peripheral implantation of indwelling venous catheters, between November 2013 and June 2014. The procedures were performed in the operating room by the same team of three vascular surgeons. The primary endpoints assessed were early postoperative complications, occurring within 30 days after implantation. The evaluation of patient satisfaction was based on a specific questionnaire used in previous studies. In all cases, ultrasound-guided puncture of the basilic vein was feasible and the procedure successfully completed. Early complications included one case of basilic vein thrombophlebitis and one case of pocket infection that did not require device removal. Out of 35 patients interviewed, 33 (94.3%) would recommend the device to other patients. Implanting brachial ports is a feasible option, with low intraoperative risk and similar rates of early postoperative complications when compared to the existing data of the conventional technique. The patients studied were satisfied with the device and would recommend the procedure to others. Avaliar prospectivamente segurança perioperatória, complicações precoces e grau de satisfação de pacientes submetidos ao implante de cateteres centrais de inserção periférica pela veia basílica. Foram acompanhados prospectivamente e submetidos ao implante de cateteres de longa permanência de inserção periférica, entre novembro de 2013 e junho de 2014, 35 pacientes consecutivos com doença oncológica ativa necessitando de quimioterapia. Os procedimentos foram realizados em centro cirúrgico por uma mesma equipe composta por três cirurgiões vasculares. Os desfechos primários avaliados foram as

  9. Infraclavicular versus axillary nerve catheters: A retrospective comparison of early catheter failure rate.

    Science.gov (United States)

    Quast, Michaela B; Sviggum, Hans P; Hanson, Andrew C; Stoike, David E; Martin, David P; Niesen, Adam D

    2018-05-01

    Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. Retrospective study. Postoperative recovery unit and inpatient hospital floor. 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database. Data collected included unplanned catheter dislodgement, catheter replacement rate, postoperative pain scores, and opioid administration on postoperative day 1. Catheter failure was defined as unplanned dislodging within 24 h of placement or requirement for catheter replacement and evaluated using a covariate adjusted model. 119 IC catheters and 209 AX catheters were evaluated. There were 8 (6.7%) failed IC catheters versus 13 (6.2%) failed AX catheters. After adjusting for age, BMI, and gender there was no difference in catheter failure rate between IC and AX nerve catheters (p = 0.449). These results suggest that IC and AX nerve catheters do not differ in the rate of early catheter failure, despite differences in anatomic location and catheter placement techniques. Both techniques provided effective postoperative analgesia with median pain scores < 3/10 for patients following elbow surgery. Reasons other than rate of early catheter failure should dictate which approach is performed. Copyright © 2018. Published by Elsevier Inc.

  10. Malfunctioning and infected tunneled infusion catheters: over-the-wire catheter exchange versus catheter removal and replacement.

    Science.gov (United States)

    Guttmann, David M; Trerotola, Scott O; Clark, Timothy W; Dagli, Mandeep; Shlansky-Goldberg, Richard D; Itkin, Maxim; Soulen, Michael C; Mondschein, Jeffrey I; Stavropoulos, S William

    2011-05-01

    To compare the safety and effectiveness of over-the-wire catheter exchange (catheter-exchange) with catheter removal and replacement (removal-replacement) at a new site for infected or malfunctioning tunneled infusion catheters. Using a quality assurance database, 61 patients with tunneled infusion catheters placed during the period July 2001 to June 2009 were included in this study. Patients receiving hemodialysis catheters were excluded. Catheter-exchange was performed in 25 patients, and same-day removal-replacement was performed in 36 patients. Data collected included demographic information, indication for initial catheter placement and replacement, dwell time for the new catheter, and ultimate fate of the new device. Statistical comparisons between the two cohorts were analyzed using the Kaplan-Meier technique and Fisher exact test. Catheters exchanged over the wire remained functional without infection for a median of 102 days (range, 2-570 days), whereas catheters removed and replaced were functional for a median 238 days (range, 1-292 days, P = .12). After catheter replacement, there were 11 instances of subsequent infection in the catheter-exchange group and 7 instances in the removal-replacement cohort, accounting for infection rates of 4.4 and 2.3 per 1,000 catheter days (P = .049). Patients in the catheter-exchange group had 3.2 greater odds of infection compared with patients in the removal-replacement group. Five malfunction events occurred in each group, accounting for 2.0 and 1.7 malfunctions per 1,000 catheter days in the catheter-exchange and removal-replacement groups (P = .73). Catheter-exchange of tunneled infusion catheters results in a higher infection rate compared with removal-replacement at a new site. The rate of catheter malfunction is not significantly different between the two groups. Catheter-exchange is an alternative for patients with tunneled infusion catheters who have limited venous access, but this technique should not be

  11. Spinal canal extension of hyperalimentation catheter without neurologic sequela

    International Nuclear Information System (INIS)

    Glasier, M.; Arkansas Children's Hospital, Little Rock; Hassell, D.R.

    1989-01-01

    An attempt at placement of a left femoral vein hyperalimentation catheter resulted in entrance of the catheter into the spinal canal. Catheter location was documented by injections of nonionic contrast material into the catheter without neurologic sequellae. (orig.)

  12. Translumbar aortography by catheter technique

    International Nuclear Information System (INIS)

    Hagen, B.; Honemeyer, U.; Meier-Duis, H.

    1982-01-01

    400 examinations performed during the last three years by TLA (only catheter technique) were subjected to critical analysis and studied particularly in respect to the rate of complications. We observed 13 complications (3.25%) of moderate severity, including 3 large hematomas (documented by CT), 3 paravasations and 7 dissections, but no fatal complication. Two (0.5%) of these complications had clinical evidence. The advantages of the catheter technique of TLA are described. Injections through rigid metal cannula should be avoided because of the high incidence of complications (mainly the increased risk of dissection). Downstream injection resulted in excellent visualization of peripheral occluding vascular disease. Upstream injection should be preferred to demonstrate the major abdominal arteries as well as supraceliac collateral circulation in the case of high Leriche syndrome. The low or intermediate puncture of the aorta is preferable to facilitate caudad direction of the catheter and to diminish the risk of damaging other vessels or puncturing an organ. (orig.) [de

  13. The permanent process

    DEFF Research Database (Denmark)

    Møller, Jesper; McCullagh, Peter

    We extend the boson process first to a large class of Cox processes and second an even larger class of infinitely divisible point processes. Density and moment results are studied in detail. These results are obtained in closed form as weighted permanents, so the extension is called a permanent...... process. Temporal extensions and a particularly tractable case of the permanent process are also studied. Extensions of the ferminon process along similar lines, leading to so-called determinant processes, are discussed at the end. While the permanent process is attractive, the determinant process...

  14. Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip fracture patients receiving urine catheter: a double-blind randomized trial

    Directory of Open Access Journals (Sweden)

    Gunnarsson AK

    2017-01-01

    Full Text Available Anna-Karin Gunnarsson,1 Lena Gunningberg,2 Sune Larsson,1 Kenneth B Jonsson1 1Institution of Surgical Sciences, Uppsala University, Uppsala, Sweden; 2Institution of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Background: Urinary tract infection (UTI is a common complication among patients with hip fractures. Receiving an indwelling urinary catheter is a risk factor for developing UTIs. Treatment of symptomatic UTIs with antibiotics is expensive and can result in the development of antimicrobial resistance. Cranberries are thought to prevent UTI. There is no previous research on this potential effect in patients with hip fracture who receive urinary catheters. Aim: The aim of this study is to investigate whether intake of cranberry juice concentrate preoperatively decreases the incidence of postoperative UTIs in hip fracture patients that received a urinary catheter. Design: This study employed a randomized, placebo-controlled double-blind trial. Method: Female patients, aged 60 years and older, with hip fracture (n=227 were randomized to receive cranberry or placebo capsules daily, from admission, until 5 days postoperatively. Urine cultures were obtained at admission, 5 and 14 days postoperatively. In addition, Euro Qual five Dimensions assessments were performed and patients were screened for UTI symptoms. Result: In the intention-to-treat analysis, there was no difference between the groups in the proportion of patients with hospital-acquired postoperative positive urine cultures at any time point. When limiting the analysis to patients that ingested at least 80% of the prescribed capsules, 13 of 33 (39% in the placebo group and 13 of 47 (28% in the cranberry group (P=0.270 had a positive urine culture at 5 days postoperatively. However, this difference was not statistically significant (P=0.270. Conclusion: Cranberry concentrate does not seem to effectively prevent UTIs in female patients with hip fracture and

  15. Epidural Catheter Breakage In-Situ

    Directory of Open Access Journals (Sweden)

    Geetanjali S Verma

    2014-09-01

    Full Text Available A 45yr old woman diagnosed with dysfunctional uterine bleeding and incisional hernia was planned for total abdominal hysterectomy with bilateral salpingo-oophorectomy and mesh repair under combined spinal and epidural anaesthesia. Using VYGON® epidural catheter with its recommended introducer, the catheter was inserted but it snapped off at 11cm mark while positioning the catheter. After radiological confirmation, the neurosurgeon removed the catheter under general anaesthesia, which was followed by the scheduled surgery.

  16. An integrated multi-study analysis of intra-subject variability in cerebrospinal fluid amyloid-β concentrations collected by lumbar puncture and indwelling lumbar catheter

    DEFF Research Database (Denmark)

    Lucey, Brendan P; Gonzales, Celedon; Das, Ujjwas

    2015-01-01

    unknown what effect differences in CSF collection methodology have on Aβ variability. In this study, we sought to determine the effect of different collection methodologies on the stability of CSF Aβ concentrations over time. METHODS: Grouped analysis of CSF Aβ levels from multiple industry and academic...... by enzyme linked immunosorbent assay. Data from all sponsors was converted to percent of the mean for Aβ40 and Aβ42 for comparison. Repeated measures analysis of variance was performed to assess for factors affecting the linear rise of Aβ concentrations over time. RESULTS: Analysis of studies collecting CSF...

  17. Catheter – associated urinary tract infection: process indicators for analysis of prevention practices in critical patients

    Directory of Open Access Journals (Sweden)

    Caroline Cury Ferreira

    2017-07-01

    Full Text Available Background and objective: Urinary tract infections have a significant impact on the patient's clinical evolution. In this way, the objective of this study was to analyze, through two process indicators. The conformities and nonconformities related to the practices of control and prevention of urinary tract infection related to delayed bladder catheterization in sectors with critical patients. Methods: Documental, observational and cross-sectional research of quantitative approach, performed in an Intensive Care Center and an Emergency unit of a public hospital in Curitiba. The data collection and analysis were based on process indicators elaborated and validated by Fernandez (2006. The indicators are evaluated accordingly when values between 73 – 87 % and 75 – 85 %, respectively. Results: For Indicators 1 and 2, the overall compliance rate was 68.8 % and 29.5 %, respectively. When the items that subsided the numerator of both indicators were registered, the indication for use of the device was more satisfactory in the Emergency (80.6 % and the adequate fixation presented nonconformity in the two sectors evaluated (67.5 % in the Center for Intensive Care and 96.8 % in Emergency.Conclusion: In general, the indicators revealed nonconformities with regard to the prevention practices for urinary tract infection related to delayed bladder catheterization and address the need for the implementation of guidance strategies for care teams and continuous monitoring of catheter use. KEYWORDS: Indicators. Quality indicators, Health care. Urinary Tract Infections. Catheters, Indwelling.

  18. Inappropriate use of urinary catheters and its common complications in different hospital wards

    Directory of Open Access Journals (Sweden)

    Parivash Davoodian

    2012-01-01

    Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

  19. A percepção do paciente referente a ser portador de um cateter de longa permanência La percepción del paciente respecto a ser portador de un catéter de permanencia prolongada Patients' perception regarding the use of a long-term catheter

    Directory of Open Access Journals (Sweden)

    Fernanda Titareli Merizio Martins

    2008-09-01

    ó que el paciente siguió tranquilo y seguro durante el procedimiento; Infusión de Quimioterapia (100% de los IC evidenció el catéter como un facilitador del tratamiento quimioterápico.This study aimed to evaluate patients' perception regarding their use of a Totally Implanted Catheter (TIC. This descriptive study uses the Critical Incident Technique (CI for data analysis. The study was performed at a Teaching Hospital in São Paulo State, Brazil. Study participants were 15 patients using TIC. Data were grouped into four categories: Activity Performance (40% of the CI showed that patients were more independent, while 60% revealed that some kind of activity was restricted due to the TIC; Altered Body Image (57% showed the patients' dissatisfaction after the TIC implant, 14% of the CI revealed pre-implant problems, 28% of the CI showed that the TIC favored body esthetics; Catheter Implantation (75% of the CI revealed catheter implantation as a traumatizing procedure, while 25% of the CI revealed patients remained calm and confident during the procedure; Chemotherapy Infusion (100% of the CI showed that the catheter made chemotherapy easier.

  20. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

    International Nuclear Information System (INIS)

    Hashimoto, Aya; Tanaka, Toshihiro; Sho, Masayuki; Nishiofuku, Hideyuki; Masada, Tetsuya; Sato, Takeshi; Marugami, Nagaaki; Anai, Hiroshi; Sakaguchi, Hiroshi; Kanno, Masatoshi; Tamamoto, Tetsuro; Hasegawa, Masatoshi; Nakajima, Yoshiyuki; Kichikawa, Kimihiko

    2016-01-01

    PurposePrevious reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.Materials and Methods93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.ResultsThe overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).ConclusionsThe coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.

  1. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Aya; Tanaka, Toshihiro, E-mail: toshihir@bf6.so-net.ne.jp [Nara Medical University, Department of Radiology (Japan); Sho, Masayuki [Nara Medical University, Department of Surgery (Japan); Nishiofuku, Hideyuki; Masada, Tetsuya; Sato, Takeshi; Marugami, Nagaaki [Nara Medical University, Department of Radiology (Japan); Anai, Hiroshi [Nara City Hospital, Department of Radiology (Japan); Sakaguchi, Hiroshi [Nara Prefectural Western Medical Center, Department of Radiology (Japan); Kanno, Masatoshi [Nara Medical University, Oncology Center (Japan); Tamamoto, Tetsuro; Hasegawa, Masatoshi [Nara Medical University, Department of Radiation Oncology (Japan); Nakajima, Yoshiyuki [Nara Medical University, Department of Surgery (Japan); Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2016-06-15

    PurposePrevious reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.Materials and Methods93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.ResultsThe overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).ConclusionsThe coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.

  2. Transhepatic venous catheters for hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed El Gharib

    2014-06-01

    Conclusion: Based on our findings, transhepatic hemodialysis catheters have proven to achieve good long-term functionality. A high level of maintenance is required to preserve patency, although this approach provides remarkably durable access for patients who have otherwise exhausted access options.

  3. Button self-retaining drainage catheter

    International Nuclear Information System (INIS)

    Caridi, James G.; Hawkins, Irvin F.; Akins, E. William; Young, Ronald S.

    1997-01-01

    To help improve patient acceptance of long-term internal/external catheter access to the biliary tract in those with benign biliary obstruction, a simple design allows the catheter end to remain flush with the skin. It consists of a clothes button affixed to the drainage catheter with a wood screw after the catheter has been cut off at the skin exit. This button/screw device has been used successfully in 22 patients over the last 10 years; catheter exchanges were easily accomplished

  4. Retrievable Inferior Vena Cava Filters: Indications, Indwelling Time, Removal, Success and Complication Rates.

    Science.gov (United States)

    Tashbayev, Alisher; Belenky, Alexander; Litvin, Sergey; Knizhnik, Michael; Bachar, Gil N; Atar, Eli

    2016-02-01

    Various vena cava filters (VCF) are designed with the ability to be retrieved percutaneously. Yet, despite this option most of them remain in the inferior vena cava (IVC). To report our experience in the placement and retrieval of three different types of VCFs, and to compare the indications for their insertion and retrieval as reported in the literature. During a 5 year period three types of retrievable VCF (ALN, OptEase, and Celect) were inserted in 306 patients at the Rabin Medical Center (Beilinson and Hasharon hospitals). Indications, retrieval rates, median time to retrieval, success and complication rates were viewed and assessed in the three groups of filter types and were compared with the data of similar studies in the literature. Of the 306 VCFs inserted, 31 (10.1%) were retrieved with equal distribution in the three groups. In most patients the reason for filter insertion was venous thromboembolic events (VTE) and contraindications to anticoagulant therapy. Mean age was 68.38 ± 17.5 years (range 18-99) and was noted to be significantly higher compared to similar studies (53-56 years) (P < 0.0001). Multi-trauma patients were significantly older (71.11 ± 14.99 years) than post-pulmonary embolism patients (48.03 ± 20.98 years, P < 0.0001) and patients with preventive indication (26.00 ± 11.31, P < 0.0001). The mean indwelling time was 100.6 ± 103.399 days. Our results are comparable with the results of other studies, and there was no difference in percentage of retrieval or complications between patients in each of the three groups. In 1 of 10 patients filters should be removed after an average of 3.5 months. All three IVC filter types used are safe to insert and retrieve.

  5. Light insensitive silver(I) cyanoximates as antimicrobial agents for indwelling medical devices.

    Science.gov (United States)

    Gerasimchuk, Nikolay; Gamian, Andrzej; Glover, Garrett; Szponar, Bogumila

    2010-11-01

    Ten silver(I) cyanoximates of AgL composition (L = NC-C(NO)-R, where R is electron withdrawing groups: -CN, -C(O)NR(2), -C(O)R' (alkyl), -C(O)OEt, 2-heteroaryl fragments such as 2-pyridyl, 2-benzimidazolyl, 2-benzoxazolyl, 2-benzthiazolyl) were synthesized and characterized using spectroscopic methods and X-ray analysis. Crystal structures of four complexes were determined and revealed the formation of two-dimensional (2D) coordination polymers of different complexity in which anions exhibit bridging or combined chelate and bridging binding modes. In these compounds, anions are in the nitroso form. All studied AgL complexes are sparingly soluble in water and are thermally stable to 150 °C. Synthesized compounds demonstrated remarkable insensitivity toward visible light and UV-radiation, which was explained based on their polymeric structures with multiple covalent bonds between bridging cyanoxime ligands and Ag(I) centers. All 10 silver(I) cyanoximates were tested in vitro on the subject of their antimicrobial activity against both Gram-positive and Gram-negative microorganisms such as Escherichia coli, Klebsiella pneumoniae, Proteus sp., Pseudomonas aeruginosa, Enterococcus hirae, Streptococcus mutans, Staphylococcus aureus, and Mycobacterium fortuitum as well as against Candida albicans in solutions, and in the solid state as pressed pellets and dried filter paper disks presoaked with solutions of AgL in DMF. Results showed pronounced antimicrobial activity for all investigated complexes. A combination of five factors: (1) light insensitivity, (2) poor water solubility, (3) high thermal stability, (4) lack of toxicity of organic ligands, and (5) in vitro antimicrobial activity allows development of silver(I) cyanoximates for medical applications. These include antimicrobial additives to acrylate glue, cured by UV-radiation, used in introduction of prosthetic joints and dental implants, and prevention of biofilm formation on several types of indwelling medical

  6. Permanences GAG-EPA

    CERN Document Server

    GAC-EPA

    2015-01-01

    Le GAC organise chaque mois des permanences avec entretiens individuels. La prochaine permanence se tiendra le : Mardi 5 mai de 13 h 30 à 16 h 00 Salle de réunion de l’Association du personnel Les permanences suivantes auront lieu les mardis 2 juin, 1er septembre, 6 octobre, 3 novembre et 1er décembre 2015. Les permanences du Groupement des Anciens sont ouvertes aux bénéficiaires de la Caisse de pensions (y compris les conjoints survivants) et à tous ceux qui approchent de la retraite. Nous invitons vivement ces derniers à s’associer à notre groupement en se procurant, auprès de l’Association du personnel, les documents nécessaires.

  7. Permanent quadrupole magnets

    International Nuclear Information System (INIS)

    Bush, E.D. Jr.

    1976-01-01

    A family of quadrupole magnets using a soft iron return yoke and circular cross-section permanent magnet poles were fabricated to investigate the feasibility for use in ion or electron beam focusing applications in accelerators and transport lines. Magnetic field measurements yielded promising results. In fixed-field applications, permanent magnets with sufficient gradients would be a low cost substitute for conventional electromagnets, eliminating the need for power supplies, associated wiring, and cooling. Based on preliminary tests, it was seen that permanent quadrupole magnets can offer a low cost, reliable solution in applications requiring small, fixed-field focusing devices for use in ion or electron-beam transport systems. Permanent magnets do require special considerations in design, fabrication, handling, and service that are different than encountered in conventional quadrupole magnets. If these basic conditions are satisfied, the resulting beam-focusing device would be stable, maintenance free, with virtually an indefinite lifetime

  8. Permanent quadrupole magnets

    International Nuclear Information System (INIS)

    Bush, E.D. Jr.

    1976-01-01

    A family of quadrupole magnets using a soft iron return yoke and circular cross-section permanent magnet poles were fabricated to investigate the feasibility for use in ion or electron beam focusing applications in accelerators and transport lines. Magnetic field measurements yielded promising results. In fixed-field applications, permanent magnets with sufficient gradients would be a low cost substitute for conventional electromagnets, eliminating the need for power supplies, associated wiring, and cooling. (author)

  9. Marxism as permanent revolution

    OpenAIRE

    van Ree, E.

    2013-01-01

    This article argues that the 'permanent revolution' represented the dominant element in Karl Marx and Friedrich Engels' political discourse, and that it tended to overrule considerations encapsulated in 'historical materialism'. In Marx and Engels's understanding, permanent revolution did not represent a historical shortcut under exceptional circumstances, but the course revolutions in the modern era would normally take. Marx and Engels traced back the pattern to the sixteenth century. It is ...

  10. STUDY OF CENTRAL VENOUS CATHETER RELATED BLOOD STREAM INFECTIONS IN PATIENTS ON HAEMODIALYSIS

    Directory of Open Access Journals (Sweden)

    Pranjal Pankaj

    2018-01-01

    Full Text Available BACKGROUND Temporary and permanent central venous catheters are used in majority of patients of CKD when initiated on hemodialysis and mostly these catheters act as bridge before permanent AV fistula assess could be obtained. Blood stream infections related to these central venous catheters are an important cause of morbidity and mortality in these patients. Appropriate antiseptic precautions while inserting central venous catheter and early identification of catheter related blood stream infections (CRBSI are of utmost importance for reducing hospital stay, cost of therapy and mortality. MATERIALS AND METHODS A total of 50 patients of CKD were included in the study who had central venous catheter in situ (internal jugular or subclavian and developed symptoms related to blood stream infections. Blood cultures were obtained from the catheter lumen and a separate venous site 1 hour apart. All the culture sensitivity reports were obtained from department of microbiology of our institute. Inclusion Criteria- Known case of CKD patients aged more than 18yrs on hemodialysis with symptoms and signs of catheter related blood stream infections were included in the study. Exclusion Criteria- Patients with other associated comorbid infections like Koch’s, urinary tract infection or others mimicking symptoms of CRBSI. RESULTS The cultures were found positive in 38 patients (76% while in rest 24% cases positive cultures could not be obtained. Out of culture positive patients 52.63% cases were found to have gram positive infections while 44.74% had gram negative infections. In 2.63% patients, fungus was isolated to be the causative organism. Among the gram positive organisms 50% had CoNS, 30% had MSSA and 20% had MRSA infections. Among the gram negative group, 47.06% had klebsiella, 23.53% had acinetobacter, 17.65% had E.coli and 11.76% had pseudomonas as the causative organisms. Mortality was observed in 14% patients out of which 28.57% were culture

  11. Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Ha, Thuong G. Van; Chien, Andy S.; Funaki, Brian S.; Lorenz, Jonathan; Piano, Giancarlo; Shen, Maxine; Leef, Jeffrey

    2008-01-01

    The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These included both retrievable and permanent filters. The Recovery nitinol and Guenther tulip filters were used as retrievable filters. The frequency of retrievable filter used was calculated. Clinical data and technical data related to filter placement were reviewed. Outcomes, including pulmonary embolism, complications associated with placement, retrieval, or indwelling, were calculated. During the study period, 604 IVC filters were placed. Of these, 97 retrievable filters (16%) were placed in 96 patients. There were 53 Recovery filter and 44 Tulip filter insertions. Subjects were 59 women and 37 men; the mean age was 52 years, with a range of from 18 to 97 years. The placement of retrievable filters increased from 2% in year 1 to 32% in year 5 of the study period. The total implantation time for the permanent group was 145,450 days, with an average of 288 days (range, 33-1811 days). For the retrievable group, the total implantation time was 21,671 days, with an average of 226 days (range, 2-1217 days). Of 29 patients who returned for filter retrieval, the filter was successfully removed in 28. There were 14 of 14 successful Tulip filter retrievals and 14 of 15 successful Recovery filter retrievals. In one patient, after an indwelling period of 39 days, a Recovery nitinol filter could not be removed secondary to a large clot burden within the filter. For the filters that were removed, the mean dwell time was 50 days for the Tulip type and 20 days for the Recovery type. Over the follow-up period there was an overall PE incidence of 1.4% for the permanent group and 1% for the retrieval group. In

  12. Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.

    Science.gov (United States)

    Levin, Ricardo; Leacche, Marzia; Petracek, Michael R; Deegan, Robert J; Eagle, Susan S; Thompson, Annemarie; Pretorius, Mias; Solenkova, Nataliya V; Umakanthan, Ramanan; Brewer, Zachary E; Byrne, John G

    2010-08-01

    In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. A retrospective study. A single institutional university hospital. Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications. Copyright 2010 Elsevier Inc. All rights reserved.

  13. Initial clinical results with the ThermoCool® SmartTouch® Surround Flow catheter.

    Science.gov (United States)

    Gonna, Hanney; Domenichini, Giulia; Zuberi, Zia; Norman, Mark; Kaba, Riyaz; Grimster, Alexander; Gallagher, Mark M

    2017-08-01

    The Biosense Webster ThermoCool® SmartTouch® Surround Flow (STSF) catheter is a recently developed ablation catheter incorporating Surround Flow (SF) technology to ensure efficient cooling and force sensing to quantify tissue contact. In our unit, it superseded the ThermoCool® SF catheter from the time of its introduction in May 2015. Procedure-related data were collected prospectively for the first 100 ablation procedures performed in our department using the STSF catheter. From a database of 654 procedures performed in our unit using the SF catheter, we selected one to match each STSF procedure, matching for procedure type, operator experience, patient age, and gender. The groups were well matched for patient age, gender, and procedure type. Procedure duration was similar in both groups (mean 225.5 vs. 221.4 min, IQR 106.5 vs. 91.5, P = 0.55), but fluoroscopy duration was shorter in the STSF group (mean 25.8 vs. 30.0, IQR 19.6 vs. 18.5, P = 0.03). No complication occurred in the STSF group. Complications occurred in two cases in the SF group (one pericardial effusion requiring drainage and one need for permanent pacing). Complete procedural success was achieved in 98 cases in the STSF group and 94 cases in the SF group (P = 0.15). The composite endpoint of procedure failure or acute complication was less common in the STSF group (2 vs. 8, P = 0.05). The STSF catheter is safe and effective in treating a range of arrhythmias. Compared with the SF catheter, it shows a trend towards improved safety-efficacy balance. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  14. Introduction to permanent magnets

    International Nuclear Information System (INIS)

    Zijlstra, H.

    1985-01-01

    Some general considerations concerning the application of permanent magnets are developed. The relevant magnet properties are discussed, with particular reference to Nd-Fe-B alloy. The author comes to the following conclusions; the air gap field B should be high, for high electrical efficiency; the magnet should face the air gap, for efficient use of the magnet material; the magnet material should therefore have a high remanence; and the new Nd-Fe-B magnet fits in nicely, having (potentially) the highest remanence ever reported in permanent magnets, combined with sufficient coercivity to sustain it

  15. Role of Tolterodine in the Management of Postoperative Catheter ...

    African Journals Online (AJOL)

    2016-10-01

    Oct 1, 2016 ... prophylaxis (TP) was associated with an absolute risk reduction (ARR) of 5.4%, relative risk ... or strong urge to pass urine in the presence of a patent indwelling ... management of patients with incontinence and patients.

  16. Lung abscess; Percutaneous catheter therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ha, H.K. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Kang, M.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Park, J.M. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Yang, W.J. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Shinn, K.S. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Bahk, Y.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of))

    1993-07-01

    Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologicall impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess. (orig.).

  17. Object permanence in lemurs.

    Science.gov (United States)

    Deppe, Anja M; Wright, Patricia C; Szelistowski, William A

    2009-03-01

    Object permanence, the ability to mentally represent objects that have disappeared from view, should be advantageous to animals in their interaction with the natural world. The objective of this study was to examine whether lemurs possess object permanence. Thirteen adult subjects representing four species of diurnal lemur (Eulemur fulvus rufus, Eulemur mongoz, Lemur catta and Hapalemur griseus) were presented with seven standard Piagetian visible and invisible object displacement tests, plus one single visible test where the subject had to wait predetermined times before allowed to search, and two invisible tests where each hiding place was made visually unique. In all visible tests lemurs were able to find an object that had been in clear view before being hidden. However, when lemurs were not allowed to search for up to 25-s, performance declined with increasing time-delay. Subjects did not outperform chance on any invisible displacements regardless of whether hiding places were visually uniform or unique, therefore the upper limit of object permanence observed was Stage 5b. Lemur species in this study eat stationary foods and are not subject to stalking predators, thus Stage 5 object permanence is probably sufficient to solve most problems encountered in the wild.

  18. Laser welding of balloon catheters

    Science.gov (United States)

    Flanagan, Aidan J.

    2003-03-01

    The balloon catheter is one of the principal instruments of non-invasive vascular surgery. It is used most commonly for angioplasty (and in recent years for delivering stents) at a multitude of different sites in the body from small arteries in the heart to the bilary duct. It is composed of a polymer balloon that is attached to a polymer shaft at two points called the distal and proximal bonds. The diverse utility of balloon catheters means a large range of component sizes and materials are used during production; this leads to a complexity of bonding methods and technology. The proximal and distal bonds have been conventionally made using cyanoacrylate or UV curing glue, however with performance requirements of bond strength, flexibility, profile, and manufacturing costs these bonds are increasingly being made by welding using laser, RF, and Hot Jaw methods. This paper describes laser welding of distal and proximal balloon bonds and details beam delivery, bonding mechanisms, bond shaping, laser types, and wavelength choice.

  19. 21 CFR 880.5200 - Intravascular catheter.

    Science.gov (United States)

    2010-04-01

    ... Devices § 880.5200 Intravascular catheter. (a) Identification. An intravascular catheter is a device that consists of a slender tube and any necessary connecting fittings and that is inserted into the patient's vascular system for short term use (less than 30 days) to sample blood, monitor blood pressure, or...

  20. The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection

    Directory of Open Access Journals (Sweden)

    Alanood Ahmed Aljohi

    2016-01-01

    Results: A 90% relative risk reduction in the rate of CAUTI was observed with the noble metal alloy catheter compared to the standard catheter (10 vs. 1 cases, P = 0.006. When considering both catheter-associated asymptomatic bacteriuria and CAUTI, the relative risk reduction was 83% (12 vs. 2 cases, P = 0.005. In addition to CAUTI, the risk of acquiring secondary bacteremia was lower (100% for the patients using noble metal alloy catheters (3 cases in the standard group vs. 0 case in the noble metal alloy catheter group, P = 0.24. No adverse events related to any of the used catheters were recorded. Conclusion: Results from this study revealed that noble metal alloy catheters are safe to use and significantly reduce CAUTI rate in ICU patients after 3 days of use.

  1. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...... cardiologists towards catheter ablation for AF, using a nationwide survey. METHODS AND RESULTS: We developed a purpose-designed questionnaire to evaluate attitudes towards catheter ablation for AF that was sent to all Danish cardiologists (n = 401; response n = 272 (67.8%)). There was no association between...... attitudes towards ablation and the experience or age of the cardiologist with respect to patients with recurrent AF episodes with a duration of 7 days and/or need for cardioversion. The majority (69%) expected a recurrence of AF after catheter ablation in more than 30% of the cases...

  2. Catheter Associated Urinary Tract Infection Prevention bundle

    Directory of Open Access Journals (Sweden)

    O. Zarkotou

    2017-01-01

    Full Text Available Catheter-associated urinary tract infections (CAUTI are among the most common healthcare-associated infections, and potentially lead to significant morbidity and mortality. Multifaceted infection control strategies implemented as bundles can prevent nosocomial infections associated with invasive devices such as CAUTIs. The components of the CAUTI bundle proposed herein, include appropriate indications for catheterization and recommendations for the procedures of catheter insertion and catheter maintenance and care. Avoiding unnecessary urinary catheter use is the most effective measure for their prevention. To minimize the risk of CAUTI, urinary catheters should be placed only when a clinical valid indication is documented and they should be removed as soon as possible; alternatives to catheterization should also be considered. Aseptic insertion technique, maintenance of closed drainage system and strict adherence to hand hygiene are essential for preventing CAUTI. The successful implementation of the bundle requires education and training for all healthcare professionals and evaluation of surveillance data.

  3. The Question of Decalage Between Object Permanence and Person Permanence

    Science.gov (United States)

    And Others; Jackson, Elaine

    1978-01-01

    Presents a study of decalage between object permanence and person permanence. Decalage was influenced by environmental as well as stimulus factors with infants tested between 6- and 81/4-months/of-age. (BD)

  4. Variable Permanent Magnet Quadrupole

    International Nuclear Information System (INIS)

    Mihara, T.; Iwashita, Y.; Kyoto U.; Kumada, M.; NIRS, Chiba; Spencer, C.M.; SLAC

    2007-01-01

    A permanent magnet quadrupole (PMQ) is one of the candidates for the final focus lens in a linear collider. An over 120 T/m strong variable permanent magnet quadrupole is achieved by the introduction of saturated iron and a 'double ring structure'. A fabricated PMQ achieved 24 T integrated gradient with 20 mm bore diameter, 100 mm magnet diameter and 20 cm pole length. The strength of the PMQ is adjustable in 1.4 T steps, due to its 'double ring structure': the PMQ is split into two nested rings; the outer ring is sliced along the beam line into four parts and is rotated to change the strength. This paper describes the variable PMQ from fabrication to recent adjustments

  5. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal.

    Science.gov (United States)

    Urbanetto, Janete de Souza; Peixoto, Cibelle Grassmann; May, Tássia Amanda

    2016-08-08

    to investigate the incidence of phlebitis and its association with risk factors when using peripheral IV catheters (PIC) and following their removal - (post-infusion phlebitis) in hospitalized adults. a cohort study of 171 patients using PIC, totaling 361 punctures. Sociodemographic variables and variables associated with the catheter were collected. Descriptive and analytical statistical analyses were performed. average patient age was 56.96 and 51.5% of the sample population was male. The incidence of phlebitis was 1.25% while using PIC, and 1.38% post-infusion. The incidence of phlebitis while using PIC was associated with the length of time the catheter remained in place, whereas post-infusion phlebitis was associated with puncture in the forearm. Ceftriaxone, Clarithromycin and Oxacillin are associated with post-infusion phlebitis. this study made it possible to investigate the association between risk factors and phlebitis during catheter use and following its removal. The frequency of post-infusion phlebitis was larger than the incidence of phlebitis with the catheter in place, with Phlebitis Grade III and II being the most frequently found in each of these situations, respectively. Aspects related to post-infusion phlebitis can be explained, given the limited number of studies addressing this theme from this perspective. investigar a incidência de flebites e a associação de fatores de risco com a sua ocorrência durante o uso e após a retirada do cateter intravenoso periférico - CIP (Flebite pós-infusão) em adultos hospitalizados. estudo de coorte com 171 pacientes com CIP, totalizando 361 punções. Foram coletadas variáveis sociodemográficas e relacionadas ao cateter. Análise estatística descritiva e analítica. dos pacientes, 51,5% eram homens e a média de idade foi de 56,96 anos. A incidência de flebites durante o uso do CIP foi de 1,25% e a pós-infusão foi de 1,38%. Associou-se à flebite durante o uso do CIP ao tempo de permanência do

  6. Superconducting permanent magnets

    International Nuclear Information System (INIS)

    Wipf, S.L.; Laquer, H.L.

    1989-01-01

    The concept of superconducting permanent magnets with fields trapped in shells or cylinders of Type II superconductors is an old one. Unfortunately, the low values of 0.5 to 1T for the first flux jump field, which is independent of the actual current density, have frustrated its implementation with classical Type II superconductors. The fact that the flux jump fields for high temperature superconductors should be an order of magnitude larger at liquid nitrogen temperatures allows us to reconsider these options. Analysis of the hysteresis patterns, based on the critical state model, shows that, if the dimensions are chosen so that the sample is penetrated at a field B/sub p/, which is equal to or just less than the first flux jump field, B/sub fj/, a temporarily applied field of 2B/sub fj/ will trap 0.5 B/sub fj/. Thus for a 90 K superconductor with a B/sub fj/ of 6T, a permanent field of 3 T should be trapped, with an energy product of 1.8 MJ/m/sup 3/ (225 MG . Oe). This is five times as large as for the best permanent magnet materials. The authors discuss means to verify the analysis and the limitations imposed by the low critical current densities in presently available high temperature superconductors

  7. Wounds, Functional Disability, and Indwelling Devices Are Associated With Cocolonization by Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci in Southeast Michigan

    OpenAIRE

    Flannery, Erika L.; Wang, Linda; Zöllner, Sebastian; Foxman, Betsy; Mobley, Harry L. T.; Mody, Lona

    2011-01-01

    Cocolonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) is a precursor to vancomycin-resistant S. aureus emergence. MRSA/VRE cocolonization incidence is higher among skilled nursing facility residents with functional disability and indwelling devices and occurs more frequently in wounds than other anatomical sites.

  8. Patient preferences for clean intermittent catheterisation and transurethral indwelling catheterisation for treatment of abnormal post-void residual bladder volume after vaginal prolapse surgery

    NARCIS (Netherlands)

    Hakvoort, R. A.; Nieuwkerk, P. T.; Burger, M. P.; Emanuel, M. H.; Roovers, J. P.

    2011-01-01

    To determine patient preferences for clean intermittent catheterisation (CIC) relative to transurethral indwelling catheterisation (TIC) as the treatment of abnormal post-void residual bladder volume (PVR) following vaginal prolapse surgery. Scenario-based preference assessment during face-to-face

  9. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

    Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

  10. Incidence of bacterial colonisation after indwelling of double-J ureteral stent

    Directory of Open Access Journals (Sweden)

    Hasan Riza Aydin

    2016-01-01

    Full Text Available Objective: To determine the bacterial colonisation after double-J stent use and the risk factors for bacteriuria linked to the stent. Materials and Methods: A total of 102 patients (61 men and 41 women, mean age 47.5 ± 14.16 were examined. The stents were removed under aseptic conditions, and a urine culture was obtained before the removal of the stents. After the stents were removed, the upper, central and lower sections were separated, and washing water was sent through the stent. Results: Bacterial colonisation was found in 29.4% (30 of 102 of the stents. The most frequently observed microorganisms were determined as staphylococcus, coagulase negative (8 of 30 and E. coli (5 of 30. The washing fluid used to clean the interior of the catheter produced pathogens in 8 patients (7.8%, and these pathogens were observed to be the same microorganisms that colonised the outside of the stent. There was no statistical difference between the patients with colonisation and those without in terms of age, gender, duration of stenting and reason for stent insertion. Conclusions: Though stent colonisation does not always entail symptomatic urinary tract infections, as shown in our study, the pathogens in the urine culture are the same as those colonising the stent, confirming the reality that colonisation is the main factor in these events. Additionally, according to our study, significant colonisation may be found in the first 3 weeks, contrary to the literature, causing us to consider that urinary tract infections may develop even in the early period.

  11. [Venous catheter-related infections].

    Science.gov (United States)

    Ferrer, Carmen; Almirante, Benito

    2014-02-01

    Venous catheter-related infections are a problem of particular importance, due to their frequency, morbidity and mortality, and because they are potentially preventable clinical processes. At present, the majority of hospitalized patients and a considerable number of outpatients are carriers of these devices. There has been a remarkable growth of knowledge of the epidemiology of these infections, the most appropriate methodology for diagnosis, the therapeutic and, in particular, the preventive strategies. Multimodal strategies, including educational programs directed at staff and a bundle of simple measures for implementation, applied to high-risk patients have demonstrated great effectiveness for their prevention. In this review the epidemiology, the diagnosis, and the therapeutic and preventive aspects of these infections are updated. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  12. Radiofrequency catheter oblation in atrial flutter

    International Nuclear Information System (INIS)

    Yan Ji; Wang Heping; Xu Jian; Liu Fuyuan; Fan Xizhen; An Chunsheng; Han Xiaoping; Ding Xiaomei; Wang Jiasheng; Gu Tongyuan

    2002-01-01

    Objective: To evaluate the radiofrequency catheter ablation for type I atrial flutter through application of Holo catheter labelling with anatomic imaging localization to ablate the isthmus of IVCTA during complete double-way block. Methods: Eleven cases with type I atrial flutter undergone Holo catheter labelling technique and consecution with conduction time change of coronary venous sinus orifice with-right atrial lower lateral wall pace excitation, were performed with radiofrequency catheter ablation for the isthmus outcoming with complete double-way conduction block. Results: All together 11 cases with 4 of atrial flutter and 7 of sinus rhythm were undergone radiofrequency catheter ablation resulting with double-way conduction block of the isthmus accompanied by prolongation of right atrial conduction time 56.0 ± 2.3 ms and 53.0 ± 4.6 ms respectively. The right atrial excitation appeared to be in clockwise and counter-clockwise of single direction. No recurrence occurred during 3-34 months follow up with only one showing atrial fibrillation. Conclusions: The application of Holo catheter labelling technique with anatomic imaging localization to achieve the double-way conduction block by radiofrequency catheter ablation of TVC-TA isthmus, is a reliable method for treating atrial flutter

  13. Primary thromboprophylaxis for cancer patients with central venous catheters--a reappraisal of the evidence.

    LENUS (Irish Health Repository)

    Cunningham, M S

    2006-01-30

    Venous thromboembolism (VTE) is responsible for an estimated 25 000 deaths per annum in UK hospital practice. It is well established that many of these deaths could be prevented through the use of appropriate thromboprophylaxis. This issue is of particular relevance in oncology practice, where the risks of VTE and bleeding are both significantly higher than those observed in general medical patients. Cancer patients with in-dwelling central venous catheters (CVCs) are at particularly high risk of developing thrombotic complications. However, the literature has produced conflicting conclusions regarding the efficacy of using routine primary thromboprophylaxis in these patients. Indeed such is the level of confusion around this topic, that the most recent version of the American College of Chest Physicians (ACCP) guidelines published in 2004 actually reversed their previous recommendation (published in 2001). Nevertheless, minidose warfarin continues to be routinely used in many oncology centres in the UK. In this article, we have performed a systematic review of the published literature regarding the efficacy and the risks, associated with using thromboprophylaxis (either minidose warfarin or low-dose LMWH) in cancer patients with CVC. On the basis of this evidence, we conclude that there is no proven role for using such thromboprophylaxis. However, asymptomatic CVC-related venous thrombosis remains common, and further more highly powered studies of better design are needed in order to define whether specific subgroups of cancer patients might benefit from receiving thromboprophylaxis.

  14. Central venous catheters: the role of radiology

    International Nuclear Information System (INIS)

    Tan, P.L.; Gibson, M.

    2006-01-01

    The insertion and management of long-term venous catheters have long been the province of anaesthetists, intensive care physicians and surgeons. Radiologists are taking an increasing role in the insertion of central venous catheters (CVCs) because of their familiarity with the imaging equipment and their ability to manipulate catheters and guide-wires. The radiological management of the complications of CVCs has also expanded as a result. This article reviews the role of radiology in central venous access, covering the detection and management of their complications

  15. Miniaturization of catheter systems for angiography

    International Nuclear Information System (INIS)

    Hawkins, I.F. Jr.; Akins, E.W.

    1988-01-01

    The authors discuss the use of small catheters and needles in angiography and interventional procedures to improve the quality of the procedures and increase the success rate and safety. This philosophy was initially poorly received, both by operators and by industry; however, more recently microtechniques have become more acceptable primarily because of the changing economic climate requiring procedures with shorter or no hospitalization time. Since 1970, the authors have performed well over 10,000 angiographic procedures using 5 French catheters, or smaller. During the last 12 years, they have used almost exclusively 4 French catheters, primarily with standard filming techniques which have resulted in no thrombosed arteries, or significant hematoma formation

  16. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  17. Iatrogenic Bowel Injury at Exchange of Supra-Pubic Catheter

    LENUS (Irish Health Repository)

    Foran, AT

    2018-04-01

    Suprapubic catheter insertion and exchange is a common urological procedure, but it is not without risks and complications. While bowel perforation is a recognised complication at suprapubic catheter insertion, it is not commonly reported at suprapubic catheter exchange. We report our experience of recognition, diagnosis and subsequent successful management of the most important complication related to suprapubic catheters.

  18. Catheter visualisation in MR tomography: first animal experimental experiences with field inhomogeneity catheters

    International Nuclear Information System (INIS)

    Adam, G.; Glowinski, A.; Neuerburg, J.; Buecker, A.; Vaals, J.J. van; Hurtak, W.; Guenther, R.W.

    1997-01-01

    Purpose: To assess the feasibility of a new developed field inhomogeneity catheter for interventional MR imaging in vivo. Materials and methods: Three different prototypes of a field inhomogeneity catheter were investigated in 6 pigs. The catheters were introduced in Seldinger technique via the femoral vessels over a guide wire on an interventional MR system (Philips Gyroscan NT combined with a C-arm fluoroscopy unit [Philips BV 212[). Catheters were placed in veins and arteries. The catheter position was controlled by a fast gradient echo sequence (Turbo Field Echo [TEF[). Results: Catheters were introduced over a guide wire without complications in all cases. Using the field inhomogeneity concept, catheters were easily visualised in the inferior vena cava and the aorta by the fast gradient echo technique on MR in all cases. Although aortic branches were successfully cannulated, the catheters were not displayed by the TFE technique due to the complex and tortuous anatomy. All animals survived the experiments without complications. Conclusion: MR guided visualisation of a field inhomogeneity catheter is a simple concept which can be realised on each MR scanner and may allow intravascular MR guided interventions in future. (orig.) [de

  19. Catheter-Associated Urinary Tract Infections

    Science.gov (United States)

    ... Duodenoscope Sampling Method Interim Duodenoscope Culture Method Multiplex Real-Time PCR Detection of KPC & NDM-1 genes Quinolones ... The most commonly used external catheter is a soft flexible sheath that fits over the penis (“condom” ...

  20. [Peripheral intravenous catheter-related phlebitis].

    Science.gov (United States)

    van der Sar-van der Brugge, Simone; Posthuma, E F M Ward

    2011-01-01

    Phlebitis is a very common complication of the use of intravenous catheters. Two patients with an i.v. catheter complicated by thrombophlebitis are described. Patient A was immunocompromised due to chronic lymphatic leukaemia and developed septic thrombophlebitis with positive blood cultures for S. Aureus. Patient B was being treated with flucloxacillin because of an S. Aureus infection and developed chemical phlebitis. Septic phlebitis is rare, but potentially serious. Chemical or mechanical types of thrombophlebitis are usually less severe, but happen very frequently. Risk factors include: female sex, previous episode of phlebitis, insertion at (ventral) forearm, emergency placement and administration of antibiotics. Until recently, routine replacement of peripheral intravenous catheters after 72-96 h was recommended, but randomised controlled trials have not shown any benefit of this routine. A recent Cochrane Review recommends replacement of peripheral intravenous catheters when clinically indicated only.

  1. New permanent magnets

    Science.gov (United States)

    Müller, K.-H.; Krabbes, G.; Fink, J.; Gruß, S.; Kirchner, A.; Fuchs, G.; Schultz, L.

    2001-05-01

    Permanent magnets play an important role and are widely spread in daily-life applications. Due to their very low costs, large availability of the row materials and their high chemical stability, hard ferrites are still dominant in the permanent magnet market although their relatively poor magnetic properties are a distinct disadvantage. Today's high-performance magnets are mostly made from Nd 2Fe 14B. The aim of research is to combine the large spontaneous magnetization of 3d metals with strong anisotropy fields known from rare-earth transition-metal compounds and, at the same time, to maintain a high value of the Curie temperature. However, the number of iron-rich rare-earth intermetallics is very limited and, consequently, not much success can be noted in this field for the last 10 years. One alternative concept is to use magnetic fields trapped in type II superconductors where much higher fields can be achieved compared to conventional rare-earth magnets. Very recently, we obtained a trapped field as high as 14.4 T in a melt-textured YBCO bulk sample of a few centimeters in diameter. This is the highest value ever achieved in a bulk superconductor. The trapped field of a superconductor is not governed by the Laplace equation and, therefore, levitation works without any additional (active) stabilization. The disadvantage of these magnets is their low working temperature (of liquid nitrogen and below).

  2. Cryogenic Permanent Magnet Undulators

    International Nuclear Information System (INIS)

    Chavanne, J.; Lebec, G.; Penel, C.; Revol, F.; Kitegi, C.

    2010-01-01

    For an in-vacuum undulator operated at small gaps the permanent magnet material needs to be highly resistant to possible electron beam exposure. At room temperature, one generally uses Sm 2 Co 17 or high coercivity NdFeB magnets at the expense of a limited field performance. In a cryogenic permanent magnet undulator (CPMU), at a temperature of around 150 K, any NdFeB grade reveals a coercivity large enough to be radiation resistant. In particular, very high remanence NdFeB material can be used to build undulators with enhanced field and X-ray brilliance at high photon energy provided that the pre-baking of the undulator above 100 deg. C can be eliminated. The ESRF has developed a full scale 2 m long CPMU with a period of 18 mm. This prototype has been in operation on the ID6 test beamline since January 2008. A significant effort was put into the characterization of NdFeB material at low temperature, the development of dedicated magnetic measurement systems and cooling methods. The measured heat budget with beam is found to be larger than expected without compromising the smooth operation of the device. Leading on from this first experience, new CPMUs are currently being considered for the upgrade of the ESRF.

  3. Peritoneal catheter fixation combined with straight upward tunnel and low implant position to prevent catheter malfunction.

    Science.gov (United States)

    Zhang, Qingyan; Jiang, Chunming; Zhu, Wei; Sun, Cheng; Xia, Yangyang; Tang, Tianfeng; Wan, Cheng; Shao, Qiuyuan; Liu, Jing; Jin, Bo; Zhang, Miao

    2018-03-01

    Catheter malfunction is the main reason for early peritoneal dialysis (PD) technique failure. This study aimed to evaluate the effect of a new surgery technique with catheter fixation to the lower abdominal wall combined with straight upward tunnel and low implant position in reducing catheter malfunction. Patients with end stage renal disease who received PD in our centre from January 2013 to December 2015 were involved in this study. They were randomly divided into three groups according to surgical technique: traditional open surgery group, modified open surgery group and modified open surgery with catheter fixation group. All patients were followed up for six months after surgery. Catheter- related complications were analyzed. A total of 152 patients were involved. Among them, 49 received traditional open surgery (TOS group), 49 received modified open surgery (MOS group), and 54 received modified open surgery with catheter fixation (MOS-F group). During follow-up, no patients (0%) in MOS-F group developed catheter malfunction which was significantly lower than that of the TOS group (0 vs 16.33%, P = 0.002). Although not statistically significant, the incidence of catheter malfunction was lower in MOS-F group than that in MOS group (0 vs 4.08%, P = 0.134). No significant difference was observed in the episodes of infection, bleeding, leakage, inflow or outflow pain, hernia and delayed wound healing among the three groups (all P > 0.05). Catheter fixation combined with straight upward tunnel and low implant position can effectively prevent catheter malfunction in PD catheter placement. © 2016 Asian Pacific Society of Nephrology.

  4. Effect of abomasal glucose infusion on splanchnic and whole-body glucose metabolism in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Kristensen, Niels Bastian

    2009-01-01

    Six periparturient Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the hepatic portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic and whole-body glucose metabolism.......Six periparturient Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the hepatic portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic and whole-body glucose metabolism....

  5. Clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of catheter-related bloodstream infections in neonatology: A systematic review.

    Science.gov (United States)

    Ferreira, Janita; Camargos, Paulo Augusto Moreira; Clemente, Wanessa Trindade; Romanelli, Roberta Maia de Castro

    2018-01-01

    Neonatal sepsis is the most frequent health care-associated infection in neonatal units. This study aimed to analyze articles on the clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of intravascular catheter-related bloodstream infection (CRBSI) in neonates. A systematic search was performed for studies published from 1987-2017, without language restriction. Observational studies carried out in neonates with CRBSI diagnosed using catheter-drawn blood samples or catheter tip cultures were included. A total of 412 articles were identified in the databases and 10 articles were included. The 7 studies that evaluated central venous catheter tip cultures and cultures of catheter fragments presented sensitivities ranging from 58.5%-100% and specificities ranging from 60%-95.7%. Three studies that evaluated catheter-drawn blood cultures, paired with peripheral blood cultures, reported sensitivity and specificity of 94% and 71% when evaluated for the differential time to positivity. When quantitative evaluation was performed, the sensitivity and specificity were 80% and 99.4%. Most of the studies analyzed cultures from the central venous catheter tip and catheter fragments for the diagnosis of CRBSI in neonatal populations. The results of this review suggest that the analysis of the catheter-drawn blood samples and catheter tip cultures, paired with peripheral blood cultures, are efficient methods for the diagnosis of CRBSI in neonates. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Catheter ablation of epicardial ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Takumi Yamada, MD, PhD

    2014-08-01

    Full Text Available Ventricular tachycardias (VTs can usually be treated by endocardial catheter ablation. However, some VTs can arise from the epicardial surface, and their substrate can be altered only by epicardial catheter ablation. There are two approaches to epicardial catheter ablation: transvenous and transthoracic. The transvenous approach through the coronary venous system (CVS has been commonly used because it is easily accessible. However, this approach may be limited by the distribution of the CVS and insufficient radiofrequency energy delivery. Transthoracic epicardial catheter ablation has been developed to overcome these limitations of the transvenous approach. It is a useful supplemental or even preferred strategy to eliminate epicardial VTs in the electrophysiology laboratory. This technique has been applied for scar-related VTs secondary to often non-ischemic cardiomyopathy and sometimes ischemic cardiomyopathy, and idiopathic VTs as the epicardial substrates of these VTs have become increasingly recognized. When endocardial ablation and epicardial ablation through the CVS are unsuccessful, transthoracic epicardial ablation should be the next option. Intrapericardial access is usually obtained through a subxiphoidal pericardial puncture. This approach might not be possible in patients with pericardial adhesions caused by prior cardiac surgery or pericarditis. In such cases, a hybrid procedure involving surgical access with a subxiphoid pericardial window and a limited anterior or lateral thoracotomy might be a feasible and safe method of performing an epicardial catheter ablation in the electrophysiology laboratory. Potential complications associated with this technique include bleeding and collateral damage to the coronary arteries and phrenic nerve. Although the risk of these complications is low, electrophysiologists who attempt epicardial catheter ablation should know the complications associated with this technique, how to minimize their

  7. A new technique for end-to-end ureterostomy in the rat, using an indwelling reabsorbable stent.

    Science.gov (United States)

    Carmignani, G; Farina, F P; De Stefani, S; Maffezzini, M

    1983-01-01

    The restoration of the continuity of the urinary tract represents one of the major problems in rat renal transplantation. End-to-end ureterostomy is the most physiologically effective technique; however, it involves noteworthy technical difficulties because of the extremely thin caliber of the ureter in the rat and the high incidence of postoperative hydronephrosis. We describe a new technique for end-to-end ureterostomy in the rat, where the use of an absorbable ureteral stent is recommended. A 5-0 plain catgut thread is used as a stent. The anastomosis is performed under an operating microscope at X 25-40 magnification with interrupted sutures of 11-0 Vicryl. The use of the indwelling stent facilitates the performance of the anastomosis and yields optimal results. The macroscopical, radiological, and histological controls in a group of rats operated on with this technique showed a very high percentage of success with no complications, a result undoubtedly superior to that obtained with conventional methods.

  8. The effects of indwelling voice prosthesis on the quality of life, depressive symptoms, and self-esteem in patients with total laryngectomy.

    Science.gov (United States)

    Polat, Beldan; Orhan, Kadir Serkan; Kesimli, Mustafa Caner; Gorgulu, Yasemin; Ulusan, Murat; Deger, Kemal

    2015-11-01

    This study aims to evaluate the effects of voice rehabilitation with indwelling voice prosthesis on quality of life, depression, anxiety, self-esteem, and sexual functions in laryngectomy patients. Provox-1 was applied to 30 patients who underwent total laryngectomy by opening a tracheoesophageal fistula. WHO Quality of Life-BREF, Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg Self-Esteem Scale, Arizona Sexual Experience Scale forms were asked to be filled out by the patients before voice prosthesis application. These tests were asked to be filled out again 3 months later after the voice prosthesis application. Paired samples and Wilcoxon tests were used to compare before and after operation values. Indwelling voice prosthesis was found to improve quality of life, self-esteem, and sexual function (p < 0.05). Additionally, symptoms of depression and anxiety were regressed (p < 0.05). Indwelling voice prosthesis was found to especially increase the quality of life and decrease depression (p < 0.05). This study is an uncontrolled single-arm study comparing patients' psychosocial statuses pre- and post-voice prosthesis.

  9. Percutaneous catheter drainage of intrapulmonary fluid collection

    International Nuclear Information System (INIS)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H.

    1994-01-01

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment

  10. Percutaneous catheter drainage of intrapulmonary fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H. [Gyeongsang National University Hospital, Chinju (Korea, Republic of)

    1994-01-15

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment.

  11. [The Object Permanence Fallacy.] Commentary.

    Science.gov (United States)

    Bradley, Ben S.

    1996-01-01

    Suggests that Greenberg's challenge to the centrality of object permanence in developmental thinking reveals that developmentalists' theories about childhood speak about their own self-images. Notes that developmentalists have been guilty of not only the object permanence fallacy but also the genetic fallacy, or the mistaken belief that describing…

  12. Impact of short-term hemodialysis catheters on the central veins: a catheter venographic study

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent E-mail: loguzkurt@yahoo.com; Tercan, Fahri; Torun, Dilek; Yildirim, Tuelin; Zuemruetdal, Ayseguel; Kizilkilic, Osman

    2004-12-01

    Objective: To determine the incidence of pericatheter sleeve formation, thrombus formation, and stenosis of the central veins in hemodialysis patients with temporary catheters. Methods and material: In this prospective study, 57 patients (40 males, 17 females) with temporary dialysis catheters had catheter venography by pulling back the catheter just before removal. Patient's age range was 25-87 years (mean age, 51 years). The venographic studies were evaluated for pericatheter sleeve formation, thrombus formation, and stenosis of the brachiocephalic vein (BCV) and the superior vena cava (SVC). The IJV could only be evaluated if there was adequate filling during contrast administration. In a subgroup of patients who had had only right IJV or only right SCV catheters, impact of these catheters on the central veins was compared. Results: The catheter location was right internal jugular vein (IJV) in 26 cases, right subclavian vein (SCV) in 27 cases, left IJV in 1 case, and left SCV in 3 cases. Thirty-two patients (56%) had had only one temporary catheter and the rest had had more than one inserted. The mean dwell time for the catheters was 21 days (range 7-59 days). A pericatheter sleeve was detected on venography in 32 (56%) patients and thrombus formation was noted in 16 patients (28%). A total of 41 patients (72%) exhibited pericatheter sleeve and/or thrombus formation. While 19 of the 32 patients (59%) without previous catheterization had a sleeve around the catheter, only 13 (52%) of 25 patients who had had multiple catheters inserted had a sleeve (P>0.05). Of the eight patients (14%) with BCV stenosis, two had >50% stenosis. Only one patient (2%) had mild stenosis of the SVC. Three patients out of 15 (20%) who had diagnostic venography for the IJV had severe stenosis of the vein. Pericatheter sleeve formation was more frequent in women (P<0.05). However, there were no statistical differences with respect to pericatheter sleeve formation, luminal filling

  13. Balloon-tipped flow-directed catheters

    International Nuclear Information System (INIS)

    Ganz, P.; Swan, H.J.C.; Ganz, W.

    1986-01-01

    Diagnostic catheterization of the right side of the heart with semirigid cardiac catheters requires fluoroscopic guidance and substantial skill. Abnormal positions of the heart chambers and of the great vessels associated with cardiac dilatation or with congenital malformation present difficulties even to experienced laboratory cardiologists. These problems have been largely overcome by the introduction of balloon tipped flow directed catheters, which allow for rapid and relatively safe catheterization of the pulmonary artery without fluoroscopy. It was through the application of these catheters in the intensive care unit that the many pitfalls in the clinical assessment of hemodynamic disturbances became apparent. Although S3 gallop sounds may be useful in the clinical recognition of chronic ventricular failure, their presence or absence has limited predictive value in estimating left ventricular filling pressure in myocardial infarction. Information derived from right heart catheterization is often pivotal in the evaluation of hemodynamic disorders, in directing treatment, and in monitoring the results of therapy in critically ill patients

  14. [The role of the uretral catheter in the development of catheter- related urinary tract infection].

    Science.gov (United States)

    Vasilyev, A O; Govorov, A V; Shiryaev, A A; Pushkar, D Yu

    2017-12-01

    The most common source of nosocomial infection is the urinary tract, especially if they it is drained with a urethral catheter. Catheter-associated urinary tract infections account for at least 80% of all complicated urinary tract infections and are the most common type of hospital-acquired infection. Intestinal microflora plays the leading role in the pathogenesis of catheter-associated urinary tract infections, whereas the most important risk factor for their development is the long duration of urinary catheter drainage. In the case of short-term and intermittent catheterization, routine antibiotic prophylaxis is not required, but if a patient develops clinically significant infection, antibiotic therapy is required followed by definitive therapy based on culture. Urethral catheters coated with antimicrobial substances and anti-inflammatory agents can significantly reduce the adhesion and migration of bacteria, thereby reducing the incidence of urinary tract infections. Despite this, the incidence of catheter-associated infection remains high. We have reviewed recent literature related to catheter-associated urinary tract infections and the best means of preventing this condition.

  15. Microbiocidal effects of various taurolidine containing catheter lock solutions

    NARCIS (Netherlands)

    Olthof, E.D.; Nijland, R van; Gulich, A.F.; Wanten, G.J.A.

    2015-01-01

    BACKGROUND & AIMS: We have recently shown that a catheter lock solution containing taurolidine dramatically decreases catheter-related bloodstream infections (CRBSI) in patients on home parenteral nutrition (HPN) when compared to heparin. Since several taurolidine formulations are commercially

  16. A central venous catheter coated with benzalkonium chloride for the prevention of catheter-related microbial colonization.

    Science.gov (United States)

    Moss, H A; Tebbs, S E; Faroqui, M H; Herbst, T; Isaac, J L; Brown, J; Elliott, T S

    2000-11-01

    In an attempt to overcome infections associated with central venous catheters, a new antiseptic central venous catheter coated with benzalkonium chloride on the internal and external surfaces has been developed and evaluated in a clinical trial. Patients (235) randomly received either a triple-lumen central venous catheter coated with benzalkonium chloride (117) or a polyurethane non-antiseptic catheter (118). The incidence of microbial colonization of both catheters and retained antiseptic activity of the benzalkonium chloride device following removal were determined. The benzalkonium chloride resulted in a significant reduction of the incidence of microbial colonization on both the internal and external catheter surfaces. The reduction in colonization was detected at both the intradermal (21 benzalkonium chloride catheters vs. 38 controls, P = 0.0016) and distal segments of the antiseptic-coated catheters. Following catheter removal retained activity was demonstrated in benzalkonium chloride catheters which had been in place for up to 12 days. No patients developed adverse reactions to the benzalkonium chloride catheters. The findings demonstrate that the benzalkonium chloride catheter significantly reduced the incidence of catheter-associated colonization.

  17. Vascular access in neonatology: peripherally inserted central catheter and peripheral venous catheter

    Directory of Open Access Journals (Sweden)

    Marcia Lienemann

    2014-04-01

    The objective of this paper is to present aspects of peripherally inserted central catheter and peripheral venous catheter, highlighting important points in choosing the type of access. For the passage of peripherally inserted central catheter is previously performing specific course necessary, while the primary indication occurs when it is necessary to access the patient's stay for a long period of time. Whereas peripheral venipuncture is the most appropriate in cases of needing an IV line quickly and safely, for the administration of fluids, blood collection, blood transfusion and other.

  18. Catheter Occlusion in Home Infusion: The Influence of Needleless Connector Design on Central Catheter Occlusion.

    Science.gov (United States)

    Williams, Ann

    Thrombotic catheter occlusion is a common complication associated with central venous catheters (CVCs). A wide variety of needleless connectors that differ greatly in design and function are available for use with CVCs; however, there are a limited number of studies comparing the catheter occlusion rate associated with differently designed needleless connectors. This retrospective observational study compared occlusion rates associated with a split-septum neutral-displacement needleless connector versus those of a solid-surface neutral-reflux needleless connector in patients undergoing home infusion therapy. The neutral-reflux needleless connector was associated with a significant reduction in occlusion rate and thrombolytic use versus the neutral-displacement needleless connector.

  19. Urinary catheterization diary – A useful tool in tracking causes of non-deflating Foley catheter

    Directory of Open Access Journals (Sweden)

    C.O. Okorie

    2015-06-01

    Conclusions: Most urinary catheters marketed in developing countries are unidentifiable after unpacking. A catheterization diary is a useful tool for solving catheter-related problems, and its application in health-care facilities should be encouraged. Companies marketing Foley catheters should print the catheter name on both the catheter packaging and on the catheter itself.

  20. Topology optimized permanent magnet systems

    Science.gov (United States)

    Bjørk, R.; Bahl, C. R. H.; Insinga, A. R.

    2017-09-01

    Topology optimization of permanent magnet systems consisting of permanent magnets, high permeability iron and air is presented. An implementation of topology optimization for magnetostatics is discussed and three examples are considered. The Halbach cylinder is topology optimized with iron and an increase of 15% in magnetic efficiency is shown. A topology optimized structure to concentrate a homogeneous field is shown to increase the magnitude of the field by 111%. Finally, a permanent magnet with alternating high and low field regions is topology optimized and a Λcool figure of merit of 0.472 is reached, which is an increase of 100% compared to a previous optimized design.

  1. Topology optimized permanent magnet systems

    DEFF Research Database (Denmark)

    Bjørk, Rasmus; Bahl, Christian; Insinga, Andrea Roberto

    2017-01-01

    Topology optimization of permanent magnet systems consisting of permanent magnets, high permeability iron and air is presented. An implementation of topology optimization for magnetostatics is discussed and three examples are considered. The Halbach cylinder is topology optimized with iron...... and an increase of 15% in magnetic efficiency is shown. A topology optimized structure to concentrate a homogeneous field is shown to increase the magnitude of the field by 111%. Finally, a permanent magnet with alternating high and low field regions is topology optimized and a ΛcoolΛcool figure of merit of 0...

  2. Periodic permanent magnet focused klystron

    Science.gov (United States)

    Ferguson, Patrick; Read, Michael; Ives, R Lawrence

    2015-04-21

    A periodic permanent magnet (PPM) klystron has beam transport structures and RF cavity structures, each of which has permanent magnets placed substantially equidistant from a beam tunnel formed about the central axis, and which are also outside the extent of a cooling chamber. The RF cavity sections also have permanent magnets which are placed substantially equidistant from the beam tunnel, but which include an RF cavity coupling to the beam tunnel for enhancement of RF carried by an electron beam in the beam tunnel.

  3. 21 CFR 868.5120 - Anesthesia conduction catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction catheter. 868.5120 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5120 Anesthesia conduction catheter. (a) Identification. An anesthesia conduction catheter is a flexible tubular device used to inject...

  4. 21 CFR 876.5030 - Continent ileostomy catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a form...

  5. Management of Non- Deflating Foley Suprapubic Catheters - A ...

    African Journals Online (AJOL)

    The procedure described uses a 10 ml syringe and needle passed through the lumen of the catheter to puncture the inner surface of the catheter balloon and thus deflate it. Because the catheter balloon does not burst in this procedure there is no risk of balloon fragmentation or subsequent stone formation. The technique is ...

  6. Low-angled peripheral intravenous catheter tip placement decreases phlebitis.

    Science.gov (United States)

    Tanabe, Hidenori; Murayama, Ryoko; Yabunaka, Koichi; Oe, Makoto; Takahashi, Toshiaki; Komiyama, Chieko; Sanada, Hiromi

    2016-11-02

    Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. Observational studies were carried out at a medical ward in a university hospital. Infusion therapy was administered to one group of patients in 2014 using Teflon catheters (control group, n = 200), and to another group of patients in 2015 using polyurethane catheters (investigational group, n = 207). The symptoms were assessed according to a scale developed by the Infusion Nurses Society. Long-axis ultrasonography images taken immediately before catheter removal were used to measure the angle between the central line of the catheter within 2 mm from the distal point and a tangent to the vessel wall. There were no significant differences between the two groups with respect to sex, age, and medical diagnosis. In the control and investigational groups, the rates of phlebitis were 37% (73/200) and 17% (36/207), respectively (pPhlebitis occurred more frequently when the catheter-tip was placed at angle >5.8°. The frequency of phlebitis was lower in the polyurethane, in which the catheter was placed at lower angle, almost parallel to the vessel. Our results will aid in developing new catheters and in improving PIVC-securement techniques.

  7. Intravascular catheter related infections in children admitted on the ...

    African Journals Online (AJOL)

    peripheral venous intravascular catheters uncoated with no antibiotic or antiseptic, was done. Social demographic characteristics, anthropometry, clinical examination including the catheter site were determined at enrollment. The children had their blood, catheter tip and hub samples taken off for culture and sensitivity as ...

  8. Paravertebral block catheter breakage by electrocautery during thoracic surgery.

    Science.gov (United States)

    Saeki, Noboru; Sugimoto, Yuki; Mori, Yoko; Kato, Takahiro; Miyoshi, Hirotsugu; Nakamura, Ryuji; Koga, Tomomichi

    2017-06-01

    Advantages of thoracic paravertebral analgesia (TPA) include placement of the catheter closer to the surgical field; however, the catheter can become damaged during the operation. We experienced a case of intraoperative TPA catheter breakage that prompted us to perform an experiment to investigate possible causes. A 50-year-old male underwent a thoracoscopic lower lobectomy under general anesthesia with TPA via an intercostal approach. Following surgery, it was discovered that the catheter had become occluded, as well as cut and fused, so we reopened the incision and removed the residual catheter. From that experience, we performed an experiment to examine electrocautery-induced damage in normal (Portex™, Smith's Medical), radiopaque (Perifix SoftTip™, BBraun), and reinforced (Perifix FX™, BBraun) epidural catheters (n = 8 each). Chicken meat was penetrated by each catheter and then cut by electrocautery. In the normal group, breakage occurred in 8 and occlusion in 6 of the catheters, and in the radiopaque group breakage occurred in 8 and occlusion in 7. In contrast, breakage occurred in only 3 and occlusion in none in the reinforced group, with the 5 without breakage remaining connected only by the spring coil. Furthermore, in 7 of the reinforced catheters, electric arc-induced thermal damage was observed at the tip of the catheter. A TPA catheter for thoracic surgery should be inserted via the median approach, or it should be inserted after surgery to avoid catheter damage during surgery.

  9. FAQs about Catheter-Associated Urinary Tract Infection

    Science.gov (United States)

    ... do so. o Avoid disconnecting the catheter and drain tube. This helps to pre - vent germs from getting into the catheter tube. o The catheter is secured to the leg to prevent pulling on the ... regularly. The drainage spout should not touch any - thing while emptying ...

  10. Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates

    Energy Technology Data Exchange (ETDEWEB)

    Rampoldi, Antonio; Barbosa, Fabiane, E-mail: fabiane001@hotmail.com [Ospedale Niguarda Ca’ Granda, Department of Interventional Radiology (Italy); Secco, Silvia [Ospedale Niguarda Ca’ Granda, Department of Urology (Italy); Migliorisi, Carmelo [Ospedale Niguarda Ca’ Granda, Department of Interventional Radiology (Italy); Galfano, Antonio; Prestini, Giovanni [Ospedale Niguarda Ca’ Granda, Department of Urology (Italy); Harward, Sardis Honoria [Dartmouth-Hitchcock Medical Center, The Dartmouth Institute for Health Policy and Clinical Practice (United States); Trapani, Dario Di [Ospedale Niguarda Ca’ Granda, Department of Urology (Italy); Brambillasca, Pietro Maria; Ruggero, Vercelli; Solcia, Marco [Ospedale Niguarda Ca’ Granda, Department of Interventional Radiology (Italy); Carnevale, Francisco Cesar [University of Sao Paulo Medical School, Department of Interventional Radiology (Brazil); Bocciardi, Aldo Massimo [Ospedale Niguarda Ca’ Granda, Department of Urology (Italy)

    2017-04-15

    PurposeTo prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates.MethodsPatients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality of life, prostate size and uroflowmetric parameters.ResultsA total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome.ConclusionsPAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.

  11. Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates

    International Nuclear Information System (INIS)

    Rampoldi, Antonio; Barbosa, Fabiane; Secco, Silvia; Migliorisi, Carmelo; Galfano, Antonio; Prestini, Giovanni; Harward, Sardis Honoria; Trapani, Dario Di; Brambillasca, Pietro Maria; Ruggero, Vercelli; Solcia, Marco; Carnevale, Francisco Cesar; Bocciardi, Aldo Massimo

    2017-01-01

    PurposeTo prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates.MethodsPatients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality of life, prostate size and uroflowmetric parameters.ResultsA total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome.ConclusionsPAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.

  12. Polymer multilayers loaded with antifungal β-peptides kill planktonic Candida albicans and reduce formation of fungal biofilms on the surfaces of flexible catheter tubes.

    Science.gov (United States)

    Raman, Namrata; Lee, Myung-Ryul; Palecek, Sean P; Lynn, David M

    2014-10-10

    Candida albicans is the most common fungal pathogen responsible for hospital-acquired infections. Most C. albicans infections are associated with the implantation of medical devices that act as points of entry for the pathogen and as substrates for the growth of fungal biofilms that are notoriously difficult to eliminate by systemic administration of conventional antifungal agents. In this study, we report a fill-and-purge approach to the layer-by-layer fabrication of biocompatible, nanoscale 'polyelectrolyte multilayers' (PEMs) on the luminal surfaces of flexible catheters, and an investigation of this platform for the localized, intraluminal release of a cationic β-peptide-based antifungal agent. We demonstrate that polyethylene catheter tubes with luminal surfaces coated with multilayers ~700nm thick fabricated from poly-l-glutamic acid (PGA) and poly-l-lysine (PLL) can be loaded, post-fabrication, by infusion with β-peptide, and that this approach promotes extended intraluminal release of this agent (over ~4months) when incubated in physiological media. The β-peptide remained potent against intraluminal inoculation of the catheters with C. albicans and substantially reduced the formation of C. albicans biofilms on the inner surfaces of film-coated catheters. Finally, we report that these β-peptide-loaded coatings exhibit antifungal activity under conditions that simulate intermittent catheter use and microbial challenge for at least three weeks. We conclude that β-peptide-loaded PEMs offer a novel and promising approach to kill C. albicans and prevent fungal biofilm formation on surfaces, with the potential to substantially reduce the incidence of device-associated infections in indwelling catheters. β-Peptides comprise a promising new class of antifungal agents that could help address problems associated with the use of conventional antifungal agents. The versatility of the layer-by-layer approach used here thus suggests additional opportunities to

  13. Emergency coronary angioplasty with stenting using Cordis® diagnostic coronary catheters when there is difficulty in engaging guide catheters and bench evaluation of diagnostic and guide catheters.

    Science.gov (United States)

    Arokiaraj, Mark Christopher

    2018-02-01

    Difficulty in engaging with guide catheters is not uncommon in acute emergencies. We aimed to evaluate the use of Cordis ® INFINITI diagnostic catheters to perform angioplasty in patients in whom the coronaries cannot be engaged using standard guide catheters. In 34 cases of acute coronary syndrome, when difficulty in engagement with two standard guide catheters was encountered with reasonable manipulations, angioplasty was performed using diagnostic catheters. In total, 40 stents were placed by this technique. Pushability and trackability, distal tip flexion and three-point bending tests were performed to evaluate the performance of the guide and diagnostic catheters. Angioplasty was performed easily in a setting where it would have been very difficult to perform. Coronary dissection occurred in one patient, treated by a stent. The stent and dilatation balloons were easily passed through the diagnostic catheters. Pressure tracings were clearly preserved with certain stent delivery systems, and at angioplasty, although there was slightly reduced opacification of the respective artery, the coronary anatomy was sufficiently visualized to perform angioplasty. No periprocedural target lesion complications were seen in any cases. Pushability and trackability tests showed good force transmission along a tortuous path with diagnostic catheters, and balanced force-displacement curves from three-point bending tests and distal tip softness tests. Angioplasty with stenting can be performed safely through 6F Cordis ® infiniti diagnostic catheters when difficulty in engaging guide catheters is encountered. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. 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.

  15. OCCASIONAL REVIEW 'Map and zap' - electrode catheter ...

    African Journals Online (AJOL)

    Where does this leave surgical treatment of WPW syndrome? Despite the high success rates reported, ·it is acknowledged that not all patients can be successfully treated by catheter ablation. The treatment of those with multiple accessory pathways and associated defects such as Ebstein's anomaly of the tricuspid valve is ...

  16. Thoracoscopic retrieval of a fractured thoracentesis catheter.

    Science.gov (United States)

    Albrink, M H; McAllister, E W

    1994-08-01

    With the resurgence of laparoscopic surgical procedures, thorascopic procedures have followed close behind. Many procedures which in the past have required formal thoracotomy may now be performed via less invasive methods. Presented herein is a report and description of thoracoscopic retrieval of a fractured thoracentesis catheter.

  17. Lawful Permanent Residents Fiscal Year 2014 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  18. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  19. Lawful Permanent Residents Fiscal Year 2015 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  20. Lawful Permanent Residents Fiscal Year 2016 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  1. Lawful Permanent Residents Fiscal Year 2014 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  2. Lawful Permanent Residents Fiscal Year 2015 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  3. Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project.

    Directory of Open Access Journals (Sweden)

    Katiuska Miliani

    Full Text Available Peripheral venous catheters (PVC are medical devices most frequently used during hospital care. Although the frequency of specific PVC-related adverse events (PVCAEs has been reported, the global risk related to the insertion of this device is poorly estimated. The aim of this study is to determine the incidence of PVCAEs during the indwell time, after catheter removal, and to identify practice-mirroring risk factors.A prospective observational study was conducted as a part of a research project, called CATHEVAL, in one surgery ward and four medicine wards from three public general tertiary care hospitals in Northern France that were invited to participate between June-2013 and June-2014. Each participating ward included during a two-month study period all patients older than 15 years carrying a PVC. All inserted PVCs were monitored from insertion of PVC to up to 48 hours after removal. Monitored data included several practice-mirroring items, as well as the occurrence of at least one PVCAE. A multivariate Cox proportional hazard model, based on a marginal risk approach, was used to identify factors associated with the occurrence of at least one PVCAE.Data were analysed for 815 PVCs (1964 PVC-days in 573 patients. The incidence of PVCAE was 52.3/100 PVCs (21.9/100 PVC-days. PVCAEs were mainly clinical: phlebitis (20.1/100 PVCs, haematoma (17.7/100 PVCs and liquid/blood escape (13.1/100 PVCs. Infections accounted for only 0.4/100 PVCs. The most frequent mechanical PVCAEs, was obstruction/occlusion of PVC (12.4/100 PVCs. The incidence of post-removal PVCAEs was 21.7/100 PVCs. Unstable PVC and unclean dressing were the two main risk factors.Limitation of breaches in healthcare quality including post-removal monitoring should be reinforced to prevent PVC-related adverse events in hospital settings.

  4. Concurrent use of pigtail and loop snare catheters for percutaneous retrieval of dislodged central venous port catheter

    Directory of Open Access Journals (Sweden)

    Ming-Tsung Chuang

    2011-11-01

    Full Text Available The purpose of this study was to report our experience of percutaneous retrieval of dislodged port catheters with concurrent use of pigtail and loop snare catheters. During a 5-year period at our institute (June 2005 to July 2010, a total of 23 dislodged port catheters were retrieved. The interval between port catheter implantation and dislodged catheter retrieval ranged from 43 days to 1,414 days (mean 586.7 days. The time of delayed retrieval ranged from 1 day to 45 days (mean 4.6 days. All dislodged catheters were retrieved with the concurrent use of pigtail and loop snare catheters via femoral venous route. The prevalence of port catheter dislodgement at our institute was 3.4%. All dislodged port catheters were removed successfully with pigtail and loop snare catheters together. No procedure-related complications were encountered, except for transient arrhythmia in two patients, which required no medication. In conclusion, the concurrent use of pigtail and loop snare catheters is a feasible and easy way for percutaneous retrieval of a dislodged central venous port catheter.

  5. [Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol].

    Science.gov (United States)

    Ferrete-Morales, C; Vázquez-Pérez, M A; Sánchez-Berna, M; Gilabert-Cerro, I; Corzo-Delgado, J E; Pineda-Vergara, J A; Vergara-López, S; Gómez-Mateos, J

    2010-01-01

    To assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients. A total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined. The incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (phistory of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05-9.98, p=0.04). A catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.

  6. Repositioning of malpositioned or flipped central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Thalhammer, A.; Jacobi, V.; Balzer, J.; Vogl, T.J. [Institute for Diagnostic and Interventional Radiology, Central Radiology Clinic, J.W. Goethe University, Frankfurt am Main (Germany)

    2002-03-01

    Primary misplaced or secondary flipped implanted catheters are located mostly in the right jugular vein. We demonstrate an effective method to replace fix implanted catheters such as Ports, Grochomg or Hickman catheters. Using a femoral venous approach, replacement into the superior vena cava can easily be done with a Sidewinder 1 catheter which is hooked over the misplaced central venous approach. In all our patients the method was successful. The repositioning technique described is simple, fast and has low costs. We can keep sterile conditions and do not need to solve the catheters' fixation. (orig.)

  7. Detection of electrophysiology catheters in noisy fluoroscopy images.

    Science.gov (United States)

    Franken, Erik; Rongen, Peter; van Almsick, Markus; ter Haar Romeny, Bart

    2006-01-01

    Cardiac catheter ablation is a minimally invasive medical procedure to treat patients with heart rhythm disorders. It is useful to know the positions of the catheters and electrodes during the intervention, e.g. for the automatization of cardiac mapping. Our goal is therefore to develop a robust image analysis method that can detect the catheters in X-ray fluoroscopy images. Our method uses steerable tensor voting in combination with a catheter-specific multi-step extraction algorithm. The evaluation on clinical fluoroscopy images shows that especially the extraction of the catheter tip is successful and that the use of tensor voting accounts for a large increase in performance.

  8. Risk factors for central venous catheter-related infections in a neonatal population – systematic review

    Directory of Open Access Journals (Sweden)

    Viviane Rosado

    2018-01-01

    Full Text Available Objective: This was a systematic review of the incidence density and risk factors for central venous catheter-related infections in a neonatal population. Data source: The MEDLINE, Embase, Cochrane, BDENF, SciELO, and LILACS databases were used without date or language restriction. Studies that analyzed risk factors for bloodstream infections in newborns were identified. Data synthesis: A total of 134 articles were found that met the eligibility criteria. Of these articles, 14 were selected that addressed risk factors for central venous catheter-related infection in neonates. Catheter-related bloodstream infections remain an important complication, as shown by the incidence rates reported in the studies included in this review. The observed risk factors indicate that low birth weight, prematurity, and longer catheter permanence are related to a higher incidence of bloodstream infections. It has been observed that low rates of catheter-related infections, i.e., close to zero, are already a reality in health institutions in developed countries, since they use infection surveillance and control programs. Conclusion: Catheter-related bloodstream infections still show high incidence density rates in developing countries. The authors emphasize the need for further longitudinal studies and the need for better strategies to prevent risk factors, aiming at the reduction of catheter-related infections. Resumo: Objetivo: Trata-se de uma revisão sistemática sobre a densidade de incidência e de fatores de risco para infecção associada a cateter venoso central em população neonatal. Fontes dos dados: Utilizou-se os bancos de dados Medline, Embase, Cochrane, Bdenf, Scielo, Lilacs, sem restrição de data ou de idioma. Identificaram-se os estudos que analisaram fatores de risco para infecção da corrente sanguínea em recém-nascidos. Síntese dos dados: Foram encontrados 134 artigos conforme os critérios de elegibilidade. Destes artigos, foram

  9. Use of monorail PTCA balloon catheter for local drug delivery.

    Science.gov (United States)

    Trehan, Vijay; Nair, Girish M; Gupta, Mohit D

    2007-01-01

    We report the use of monorail coronary balloon as an infusion catheter to give bailout abciximab selectively into the site of stent thrombosis as an adjunct to plain old balloon angioplasty (POBA) in a patient of subacute stent thrombosis of the left anterior descending coronary artery. The balloon component (polyamide material) of the monorail balloon catheter was shaved off the catheter so that abciximab injected through the balloon port of the catheter exited out the shaft of the balloon catheter at the site from where the balloon material was shaved off. We believe that selective infusion with abciximab along with POBA established antegrade flow and relieved the patient's ischemia. In the absence of essential hardware to give intracoronary drugs in an emergency situation, one may employ our technique of infusion through a monorail balloon catheter after shaving the balloon component from the catheter.

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

    International Nuclear Information System (INIS)

    Towbin, Richard

    2008-01-01

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    International Nuclear Information System (INIS)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T.; Akhan, Okan

    2011-01-01

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  13. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T. [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey)

    2011-11-15

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  14. Catheter versus non-catheter angiography in isolated third nerve palsy

    International Nuclear Information System (INIS)

    Lee, A.G.

    2007-01-01

    To discuss the controversies surrounding the indications for catheter angiography versus non-catheter and less invasive angiography techniques (e.g. magnetic resonance angiography (MRA) and computerized tomography angiography (CTA)) in the evaluation of patients with a third nerve palsy. Clinical opinion-perspective and literature review. The patient with an isolated third nerve palsy might have a vasculopathic (and typically benign, self limited course) etiology or a life threatening intracranial posterior communicating artery aneurysm. Although it is clear that non-isolated third nerve palsies require imaging directed at the topographical localization of the clinical findings, the evaluation of the neurologically isolated third nerve palsy remains controversial. The completeness of the external (i.e. somatic) motor dysfunction and the presence or absence of internal (i.e. pupillary) dysfunction are generally used to guide the choice of initial neuroimaging. Advances in MRA and CTA technology have reduced but not eliminated our dependence upon catheter angiography in this setting. A properly performed and interpreted MRA or CTA probably will be able to detect greater than 95 % of aneurysms producing a third nerve palsy. The issues surrounding the use of catheter angiography in third nerve palsy are reviewed. If the clinician is highly confident in the capability, availability, and reliability of the neuroradiologist and of their institutional experience and quality of less invasive non-catheter MRA and CTA and if the risk of aneurysm is low or if the risk of angiography is high (e.g. elderly, renal failure, iodinated contrast allergy, risk of stroke) then MRI and MRA (or CTA) may be a reasonable alternative to catheter angiography. Patients with a moderate or uncertain risk of aneurysm and a lower risk for catheter angiography or if there is a low confidence in the quality or the interpretation of the institutional MRA (or CTA) may still require catheter

  15. Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

    Science.gov (United States)

    Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E

    1994-01-01

    The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359

  16. In vitro analysis of balloon cuffing phenomenon: inherent biophysical properties of catheter material or mechanics of catheter balloon deflation?

    Science.gov (United States)

    Chung, Eric; So, Karina

    2012-06-01

    To investigates the different methods of balloon deflation, types of urinary catheters and exposure to urine media in catheter balloon cuffing. Bardex®, Bard-Lubri-Sil®, Argyle®, Releen® and Biocath® were tested in sterile and E.Coli inoculated urine at 0, 14 and 28 days. Catheter deflation was performed with active deflation; passive deflation; passive auto-deflation; and excision of the balloon inflow channel. Balloon cuffing was assessed objectively by running the deflated balloon over a plate of agar and subjectively by 3 independent observers. Bardex®, Argyle® and Biocath® showed greater degree of catheter balloon cuffing (p deflation was the worst method (p 0.05). Linear regression model analysis confirmed time as the most significant factor. The duration of catheters exposure, different deflation methods and types of catheters tested contributed significantly to catheter balloon cuffing (p < 0.01).

  17. Effect of abomasal glucose infusion on plasma concentrations of gut peptides in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Relling, A E; Reynolds, C K

    2010-01-01

    Six Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic plasma concentrations of gut peptides. The experimental design was a randomi...

  18. Effect of time duration of ruminal urea infusions on ruminal ammonia concentrations and portal-drained visceral extraction of arterial urea-N in lactating Holstein cows

    DEFF Research Database (Denmark)

    Røjen, Betina Amdisen; Kristensen, Niels Bastian

    2012-01-01

    investigated. Three Danish Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in major splanchnic blood vessels were randomly allocated to a 3 × 3 Latin square design with 21-d periods. Treatments were ventral ruminal infusion of water for 24h (water INF), 24-h infusion of 15g...

  19. Effect of abomasal glucose infusion on splanchnic amino acid metabolism in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Kristensen, Niels Bastian

    2009-01-01

    Six Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic AA metabolism. The experimental design was a split plot, with cow as the whole...

  20. Distributed pressure sensors for a urethral catheter.

    Science.gov (United States)

    Ahmadi, Mahdi; Rajamani, Rajesh; Timm, Gerald; Sezen, A S

    2015-01-01

    A flexible strip that incorporates multiple pressure sensors and is capable of being fixed to a urethral catheter is developed. The urethral catheter thus instrumented will be useful for measurement of pressure in a human urethra during urodynamic testing in a clinic. This would help diagnose the causes of urinary incontinence in patients. Capacitive pressure sensors are fabricated on a flexible polyimide-copper substrate using surface micromachining processes and alignment/assembly of the top and bottom portions of the sensor strip. The developed sensor strip is experimentally evaluated in an in vitro test rig using a pressure chamber. The sensor strip is shown to have adequate sensitivity and repeatability. While the calibration factors for the sensors on the strip vary from one sensor to another, even the least sensitive sensor has a resolution better than 0.1 psi.

  1. Percutaneous catheter drainage of tuberculous psoas abscesses

    International Nuclear Information System (INIS)

    Pombo, F.; Martin-Egana, R.; Cela, A.; Diaz, J.L.; Linares-Mondejar, P.; Freire, M.

    1993-01-01

    Six patients with 7 tuberculous psoas or ilio-psoas abscesses were treated by CT-guided catheter drainage and chemotherapy. The abscesses (5 unilateral and 1 bilateral) were completely drained using a posterior or lateral approach. The abscess volume was 70 to 700 ml (mean 300 ml) and the duration of drainage 5 to 11 days (mean 7 days). Immediate local symptomatic improvement was achieved in all patients, and there were no procedural complications. CT follow-up at 3 to 9 months showed normalization in 5 patients, 2 of whom are still in medical therapy. One patient, who did not take the medication regularly, had a recurrent abscess requiring new catheter drainage after which the fluid collection disappeared. Percutaneous drainage represents an efficient and attractive alternative to surgical drainage as a supplement to medical therapy in the management of patients with large tuberculous psoas abscesses. (orig.)

  2. Pancreas tumor interstitial pressure catheter measurement

    Science.gov (United States)

    Nieskoski, Michael D.; Gunn, Jason; Marra, Kayla; Trembly, B. Stuart; Pogue, Brian W.

    2016-03-01

    This paper highlights the methodology in measuring interstitial pressure in pancreatic adenocarcinoma tumors. A Millar Mikrotip pressure catheter (SPR-671) was used in this study and a system was built to amplify and filter the output signal for data collection. The Millar pressure catheter was calibrated prior to each experiment in a water column at 37°C, range of 0 to 60 inH2O (112 mmHg), resulting in a calibration factor of 33 mV / 1 inH2O. The interstitial pressures measured in two orthotopically grown pancreatic adenocarcinoma tumor were 57 mmHg and 48 mmHg, respectively. Verteporfin uptake into the pancreatic adenocarcinoma tumor was measured using a probe-based experimental dosimeter.

  3. Transient or permanent fisheye views

    DEFF Research Database (Denmark)

    Jakobsen, Mikkel Rønne; Hornbæk, Kasper

    2012-01-01

    Transient use of information visualization may support specific tasks without permanently changing the user interface. Transient visualizations provide immediate and transient use of information visualization close to and in the context of the user’s focus of attention. Little is known, however......, about the benefits and limitations of transient visualizations. We describe an experiment that compares the usability of a fisheye view that participants could call up temporarily, a permanent fisheye view, and a linear view: all interfaces gave access to source code in the editor of a widespread...... programming environment. Fourteen participants performed varied tasks involving navigation and understanding of source code. Participants used the three interfaces for between four and six hours in all. Time and accuracy measures were inconclusive, but subjective data showed a preference for the permanent...

  4. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal

    Directory of Open Access Journals (Sweden)

    Janete de Souza Urbanetto

    Full Text Available ABSTRACT Objective: to investigate the incidence of phlebitis and its association with risk factors when using peripheral IV catheters (PIC and following their removal - (post-infusion phlebitis in hospitalized adults. Method: a cohort study of 171 patients using PIC, totaling 361 punctures. Sociodemographic variables and variables associated with the catheter were collected. Descriptive and analytical statistical analyses were performed. Results: average patient age was 56.96 and 51.5% of the sample population was male. The incidence of phlebitis was 1.25% while using PIC, and 1.38% post-infusion. The incidence of phlebitis while using PIC was associated with the length of time the catheter remained in place, whereas post-infusion phlebitis was associated with puncture in the forearm. Ceftriaxone, Clarithromycin and Oxacillin are associated with post-infusion phlebitis. Conclusions: this study made it possible to investigate the association between risk factors and phlebitis during catheter use and following its removal. The frequency of post-infusion phlebitis was larger than the incidence of phlebitis with the catheter in place, with Phlebitis Grade III and II being the most frequently found in each of these situations, respectively. Aspects related to post-infusion phlebitis can be explained, given the limited number of studies addressing this theme from this perspective.

  5. CATHETER DURATION AND THE RISK OF SEPSIS IN PREMATURE BABIES WITH UMBILICAL VEIN CATHETERS

    Directory of Open Access Journals (Sweden)

    Hartojo Hartojo

    2012-01-01

    Full Text Available Umbilical catheters are frequently required in the management of severely ill premature babies. The risk of complications may increase with duration of UVC use. Objective: To determine whether the risk of central line-associated bloodstream infections (CLA-BSIs and sepsis remained constant over the duration of umbilical vein catheters (UVCs in high-risk premature neonates. Methods:retrospective analysis. The data were collected from the medical record of high risk premature neonates who had a UVC placed in neonatal care unit of Husada Utama Hospital between April 1st 2008 to April 30th 2011 with purposive sampling. Catheter duration was observed before and after 14 days on placement. Blood and UVC culture was performed to establish the risk of CLA-BSIs and sepsis. Chi-square and logistic regression analysis were performed in the laboratorium data. Result: A total 44 high risk premature babies with UVCs were enrolled (sepsis group: n = 23 and non sepsis group: n = 21. Baseline demographics were similar between the groups. 15 babies in sepsis group have UVCs duration > 14 days, and 8 babies have UVCs 14 days show blood culture performance in 11 babies with positive evidence, UVCs culture performance is negative in 18 babies (p = 0.456. Burkholderia cepacia and Klebsiella pneumonia mostly appeared in blood culture performance. 25% of UVC culture performance shows Pseudomonas aeroginosa. Conclusions: The catheter duration have no significant difference in risk of sepsis in premature babies with Umbilical Vein Catheters.

  6. Retrograde prostatic urethroplasty with balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Hulbert, J.; Letourneau, J.G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1987-01-01

    The authors performed retrograde prostatic urethroplasty in 18 patients using a 25-mm urethroplasty balloon catheter. The procedure was performed on an outpatient basis under local anesthesia. Voiding cystourethrography, retrograde urethrography, rectal US, and MRE imaging were performed before and immediately after the procedure and at 2 weeks and 3, 6, 12, and 18 months. Long-term results at 18 months and possible clinical implications are discussed

  7. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    International Nuclear Information System (INIS)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho

    2010-01-01

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate

  8. Biological safety evaluation of the modified urinary catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kowalczuk, Dorota, E-mail: dorota.kowalczuk@umlub.pl [Department of Medicinal Chemistry, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin (Poland); Przekora, Agata; Ginalska, Grazyna [Department of Biochemistry and Biotechnology, Medical University of Lublin, Chodzki 1, 20-093 Lublin (Poland)

    2015-04-01

    The purpose of this study was to evaluate in vitro safety of the novel tosufloxacin (TOS)-treated catheters with the prolonged antimicrobial activity. The test samples of silicone latex catheter were prepared by the immobilization of TOS on chitosan (CHIT)-coated catheter by means of covalent bonds and non-covalent interactions. Each step of the modification process of catheter surface was observed using ATR–Fourier transform infrared spectroscopy. In vitro cytotoxicity of the modified and unmodified catheters was assessed by direct and indirect tests in accordance with ISO standards using green monkey kidney (GMK) cell line. The MTT, lactate dehydrogenase activity (LDH), WST-8, Sulforhodamine B (SRB) test results and microscopic observation clearly indicated that unmodified silicone latex catheters decrease cell metabolic activity, act as a cytotoxic agent causing cell lysis and induce cell death through necrotic or apoptotic process. We suggest that chitosan coat with TOS immobilized limits leaching of harmful agents from silicone latex material, which significantly enhances survivability of GMK cells and therefore is quite a good protection against the cytotoxic effect of this material. - Highlights: • Characterization of the novel antimicrobial urinary catheters • Monitoring of the catheter modification by FTIR analysis • Confirmation of high cytotoxicity of latex-based catheter used in urological practice • Chitosan-coated and tosufloxacin-treated catheter is less toxic than the untreated one. • The proposed surface modification protects cells against latex-induced death.

  9. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate.

  10. Current status of endovascular catheter robotics.

    Science.gov (United States)

    Lumsden, Alan B; Bismuth, Jean

    2018-06-01

    In this review, we will detail the evolution of endovascular therapy as the basis for the development of catheter-based robotics. In parallel, we will outline the evolution of robotics in the surgical space and how the convergence of technology and the entrepreneurs who push this evolution have led to the development of endovascular robots. The current state-of-the-art and future directions and potential are summarized for the reader. Information in this review has been drawn primarily from our personal clinical and preclinical experience in use of catheter robotics, coupled with some ground-breaking work reported from a few other major centers who have embraced the technology's capabilities and opportunities. Several case studies demonstrating the unique capabilities of a precisely controlled catheter are presented. Most of the preclinical work was performed in the advanced imaging and navigation laboratory. In this unique facility, the interface of advanced imaging techniques and robotic guidance is being explored. Although this procedure employs a very high-tech approach to navigation inside the endovascular space, we have conveyed the kind of opportunities that this technology affords to integrate 3D imaging and 3D control. Further, we present the opportunity of semi-autonomous motion of these devices to a target. For the interventionist, enhanced precision can be achieved in a nearly radiation-free environment.

  11. Connecting Temporary and Permanent Organizing

    DEFF Research Database (Denmark)

    Stjerne, Iben Sandal; Velikova, Silviya Svejenova

    2016-01-01

    This paper investigates the relationship between a permanent organization and a series of temporary organizations. It draws on an in-depth study of the process through which a Danish film production company, seeking to balance innovation and persistence in a troubled industry, struggles to realize...... a novel children’s film and its sequels. The study reveals tensions at different levels as well as boundary work and boundary roles that address them, bringing in shadows of past and future projects. The study extends the understanding of the dialectic between temporary and permanent organizing...

  12. An animal study of a newly developed skin-penetrating pad and covering material for catheters to prevent exit-site infection in continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Aoyama, Masato; Mizuno, Toshihide; Tatsumi, Eisuke; Taenaka, Yoshiyuki; Nemoto, Yasushi; Okamoto, Yoshihiro; Takemoto, Yoshiaki; Naganuma, Toshihide; Nakatani, Tatsuya

    2009-12-01

    Because currently available peritoneal dialysis catheters are not sufficiently biocompatible with the skin and subcutaneous tissue at the site of penetration, exit-site infection due to pericatheter pocket formation caused by epidermal downgrowth over a long period of time has increasingly become a problem. We developed a new, biocompatible, segmented polyurethane porous material and devised a novel skin-penetrating pad, the form and material of which we optimized for application in peritoneal dialysis catheters. For the extent of tissue ingrowth into this porous material to be examined, test materials with different pore diameters were inserted into hollow silicone tubes and implanted in the subcutaneous tissue of a goat. Four weeks later, the tubes were extracted, and, after the extent of granulation tissue ingrowth was measured, histopathological evaluation was made. Our novel skin-penetrating pad has three disklike layers of the segmented polyurethane material with different pore sizes, into the center of which a polyurethane catheter is inserted. These pads were implanted in the skin of a goat and clinically observed over a 2-year period, after which they were extracted and histopathologically analyzed. In accordance with actual clinical procedures, a commercial CAPD catheter equipped with our skin-penetrating pad was left indwelling in a goat for 4 months, and the performance of the pad was evaluated after repeated periodic infusion and drainage of the dialysate in and out of the abdominal cavity. There was no inflammation of the ingrown tissue in the pores of the segmented polyurethane material as well as the surrounding tissue, which indicated favorable tissue biocompatibility. The extent of tissue ingrowth was greater as the pore size of the material was larger, and the tissue tended to be mature, mainly consisting of collagenous fibers. The skin-penetrating pad using the porous material, of which tissue ingrowth was thus optimized, tightly adhered to the

  13. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis.

    Science.gov (United States)

    Napalkov, Pavel; Felici, Diana M; Chu, Laura K; Jacobs, Joan R; Begelman, Susan M

    2013-10-16

    Central venous catheter (CVC) and hemodialysis (HD) catheter usage are associated with complications that occur during catheter insertion, dwell period, and removal. This study aims to identify and describe the incidence rates of catheter-related complications in a large patient population in a United States-based health care claims database after CVC or HD catheter placement. Patients in the i3 InVision DataMart® health care claims database with at least 1 CVC or HD catheter insertion claim were categorized into CVC or HD cohorts using diagnostic and procedural codes from the US Renal Data System, American College of Surgeons, and American Medical Association's Physician Performance Measures. Catheter-related complications were identified using published diagnostic and procedural codes. Incidence rates (IRs)/1000 catheter-days were calculated for complications including catheter-related bloodstream infections (CRBSIs), thrombosis, embolism, intracranial hemorrhage (ICH), major bleeding (MB), and mechanical catheter-related complications (MCRCs). Thirty percent of the CVC cohort and 54% of the HD cohort had catheter placements lasting <90 days. Catheter-related complications occurred most often during the first 90 days of catheter placement. IRs were highest for CRBSIs in both cohorts (4.0 [95% CI, 3.7-4.3] and 5.1 [95% CI, 4.7-5.6], respectively). Other IRs in CVC and HD cohorts, respectively, were thrombosis, 1.3 and 0.8; MCRCs, 0.6 and 0.7; embolism, 0.4 and 0.5; MB, 0.1 and 0.3; and ICH, 0.1 in both cohorts. Patients with cancer at baseline had significantly higher IRs for CRBSIs and thrombosis than non-cancer patients. CVC or HD catheter-related complications were most frequently seen in patients 16 years or younger. The risk of catheter-related complications is highest during the first 90 days of catheter placement in patients with CVCs and HD catheters and in younger patients (≤16 years of age) with HD catheters. Data provided in this study can be applied

  14. Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio.

    Science.gov (United States)

    Spencer, Timothy R; Mahoney, Keegan J

    2017-11-01

    In vascular access practices, the internal vessel size is considered important, and a catheter to vessel ratio (CVR) is recommended to assist clinicians in selecting the most appropriate-sized device for the vessel. In 2016, new practice recommendations stated that the CVR can increase from 33 to 45% of the vessels diameter. There has been evidence on larger diameter catheters and increased thrombosis risk in recent literature, while insufficient information established on what relationship to vessel size is appropriate for any intra-vascular device. Earlier references to clinical standards and guidelines did not clearly address vessel size in relation to the area consumed or external catheter diameter. The aim of this manuscript is to present catheter-related thrombosis evidence and develop a standardized process of ultrasound-guided vessel assessment, integrating CVR, Virchow's triad phenomenon and vessel health and preservation strategies, empowering an evidence-based approach to device placement. Through review, calculation and assessment on the areas of the 33 and 45% rule, a preliminary clinical tool was developed to assist clinicians make cognizant decisions when placing intravascular devices relating to target vessel size, focusing on potential reduction in catheter-related thrombosis. Increasing the understanding and utilization of CVRs will lead to a safer, more consistent approach to device placement, with potential thrombosis reduction strategies. The future of evidence-based data relies on the clinician to capture accurate vessel measurements and device-related outcomes. This will lead to a more dependable data pool, driving the relationship of catheter-related thrombosis and vascular assessment.

  15. Technique of Peritoneal Catheter Placement under Fluoroscopic Guidance

    International Nuclear Information System (INIS)

    Abdel-Aal, A.K.; Gaddikeri, S.; Saddekni, S.

    2011-01-01

    Peritoneal catheters are mainly used for peritoneal dialysis in patients with end-stage renal disease. Other uses of this catheter include intraperitoneal chemotherapy and gene therapy for ovarian cancer and draining of uncontrolled refractory ascites in patients with liver cirrhosis. Traditionally, surgeons place most of these peritoneal catheters either by laparoscopy or open laparotomy. We detail our percutaneous approach to placing peritoneal catheters using fluoroscopic guidance. We emphasize the use of additional ultrasound guidance, including gray scale and color Doppler ultrasound, to determine the safest puncture site and to guide the initial needle puncture in order to avoid bowel perforation and injury to epigastric artery. We present our experience in placing peritoneal catheters using this technique in 95 patients with various indications. Fluoroscopic guided percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to open surgical or laparoscopic placement.

  16. High performance permanent magnet materials

    International Nuclear Information System (INIS)

    Sankar, S.G.; Herbst, J.F.; Koon, N.C.

    1987-01-01

    This book contains 25 selections. Some of the titles are: Initial magnetization behavior of rapidly quenched neodymium-iron-boron magnets; Optimization of liquid dynamic compaction for Fe-Nd-B magnet alloys; Misch-metal and/or aluminum substitutions in Nd-Fe-B permanent magnets; and NdFeB magnets with improved temperature characteristics

  17. OAS :: Member States : Permanent Representatives

    Science.gov (United States)

    Rights Actions against Corruption C Children Civil Registry Civil Society Contact Us Culture Cyber Barbados Belize Bolivia Brazil Canada Chile Colombia Costa Rica Cuba 1 Dominica (Commonwealth of) Dominican Gutierez Ambassador, Permanent Representative of Belize Diego Pary Rodríguez Bolivia Diego Pary Rodríguez

  18. Embolization of brain arteriovenous malformations using tracker catheter

    International Nuclear Information System (INIS)

    Kim, Sun Yong; Son, Mi Young; Jang, Jae Chun; Hwang, Mi Soo; Park, Bok Hwan

    1990-01-01

    With the recent advance in micro catheters, steerable guide wires, balloons, embolic materials and digital subtraction angiography (DSA), as well as technical refinements in endovascular surgery, there has been a revolution in therapeutic strategies for cerebral arteriovenous malformations (AVMs). We have performed super selective angiography and embolization with Tracker micro catheter about 12 cases of brain AVMs for therapeutic and preoperative aims. This micro catheter and guide wire provided high selectivity of feeding artery, greater maneuverability and useful for deliver various embolus materials

  19. Successful Use of Modified Suprapubic Catheter to Rescue Prostatorectal Fistula

    Directory of Open Access Journals (Sweden)

    Yi-Chun Chiu

    2008-06-01

    Full Text Available Prostatorectal fistula is a complication following radiotherapy. It remains a clinical challenge to treat because most patients experience a poor quality of life. This case report discusses a modified suprapubic catheter for use in a patient with a prostatorectal fistula that developed after radiotherapy for localized prostate cancer. It is an inexpensive, easily available, and more patient-tolerable catheter that improves quality of life. Herein, we describe the development of this catheter.

  20. Analog experiment of transarterial catheter hyperthermic infusion in vitro

    International Nuclear Information System (INIS)

    Fan Shufeng Li Zheng; Gu Weizhong; Ru Fuming

    2006-01-01

    Objective: To investigate the factors related to the heating effect by transarterial catheter hyperthermic infusion with the evaluation of the feasibility in controlling the tumor temperature. Methods: Infusing 55-68 degree C liquid at the speed of 10-40 ml/min through 6F, 5F or 3F catheter with different length respectively under the similar clinical condition. The liquid temperature at the terminal exit of the catheter was measured with a digital thermometer. The factors related to the liquid temperature at the exit of the catheter were analyzed by multiple regression analysis. Results: The infusion temperature , rate and the catheter length were the main related factors to the liquid temperature at the exit of the catheter as the condition similar in clinical use. When 60-65 degree C liquid was infused at the rate of 20-40 ml/min through 5F catheter with length of 80 cm, the mean and 95% confident interval of the liquid temperature at the catheter exit were (47.55±0.44) degree C and 44.61-48.49 degree C respectively. Conclusions: The liquid temperature at the exit of infusion catheter can be regulated and controlled through adjusting the liquid perfusion temperature and speed. (authors)

  1. Methicillin-Resistant Staphylococcus Aureus (MRSA Carriage Certainly Poses a Risk in Pregnant Women

    Directory of Open Access Journals (Sweden)

    Azadeh Bagheri

    2015-03-01

    Conclusion: Patients with a history of hospitalization, surgery, dialysis, or residence in a long-term care facility within 1 year of enrollment, a permanent indwelling catheter or percutaneous medical device (eg, tracheostomy tube, gastrostomy tube, or Foley catheter as well as pregnancy are known positive culture for MRSA and require an extensive check up to role out this problem. [Cukurova Med J 2015; 40(1.000: 28-35

  2. Coronary angioplasty with second generation Monorail catheters.

    Science.gov (United States)

    Pande, A K; Meier, B; Urban, P; Villavicencio, R; de la Serna, F; Moles, V

    1991-07-01

    The Monorail system (Schneider) consists of a balloon catheter in which the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the length of the guiding catheter. It offers distinct advantages over conventional systems of coronary angioplasty. It facilitates contrast injections and permits rapid balloon exchanges. This system was used for coronary angioplasty in 273 unselected consecutive patients (age 59 +/- 10, mean 35 to 73 years). There were 216 patients (84%) undergoing single-vessel and 57 patients (16%) with multi-vessel coronary angioplasty. A total of 335 coronary stenoses were dilated, which included 35 total occlusions. The size of balloon used ranged from 2.0 to 4.25 mm (3.0 +/- 0.5 mm) and the severity of stenosis was 85 +/- 11%. Technical success was defined as a residual stenosis of less than 50% as determined angiographically. Clinical success was defined as technical success, and absence of a major inhospital complication defined as absence of myocardial infarction, lack of need for coronary arterial bypass surgery, and survival. The Monorail system was technically successful in 294/300 stenotic lesions (98%). It was clinically successful for 281 lesions (94%). Of the 35 total occlusions, technical success was obtained in 25 (71%). The residual stenosis of successful cases was 26 +/- 21%. The Monorail system was also successful in 5 patients with stenosis of more than 90% in whom conventional systems failed. The complications included acute occlusion causing acute myocardial infarction in 13 cases (5%), emergency coronary arterial bypass surgery in 1 patient (0.4%), and death in 4 patients (1.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Where does the pulmonary artery catheter float: Transesophageal echocardiography evaluation

    Directory of Open Access Journals (Sweden)

    Deepak K Tempe

    2015-01-01

    Full Text Available Background: Pulmonary artery (PA catheter provides a variety of cardiac and hemodynamic parameters. In majority of the patients, the catheter tends to float in the right pulmonary artery (RPA than the left pulmonary artery (LPA. We evaluated the location of PA catheter with the help of transesophageal echocardiography (TEE to know the incidence of its localization. Three views were utilized for this purpose; midesophageal ascending aorta (AA short-axis view, modified mid esophageal aortic valve long-axis view, and modified bicaval view. Methods: We enrolled 135 patients undergoing elective cardiac surgery where both the PA catheter and TEE were to be used; for this prospective observational study. PA catheter was visualized by TEE in the above mentioned views and the degree of clarity of visualization by three views was also noted. Position of the PA catheter was further confirmed by a postoperative chest radiograph. Results: One patient was excluded from the data analysis. PA catheter was visualized in RPA in 129 patients (96% and in LPA in 4 patients (3%. In 1 patient, the catheter was visualized in main PA in the chest radiograph. The midesophageal AA short-axis, modified aortic valve long-axis, and modified bicaval view provided good visualization in 51.45%, 57.4%, and 62.3% patients respectively. Taken together, PA catheter visualization was good in 128 (95.5% patients. Conclusion: We conclude that the PA catheter has a high probability of entering the RPA as compared to LPA (96% vs. 3% and TEE provides good visualization of the catheter in RPA.

  4. Totally implantable venous catheters for chemotherapy: experience in 500 patients

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    Full Text Available CONTEXT: Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients, although few studies have been done in our environment to analyze the results obtained from the implantation and utilization of such catheters. OBJECTIVE: To study the results obtained from the implantation of totally implantable catheters in patients submitted to chemotherapy. TYPE OF STUDY: Prospective. SETTING: Hospital do Câncer A.C. Camargo, São Paulo, Brazil. METHODS: 519 totally implantable catheters were placed in 500 patients submitted to chemotherapy, with preference for the use of the right external jugular vein. Evaluations were made of the early and late-stage complications and patient evolution until removal of the device, death or the end of the treatment. RESULTS: The prospective analysis showed an average duration of 353 days for the catheters. There were 427 (82.2% catheters with no complications. Among the early complications observed, there were 15 pathway hematomas, 8 cases of thrombophlebitis of the distal stump of the external jugular vein and one case of pocket infection. Among the late-stage complications observed, there were 43 infectious complications (0.23/1000 days of catheter use, 11 obstructions (0.06/1000 days of catheter use and 14 cases of deep vein thrombosis (0.07/1000 days of catheter use. Removal of 101 catheters was performed: 35 due to complications and 66 upon terminating the treatment. A total of 240 patients died while the catheter was functioning and 178 patients are still making use of the catheter. CONCLUSION: The low rate of complications obtained in this study confirms the safety and convenience of the use of totally implantable accesses in patients undergoing prolonged chemotherapy regimes.

  5. Dosimetric equivalence of nonstandard HDR brachytherapy catheter patterns

    International Nuclear Information System (INIS)

    Cunha, J. A. M.; Hsu, I-C.; Pouliot, J.

    2009-01-01

    Purpose: To determine whether alternative high dose rate prostate brachytherapy catheter patterns can result in similar or improved dose distributions while providing better access and reducing trauma. Materials and Methods: Standard prostate cancer high dose rate brachytherapy uses a regular grid of parallel needle positions to guide the catheter insertion. This geometry does not easily allow the physician to avoid piercing the critical structures near the penile bulb nor does it provide position flexibility in the case of pubic arch interference. This study used CT datasets with 3 mm slice spacing from ten previously treated patients and digitized new catheters following three hypothetical catheter patterns: conical, bi-conical, and fireworks. The conical patterns were used to accommodate a robotic delivery using a single entry point. The bi-conical and fireworks patterns were specifically designed to avoid the critical structures near the penile bulb. For each catheter distribution, a plan was optimized with the inverse planning algorithm, IPSA, and compared with the plan used for treatment. Irrelevant of catheter geometry, a plan must fulfill the RTOG-0321 dose criteria for target dose coverage (V 100 Prostate >90%) and organ-at-risk dose sparing (V 75 Bladder 75 Rectum 125 Urethra <<1 cc). Results: The three nonstandard catheter patterns used 16 nonparallel, straight divergent catheters, with entry points in the perineum. Thirty plans from ten patients with prostate sizes ranging from 26 to 89 cc were optimized. All nonstandard patterns fulfilled the RTOG criteria when the clinical plan did. In some cases, the dose distribution was improved by better sparing the organs-at-risk. Conclusion: Alternative catheter patterns can provide the physician with additional ways to treat patients previously considered unsuited for brachytherapy treatment (pubic arch interference) and facilitate robotic guidance of catheter insertion. In addition, alternative catheter

  6. Automated phenotyping of permanent crops

    Science.gov (United States)

    McPeek, K. Thomas; Steddom, Karl; Zamudio, Joseph; Pant, Paras; Mullenbach, Tyler

    2017-05-01

    AGERpoint is defining a new technology space for the growers' industry by introducing novel applications for sensor technology and data analysis to growers of permanent crops. Serving data to a state-of-the-art analytics engine from a cutting edge sensor platform, a new paradigm in precision agriculture is being developed that allows growers to understand the unique needs of each tree, bush or vine in their operation. Autonomous aerial and terrestrial vehicles equipped with multiple varieties of remote sensing technologies give AGERpoint the ability to measure key morphological and spectral features of permanent crops. This work demonstrates how such phenotypic measurements combined with machine learning algorithms can be used to determine the variety of crops (e.g., almond and pecan trees). This phenotypic and varietal information represents the first step in enabling growers with the ability to tailor their management practices to individual plants and maximize their economic productivity.

  7. Permanently calibrated interpolating time counter

    International Nuclear Information System (INIS)

    Jachna, Z; Szplet, R; Kwiatkowski, P; Różyc, K

    2015-01-01

    We propose a new architecture of an integrated time interval counter that provides its permanent calibration in the background. Time interval measurement and the calibration procedure are based on the use of a two-stage interpolation method and parallel processing of measurement and calibration data. The parallel processing is achieved by a doubling of two-stage interpolators in measurement channels of the counter, and by an appropriate extension of control logic. Such modification allows the updating of transfer characteristics of interpolators without the need to break a theoretically infinite measurement session. We describe the principle of permanent calibration, its implementation and influence on the quality of the counter. The precision of the presented counter is kept at a constant level (below 20 ps) despite significant changes in the ambient temperature (from −10 to 60 °C), which can cause a sevenfold decrease in the precision of the counter with a traditional calibration procedure. (paper)

  8. The cycloid Permanent Magnetic Gear

    DEFF Research Database (Denmark)

    Rasmussen, Peter Omand; Andersen, Torben Ole; Jørgensen, Frank T.

    2008-01-01

    This paper presents a new permanent-magnet gear based on the cycloid gearing principle. which normally is characterized by an extreme torque density and a very high gearing ratio. An initial design of the proposed magnetic gear was designed, analyzed, and optimized with an analytical model...... regarding torque density. The results were promising as compared to other high-performance magnetic-gear designs. A test model was constructed to verify the analytical model....

  9. Use of asymmetric bidirectional catheters with different curvature radius for catheter ablation of cardiac arrhythmias.

    Science.gov (United States)

    Mantziari, Lilian; Suman-Horduna, Irina; Gujic, Marko; Jones, David G; Wong, Tom; Markides, Vias; Foran, John P; Ernst, Sabine

    2013-06-01

    The impact of recently introduced asymmetric bidirectional ablation catheters on procedural parameters and acute success rates of ablation procedures is unknown. We retrospectively analyzed data regarding ablations using a novel bidirectional catheter in a tertiary cardiac center and compared these in 1:5 ratio with a control group of procedures matched for age, gender, operator, and ablation type. A total of 50 cases and 250 controls of median age 60 (50-68) years were studied. Structural heart disease was equally prevalent in both groups (39%) while history of previous ablations was more common in the study arm (54% vs 30%, P = 0.001). Most of the ablation cases were for atrial fibrillation (46%), followed by atrial tachycardia (28%), supraventricular tachycardia (12%), and ventricular tachycardia (14%). Median procedure duration was 128 (52-147) minutes with the bidirectional, versus 143 (105-200) minutes with the conventional catheter (P = 0.232), and median fluoroscopy time was 17 (10-34) minutes versus 23 (12-39) minutes, respectively (P = 0.988). There was a trend toward a lower procedure duration for the atrial tachycardia ablations, 89 (52-147) minutes versus 130 (100-210) minutes, P = 0.064. The procedure was successfully completed in 96% of the bidirectional versus 84% of the control cases (P = 0.151). A negative correlation was observed between the relative fluoroscopy duration and the case number (r = -0.312, P = 0.028), reflecting the learning curve for the bidirectional catheter. The introduction of the bidirectional catheter resulted in no prolongation of procedure parameters and similar success rates, while there was a trend toward a lower procedure duration for atrial tachycardia ablations. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  10. Complications of central venous catheter in patients transplanted with hematopoietic stem cells in a specialized service.

    Science.gov (United States)

    Barretta, Lidiane Miotto; Beccaria, Lúcia Marinilza; Cesarino, Cláudia Bernardi; Pinto, Maria Helena

    2016-06-07

    to identify the model, average length of stay on site and complications of central venous catheter in patients undergoing transplant of hematopoietic stem cells and verify the corresponding relationship between the variables: age, gender, medical diagnosis, type of transplant, implanted catheter and insertion site. a retrospective and quantitative study with a sample of 188 patients transplanted records between 2007 and 2011. the majority of patients used Hickman catheter with an average length of stay on site of 47.6 days. The complication fever/bacteremia was significant in young males with non-Hodgkin's lymphoma undergoing autologous transplant, which remained with the device for a long period in the subclavian vein. nurses should plan with their team the minimum waiting time, recommended between the catheter insertion and start of the conditioning regimen, as well as not to extend the length of time that catheter should be on site and undertake their continuing education, focusing on the prevention of complications. identificar o modelo, tempo médio de permanência e complicações de cateter venoso central em pacientes submetidos ao transplante de células-tronco hematopoiéticas e verificar a relação de correspondência entre as variáveis: idade, sexo, diagnóstico médico, tipo de transplante, cateter implantado e local de inserção. retrospectivo, quantitativo, com amostra de prontuários de 188 pacientes transplantados, entre 2007 e 2011. a maioria dos pacientes utilizou o cateter de Hickman com permanência média de 47,6 dias. A complicação febre/bacteremia foi significante em jovens do sexo masculino, com linfoma não Hodgkin, submetidos ao transplante autólogo, que permaneceram com o dispositivo por longo período, em veia subclávia. os enfermeiros devem planejar com a equipe o aguardo do tempo mínimo preconizado entre o implante do cateter e início do regime de condicionamento, assim como não estender o período de permanência e realizar

  11. Lawful Permanent Residents Fiscal Year 2011 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  12. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer.

    Science.gov (United States)

    Debourdeau, P; Farge, D; Beckers, M; Baglin, C; Bauersachs, R M; Brenner, B; Brilhante, D; Falanga, A; Gerotzafias, G T; Haim, N; Kakkar, A K; Khorana, A A; Lecumberri, R; Mandala, M; Marty, M; Monreal, M; Mousa, S A; Noble, S; Pabinger, I; Prandoni, P; Prins, M H; Qari, M H; Streiff, M B; Syrigos, K; Büller, H R; Bounameaux, H

    2013-01-01

    Although long-term indwelling central venous catheters (CVCs) may lead to pulmonary embolism (PE) and loss of the CVC, there is lack of consensus on management of CVC-related thrombosis (CRT) in cancer patients and heterogeneity in clinical practices worldwide. To establish common international Good Clinical Practices Guidelines (GCPG) for the management of CRT in cancer patients. An international working group of experts was set up to develop GCPG according to an evidence-based medicine approach, using the GRADE system. For the treatment of established CRT in cancer patients, we found no prospective randomized studies, two non-randomized prospective studies and one retrospective study examining the efficacy and safety of low-molecular-weight heparin (LMWH) plus vitamin K antagonists (VKAs). One retrospective study evaluated the benefit of CVC removal and two small retrospective studies were on thrombolytic drugs. For the treatment of symptomatic CRT, anticoagulant treatment (AC) is recommended for a minimum of 3 months; in this setting, LMWHs are suggested. VKAs can also be used, in the absence of direct comparisons of these two types of anticoagulants in this setting [Guidance]. The CVC can be kept in place if it is functional, well-positioned and non-infected and there is good resolution under close surveillance; whether the CVC is kept or removed, no standard approach in terms of AC duration has been established [Guidance]. For the prophylaxis of CRT in cancer patients, we found six randomized studies investigating the efficacy and safety of VKA vs. placebo or no treatment, one on the efficacy and safety of unfractionnated heparin, six on the value of LMWH, one double-blind randomized and one non randomized study on thrombolytic drugs and six meta-analyses of AC and CVC thromboprophylaxis. Type of catheter (open-ended like the Hickman(®) catheter vs. closed-ended catheter with a valve like the Groshong(®) catheter), its position (above, below or at the

  13. Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department.

    Science.gov (United States)

    Radtke, Josephine; Schild, Raphael; Reismann, Marc; Ridwelski, Robert-Richard; Kempf, Caroline; Nashan, Bjoern; Rothe, Karin; Koch, Martina

    2018-04-01

    Peritoneal dialysis (PD) catheter occlusion is a common complication with up to 36% of catheter obstructions described in the literature. We present a comparison of complications and outcome after implantation of PD catheters in a transplant surgical and a pediatric surgical department. We retrospectively analyzed 154 PD catheters, which were implanted during 2009-2015 by transplant surgeons (TS, University Medical Center Hamburg-Eppendorf, Germany, n=85 catheters) and pediatric surgeons (PS, Charité University Medicine Berlin, Germany, n=69 catheters) in 122 children (median (range) age 3.0 (0.01-17.1) years) for acute (n=65) or chronic (n=89) renal failure. All catheters were one-cuffed or double-cuffed curled catheters, except that straight catheters were implanted into smaller children (n=19) by TS in Hamburg. Patient characteristics and operation technique did not differ between the departments. Peritonitis was the most common complication (33 catheters, 21.4%). Leakage (n=18 catheters, 11.7%) occurred more often in children weighing <10kg (p<0.001). The incidence of obstruction and dysfunction was significantly higher in catheters used in PS than catheters used in TS (30.4% vs. 11.8%, p=0.004). Omentectomy did not reduce the incidence of catheter obstruction (p=1.0). Perforation at the catheter tips was larger and appeared to be rougher in catheters used in PS than the catheters in TS. The type of catheter and presumably the type of perforation at the catheter tip may influence the incidence of peritoneal dialysis catheter obstruction. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Percutaneous catheter drainage of lung abscess

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub [Catholic University Medical college, Seoul (Korea, Republic of)

    1993-09-15

    From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess.

  15. Percutaneous catheter drainage of lung abscess

    International Nuclear Information System (INIS)

    Kim, Young Shin; Chun, Kyung Ah; Choi, Hyo Sun; Ha, Hyun Kown; Shinn, Kyung Sub

    1993-01-01

    From March 1987 to July 1989, six patients (five adults and one child) with lung abscess (size, 5-13 cm in diameter) were treated with percutaneous aspiration and drainage. In each case, the puncture was made where the wall of the abscess was in contact with the pleural surface. An 8 to 10 Fr cartheter was inserted for drainage. Five of 6 had a dynamatic clinical response within 24 hours of the drainage. Percutaneous drainage was successful with complete abscess resolution in four and partial resolution in one patient. No response was seen in the rest one. The duration of drainage ranged from 7 to 18 days(average, 15.5 days) in successful cases. One case of the failure in drainage was due tio persistent aspiration of the neurologically impaired patient. In one patient, the abscess resolved after drainage but recurred after inadvertent removal of the catheter 7 days after insertion. In two patients, concurrent pleural empyema was resolved completely by the drainage. Computed tomography provide anatomic details necessary for choosing the puncture site and avoiding a puncture of the lung parenchyma. Percutaneous catheter drainage is safe and effective method for treating patient with lung abscess

  16. Femoral venous catheters: a safe alternative for delivering parenteral alimentation.

    Science.gov (United States)

    Friedman, B; Kanter, G; Titus, D

    1994-04-01

    Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.

  17. Management of retained encrusted urethral catheter with extracorporeal shockwave lithotripsy

    Directory of Open Access Journals (Sweden)

    Sameh Anwar Kunzman

    2002-01-01

    Full Text Available We report a case of non-deflating heavily encrusted Foley catheter successfully removed by extracorporeal shockwave lithotripsy (ESWL. To our knowledge this is the first case of using ESWL to remove encrusted foley catheter retained in the bladder.

  18. The left atrial catheter: its uses and complications.

    Science.gov (United States)

    Leitman, B S; Naidich, D P; McGuinness, G; McCauley, D I

    1992-11-01

    The authors describe the radiographic appearance of the left atrial catheter, a widely used postsurgical intracardiac device. Recognition of the characteristic appearance of this catheter should be of value in detection of potential complications, including line fracture with resultant retention and/or embolization, infection, prosthetic valve dysfunction, and even cardiac tamponade.

  19. Prevention of catheter-related blood stream infection.

    Science.gov (United States)

    Byrnes, Matthew C; Coopersmith, Craig M

    2007-08-01

    Catheter-related blood stream infections are a morbid complication of central venous catheters. This review will highlight a comprehensive approach demonstrated to prevent catheter-related blood stream infections. Elements of prevention important to inserting a central venous catheter include proper hand hygiene, use of full barrier precautions, appropriate skin preparation with 2% chlorhexidine, and using the subclavian vein as the preferred anatomic site. Rigorous attention needs to be given to dressing care, and there should be daily assessment of the need for central venous catheters, with prompt removal as soon as is practicable. Healthcare workers should be educated routinely on methods to prevent catheter-related blood stream infections. If rates remain higher than benchmark levels despite proper bedside practice, antiseptic or antibiotic-impregnated catheters can also prevent infections effectively. A recent program utilizing these practices in 103 ICUs in Michigan resulted in a 66% decrease in infection rates. There is increasing recognition that a comprehensive strategy to prevent catheter-related blood stream infections can prevent most infections, if not all. This suggests that thousands of infections can potentially be averted if the simple practices outlined herein are followed.

  20. Encrusted and incarcerated urinary bladder catheter: what are the ...

    African Journals Online (AJOL)

    Urinary bladder catheter encrustations are known complications of long-term urinary catheterisation, which is commonly seen in clinical practice. These encrustations can impede deflation of the balloon and therefore cause problems in the removal of the catheter. The options in managing an encrusted and incarcerated ...

  1. Detection of electrophysiology catheters in noisy fluoroscopy images

    NARCIS (Netherlands)

    Franken, E.M.; Rongen, P.M.J.; Almsick, van M.A.; Haar Romenij, ter B.M.

    2006-01-01

    Cardiac catheter ablation is a minimally invasive medical procedure to treat patients with heart rhythm disorders. It is useful to know the positions of the catheters and electrodes during the intervention, e.g. for the automatization of cardiac mapping. Our goal is therefore to develop a robust

  2. Risk factors for peritoneal dialysis catheter failure in children ...

    African Journals Online (AJOL)

    Background Peritoneal dialysis catheter (PDC) failure still remains a common clinical problem in pediatric patients despite advancements in catheter placement and dialysis techniques. Our aim was to determine the risk factors that may lead to PDC failure, especially those factors that could be potentially modified to ...

  3. Unusual migration of ventriculo peritoneal distal catheter into vagina

    Directory of Open Access Journals (Sweden)

    Sghavamedin Tavallaee

    2015-04-01

    Full Text Available VP shunt is one of the most popular methods for ICP reduction and treatment of hydrocephalus. Various complications of this method are not uncommon such as shunt malfunction, infection and unusual migration of distal catheter. I present a case of migration of the peritoneal catheter out of the vagina.

  4. Percutaneous transfemoral repositioning of malpositioned central venous catheters.

    Science.gov (United States)

    Hartnell, G G; Roizental, M

    1995-04-01

    Central venous catheters inserted by blind surgical placement may not advance into a satisfactory position and may require repositioning. Malpositioning via surgical insertion is common in patients in whom central venous catheters have previously been placed, as these patients are more likely to have central venous thrombosis and distortion of central venous anatomy. This is less of a problem when catheter placement is guided by imaging; however, even when insertion is satisfactory, central venous catheters may become displaced spontaneously after insertion (Fig. 1). Repositioning can be effected by direct manipulation using guidewires or tip-deflecting wires [1, 2], by manipulation via a transfemoral venous approach [3-5], and by injection of contrast material or saline [6]. Limitations of the direct approach include (1) the number and type of maneuvers that can be performed to effect repositioning when anatomy is distorted, (2) difficulty in accessing the catheter, and (3) the risk of introducing infection. Moreover, these patients are often immunosuppressed, and there is a risk of introducing infection by exposing and directly manipulating the venous catheter. Vigorous injection of contrast material or saline may be unsuccessful for the same reasons: It seldom exerts sufficient force to reposition large-caliber central venous catheters and may cause vessel damage or rupture if injection is made into a small or thrombosed vessel. We illustrate several alternative methods for catheter repositioning via a transfemoral venous approach.

  5. A prototype catheter designed for ultraviolet C disinfection

    DEFF Research Database (Denmark)

    Bak, Jimmy; Begovic, Tanja

    2013-01-01

    UVC light exposure, sampling and plate counting. Findings Two minutes of UVC exposure was sufficient to obtain 4 log10 disinfection for the full-length prototype catheter. This exposure corresponds to ∼40 mJ/cm2 at the catheter tip and indicates that even shorter exposure times can be achieved...

  6. Intravascular catheter-related infection – current concepts

    African Journals Online (AJOL)

    2006-08-28

    Aug 28, 2006 ... prevented. ... blood from both the catheter and a peripheral site, may ... Given the important role of cutaneous microflora in the ... valvular heart disease (especially prosthetic valves) and ... be explained by high arterial flow around the catheter, ... vena cava or right atrium via the cephalic and basilar veins of ...

  7. Predicting success of catheter drainage in infected necrotizing pancreatitis

    NARCIS (Netherlands)

    Hollemans, Robbert A.; Bollen, Thomas L.; Van Brunschot, Sandra; Bakker, Olaf J.; Ali, Usama Ahmed; Van Goor, Harry; Boermeester, Marja A.; Gooszen, Hein G.; Besselink, Marc G.; Van Santvoort, Hjalmar C.

    2016-01-01

    Introduction: At least 30% of patients with infected necrotizing pancreatitis are successfully treated with catheter drainage alone. It is currently not possible to predict which patients also need necrosectomy. We evaluated predictive factors for successful catheter drainage. Methods: This was a

  8. Predicting Success of Catheter Drainage in Infected Necrotizing Pancreatitis

    NARCIS (Netherlands)

    Hollemans, Robbert A.; Bollen, Thomas L.; van Brunschot, Sandra; Bakker, Olaf J.; Ahmed Ali, Usama; van Goor, Harry; Boermeester, Marja A.; Gooszen, Hein G.; Besselink, Marc G.; van Santvoort, Hjalmar C.

    2016-01-01

    At least 30% of patients with infected necrotizing pancreatitis are successfully treated with catheter drainage alone. It is currently not possible to predict which patients also need necrosectomy. We evaluated predictive factors for successful catheter drainage. This was a post hoc analysis of 130

  9. Predicting Success of Catheter Drainage in Infected Necrotizing Pancreatitis

    NARCIS (Netherlands)

    Hollemans, R.A.; Bollen, T.L.; Brunschot, S. van; Bakker, O.J.; Ali, U. Ahmed; Goor, H. van; Boermeester, M.A.; Gooszen, H.G.; Besselink, M.G.; Santvoort, H.C. van

    2016-01-01

    INTRODUCTION: At least 30% of patients with infected necrotizing pancreatitis are successfully treated with catheter drainage alone. It is currently not possible to predict which patients also need necrosectomy. We evaluated predictive factors for successful catheter drainage. METHODS: This was a

  10. Encrusted and incarcerated urinary bladder catheter: what are the ...

    African Journals Online (AJOL)

    2010-11-25

    Nov 25, 2010 ... cases of extraluminal encrusted urethral catheters. Extracorporeal shock wave lithotripsy (ESWL) has been utilised in the treatment of the bladder stones. Borrowing this principle, Kunzman et al. (12) has even used ESWL to fragment the stone-like encrustation over the retained Foley catheter balloon.

  11. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    International Nuclear Information System (INIS)

    Oh, Jung Suk; Lee, Hae Giu; Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-01-01

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6–20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6–38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5–14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10–58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites

  12. Preprocedural ultrasound examination versus manual palpation for thoracic epidural catheter insertion

    Directory of Open Access Journals (Sweden)

    Ahmed M Hasanin

    2017-01-01

    Conclusion: Preprocedural ultrasound imaging increased the incidence of first pass success in thoracic epidural catheter insertion and reduced the catheter insertion time compared to manual palpation method.

  13. Teaching Object Permanence: An Action Research Study

    Science.gov (United States)

    Bruce, Susan M.; Vargas, Claudia

    2013-01-01

    "Object permanence," also known as "object concept" in the field of visual impairment, is one of the most important early developmental milestones. The achievement of object permanence is associated with the onset of representational thought and language. Object permanence is important to orientation, including the recognition of landmarks.…

  14. 21 CFR 886.4445 - Permanent magnet.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Permanent magnet. 886.4445 Section 886.4445 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4445 Permanent magnet. (a) Identification. A permanent magnet is a nonelectric device that generates a magnetic field intended to find and remove metallic...

  15. Catheter Ablation of Ectopic Atrial Tachycardia Originating from the Left Atrial Appendage using CARTOMERGE® System

    Directory of Open Access Journals (Sweden)

    Masahiko Goya, MD

    2008-01-01

    Full Text Available A 70-year-old woman was referred because of drug resistant and daily incessant palpitation attack. She had undergone two previous unsuccessful radiofrequency catheter ablations at another hospital. The physical examination, chest X-ray, and echocardiogram were all normal. The 12-lead ECG during tachycardia showed narrow QRS, short PR tachycardia and negative polarity of the P wave in leads I and aVL (Fig. 1A. The ECG monitor showed incessant tachycardia with warming-up phenomenon. Three dimensional electroanatomical map integrated with CT imaging (CARTOMERGE®, Biosense Webster Inc. clearly revealed the radial activation pattern originating from the basalo-postero-inferior aspect of the left atrial appendage. Radiofrequency energy application at this site eliminated tachycardia permanently.

  16. An experimental study about efficacy of the drain catheters

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Bum Gyu; Nho, Joon Young; Woo, Hyo Cheol; Hwang, Woo Cheol; Park, Choong Ki; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre- and post-procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drainage efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were very lower than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we thought that it will be very helpful to the treatment of patient as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.

  17. Positioning of nasobiliary tube using magnet-loaded catheters.

    Science.gov (United States)

    Watanabe, Seitaro; Sato, Takamitsu; Kato, Shingo; Hosono, Kunihiro; Kobayashi, Noritoshi; Nakajima, Atsushi; Kubota, Kensuke

    2013-10-01

    In endoscopic nasobiliary drainage (ENBD), repositioning the catheter from the mouth to the nose is complicated. We devised a method using catheters with magnets and verified its utility and safety. We prospectively enrolled 20 patients undergoing ENBD at Yokohama City University Hospital. The procedures were successful in all 20 cases and no case required a change of operators to a senior doctor. The mean time for the procedure was 36.6 seconds. The emetic reflex was induced 0.5 times on average using the magnet method. The mean X-ray exposure time was 29.6 seconds. No complications occurred. The magnet-loaded catheter method for positioning the ENBD catheter before finally leading it through the nose took little time and was performed successfully and safely. Therefore, the magnet method could become the first choice among techniques for ENBD catheter placement. © Georg Thieme Verlag KG Stuttgart · New York.

  18. The dialysis catheter and infectious peritonitis in intermittent peritoneal dialysis

    DEFF Research Database (Denmark)

    Kolmos, Hans Jørn; Hemmeløff Andersen, Karl Erik; Hansen, Lise

    1984-01-01

    118 episodes of infectious peritonitis registered among 156 patients treated with intermittent peritoneal dialysis over a 5-yr period were analysed with special reference to potential routes of infection associated with the dialysis catheter. Peritonitis was randomly distributed among the patients......, and the change of keeping free of peritonitis declined exponentially with time. The main factor determining the individual number of episodes was the total space of time, in which a patient had been wearing a dialysis catheter, whereas the number of catheter disconnections played no significant role. A relative...... preponderance of cases due to Enterobacteriaceae was noted within the first week after catheter implantation. In contrast with this, peritonitis with skin microorganisms was not associated with the implantation of catheters....

  19. Removal of non-deflatable retained foley catheter in the bladder by percutaneous puncture of catheter balloon

    International Nuclear Information System (INIS)

    Yoo, Jae Duk; Kim, Jae Kyu; Park, Jin Gyun; Chung, Hyon De

    1988-01-01

    Nondeflatable Foley catheter in the bladder is an uncommon event. We recently experienced a patient in whom the urologist were unable to remove a Foley catheter with cystoscope due to public bone fractures. The procedure, which was successfully carried out, consists of puncturing the ballon under fluoroscope.

  20. Permanent magnets including undulators and wigglers

    CERN Document Server

    Bahrdt, J

    2010-01-01

    After a few historic remarks on magnetic materials we introduce the basic definitions related to permanent magnets. The magnetic properties of the most common materials are reviewed and the production processes are described. Measurement techniques for the characterization of macroscopic and microscopic properties of permanent magnets are presented. Field simulation techniques for permanent magnet devices are discussed. Today, permanent magnets are used in many fields. This article concentrates on the applications of permanent magnets in accelerators starting from dipoles and quadrupoles on to wigglers and undulators.

  1. Optimally segmented permanent magnet structures

    DEFF Research Database (Denmark)

    Insinga, Andrea Roberto; Bjørk, Rasmus; Smith, Anders

    2016-01-01

    We present an optimization approach which can be employed to calculate the globally optimal segmentation of a two-dimensional magnetic system into uniformly magnetized pieces. For each segment the algorithm calculates the optimal shape and the optimal direction of the remanent flux density vector......, with respect to a linear objective functional. We illustrate the approach with results for magnet design problems from different areas, such as a permanent magnet electric motor, a beam focusing quadrupole magnet for particle accelerators and a rotary device for magnetic refrigeration....

  2. Comparative study of peripherally inserted central venous catheter and traditional central catheter assisted with X-ray

    International Nuclear Information System (INIS)

    Yu Jianchun; Wang Xiurong; Jiang Zhuming

    1999-01-01

    Objective: To study the feasibility, complications, mid- and long-term advantages of peripherally inserted central catheters (PICC) compared with central venous access assisted with X-ray. Methods: From Jan 1997 to Dec 1998, the authors conducted a study in 60 patients with placed PICC lines and 60 patients with central lines. Study variables included tip placement and complication rates. Results: Tere were on significant differences between PICC and CVC in the successful placement 95.0% and 88.3%, t = 1.745, P 0.19; the mean duration 13(6-98) days and 14 (7-104) days, F = 0.049, P = 0.83; the total occlusion rate 6.7% (4/60) and 5.0%(3/60), t = 0.152, P = 0.70. In PICC patients, the occlusion rate was slightly higher in 3 Fr (20-gauge) catheter (3/20, 15.0%) than in 4 Fr(18-gauge) catheters (1/20, 5.0%), t = 1.111, P=0.29. Phlebitis occurred in 5.0% of patients (3/60) and one catheter fracture was happened on the catheter hub junction (1.7%). In 3 catheter tips dislocation cases, the catheter tips were moved to the optional position assisted with X-ray image. In CVC group, pneumothorax happened in 1 case (1.7%). In 4 catheter dislocation cases, the catheters were with drawn. No catheter-related sepsis and hemo-pneumothorax happened in both group patients. Conclusions: Both PICC and CVC can be acceptable in clinical use. PICC assisted with X-ray possesses the advantages of less trauma, accurate localization preventing some possible severe complications of central venous access such as pneumothorax. The new method provides a reliable, effective venous access for mid-and long-term usage in patients receiving a variety of solutions, primarily parenteral alimentation, chemotherapy or antibiotic infusion

  3. Image-guided placement of port catheters: is there an increased risk of infection if the port is immediately accessed and used?

    Science.gov (United States)

    Salazar, Gloria; Yeddula, Kalpana; Wicky, Stephan; Oklu, Ramhi; Ganguli, Suvranu; Waltman, Arthur C; Walker, Thomas G; Kalva, Sanjeeva P

    2013-01-01

    To compare complication rates in patients who have port-a-catheters inserted and left accessed for immediate use and those who have ports inserted but not accessed. In this retrospective, IRB-approved study, medical records of patients who received a port catheter between 9/2009 and 2/2010 were reviewed. The data collected included patient demographics, diagnosis, procedure and complications. The patients were categorized into two groups: accessed (patients in whom the port was accessed with a Huber needle for immediate intravenous use and the patient left the procedure area with needle indwelling) and control (patients in whom the ports were not accessed). Complications were classified according to Society of Interventional Radiology guidelines. Results are given as mean ±SD. Statistical analysis was performed with student t test and statistical significance was considered at Pports were placed in 465 patients (Men: 206); 10.7% in the accessed group (n=50, age: 60±13.9) and 89.3% in the control group (n=417, age: 59±13.5). There were no statistically significant differences in patient demographics between the groups. The overall complication rate was 0.6% (n=3). Two complications (hematoma causing skin necrosis and thrombosis of the port) occurred in the control group and one (infection) in the accessed group. Infection rates after procedures were 2% (1/50) in the accessed group and 0% (0/417) in the control group. There was no statistically significant difference in overall complication (P=.1) and infection (P=.1) rates among the groups. Leaving the port accessed immediately after placement does not increase the risk of infection or other complications.

  4. Innovations in Balloon Catheter Technology in Rhinology.

    Science.gov (United States)

    D'Anza, Brian; Sindwani, Raj; Woodard, Troy D

    2017-06-01

    Since being introduced more than 10 years ago, balloon catheter technology (BCT) has undergone several generations of innovations. From construction to utilization, there has been a myriad of advancements in balloon technology. The ergonomics of the balloon dilation systems have improved with a focus on limiting the extra assembly. "Hybrid" BCT procedures have shown promise in mucosal preservation, including treating isolated complex frontal disease. Multiple randomized clinical trials report improved long-term outcomes in stand-alone BCT, including in-office use. The ever-expanding technological innovations ensure BCT will be a key component in the armamentarium of the modern sinus surgeon. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Central venous catheter insertion problem solving using intravenous catheter: technical communication

    Directory of Open Access Journals (Sweden)

    Alemohammad M

    2013-02-01

    Full Text Available Insertion of central venous catheter is an accepted method for hemodynamic monitor-ring, drug and fluid administration, intravenous access, hemodialysis and applying cardiac pace-maker in hospitalized patients. This procedure can be associated with severe complications. The aim of this article is to provide a practical approach to prevent catheter malposition in states that the guide wire will not pass freely.During central venous insertion in internal jugular vein using modified seldinger technique, when after venous insertion, the passage of the guide wire shows difficulties and don’t pass freely, insertion of an intravenous cannula over the wire and re-insertion of the wire can help to prevent malposition of the wire and the catheter. Use of an intravenous cannula over the guide, in situations that the guide wire cannot pass freely among the needle inserted in internal jugular vein, and re-insertion of the guide can probably prevent or reduce the tissue or vascular trauma and the associated complica-tions. This simple maneuver can be helpful in difficult cases especially in cardiac surgery patients who receive high dose heparin and it is necessary to avoid traumatize-tion of carotid artery.

  6. Permanent magnet-based MRI

    Science.gov (United States)

    Cole, David Mitchell

    1997-10-01

    The principal goal of this project is to design and build a low-cost, imaging quality permanent magnet, together with the requisite shim, gradient, and radiofrequency coils, and to integrate the magnet with an existing imaging station. There are commercial products presently available that are very similar to this imager, but information about these products is proprietary. We present here all of the details concerning the design and the manufacturing process for constructing the permanent magnet, and include suggestions for improvement. Specifically, the prototype has a mass of about 150 kilograms and is therefore portable. It's C-type geometry allows maximum access to the imaging region, which is an oblate sphere about 0.5 inches in diameter centered in a 4.7 inch air gap between two seven-inch diameter polefaces. It is hoped that this imaging magnet will serve as the prototype for a series of larger versions that will be clinically useful and affordable to physicians in developing nations. To this end, scientists in the United States and Mexico have begun to collaborate with the intention to create an MRI institute in Mexico that will train new students in this discipline, and fabricate improved imagers. The prototype resulting from this work will seed the creation of this institute, and is intended to entice students into the study of MRI by enabling hands-on interaction with an otherwise prohibitively expensive instrument.

  7. Permanent burying method for product

    International Nuclear Information System (INIS)

    Sakai, Goro; Sakata, Noboru; Hironaka, Yoshikazu; Shigematsu, Kazuo; Yurugi, Masahiro; Minami, Masayoshi; Yoshisaki, Masato.

    1995-01-01

    In a method of permanently burying an object by filling and solidifying a cement mortar in gaps between each of objects to be buried underground, cement mortar is filled into gaps, which comprises water at a unit amount determined as from 200 to 250kg/m 3 , a cement at low water/cement ratio (%) of from 70 to 400%, and contains fine powder having an average grain size of not greater than 100μm (not containing cement) of 50 to 800kg/m 3 , fine aggregates of 800 to 1200kg/m 3 , UERAN gum (a bio-gum powder produced by aerobic fermentation of alcaligenes-bacteria) of 20g/m 3 to 1.3kg/m 3 , a dispersing agent of 0 to 40kg/m 3 , a swelling agent of 0 to 40kg/m 3 . Then if the mortar blended with the UERAN gum is injected, any gaps can be filled tightly, no breeding is caused and since the amount of cement is small, it does not suffer from temperature cracking. Therefore, the state of filling is kept permanently, and environmental pollution caused by radioactive wastes can be prevented. (N.H.)

  8. Prostate HDR brachytherapy catheter displacement between planning and treatment delivery

    International Nuclear Information System (INIS)

    Whitaker, May; Hruby, George; Lovett, Aimee; Patanjali, Nitya

    2011-01-01

    Background and purpose: HDR brachytherapy is used as a conformal boost for treating prostate cancer. Given the large doses delivered, it is critical that the volume treated matches that planned. Our outpatient protocol comprises two 9 Gy fractions, two weeks apart. We prospectively assessed catheter displacement between CT planning and treatment delivery. Materials and methods: Three fiducial markers and the catheters were implanted under transrectal ultrasound guidance. Metal marker wires were inserted into 4 reference catheters before CT; marker positions relative to each other and to the marker wires were measured from the CT scout. Measurements were repeated immediately prior to treatment delivery using pelvic X-ray with marker wires in the same reference catheters. Measurements from CT scout and film were compared. For displacements of 5 mm or more, indexer positions were adjusted prior to treatment delivery. Results: Results are based on 48 implants, in 25 patients. Median time from planning CT to treatment delivery was 254 min (range 81–367 min). Median catheter displacement was 7.5 mm (range −2.9–23.9 mm), 67% of implants had displacement of 5 mm or greater. Displacements were predominantly caudal. Conclusions: Catheter displacement can occur in the 1–3 h between the planning CT scan and treatment. It is recommended that departments performing HDR prostate brachytherapy verify catheter positions immediately prior to treatment delivery.

  9. The effect of elastic modulus on ablation catheter contact area.

    Science.gov (United States)

    Camp, Jon J; Linte, Cristian A; Rettmann, Maryam E; Sun, Deyu; Packer, Douglas L; Robb, Richard A; Holmes, David R

    2015-02-21

    Cardiac ablation consists of navigating a catheter into the heart and delivering RF energy to electrically isolate tissue regions that generate or propagate arrhythmia. Besides the challenges of accurate and precise targeting of the arrhythmic sites within the beating heart, limited information is currently available to the cardiologist regarding intricate electrode-tissue contact, which directly impacts the quality of produced lesions. Recent advances in ablation catheter design provide intra-procedural estimates of tissue-catheter contact force, but the most direct indicator of lesion quality for any particular energy level and duration is the tissue-catheter contact area, and that is a function of not only force, but catheter pose and material elasticity as well. In this experiment, we have employed real-time ultrasound (US) imaging to determine the complete interaction between the ablation electrode and tissue to accurately estimate contact, which will help to better understand the effect of catheter pose and position relative to the tissue. By simultaneously recording tracked position, force reading and US image of the ablation catheter, the differing material properties of polyvinyl alcohol cryogel [1] phantoms are shown to produce varying amounts of tissue depression and contact area (implying varying lesion quality) for equivalent force readings. We have shown that the elastic modulus significantly affects the surface-contact area between the catheter and tissue at any level of contact force. Thus we provide evidence that a prescribed level of catheter force may not always provide sufficient contact area to produce an effective ablation lesion in the prescribed ablation time.

  10. Feedforward Coordinate Control of a Robotic Cell Injection Catheter.

    Science.gov (United States)

    Cheng, Weyland; Law, Peter K

    2017-08-01

    Remote and robotically actuated catheters are the stepping-stones toward autonomous catheters, where complex intravascular procedures may be performed with minimal intervention from a physician. This article proposes a concept for the positional, feedforward control of a robotically actuated cell injection catheter used for the injection of myogenic or undifferentiated stem cells into the myocardial infarct boundary zones of the left ventricle. The prototype for the catheter system was built upon a needle-based catheter with a single degree of deflection, a 3-D printed handle combined with actuators, and the Arduino microcontroller platform. A bench setup was used to mimic a left ventricle catheter procedure starting from the femoral artery. Using Matlab and the open-source video modeling tool Tracker, the planar coordinates ( y, z) of the catheter position were analyzed, and a feedforward control system was developed based on empirical models. Using the Student's t test with a sample size of 26, it was determined that for both the y- and z-axes, the mean discrepancy between the calibrated and theoretical coordinate values had no significant difference compared to the hypothetical value of µ = 0. The root mean square error of the calibrated coordinates also showed an 88% improvement in the z-axis and 31% improvement in the y-axis compared to the unmodified trial run. This proof of concept investigation leads to the possibility of further developing a feedfoward control system in vivo using catheters with omnidirectional deflection. Feedforward positional control allows for more flexibility in the design of an automated catheter system where problems such as systemic time delay may be a hindrance in instances requiring an immediate reaction.

  11. Magnetic catheter manipulation in the interventional MR imaging environment.

    Science.gov (United States)

    Wilson, Mark W; Martin, Alastair B; Lillaney, Prasheel; Losey, Aaron D; Yee, Erin J; Bernhardt, Anthony; Malba, Vincent; Evans, Lee; Sincic, Ryan; Saeed, Maythem; Arenson, Ronald L; Hetts, Steven W

    2013-06-01

    To evaluate deflection capability of a prototype endovascular catheter, which is remotely magnetically steerable, for use in the interventional magnetic resonance (MR) imaging environment. Copper coils were mounted on the tips of commercially available 2.3-3.0-F microcatheters. The coils were fabricated in a novel manner by plasma vapor deposition of a copper layer followed by laser lithography of the layer into coils. Orthogonal helical (ie, solenoid) and saddle-shaped (ie, Helmholtz) coils were mounted on a single catheter tip. Microcatheters were tested in water bath phantoms in a 1.5-T clinical MR scanner, with variable simultaneous currents applied to the coils. Catheter tip deflection was imaged in the axial plane by using a "real-time" steady-state free precession MR imaging sequence. Degree of deflection and catheter tip orientation were measured for each current application. The catheter tip was clearly visible in the longitudinal and axial planes. Magnetic field artifacts were visible when the orthogonal coils at the catheter tip were energized. Variable amounts of current applied to a single coil demonstrated consistent catheter deflection in all water bath experiments. Changing current polarity reversed the observed direction of deflection, whereas current applied to two different coils resulted in deflection represented by the composite vector of individual coil activations. Microcatheter navigation through the vascular phantom was successful through control of applied current to one or more coils. Controlled catheter deflection is possible with laser lithographed multiaxis coil-tipped catheters in the MR imaging environment. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  12. [Prevention of catheter-related infection: usefulness and cost-effectiveness of antiseptic catheters in children].

    Science.gov (United States)

    Lenz, Ana M; Vassallo, Juan C; Moreno, Guillermo E; Althabe, María; Gómez, Silvia; Magliola, Ricardo; Casimir, Lidia; Bologna, Rosa; Barretta, Jorge; Ruffa, Pablo

    2010-06-01

    To evaluate the cost-effectiveness of the antiseptic-impregnated catheter compared with conventional catheters in preventing catheter- related blood stream infections (CR-BSI). Cost-effectiveness analysis; clinical trial, experimental, randomized, controlled, prospective, open label. Patients and methods. A 172 patient cohort, under 1-year-old or less than 10 kg, postoperative cardiovascular children with central venous catheters (CVC) admitted to Cardiac Intensive Care Unit (UCI 35) at Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", since September 2005 to December 2007. Demographic and CVC data were retrieved to compare: age, gender, weight, diagnosis, surgery, CVC days, costs and complications. Intervention. CVC Arrow, double-lumen, > 48 h of duration; intervention group: antiseptic-impregnated CVC vs. control group: CVC without antiseptics (conventional). The incidence of CR-IE (CR-Infected Events: colonization, local infection and/or CRBSI; combined end point) was 27% for antiseptic- impregnated CVC vs. 31% for conventional catheters (p= 0.6) with similar accumulated incidence of CR- BSI: 2.8 vs. 3.3 per 1000 dayscatheter. We found no differences between groups, except in weight: median 4.0 kg (r 2-17) vs. 4.7 kg (r 2-9) p= 0.0002 and age, median 2 months (r 1- 48) vs. 5 months (r 1- 24) p= 0.0019 in antiseptic-impregnated CVC group. These differences, though statistically significant were clinically non relevant. Median cost per patient during intensive care stay in the conventional CVC group was $3.417 (359-9.453) and in the antiseptic-impregnated-CVC group was $4.962 (239-24.532), p= 0.10. The use of antiseptic-impregnated CVC compared with conventional CVC did not decrease CR-BSI in this population. The cost per patients was higher in the antiseptic impregnated CVC group. These results do not support the routine use of this type of CVC in our population.

  13. Catheter Closure Through a Venous Approach of Patent Ductus Arteriosus in Small Pediatric Patients Using Combined Angiographic and Echocardiographic Guidance.

    Science.gov (United States)

    Thanopoulos, Basil Vasilios D; Ninios, Vlassis; Dardas, Petros; Giannopoulos, Andreas; Deleanou, Dan; Iancovici, Silvia

    2016-11-15

    The standard technique of catheter closure of patent ductus arteriosus (PDA) may be associated with arterial complications particularly in small pediatric patients. The aim of this study was to evaluate whether catheter closure of PDA in small children using an exclusive venous approach is a safe and effective alternative to closure with the standard technique. One hundred-twelve patients, aged 2 to 24 months, were randomly assigned in a 1:1 ratio to catheter closure of PDA using the standard technique (group 1) and an exclusive venous approach (group 2), respectively. In group 2, the procedure was guided using hand injections of contrast media through the delivery sheath and 2-dimensional and color Doppler echocardiography. Group 1: the PDA diameter ranged from 2 to 5.5 mm and the device diameter ranged from 4 to 8 mm. The PDA occluders were permanently implanted in all patients. Five losses of the arterial pulses that were restored with intravenous infusion of heparin and recombinant tissue plasminogen activator (rtPA), and 4 groin hematomas were the main complications of the procedure. Group 2: the mean PDA diameter ranged from 2.5 to 6 mm and the device diameter ranged from 3 to 8 mm. The PDA occluders were permanently implanted in all but 2 patients. There were no complications. Complete echocardiographic closure of PDA at 1-month follow-up was observed in all 110 patients. Exclusive transvenous PDA occlusion is an effective and safe technique that prevents the arterial complications of the standard approach in small children. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Hematologic patients' clinical and psychosocial experiences with implanted long-term central venous catheter

    DEFF Research Database (Denmark)

    Møller, Tom; Adamsen, Lis

    2010-01-01

    A significant decrease in catheter-related infections was demonstrated in our earlier randomized controlled trial of central venous catheter (CVC) care in hematologic patients.......A significant decrease in catheter-related infections was demonstrated in our earlier randomized controlled trial of central venous catheter (CVC) care in hematologic patients....

  15. Percutaneous untying of a knot in a retained Swan-Ganz catheter

    International Nuclear Information System (INIS)

    Bhatti, Waqar A.; Sinha, Sankar; Rowlands, Peter

    2000-01-01

    A patient was referred to us with a tightly knotted Swan-Ganz catheter. The catheter could not be removed by conventional simple methods. We describe a minimally invasive means of removal of the catheter using an Amplatz gooseneck snare and an angioplasty balloon. This allowed the Catheter to be removed without trauma.

  16. Patency of Femoral Tunneled Hemodialysis Catheters and Factors Predictive of Patency Failure

    International Nuclear Information System (INIS)

    Burton, Kirsteen R.; Guo, Lancia L. Q.; Tan, Kong T.; Simons, Martin E.; Sniderman, Kenneth W.; Kachura, John R.; Beecroft, John R.; Rajan, Dheeraj K.

    2012-01-01

    Purpose: To determine the patency rates of and factors associated with increased risk of patency failure in patients with femoral vein tunneled hemodialysis catheters. Methods: All femoral tunneled catheter insertions from 1996 to 2006 were reviewed, during which time 123 catheters were inserted. Of these, 66 were exchanges. Patients with femoral catheter failure versus those with femoral catheter patency were compared. Confounding factors, such as demographic and procedural factors, were incorporated and assessed using univariate and multivariable Cox proportional hazards regression analyses. Results: Mean catheter primary patency failure time was 96.3 days (SE 17.9 days). Primary patency at 30, 60, 90, and 180 days was 53.8%, 45.4%, 32.1%, and 27.1% respectively. Crude rates of risk of catheter failure did not suggest a benefit for patients receiving catheters introduced from one side versus the other, but more cephalad location of catheter tip was associated with improved patency. Multivariate analysis showed that patients whose catheters were on the left side (p = 0.009), were of increasing age at the time of insertion (p = 0.002) and that those who had diabetes (p = 0.001) were at significantly greater risk of catheter failure. The catheter infection rate was 1.4/1000 catheter days. Conclusion: Patients who were of a more advanced age and had diabetes were at greater risk of femoral catheter failure, whereas those who received femoral catheters from the right side were less at risk of catheter failure.

  17. Septic Thrombophlebitis of the Cephalic Vein Caused by a Peripherally Inserted Venous Catheter

    Directory of Open Access Journals (Sweden)

    M Mirmohammadsadeghi

    2005-07-01

    Full Text Available Septic thrombophlebitis of a vein is a rare but life-threatening complication of an intravascular (IV catheter placed percutaneously in the veins. Most published clinical experiences with IV catheters, mainly in the outpatient settings, have reported very low rates of catheter-related bloodstream infection compared to rates with central venous catheters placed in a subclavian or internal jugular vein. Most of the complications reported with IV catheters have been non-infectious, particularly sterile phlebitis or thrombosis. We report a case of cephalic vein suppurative thrombophlebitis from an intravascular catheter and offer guidelines for diagnosis and management of this complication. Key words: Septic thrombophlebitis, Intravascular catheter, Suppurative thrombophlebitis

  18. Advance and permanent public information

    International Nuclear Information System (INIS)

    d'Oleon, C.

    1990-01-01

    The accident at CHERNOBYL highlighted one of the major problems facing the nuclear industry at present and during the years to come: the need to provide information. There are two aspects to this requirement: information at a time of crisis issued when an accident such as that at CHERNOBYL takes place, but which has to be based on a procedure set up before the crisis, and advance and permanent information which prepares the ground for information at a time of crisis. The requirement for information is of particular importance in France, given the preponderance of nuclear energy in the electricity generating industry. The procedure covers the principles which were forcefully asserted by the French public authorities during the CHERNOBYL crisis, the resources strengthened or established at that time, and finally, the introduction of a policy of wider-ranging communication which is based on the idea that one can never compromise with safety

  19. CHALLENGES OF PERMANENT TEACHER TRAINING

    Directory of Open Access Journals (Sweden)

    María Manuela Valles-Ornelas

    2015-07-01

    Full Text Available The new challenges for teachers and managers require to assume permanent formation as a tool for responding effectively and efficiently to them, different perspective to strengthen from the initial teacher education programs. The research was done in a primary school in the state of Chihuahua. The method used was research action, the question was: How can we encourage the lifelong learning and training of the staff of this school, with the purpose to assist them in these processes to improve the service that the school provides to students. The school group is the center of the process, the cooperative and collaborative work accompanied by educational leadership and persuasive provide better results, and all accompanied by the professional selfinvitation.

  20. Monorail Piccolino catheter: a new rapid exchange/ultralow profile coronary angioplasty system.

    Science.gov (United States)

    Mooney, M R; Douglas, J S; Mooney, J F; Madison, J D; Brandenburg, R O; Fernald, R; Van Tassel, R A

    1990-06-01

    The Monorail Piccolino coronary angioplasty balloon catheter (MBC) was evaluated on 118 patients at two centers. Technical success was achieved in 110 patients (93%). Time for catheter exchange and total fluoroscopy time were significantly lower for the Monorail catheter than with standard equipment (exchange time 97 vs. 170 seconds P less than .05 and fluoroscopy time 17 vs. 88 seconds P less than .001). The advantages of rapid exchange and the ability of utilize 2 Monorail balloon catheters through one 9F guiding catheter for simultaneous inflations allowed for maximal flexibility in treating patients with bifurcation lesions. The double wire approach utilizing one Monorail balloon catheter with a 7F guiding catheter was also technically successful. The Monorail Piccolino balloon catheter has unique features that allow for greater ease of operator use, rapid catheter exchange, and optimal angiographic visualization. It is felt that this catheter design provides distinct advantages over standard angioplasty equipment.

  1. Modern permanent magnetic materials - preparation and properties

    International Nuclear Information System (INIS)

    Rodewald, W.

    1989-01-01

    First of all, the basic properties of the classical (steel, AlNiCo) permanent magnetic materials and the modern rare-earth (RE) permanent magnetic materials are compared. Since the properties of RE permanent magnets depend on the particular production process, the fundamentals of the main industrial processes (powder metallurgy, rapid-solidification technique) are described and the typical properties are explained. Furthermore the production processes in development such as mechanical alloying, melt spinning technique and extrusion upsetting are briefly outlined. For applying the permanent magnets, they have to be completely magnetized. The magnetization behaviour of the various RE permanent magnets is discussed by means of the internal demagnetization curve. Finally the various influences on the temperature stability of RE permanent magnets are compiled. (orig./MM) [de

  2. Catheter-Related Urinary Tract Infection in Patients Suffering from Spinal Cord Injuries

    Directory of Open Access Journals (Sweden)

    Amela Dedeić-Ljubović

    2009-02-01

    Full Text Available Urinary tract infection is commoner in patients with spinal cord injuries because of incomplete bladder emptying and the use of catheters that can result in the introduction of bacteria into the bladder. 145 patients suffering from spinal cord injuries, admitted to the Institute for physical medicine and rehabilitation, Centre for paraplegia of the Clinical Centre of the University of Sarajevo, were included. The patients were divided in three groups according to the method of bladder drainage: Group A (n=61 consisted of patients on clean intermittent catheterization; Group B (n=54 consisted of patients with indwelling catheters; Group C (n=30 consisted of patients who had performed self-catheterization. From a total of 4539 urine samples, 3963 (87,3% were positive and 576 (12,7% were sterile. More than 90% of the infected patients were asymptomatic.The overall rate of urinary infection amounted to about 2,1 episodes, and bacteriuria to 8,1 episodes per patient. 77% of infections (113/145 were acquired within seven days from catheterization.Infection was usually polymicrobial; the greatest number of urine samples 1770/3943 (44,9% included more than one bacterium.The vast majority of cases of urinary tract infection and bacteriuria are caused by Gram-negative bacilli and enterococci, commensal organisms of the bowel and perineum, representative of those from the hospital environment. Providencia stuarti (18,9% being the most common, followed by Proteus mirabilis (16,3%, Escherichia coli (11,8%, Pseudomonas aeruginosa (10,2%, Klebsiella pneumoniae (8,1%, Morganella morgani (5,4%, Acinetobacter baumannii (4,6%, Providencia rettgeri (3,5%. 15,7% of isolates were Gram-positive with Enterococcus faecalis (8,6% as the most common. 55,3% of isolates were multidrug-resistant, and the highest rates of resistance were found among Acinetobacter baumannii (87,8%, Providencia rettgeri (86,7%, Pseudomonas aeruginosa (85,4%, Providencia stuarti (84,3% and

  3. Intrusive luxation of 60 permanent incisors

    DEFF Research Database (Denmark)

    Tsilingaridis, Georgios; Malmgren, Barbro; Andreasen, Jens O

    2012-01-01

      Intrusive luxation in the permanent dentition is an uncommon injury but it is considered one of the most severe types of dental trauma because of the risk for damage to the periodontal ligament, pulp and alveolar bone. Management of intrusive luxation in the permanent dentition is controversial....... The purpose of this study was to evaluate pulp survival and periodontal healing in intrusive luxated permanent teeth in relation to treatment alternatives, degree of intrusion and root development....

  4. Catheter Calibration Using Template Matching Line Interpolation Algorithm

    National Research Council Canada - National Science Library

    Nagy, L

    2001-01-01

    ..., such as: image resolution, type of the calibration, algorithm used for contour detection, size of the FOV, other parameters of the image The studied calibration method is the one using catheter size...

  5. Experience with the Bonanno Catheter in the Management of OHSS ...

    African Journals Online (AJOL)

    : A retrospective study of all IVF ... Result: Within the period under review, 234 patients had controlled ... (six intrauterine, one ectopic and one heterotopic pregnancies), giving a clinical ... The Bonanno catheter is a medical device described by.

  6. Urinary catheter related nosocomial infections in paediatric intensive care unit.

    Directory of Open Access Journals (Sweden)

    Tullu M

    1998-04-01

    Full Text Available The present prospective study was carried out in the Paediatric Intensive Care Unit (PICU of a tertiary care teaching hospital in Mumbai. The objective was to determine the incidence, risk factors, mortality and organisms responsible for urinary catheter related infections (UCRI. Colonization and/or bacteriuria was labelled as urinary catheter related infection (UCRI. Forty-four patients with 51 urinary catheters were studied. Incidence of UCRI was 47.06%. Age, female sex and immunocompromised status did not increase the risk of UCRI. Duration of catheter in-situ and duration of stay in the PICU were associated with higher risk of UCRI. The mortality was not increased by UCRI. Commonest organism isolated in UCRI was E. coli, which had maximum susceptibility to nitrofurantoin and amikacin.

  7. Catheter ablation in the treatment of electrical storm: Integrative review

    Directory of Open Access Journals (Sweden)

    Ricardo Teixeira Leal

    2017-09-01

    Conclusion: Catheter ablation is the initial therapy for patients with ischemic cardiomyopathy (ICM and ES. The endocardial approach presents more relevant success rates than the other therapeutic methods presented.

  8. Catheter-Related Sepsis Due to Rhodotorula glutinis

    Science.gov (United States)

    Hsueh, Po-Ren; Teng, Lee-Jene; Ho, Shen-Wu; Luh, Kwen-Tay

    2003-01-01

    We describe a central venous catheter-related (Port-A-Cath; Smiths Industries Medical Systems [SIMS] Deltec, Inc., St. Paul, Minn.) infection caused by Rhodotorula glutinis in a 51-year-old man with nasopharyngeal carcinoma. He was treated with fluconazole for 8 weeks and had the catheter removed. Two isolates of R. glutinis recovered from blood specimens (one obtained via peripheral veins and one via the catheter) before administration of fluconazole and one recovered from the removed catheter 17 days after initiation of fluconazole therapy exhibited high-level resistance to fluconazole (MICs, >256 μg/ml). These three isolates were found to belong to a single clone on the basis of identical antibiotypes determined by the E test (PDM Epsilometer; AB Biodisk, Solna, Sweden) and biotypes determined by API ID32 C (bioMerieux, Marcy I'Etoile, France) and their identical random amplified polymorphic DNA patterns. PMID:12574300

  9. Catheter fracture of intravenous ports and its management.

    Science.gov (United States)

    Wu, Ching-Yang; Fu, Jui-Ying; Feng, Po-Hao; Kao, Tsung-Chi; Yu, Sheng-Yueh; Li, Hao-Jui; Ko, Po-Jen; Hsieh, Hung-Chang

    2011-11-01

    Intravenous ports are widely used for oncology patients. However, catheter fractures may lead to the need for re-intervention. We aimed to identify the risk factors associated with catheter fractures. Between January 1 and December 31, 2006, we retrospectively reviewed the clinical data and plain chest films of 1,505 patients implanted with an intravenous port at Chang Gung Memorial Hospital. Different vascular sites were compared using the chi-square or Fisher's exact test for categorical variables, and the t test was used for continuous variables with normal distribution; P port type Arrow French (Fr.) 8.1 (P port and catheter removal is recommended. Female gender, intravenous port implantation via the subclavian route, and the Arrow Fr. 8.1 port were found to be risk factors. Patients with these risk factors should be monitored closely to avoid catheter fractures.

  10. Radiographic signs of non-venous placement of intended central venous catheters in children

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Erin C. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Taylor, George A. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-02-15

    Central venous catheters (CVCs) are commonly used in children, and inadvertent arterial or extravascular cannulation is rare but has potentially serious complications. To identify the radiographic signs of arterial placement of CVCs. We retrospectively reviewed seven cases of arterially malpositioned CVCs on chest radiograph. These cases were identified through departmental quality-assurance mechanisms and external consultation. Comparison of arterial cases was made with 127 age-matched chest radiographs with CVCs in normal, expected venous location. On each anteroposterior (AP) radiograph we measured the distance of the catheter tip from the right lateral border of the thoracic spine, and the angle of the vertical portion of the catheter relative to the midline. On each lateral radiograph we measured the angle of the vertical portion of each catheter relative to the anterior border of the thoracic spine. When bilateral subclavian catheters were present, the catheter tips were described as crossed, overlapping or uncrossed. On AP radiographs, arterially placed CVCs were more curved to the left, with catheter tip positions located farther to the left of midline than normal venous CVCs. When bilateral, properly placed venous catheters were present, all catheters crossed at the level of the superior vena cava (SVC). When one of the bilateral catheters was in arterial position, neither of the catheters crossed or the inter-catheter crossover distance was exaggerated. On lateral radiographs, there was a marked anterior angulation of the vertical portion of the catheter (mean angle 37 ± 15 standard deviation [SD] in arterial catheters versus 5.9 ± 8.3 SD in normally placed venous catheters). Useful radiographic signs suggestive of unintentional arterial misplacement of vascular catheters include leftward curvature of the vertical portion of the catheter, left-side catheter tip position, lack of catheter crossover on the frontal radiograph, as well as exaggerated

  11. Real-time optical monitoring of permanent lesion progression in radiofrequency ablated cardiac tissue (Conference Presentation)

    Science.gov (United States)

    Singh-Moon, Rajinder P.; Hendon, Christine P.

    2016-02-01

    Despite considerable advances in guidance of radiofrequency ablation (RFA) therapies for atrial fibrillation, success rates have been hampered by an inability to intraoperatively characterize the extent of permanent injury. Insufficient lesions can elusively create transient conduction blockages that eventually reconduct. Prior studies suggest significantly greater met-myoglobin (Mmb) concentrations in the lesion core than those in the healthy myocardium and may serve as a marker for irreversible tissue damage. In this work, we present real-time monitoring of permanent injury through spectroscopic assessment of Mmb concentrations at the catheter tip. Atrial wedges (n=6) were excised from four fresh swine hearts and submerged under pulsatile flow of warm (37oC) phosphate buffered saline. A commercial RFA catheter inserted into a fiber optic sheath allowed for simultaneous measurement of tissue diffuse reflectance (DR) spectra (500-650nm) during application of RF energy. Optical measurements were continuously acquired before, during, and post-ablation, in addition to healthy neighboring tissue. Met-myoglobin, oxy-myoglobin, and deoxy-myoglobin concentrations were extracted from each spectrum using an inverse Monte Carlo method. Tissue injury was validated with Masson's trichrome and hematoxylin and eosin staining. Time courses revealed a rapid increase in tissue Mmb concentrations at the onset of RFA treatment and a gradual plateauing thereafter. Extracted Mmb concentrations were significantly greater post-ablation (p<0.0001) as compared to healthy tissue and correlated well with histological assessment of severe thermal tissue destruction. On going studies are aimed at integrating these findings with prior work on near infrared spectroscopic lesion depth assessment. These results support the use of spectroscopy-facilitated guidance of RFA therapies for real-time permanent injury estimation.

  12. Temperature-controlled irrigated tip radiofrequency catheter ablation

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, Adrian

    1998-01-01

    INTRODUCTION: In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high infusion rates enlarges lesion......: We conclude that temperature-controlled radiofrequency ablation with irrigated tip catheters using low target temperature and low infusion rate enlarges lesion size without increasing the incidence of cratering and reduces coagulum formation of the tip....

  13. Urinary catheter with polyurethane coating modified by ion implantation

    International Nuclear Information System (INIS)

    Kondyurina, I.; Nechitailo, G.S.; Svistkov, A.L.; Kondyurin, A.; Bilek, M.

    2015-01-01

    A low friction urinary catheter that could be used without a lubricant is proposed in this work. A polyurethane coating was synthesised on the surface of a metal guide wire catheter. Ion implantation was applied to surface modify the polyurethane coating. FTIR ATR, wetting angle, AFM and friction tests were used for analysis. Low friction was found to be provided by the formation of a hard carbonised layer on the polyurethane surface

  14. False coronary dissection with the new Monorail angioplasty balloon catheter.

    Science.gov (United States)

    Esplugas, E; Cequier, A R; Sabaté, X; Jara, F

    1990-01-01

    During percutaneous transluminal coronary angioplasty, the appearance of persistent staining in the vessel by contrast media suggests coronary dissection. We report seven patients in whom a false image of severe coronary dissection was observed during angioplasty performed with the new Monorail balloon catheter. This image emerges at the moment of balloon inflation, is distally located to the balloon, and disappears with balloon catheter deflation. No complications were associated with the appearance of this image.

  15. Review of advanced catheter technologies in radiation oncology brachytherapy procedures

    OpenAIRE

    Zhou J; Zamdborg L; Sebastian E

    2015-01-01

    Jun Zhou,1,2 Leonid Zamdborg,1 Evelyn Sebastian1 1Department of Radiation Oncology, Beaumont Health System, 2Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Abstract: The development of new catheter and applicator technologies in recent years has significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. In this paper, we review these advances, focusing on the performance of catheter imaging and reconstruction techniques in brachytherapy ...

  16. Massive hydrothorax with malpositioned central venous catheter – Ultrasound detection

    Directory of Open Access Journals (Sweden)

    Neha Hasija

    2016-04-01

    Full Text Available Radioimaging is the gold standard for confirmation of the position of central venous catheter as well as its related complications. Use of ultrasound has been proven in guiding central venous cannulations, and it can also be used in detecting related complications. We report a case of a 2 year old child with hydrothorax causing desaturation due to malpositioned central venous catheter diagnosed by ultrasound in the delay for getting a radiograph.

  17. Needle catheter duodenostomy: a technique for duodenal alimentation of birds.

    Science.gov (United States)

    Goring, R L; Goldman, A; Kaufman, K J; Roberts, C; Quesenberry, K E; Kollias, G V

    1986-11-01

    A technique for duodenal alimentation (needle catheter duodenostomy) of birds was developed, using the domestic pigeon (Columba livia) as the experimental model. A needle catheter was inserted into the descending duodenum of 5 pigeons and was secured to the body wall and dorsum of each bird. A liquid diet was administered daily (in equal amounts of 0, 4, 8, 12, and 16 hours) for 14 days without adverse effects. On day 15, the catheters were removed, and the birds immediately resumed normal consumption of a pigeon ration and water diet. Although 4 of the 5 birds had minor weight loss, dietary alterations probably could be used on an individual basis to alleviate this problem. After oral alimentation was resumed, the 5 birds exceeded their initial body weight within 7 days. Four weeks after catheter removal, positive-contrast radiographic evaluations indicated that the duodenum of each pigeon appeared normal. Needle catheter duodenostomy was a viable method of alimentation in the domestic pigeon. This technique should be applicable for other avian species requiring bypass of the upper gastrointestinal tract proximal to the region of catheter insertion in the duodenum.

  18. Tunnel unroofing effectiveness in chronic peritoneal catheter infection

    Directory of Open Access Journals (Sweden)

    Lorena Carranza

    2017-04-01

    Full Text Available Introduction: Chronic catheter infection usually involves external Dacron cuff colonization, without its removal, antibiotic treatment proved ineffective. Catheter unroofing technique has been described as an alternative to peritoneal catheter removal. Material and methods: We analyzed the data from 13 patients retrospectively. Evolution after unroofing was evaluated, considering as treatment failure the appearance of new infection in the hole, tunnel or peritonitis associated to the same germ. Results: Between 1997-2014 years, unroofing was performed on 13 patients. Mean age-rate: 46.2 (IC 95%: 35.9 years – 56.5 years male sex 9, 69.23%. Germs: staphylococcus 7, pseudomona 2, polymicrobial 1, negative culture 3. Nine patiens healed: 69.2%; there was no statistical association among sex, age, microbiological result, previous hemodialysis use, type of catheter, surgical technique or with the surgeon who performed the procedure (p≥ 0.05. Discussion: Catheter removal implies transient transference to hemodialysis and new replacement surgery, although there is few experience with this technique, it could be an acceptable alternative, enabling a group of patients to continue with PD treatment. Conclusion: Unroofing technique proved to be beneficial in 69.2% of the cases (9 patients independently of the type of germ present, representing an acceptable treatment which avoids catheter removal, enabling the procedure to continue, and decreasing the need to employ more aggressive therapies.

  19. Cryo-balloon catheter localization in fluoroscopic images

    Science.gov (United States)

    Kurzendorfer, Tanja; Brost, Alexander; Jakob, Carolin; Mewes, Philip W.; Bourier, Felix; Koch, Martin; Kurzidim, Klaus; Hornegger, Joachim; Strobel, Norbert

    2013-03-01

    Minimally invasive catheter ablation has become the preferred treatment option for atrial fibrillation. Although the standard ablation procedure involves ablation points set by radio-frequency catheters, cryo-balloon catheters have even been reported to be more advantageous in certain cases. As electro-anatomical mapping systems do not support cryo-balloon ablation procedures, X-ray guidance is needed. However, current methods to provide support for cryo-balloon catheters in fluoroscopically guided ablation procedures rely heavily on manual user interaction. To improve this, we propose a first method for automatic cryo-balloon catheter localization in fluoroscopic images based on a blob detection algorithm. Our method is evaluated on 24 clinical images from 17 patients. The method successfully detected the cryoballoon in 22 out of 24 images, yielding a success rate of 91.6 %. The successful localization achieved an accuracy of 1.00 mm +/- 0.44 mm. Even though our methods currently fails in 8.4 % of the images available, it still offers a significant improvement over manual methods. Furthermore, detecting a landmark point along the cryo-balloon catheter can be a very important step for additional post-processing operations.

  20. Mechanism of prostatic urethroplasty with balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Maynar, M.; Hulbert, J.

    1988-01-01

    A series of 60 patients have undergone prostatic urethroplasty with balloon catheters at our institution. The follow-up of these patients has ranged from more than 3 years to not less than 6 months. The preliminary results have been excellent, with a success rate of 75% in patients with predominant lateral lobe hypertrophy. This success rate drops to 25% in patients with predominant middle lobe hypertrophy. In previous communications the authors have proposed that the mechanism of prostatic urethral relief of obstruction is due to stretching of the prostatic capsule, tissue compression, and possible subsequent atrophy, as suggested by findings of transrectal US, MR imaging, voiding and retrograde urethrography, and urinary flow studies. Recent clinical information that has led to further animal research has shown that in addition to the previously supposed mechanism of action, separation of the prostatic lobes occurs by splitting of the anterior and posterior commissures of the prostatic gland tissue. This separation of the prostatic lobes is therefore the goal of the procedure. As more experience is gained, the already high success rate can probably be improved

  1. Balloon catheter dilatation of benign urethral strictures

    International Nuclear Information System (INIS)

    Perini, L.; Cavallo, A.; Perin, B.; Bighi, G.

    1988-01-01

    The authors report their experience of benign urethral stricture dilatation by balloon catheter in 11 male patients. Ten posterior and 2 anterior urethral strictures were treated; in 1 patients several narrowings coexisted at various levels. Etiology was inflammatory in 4 cases, iatrogen in 3, post-traumatic in 2, and equivocal in 2. The patients were studied both before and soon after dilatation by means of retrograde and voiding cystourethrogram and uroflowgraphy; the follow-up (2-14 months) was performed by urodynamic alone. In all cases, dilatation was followed by the restoration of urethral gauge, together with prompt functional improvement of urodynamic parameters. The latter result subsisted in time in 9 patients. In 2 cases recurrences were observed demonstrated at once by clinics and urodynamics. Both lesions were successfully re-treated. Neither early not late complication occurred. In spite of the limited material, the valuable results obtained, together with the absence of complications, the peculiar morphology of recurrences, and the chance of repeating it make the procedure advisable as a valid alternative to conventional techniques for these pathologies

  2. Pulsatile flow in ventricular catheters for hydrocephalus

    Science.gov (United States)

    Giménez, Á.; Galarza, M.; Thomale, U.; Schuhmann, M. U.; Valero, J.; Amigó, J. M.

    2017-05-01

    The obstruction of ventricular catheters (VCs) is a major problem in the standard treatment of hydrocephalus, the flow pattern of the cerebrospinal fluid (CSF) being one important factor thereof. As a first approach to this problem, some of the authors studied previously the CSF flow through VCs under time-independent boundary conditions by means of computational fluid dynamics in three-dimensional models. This allowed us to derive a few basic principles which led to designs with improved flow patterns regarding the obstruction problem. However, the flow of the CSF has actually a pulsatile nature because of the heart beating and blood flow. To address this fact, here we extend our previous computational study to models with oscillatory boundary conditions. The new results will be compared with the results for constant flows and discussed. It turns out that the corrections due to the pulsatility of the CSF are quantitatively small, which reinforces our previous findings and conclusions. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.

  3. 3-D analysis of eddy current in permanent magnet of interior permanent magnet motors

    International Nuclear Information System (INIS)

    Kawase, Yoshihiro; Yamaguchi, Tadashi; Fukanaga, Hiromu; Ito, Shokichi

    2002-01-01

    Interior permanent magnet motors are widely used in various fields. However, in high-speed operations, it is important to decrease the eddy current loss in the permanent magnet. In order to decrease the eddy current loss, we propose to divide the permanent magnet. In this paper, we clarified the effect of division of permanent magnet on the eddy current loss using the 3-D finite element method. (Author)

  4. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.

    Science.gov (United States)

    Meddings, Jennifer; Rogers, Mary A M; Krein, Sarah L; Fakih, Mohamad G; Olmsted, Russell N; Saint, Sanjay

    2014-04-01

    Catheter-associated urinary tract infections (CAUTI) are costly, common and often preventable by reducing unnecessary urinary catheter (UC) use. To summarise interventions to reduce UC use and CAUTIs, we updated a prior systematic review (through October 2012), and a meta-analysis regarding interventions prompting UC removal by reminders or stop orders. A narrative review summarises other CAUTI prevention strategies including aseptic insertion, catheter maintenance, antimicrobial UCs, and bladder bundle implementation. 30 studies were identified and summarised with interventions to prompt removal of UCs, with potential for inclusion in the meta-analyses. By meta-analysis (11 studies), the rate of CAUTI (episodes per 1000 catheter-days) was reduced by 53% (rate ratio 0.47; 95% CI 0.30 to 0.64, pSMD) in catheterisation duration (days) was -1.06 overall (p=0.065) including a statistically significant decrease in stop-order studies (SMD -0.37; pSMD, -1.54; p=0.071). No significant harm from catheter removal strategies is supported. Limited research is available regarding the impact of UC insertion and maintenance technique. A recent randomised controlled trial indicates antimicrobial catheters provide no significant benefit in preventing symptomatic CAUTIs. UC reminders and stop orders appear to reduce CAUTI rates and should be used to improve patient safety. Several evidence-based guidelines have evaluated CAUTI preventive strategies as well as emerging evidence regarding intervention bundles. Implementation strategies are important because reducing UC use involves changing well-established habits.

  5. Corporate Policies with Permanent and Transitory Shocks

    NARCIS (Netherlands)

    J-P. Decamps (Jean-Paul); S. Gryglewicz (Sebastian); E. Morellec (Erwan); S. Villeneuve (Stephane)

    2016-01-01

    textabstractWe model the financing, cash holdings, and hedging policies of a firm facing financing frictions and subject to permanent and transitory cash flow shocks. We show that permanent and transitory shocks generate distinct, sometimes opposite, effects on corporate policies and use the model

  6. OAS :: Authorities : Permanent Representatives to the OAS

    Science.gov (United States)

    Rights Actions against Corruption C Children Civil Registry Civil Society Contact Us Culture Cyber Representative of Belize Diego Pary Rodríguez Bolivia Diego Pary Rodríguez Ambassador, Permanent Representative of Bolivia José Luiz Machado Brazil José Luiz Machado e Costa Ambassador, Permanent Representative

  7. Leadership in a (permanent) crisis.

    Science.gov (United States)

    Heifetz, Ronald; Grashow, Alexander; Linsky, Marty

    2009-01-01

    The current economic crisis is not just another rough spell. Today's mix of urgency, high stakes, and uncertainty will continue even after the recession ends. The immediate crisis--which we will get through with policy makers' expert technical adjustments--sets the stage for a sustained, or even permanent, crisis, a relentless series of challenges no one has encountered before. Instead of hunkering down and relying on their familiar expertise to deal with the sustained crisis, people in positions of authority--whether they are CEOs or managers heading up a company initiative--must practice what the authors call adaptive leadership. They must, of course, tackle the underlying causes of the crisis, but they must also simultaneously make the changes that will allow their organizations to thrive in turbulent environments. Adaptive leadership is an improvisational and experimental art, requiring some new practices. Like Julie Gilbert, who overcame internal resistance to reorient Best Buy toward female purchasers, adaptive leaders get things done to meet today's challenges and then modify those things to thrive in tomorrow's world. They also embrace disequilibrium, using turbulence as an opportunity to build crucial new capacities, as Paul Levy did to rescue Beth Israel Deaconess Medical Center from a profound financial crisis. Finally, adaptive leaders, such as Egon Zehnder, the founder of an executive search firm, draw out the leadership skills that reside deep in the organization, recognizing the interdependence of all employees and mobilizing everyone to generate solutions.

  8. Guidelines for removing permanent makeup

    Directory of Open Access Journals (Sweden)

    C.Bettina Rümmelein

    2016-09-01

    Full Text Available Permanent makeup (PMU is a frequently implemented cosmetic procedure performed by beauticians. From a technical point, PMU is considered a facial tattoo. Failed procedures or a change of mind can lead to the desire for removal. The purpose of this retrospective evaluation of patients who came to the clinic with the desire to remove PMU between 2011 and 2015 was to explore the problems, side effects, and results in order to define treatment guidelines for other doctors. We evaluated 87 individual cases in total. In treatable cases, i.e. 52 out of the 87 cases, laser treatments were performed using a nanosecond Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG laser. It takes between 1-12 treatments to remove the PMU. In three cases, the colour of the PMU could not be removed by laser and remained after the treatment. In two cases, laser treatment had to be terminated due to colour changes towards the green-blue spectrum. Before PMU removal, laser test shots are urgently recommended as unforeseeable colour changes can cause severe aesthetically unpleasant results. Covered up PMU (skin colour is particularly susceptible to changes in colour. Heat-induced shrinking of the eye area can cause an ectropium. Surgical solutions also have to be taken into consideration. The use of proper eye protection with intraocular eye shields is mandatory. This article is an attempt to set up some guidelines for the treatment of PMU removal.

  9. Local Intravascular Drug Delivery: In Vitro Comparison of Three Catheter Systems

    International Nuclear Information System (INIS)

    Alfke, Heiko; Wagner, Hans-Joachim; Calmer, Christian; Klose, Klaus Jochen

    1998-01-01

    Purpose: The aim of this in vitro study was to compare different catheter systems for local drug delivery with respect to the penetration depth of a biotin marker solution delivered into the vessel wall. Methods: Post-mortem carotid arteries from pigs were locally infused with a biotin solution using three different catheter systems. With all catheters (microporous balloon catheter, hydrogel-coated balloon catheter, and spiral balloon catheter) we used the same pressure of 405 kPa (4 atm) and infusion times of 60, 90, and 300 sec. After infusion the arteries were histologically prepared and stained using a biotin-specific method. With a light microscope an observer, blinded to the catheter type, scored the amount of biotin within the vessel wall, measured as staining intensity, and the penetration depth of the biotin. Results: Delivery with the hydrogel-coated balloon catheter was limited to the intima and the innermost parts of the media. The spiral balloon and microporous balloon catheter showed both a deeper penetration and a larger amount of delivered biotin compared with the hydrogel catheter, with a slightly deeper penetration using the microporous catheter. The penetration depth showed a correlation with infusion time for the spiral balloon and microporous catheters, but not for the hydrogel-coated catheter. Conclusion: Different catheter designs lead to different patterns of local drug delivery. The differences in penetration depth and amount of the substance delivered to the vessel wall should be known and might be useful for targeting specific areas within the vessel wall

  10. A pilot study to assess adductor canal catheter tip migration in a cadaver model.

    Science.gov (United States)

    Leng, Jody C; Harrison, T Kyle; Miller, Brett; Howard, Steven K; Conroy, Myles; Udani, Ankeet; Shum, Cynthia; Mariano, Edward R

    2015-04-01

    An adductor canal catheter may facilitate early ambulation after total knee arthroplasty, but there is concern over preoperative placement since intraoperative migration of catheters may occur from surgical manipulation and result in ineffective analgesia. We hypothesized that catheter type and subcutaneous tunneling may influence tip migration for preoperatively inserted adductor canal catheters. In a male unembalmed human cadaver, 20 catheter insertion trials were divided randomly into one of four groups: flexible epidural catheter either tunneled or not tunneled; or rigid stimulating catheter either tunneled or not tunneled. Intraoperative patient manipulation was simulated by five range-of-motion exercises of the knee. Distance and length measurements were performed by a blinded regional anesthesiologist. Changes in catheter tip to nerve distance (p = 0.225) and length of catheter within the adductor canal (p = 0.467) were not different between the four groups. Two of five non-tunneled stimulating catheters (40 %) were dislodged compared to 0/5 in all other groups (p = 0.187). A cadaver model may be useful for assessing migration of regional anesthesia catheters; catheter type and subcutaneous tunneling may not affect migration of adductor canal catheters based on this preliminary study. However, future studies involving a larger sample size, actual patients, and other catheter types are warranted.

  11. Atrial fibrillation ablation using a closed irrigation radiofrequency ablation catheter.

    Science.gov (United States)

    Golden, Keith; Mounsey, John Paul; Chung, Eugene; Roomiani, Pahresah; Morse, Michael Andew; Patel, Ankit; Gehi, Anil

    2012-05-01

    Catheter ablation is an effective therapy for symptomatic, medically refractory atrial fibrillation (AF). Open-irrigated radiofrequency (RF) ablation catheters produce transmural lesions at the cost of increased fluid delivery. In vivo models suggest closed-irrigated RF catheters create equivalent lesions, but clinical outcomes are limited. A cohort of 195 sequential patients with symptomatic AF underwent stepwise AF ablation (AFA) using a closed-irrigation ablation catheter. Recurrence of AF was monitored and outcomes were evaluated using Kaplan-Meier survival analysis and Cox proportional hazards models. Mean age was 59.0 years, 74.9% were male, 56.4% of patients were paroxysmal and mean duration of AF was 5.4 years. Patients had multiple comorbidities including hypertension (76.4%), tobacco abuse (42.1%), diabetes (17.4%), and obesity (mean body mass index 30.8). The median follow-up was 55.8 weeks. Overall event-free survival was 73.6% with one ablation and 77.4% after reablation (reablation rate was 8.7%). Median time to recurrence was 26.9 weeks. AF was more likely to recur in patients being treated with antiarrhythmic therapy at the time of last follow-up (recurrence rate 30.3% with antiarrhythmic drugs, 13.2% without antiarrhythmic drugs; hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.1-4.4, P = 0.024) and in those with a history of AF greater than 2 years duration (HR 2.7, 95% CI 1.1-6.9, P = 0.038). Our study represents the largest cohort of patients receiving AFA with closed-irrigation ablation catheters. We demonstrate comparable outcomes to those previously reported in studies of open-irrigation ablation catheters. Given the theoretical benefits of a closed-irrigation system, a large head-to-head comparison using this catheter is warranted. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

  12. [Recording of ventricular pressure by conventional catheter manometer systems. Efficiency of several combinations of conventional catheters, modern transducers and catheter-flush systems (author's transl)].

    Science.gov (United States)

    Hellige, G

    1976-01-01

    The experimentally in vitro determined dynamic response characteristics of 38 catheter manometer systems were uniform in the worst case to 5 c.p.s. and optimally to 26 c.p.s. Accordingly, some systems are only satisfactory for ordinary pressure recording in cardiac rest, while better systems record dp/dt correct up to moderate inotropic stimulation of the heart. In the frequency range of uniform response (amplitude error less +/- 5%) the phase distortion is also negligible. In clinical application the investigator is often restricted to special type of cardiac catheter. In this case a low compliant transducer yields superior results. In all examined systems the combination with MSD 10 transducers is best, whereas the combination with P 23 Db transducers leads to minimal results. An inadequate system for recording ventricular pressure pulses leads in most cases to overestimations of dp/dtmax. The use of low frequency pass filters to attenuate higher frequency artefacts is, under clinical conditions, not suitable for extending the range of uniform frequency response. The dynamic response of 14 catheter manometer systems with two types of continuous self flush units was determined. The use of the P 37 flush unit in combination with small internal diameter catheters leads to serious error in ordinary pressure recording, due to amplitude distortion of the lower harmonics. The frequency response characteristics of the combination of an Intraflow flush system and MSD 10 transducer was similar to the non-flushing P 23 Db transducer feature.

  13. Central venous stenosis in haemodialysis patients without a previous history of catheter placement

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-01-01

    Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term

  14. Central venous stenosis in haemodialysis patients without a previous history of catheter placement.

    Science.gov (United States)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-08-01

    To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

  15. An epidural catheter removal after recent percutaneous coronary intervention and coronary artery stenting: Epidural catheter and antiaggregation therapy

    Directory of Open Access Journals (Sweden)

    Joksić Nikola

    2016-01-01

    Full Text Available Introduction: Anticoagulation and antiplatelet therapy in the presence of the epidural catheter is still controversial. It is well known that dual antiplatelet therapy is indicated for 12 months after the placement of drug-eluting stents (DES. Removal of an epidural catheter during that period is related to an increased risk of stent occlusion in case of discontinuation of platelet function inhibitors or, on the other hand, increased risk of epidural hematoma associated with neurological deficit if suppressed platelet function is still present. Case Report: Here we present a case of a 63-year-old man who was admitted to Institute for Cardiovascular Diseases Dedinje for elective aortic surgery. Before the induction, an epidural catheter was inserted at the Th10-Th11 epidural space. Uneventful surgery was performed under the combined epidural and general anesthesia. On the 2nd postoperative day, the patient sustained a ST depression myocardial infarction treated with percutaneous coronary intervention with DES placement, while epidural catheter was still in place. Dual antiplatelet therapy with 600mg of clopidogrel, 100 mg of acetilsalicylic acid (ASA and low molecular weight heparin (LMWH were started during the procedure. The next day, clopidogrel (75 mg and ASA (100 mg were continued as well as LMWH. The decision to remove the epidural catheter was made on the 9th postoperative day, after platelet aggregation assays were performed. Six hours after catheter removal the patient again received clopidogrel, ASA and LMWH. There were no signs of epidural hematoma. Conclusion: This case shows that point-of-care testing with platelet aggregation assays may be useful in increasing the margin of safety for epidural catheter removal during dual antiplatelet therapy.

  16. Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment.

    Science.gov (United States)

    Richardson, Ian P; Sturtevant, Rachael; Heung, Michael; Solomon, Michael J; Younger, John G; VanEpps, J Scott

    2016-01-01

    Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50°C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature.

  17. Foley Catheter versus Vaginal Misoprostol for Labour Induction

    Directory of Open Access Journals (Sweden)

    Nasreen Noor

    2015-01-01

    Full Text Available Objectives. To compare the efficacy and safety of intravaginal misoprostol with transcervical Foley catheter for labour induction. Material and Methods. One hundred and four women with term gestation, with Bishop score < 4, and with various indications for labour induction were randomly divided into two groups. In Group I, 25 μg of misoprostol tablet was placed intravaginally, 4 hourly up to maximum 6 doses. In Group II, Foley catheter 16F was placed through the internal os of the cervix under aseptic condition and then inflated with 50 cc of sterile saline. Statistical analysis was done using SPSS software. Results. The induction to delivery interval was 14.03 ± 7.61 hours versus 18.40 ± 8.02 hours (p<0.01. The rate of vaginal delivery was 76.7% versus 56.8% in misoprostol and transcervical Foley catheter group, respectively. Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups. Conclusion. Intravaginal misoprostol is associated with a shorter induction to delivery interval as compared to Foley’s catheter and it increases the rate of vaginal delivery in cases of unripe cervix at term. Transcervical Foley catheter is associated with a lower incidence of uterine hyperstimulation during labour.

  18. Fantoni’s Tracheostomy using Catheter High Frequency Jet Ventilation

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    P. Török

    2012-01-01

    Full Text Available Background: It has been shown previously that conventional ventilation delivered through a long cuffed endotracheal tube is associated with a high flow-resistance and frequent perioperative complications. Aim: We attempted to supersede the conventional ventilation by high-frequency jet ventilation through a catheter (HFJV-C and assess safety of the procedure. Material and methods: Using a translaryngeal tracheostomy kit, we performed a translaryngeal (Fantoni tracheostomy (TLT. Subsequently, we introduced a special 2-way prototype ventilatory catheter into the trachea via the TLT under bronchoscopic control. Satisfactory HFJV-C ventilation through the catheter was achieved in 218 patients. Results: There were no significant adverse effects on vital signs observed in the cohort during the study. The pH, SpO2, PaO2, and PaCO2 did not change significantly following the HFJV-C. The intrinsic PEEPi measured in trachea did not exceed 4—5 cm H2O during its application, which was significantly less than during the classical ventilation via the endotracheal tube fluctuating between 12 and 17 cm H2O. No serious medical complications occurred. Conclusion: The HFJV during Fantoni’s tracheostomy using the catheter HFJV-C proved to be a safe and effective method of lung ventilation at the intensive care unit. Key words: Translaryngeal tracheostomy, HFJV via catheter.

  19. Transversus Abdominis Plane Catheter Bolus Analgesia after Major Abdominal Surgery

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    Nils Bjerregaard

    2012-01-01

    Full Text Available Purpose. Transversus abdominis plane (TAP blocks have been shown to reduce pain and opioid requirements after abdominal surgery. The aim of the present case series was to demonstrate the use of TAP catheter injections of bupivacaine after major abdominal surgery. Methods. Fifteen patients scheduled for open colonic resection surgery were included. After induction of anesthesia, bilateral TAP catheters were placed, and all patients received a bolus dose of 20 mL bupivacaine 2.5 mg/mL with epinephrine 5 μg/mL through each catheter. Additional bolus doses were injected bilaterally 12, 24, and 36 hrs after the first injections. Supplemental pain treatment consisted of paracetamol, ibuprofen, and gabapentin. Intravenous morphine was used as rescue analgesic. Postoperative pain was rated on a numeric rating scale (NRS, 0–10 at regular predefined intervals after surgery, and consumption of intravenous morphine was recorded. Results. The TAP catheters were placed without any technical difficulties. NRS scores were ≤3 at rest and ≤5 during cough at 4, 8, 12, 18, 24, and 36 hrs after surgery. Cumulative consumption of intravenous morphine was 28 (23–48 mg (median, IQR within the first 48 postoperative hours. Conclusion. TAP catheter bolus injections can be used to prolong analgesia after major abdominal surgery.

  20. Peripheral intravenous catheter-related phlebitis and related risk factors.

    Science.gov (United States)

    Nassaji-Zavareh, M; Ghorbani, R

    2007-08-01

    Peripheral intravenous catheter-related phlebitis is a common and significant problem in clinical practice. This study aims to investigate the incidence of phlebitis and to evaluate some important related factors. 300 patients admitted to medical and surgical wards of hospitals in Semnan, Iran from April 2003 to February 2004 were prospectively studied. Variables evaluated were age, gender, site and size of catheter, type of insertion and underlying conditions (diabetes mellitus, trauma, infectious disease and burns). Phlebitis was defined when at least four criteria were fulfilled (erythema, pain, tenderness, warmth, induration, palpable cord and swelling). Any patient who was discharged or their catheter removed before three days were excluded. Phlebitis occurred in 26 percent (95 percent confidence interval [CI] 21- 31 percent) of patients. There was no significant relationship between age, catheter bore size, trauma and phlebitis. Related risk factors were gender (odds-ratio [OR] 1.50, 95 percent CI 1.01-2.22), site (OR 3.25, 95 percent CI 2.26-4.67) and type of insertion (OR 2.04, 95 percent CI 1.36-3.05) of catheter, diabetes mellitus (OR 7.78, 95 percent CI 4.59-13.21), infectious disease (OR 6.21, 95 percent CI 4.27-9.03) and burns (OR 3.96, 95 percent CI 3.26-4.82). Phlebitis is still an important and ongoing problem in medical practice. In patients with diabetes mellitus and infectious diseases, more attention is needed.

  1. NURSING CARE IN PATIENTS NEONATES WITH PERIPHERALLY INSERTED CENTRAL CATHETER

    Directory of Open Access Journals (Sweden)

    Anacilda Oliveira Vieira

    2013-12-01

    Full Text Available Introduction: The PICC (peripherally inserted central catheter is a long flexible catheter which is inserted through a peripheral vein, progresses through a needle introducer until the final portion of the vena cava, acquiring characteristics of a central catheter. Objective: To point out the main theoretical and scientific ideas that demonstrate the reliability, competence and ability of nurses to perform the PICC. Methodology: Systematic review of articles, which were found by searching the database scientific journals and bibliographies area. Results: The success of integration depends on the patient assessment and choice of venous access where the catheter will be positioned, and its tip should be in the middle third of the superior vena cava, or the middle third of the inferior vena cava. In neonates, which are used more frequently, proper positioning of the catheter is through nursing care in making the dressing, and the first 24 hours it should be compressive. Ideally, the PICC remains in the vein for periods longer than seven days or until the end of treatment, thus decreasing invasive procedures. Conclusion: According to the Federal Board of Nursing (COFEN, it is lawful for the insertion of PICC nurses, provided it has undergone professional training.

  2. Permanent multipole magnets with adjustable strength

    International Nuclear Information System (INIS)

    Halbach, K.

    1983-01-01

    Preceded by a short discussion of the motives for using permanent magnets in accelerators, a new type of permanent magnet for use in accelerators is presented. The basic design and most important properties of a quadrople will be described that uses both steel and permanent magnet material. The field gradient produced by this magnet can be adjusted without changing any other aspect of the field produced by this quadrupole. The generalization of this concept to produce other multipole fields, or combination of multipole fields, will also be presented

  3. Nanocrystalline permanent magnets with enhanced properties

    International Nuclear Information System (INIS)

    Leonowicz, M.

    2002-01-01

    Parameters of permanent magnets result from the combination of intrinsic properties such as saturation magnetization, magnetic exchange, and magnetocrystalline energy, as well as microstructural parameters such as phase structure, grain size, and orientation. Reduction of grain size into nanocrystalline regime (∼ 50 nm) leads to the enhanced remanence which derives from ferromagnetic exchange coupling between highly refined grains. In this study the fundamental phenomena, quantities, and structure parameters, which define nanophase permanent magnets are presented and discussed. The theoretical considerations are confronted with experimental data for nanocrystalline Sm-Fe-N type permanent magnets. (author)

  4. Permanent molars: Delayed development and eruption

    Directory of Open Access Journals (Sweden)

    Arathi R

    2006-05-01

    Full Text Available Delayed development and eruption of all the permanent molars is a rare phenomenon, which can cause disturbance in the developing occlusion. The eruption of permanent first and second molars is very important for the coordination of facial growth and for providing sufficient occlusal support for undisturbed mastication. In the case described, the first permanent molars were delayed in their development and were seen erupting at the age of nine and a half years. Severe disparity between the left and the right side of the dentition with respect to the rate of development of molars were also present.

  5. Reactor safety review of permanent changes

    International Nuclear Information System (INIS)

    Lam, K.F.

    1997-01-01

    Operational compliance engineers review all changes as part of a change control process. Each change, permanent or temporary, is required to undergo an intricate review process to ensure that the benefits associated with the change outweigh the risk. For permanent changes, it is necessary to ensure that the proposed design meets the nuclear safety requirements, conforms to the licensing requirements and complies with regulatory requirements. In addition, during installation of the permanent change and prior to in-service, a configuration management process is in place to align the change with operating and maintenance documents. (author)

  6. Permanent multipole magnets with adjustable strength

    International Nuclear Information System (INIS)

    Halbach, K.

    1983-03-01

    Preceded by a short discussion of the motives for using permanent magnets in accelerators, a new type of permanent magnet for use in accelerators is presented. The basic design and most important properties of a quadrupole will be described that uses both steel and permanent magnet material. The field gradient produced by this magnet can be adjusted without changing any other aspect of the field produced by this quadrupole. The generalization of this concept to produce other multipole fields, or combination of multipole fields, will also be presented

  7. Spontaneous rotation of the monorail-type guide extension support catheter during advancement of a curved guiding catheter: the potential hazard of twisting with the coronary guidewire.

    Science.gov (United States)

    Hashimoto, Sho; Takahashi, Akihiko; Yamada, Takeshi; Mizuguchi, Yukio; Taniguchi, Norimasa; Hata, Tetsuya; Nakajima, Shunsuke

    2017-11-20

    The extension support guiding catheter has been used to perform complex percutaneous coronary intervention to increase back-up support for the guiding catheter or to ensure deep intubation for device delivery. However, because of its monorail design, advancement of the stent into the distal extension tubing segment is sometimes problematic. Although this problem is considered due to simple collision of the stent, operators have observed tangling between a monorail extension catheter and coronary guidewire in some patients. To examine movement of the collar of the extension guide catheter during advancement of the guiding catheter, we set up an in vitro model in which the guiding catheter had two curves. Rotation of the extension guide catheter was examined by both fluoroscopic imaging and movement of the hub of the proximal end of the catheter. During advancement in the first curve, the collar moved toward the outer side of the curve of the guiding catheter as the operator pushed the shaft of the extension guiding catheter, which overrode the guidewire. After crossing the first curve, the collar moved again to the outer side of the second curve (the inner side of the first curve) of the mother catheter, and then, another clockwise rotation was observed in the proximal hub. Consequently, the collar and tubing portion of the extension guide catheter rotated 360° around the coronary guidewire, and the monorail extension catheter and guidewire became tangled. There is a potential risk of unintentional twisting with the guidewire during advancement into the curved guiding catheter because of its monorail design.

  8. Radioecological sensitivity of permanent grasslands

    International Nuclear Information System (INIS)

    Besson, Benoit

    2009-01-01

    The project 'SENSIB' of the Institute for Radiological Protection and Nuclear Safety (IRSN) aims at characterizing and classifying parameters with significant impact on the transfer of radioactive contaminants in the environment. This thesis is focused on permanent grassland areas. Its objectives are the analysis of the activity variations of two artificial radionuclides ( 137 Cs and 90 Sr) in the chain from soil to dairy products as well as the categorization of ecological and anthropogenic parameters, which determine the sensitivity of the studied area. For this study, in situ sampling is carried out in 15 farms in 3 different French regions (Charente, Puy-de-Dome and Jura). The sampling sites are chosen according to their natural variations (geology, altitude and climate) and the soil types. Additionally to the radiologic measurements, geographic, soil and vegetation data as well as data concerning cattle-rearing and cheese manufacturing processes are gathered. From the soil to the grass vegetation, 137 Cs transfer factors vary between 3 x 10-3 and 148 x 10-3 Bq kg-1 (dry weight) per Bq kg-1 (dry weight) (N = 73). Theses transfer factors are significantly higher in the Puy-de-Dome region than in the Jura region. The 137 Cs transfer factor from cattle feed to milk varies from 5.9 x 10-3 to 258 x 10-3 Bq kg-1 (fresh weight) per Bq kg-1 (dry weight) (N = 28). Statistically, it is higher in the Charente region. Finally, the 90 Sr transfer factor from milk to cheese ranges from 3.9 to 12.1. The studied site with the highest factor is the Jura (N = 25). The link between milk and dairy products is the stage with the most 137 Cs and 90 Sr transfers. A nonlinear approach based on a discretization method of the transfer factor with multiple comparison tests admits a classification of the sensitivity factors from soil to grass vegetation. We can determine 20 factors interfering in the 137 Cs transfer into the vegetation, for instance, the clay rate of the soils or a marker

  9. Compatibility of electrolytically produced sodium hypochlorite solutions on long- term implanted dialysis catheters.

    Science.gov (United States)

    Mishkin, G J

    2007-01-01

    More than 20% of the world's population use a catheter for dialysis, despite guidelines limiting their use. Although the structure and design of the catheters differ by manufacturer, the material used in central venous catheters and peritoneal dialysis catheters are the same across manufacturers. Given the long-term use of these catheters in the dialysis population, the good compatibility of the antiseptics and disinfectants used on the catheters is imperative to prevent failure and cracking of the catheter material. Tensile strengths of commercially available catheters were measured after exposure to commonly used disinfectants. The tensile strength was then compared between the catheters by analyzing the displacement vs. force (N) curves produced during the evaluation. A total of 44 catheter lumens were evaluated. The electrolytically produced sodium hypochlorite solution, Alcavis 50/ExSept Plus, was the only solution shown to be compatible with all three catheter materials resulting in a deviation of less than 10% for each of the different catheter types. Electrolytically produced sodium hypochlorite solutions were the only solutions in this study that did not alter the physical properties of any of the catheters after long-term exposure.

  10. Outcome of tunneled infusion catheters inserted via the right internal jugular vein

    International Nuclear Information System (INIS)

    Shin, Sung Wook; Do, Young Soo; Choo, Sung Wook; Yoo, Wi Kang; Choo, In Wook; Kim, Jae Hyung

    2003-01-01

    To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheter were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted, namely the one case of thrombophlebitis. Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein

  11. Continuous measurement of reticuloruminal pH values in dairy cows during the transition period from barn to pasture feeding using an indwelling wireless data transmitting unit.

    Science.gov (United States)

    Gasteiner, J; Horn, M; Steinwidder, A

    2015-04-01

    This study was performed to investigate the effect of the transition from barn feeding to pasture on the pattern of reticuloruminal pH values in 8 multiparous dairy cows. A indwelling wireless data transmitting system for pH measurement was given to 8 multiparous cows orally. Reticuloruminal pH values were measured every 600 s over a period of 42 days. After 7 days of barn feeding (period 1), all of the animals were pastured with increasing grazing times from 2 to 7 h/day over 7 days (period 2). From day 15 to day 21 (period 3), the cows spent 7 h/day on pasture. Beginning on day 22, the animals had 20 h/day access to pasture (day and night grazing). To study reticuloruminal adaptation to pasture feeding, the phase of day and night grazing was subdivided into another 3 weekly periods (periods 4-6). Despite a mild transition period from barn feeding to pasture, significant effects on reticuloruminal pH values were observed. During barn feeding, the mean reticuloruminal pH value for all of the cows was 6.44 ± 0.14, and the pH values decreased significantly (p pH values increased again (pH 6.25 ± 0.22; pH 6.31 ± 0.17; pH 6.37 ± 0.16). Our results showed that the animals had significantly lowered reticuloruminal pH during the periods of feed transition from barn to pasture feeding. Despite these significant changes, the decrease was not harmful, as indicated by data of feed intake and milk production. Journal of Animal Physiology and Animal Nutrition © 2014 Blackwell Verlag GmbH.

  12. Perforation of the IVC: Rule Rather Than Exception After Longer Indwelling Times for the Günther Tulip and Celect Retrievable Filters

    International Nuclear Information System (INIS)

    Durack, Jeremy C.; Westphalen, Antonio C.; Kekulawela, Stephanie; Bhanu, Shiv B.; Avrin, David E.; Gordon, Roy L.; Kerlan, Robert K.

    2012-01-01

    Purpose: This study was designed to assess the incidence, magnitude, and impact upon retrievability of vena caval perforation by Günther Tulip and Celect conical inferior vena cava (IVC) filters on computed tomographic (CT) imaging. Methods: Günther Tulip and Celect IVC filters placed between July 2007 and May 2009 were identified from medical records. Of 272 IVC filters placed, 50 (23 Günther Tulip, 46%; 27 Celect, 54%) were retrospectively assessed on follow-up abdominal CT scans performed for reasons unrelated to the filter. Computed tomography scans were examined for evidence of filter perforation through the vena caval wall, tilt, or pericaval tissue injury. Procedure records were reviewed to determine whether IVC filter retrieval was attempted and successful. Results: Perforation of at least one filter component through the IVC was observed in 43 of 50 (86%) filters on CT scans obtained between 1 and 880 days after filter placement. All filters imaged after 71 days showed some degree of vena caval perforation, often as a progressive process. Filter tilt was seen in 20 of 50 (40%) filters, and all tilted filters also demonstrated vena caval perforation. Transjugular removal was attempted in 12 of 50 (24%) filters and was successful in 11 of 12 (92%). Conclusions: Longer indwelling times usually result in vena caval perforation by retrievable Günther Tulip and Celect IVC filters. Although infrequently reported in the literature, clinical sequelae from IVC filter components breaching the vena cava can be significant. We advocate filter retrieval as early as clinically indicated and increased attention to the appearance of IVC filters on all follow-up imaging studies.

  13. Perforation of the IVC: rule rather than exception after longer indwelling times for the Günther Tulip and Celect retrievable filters.

    Science.gov (United States)

    Durack, Jeremy C; Westphalen, Antonio C; Kekulawela, Stephanie; Bhanu, Shiv B; Avrin, David E; Gordon, Roy L; Kerlan, Robert K

    2012-04-01

    This study was designed to assess the incidence, magnitude, and impact upon retrievability of vena caval perforation by Günther Tulip and Celect conical inferior vena cava (IVC) filters on computed tomographic (CT) imaging. Günther Tulip and Celect IVC filters placed between July 2007 and May 2009 were identified from medical records. Of 272 IVC filters placed, 50 (23 Günther Tulip, 46%; 27 Celect, 54%) were retrospectively assessed on follow-up abdominal CT scans performed for reasons unrelated to the filter. Computed tomography scans were examined for evidence of filter perforation through the vena caval wall, tilt, or pericaval tissue injury. Procedure records were reviewed to determine whether IVC filter retrieval was attempted and successful. Perforation of at least one filter component through the IVC was observed in 43 of 50 (86%) filters on CT scans obtained between 1 and 880 days after filter placement. All filters imaged after 71 days showed some degree of vena caval perforation, often as a progressive process. Filter tilt was seen in 20 of 50 (40%) filters, and all tilted filters also demonstrated vena caval perforation. Transjugular removal was attempted in 12 of 50 (24%) filters and was successful in 11 of 12 (92%). Longer indwelling times usually result in vena caval perforation by retrievable Günther Tulip and Celect IVC filters. Although infrequently reported in the literature, clinical sequelae from IVC filter components breaching the vena cava can be significant. We advocate filter retrieval as early as clinically indicated and increased attention to the appearance of IVC filters on all follow-up imaging studies.

  14. Balloon catheter dilation of benign esophageal stenosis in children

    International Nuclear Information System (INIS)

    Fan Guoping; Yu Juming; Zhong Weixing; Zhu Ming; Wu Yeming; Shi Chengren

    2001-01-01

    Objective: To evaluate the methods and effect of balloon catheter dilation of benign esophageal stenosis in children. Methods: 9 cases had an anastomotic stenosis after surgical correction of esophageal atresia; 11 cases of esophageal stenosis due to ingestion of caustics; one case had an lower esophageal stenosis after Nissen surgery and one case after gastro-esophagoplasty. Age ranged from 17 days to 7 years. Each case had a barium esophagram before balloon dilation. The balloon size varied from 3 to 10 mm in diameter. Results: 21 cases were successful after dilation of balloon catheter. There were no esophageal perforation and complications. The satisfactory results maintained from six months to thirty months. Conclusions: Balloon catheter dilation is a simple, safe and reliable method for the treatment of benign esophageal strictures in children as the first choice

  15. Nonuniform radiation damage in permanent magnet quadrupoles.

    Science.gov (United States)

    Danly, C R; Merrill, F E; Barlow, D; Mariam, F G

    2014-08-01

    We present data that indicate nonuniform magnetization loss due to radiation damage in neodymium-iron-boron Halbach-style permanent magnet quadrupoles. The proton radiography (pRad) facility at Los Alamos uses permanent-magnet quadrupoles for magnifying lenses, and a system recently commissioned at GSI-Darmsdadt uses permanent magnets for its primary lenses. Large fluences of spallation neutrons can be produced in close proximity to these magnets when the proton beam is, intentionally or unintentionally, directed into the tungsten beam collimators; imaging experiments at LANL's pRad have shown image degradation with these magnetic lenses at proton beam doses lower than those expected to cause damage through radiation-induced reduction of the quadrupole strength alone. We have observed preferential degradation in portions of the permanent magnet quadrupole where the field intensity is highest, resulting in increased high-order multipole components.

  16. Macroscopic simulation of isotropic permanent magnets

    International Nuclear Information System (INIS)

    Bruckner, Florian; Abert, Claas; Vogler, Christoph; Heinrichs, Frank; Satz, Armin; Ausserlechner, Udo; Binder, Gernot; Koeck, Helmut; Suess, Dieter

    2016-01-01

    Accurate simulations of isotropic permanent magnets require to take the magnetization process into account and consider the anisotropic, nonlinear, and hysteretic material behaviour near the saturation configuration. An efficient method for the solution of the magnetostatic Maxwell equations including the description of isotropic permanent magnets is presented. The algorithm can easily be implemented on top of existing finite element methods and does not require a full characterization of the hysteresis of the magnetic material. Strayfield measurements of an isotropic permanent magnet and simulation results are in good agreement and highlight the importance of a proper description of the isotropic material. - Highlights: • Simulations of isotropic permanent magnets. • Accurate calculation of remanence magnetization and strayfield. • Comparison with strayfield measurements and anisotropic magnet simulations. • Efficient 3D FEM–BEM coupling for solution of Maxwell equations.

  17. Nonuniform radiation damage in permanent magnet quadrupoles

    International Nuclear Information System (INIS)

    Danly, C. R.; Merrill, F. E.; Barlow, D.; Mariam, F. G.

    2014-01-01

    We present data that indicate nonuniform magnetization loss due to radiation damage in neodymium-iron-boron Halbach-style permanent magnet quadrupoles. The proton radiography (pRad) facility at Los Alamos uses permanent-magnet quadrupoles for magnifying lenses, and a system recently commissioned at GSI-Darmsdadt uses permanent magnets for its primary lenses. Large fluences of spallation neutrons can be produced in close proximity to these magnets when the proton beam is, intentionally or unintentionally, directed into the tungsten beam collimators; imaging experiments at LANL’s pRad have shown image degradation with these magnetic lenses at proton beam doses lower than those expected to cause damage through radiation-induced reduction of the quadrupole strength alone. We have observed preferential degradation in portions of the permanent magnet quadrupole where the field intensity is highest, resulting in increased high-order multipole components

  18. Nonuniform radiation damage in permanent magnet quadrupoles

    Energy Technology Data Exchange (ETDEWEB)

    Danly, C. R.; Merrill, F. E.; Barlow, D.; Mariam, F. G. [Los Alamos National Laboratory, Los Alamos, New Mexico 87544 (United States)

    2014-08-15

    We present data that indicate nonuniform magnetization loss due to radiation damage in neodymium-iron-boron Halbach-style permanent magnet quadrupoles. The proton radiography (pRad) facility at Los Alamos uses permanent-magnet quadrupoles for magnifying lenses, and a system recently commissioned at GSI-Darmsdadt uses permanent magnets for its primary lenses. Large fluences of spallation neutrons can be produced in close proximity to these magnets when the proton beam is, intentionally or unintentionally, directed into the tungsten beam collimators; imaging experiments at LANL’s pRad have shown image degradation with these magnetic lenses at proton beam doses lower than those expected to cause damage through radiation-induced reduction of the quadrupole strength alone. We have observed preferential degradation in portions of the permanent magnet quadrupole where the field intensity is highest, resulting in increased high-order multipole components.

  19. Genetics Home Reference: permanent neonatal diabetes mellitus

    Science.gov (United States)

    ... AL. Update on mutations in glucokinase (GCK), which cause maturity-onset diabetes of the young, permanent neonatal diabetes, and hyperinsulinemic hypoglycemia. Hum Mutat. 2009 Nov;30(11):1512-26. ...

  20. [Permanent education in health: a review].

    Science.gov (United States)

    Miccas, Fernanda Luppino; Batista, Sylvia Helena Souza da Silva

    2014-02-01

    To undertake a meta-synthesis of the literature on the main concepts and practices related to permanent education in health. A bibliographical search was conducted for original articles in the PubMed, Web of Science, LILACS, IBECS and SciELO databases, using the following search terms: "public health professional education", "permanent education", "continuing education", "permanent education health". Of the 590 articles identified, after applying inclusion and exclusion criteria, 48 were selected for further analysis, grouped according to the criteria of key elements, and then underwent meta-synthesis. The 48 original publications were classified according to four thematic units of key elements: 1) concepts, 2) strategies and difficulties, 3) public policies and 4) educational institutions. Three main conceptions of permanent education in health were found: problem-focused and team work, directly related to continuing education and education that takes place throughout life. The main strategies for executing permanent education in health are discussion, maintaining an open space for permanent education , and permanent education clusters. The most limiting factor is mainly related to directly or indirect management. Another highlight is the requirement for implementation and maintenance of public policies, and the availability of financial and human resources. The educational institutions need to combine education and service aiming to form critical-reflexive graduates. The coordination between health and education is based as much on the actions of health services as on management and educational institutions. Thus, it becomes a challenge to implement the teaching-learning processes that are supported by critical-reflexive actions. It is necessary to carry out proposals for permanent education in health involving the participation of health professionals, teachers and educational institutions. To undertake a meta-synthesis of the literature on the main concepts and

  1. Radioelement gauges. Appliances intended for permanent installation

    International Nuclear Information System (INIS)

    1975-08-01

    The present norm defines for radioelement gauges intended for permanent installation: a classification of instruments and beam shutter devices; recommended construction techniques which satisfy health physics requirements; monitoring and test methods; information which must appear on the instruments [fr

  2. Canadian Eskimo permanent tooth emergence timing.

    Science.gov (United States)

    Mayhall, J T; Belier, P L; Mayhall, M F

    1978-08-01

    To identify the times of emergence of the permanent teeth of Canadian Eskimos (Inuit), 368 children and adolescents were examined. The presence or absence of all permanent teeth except the third molars was recorded and these data subjected to probit analysis. Female emergence times were advanced over males. Generally, the Inuit of both sexes showed statistically significant earlier emergence times than Montreal children, except for the incisors. The present results do not support hypotheses indicating that premature extraction of the deciduous teeth advances the emergence of their succedaneous counterparts. There is some indication the controls of deciduous tooth emergence continue to play some part in emergence of the permanent dentition, especially the first permanent teeth that emerge.

  3. Multiple Unerupted Permanent Teeth Associated with Noonan ...

    African Journals Online (AJOL)

    [2] Oral findings in patients with NS include a high arched palate ... the atypical dental anomalies such as multiple unerupted permanent ... clinical features in a child with NS. .... Disabilities, Centers for Disease Control and Prevention (CDC).

  4. Hydrophilic-coated catheter appreciation study in a pediatric population

    Science.gov (United States)

    Boucher, Andréanne; Cloutier, Jonathan; Lebel, Sylvie; Hamel, Micheline; Lamontagne, Pascale; Bolduc, Stéphane

    2010-01-01

    Objective: The objective of the paper was to compare the satisfaction of hydrophilic-coated catheters (HC) (SpeediCath, Coloplast Canada, Mississauga, ON) versus uncoated catheters in a pediatric neurogenic bladder population, in order to identify a target group for HC. The main hypothesis was that our patients, with regard to their limitations, might have difficulties using the HC. Material and methods: A comparative prospective study was initiated in one pediatric rehabilitation centre. Out of the 39 patients who tried the HC during a routine clinic visit, 31 patients/parents accepted to participate in a 1-week trial and to answer a satisfaction questionnaire. Their medical records were reviewed for age, neurological disease, intellectual deficit, impaired dexterity and method of catheterization (Mitrofanoff/urethra). Results: Thirty of the 31 patients answered the satisfaction questionnaire. The median age for the 30 patients was 13.5 years (range 6–20 years). Of these patients, 19 were females (63%), 26 performed self-catheterization (87%), and 6 had Mitrofanoff (20%). Ten children (33%) would be ready to proceed with HC and all 10 children would receive catheterization by the urethra. Of these, 9 were females (90%), 8 used compact-HC (80%) and all were self-sufficient. Patients using compact-HC would continue with this catheter. In the patient comments, males catheterizing per-urethra and patients using a continent stoma requiring long catheters had problems with the excess of lubricant. Conclusion: Most children preferred their usual uncoated catheter and would not change for HC. Female patients catheterizing per-urethra with a compact-HC seem to benefit most from this catheter. PMID:21749816

  5. Magnetic spring based on two permanent magnets

    International Nuclear Information System (INIS)

    Tsivilitsin, V.Yu.; Mil'man, Yu.V.; Goncharuk, V.A.; Bondar, I.B.

    2011-01-01

    A new type of the magnetic spring construction 'two permanent magnets' has been considered. A mathematical expression for the estimation of a pulling-in force has been offered. This expression is verified experimentally on the produced operating magnetic spring. The theoretical and experimental data are in good accordance. A number of advantages of the magnetic spring over the construction 'permanent magnet - magnetic circuit' such as an insignificant friction force between two magnets and a higher pulling force are discussed.

  6. Permanent Magnet Dipole for DIRAC Design Report

    CERN Document Server

    Vorozhtsov, Alexey

    2012-01-01

    Two dipole magnets including one spare unit are needed for the for the DIRAC experiment. The proposed design is a permanent magnet dipole. The design based on Sm2Co17 blocks assembled together with soft ferromagnetic pole tips. The magnet provides integrated field strength of 24.6 10-3 T×m inside the aperture of 60 mm. This Design Report summarizes the main magnetic and mechanic design parameters of the permanent dipole magnets.

  7. [Delayed (tension) pneumothorax after placement of a central venous catheter].

    Science.gov (United States)

    Tan, E C; van der Vliet, J A

    1999-09-11

    Laborious attempts at introducing a central venous catheter for parenteral nutrition in two women, aged 36 and 62 years, were followed by shortness of breath after 32 and 10 hours, respectively. This symptom was due to a (tension) pneumothorax not visible on earlier roentgenograms. Thoracic drainage led to recovery. In all patients with a central venous catheter an undetected delayed pneumothorax can be present. Urgent chest X-ray examination should be performed in all patients with acute respiratory symptoms. Patients undergoing elective intubation with positive pressure breathing should be examined carefully, since they are at risk of developing a late (tension) pneumothorax.

  8. Spontaneous migration of central venous catheter tip following extubation

    Directory of Open Access Journals (Sweden)

    Balaji Prabaharan

    2014-01-01

    Full Text Available Migration of the tip of central venous catheters is not an uncommon event and the mechanism for this is not clear. Increased intrathoracic pressure due to coughing, sneezing or weight lifting, changing the body position or physical movements such as abduction or adduction of the arms is thought to be the cause of such migration. We present here a case of a patient with a port catheter tip that migrated from the left subclavian to the superior vene cava following extubation.

  9. Central Venous Catheter-related Fungemia Caused by Rhodotorula glutinis.

    Science.gov (United States)

    Miglietta, Fabio; Letizia Faneschi, Maria; Braione, Adele; Palumbo, Claudio; Rizzo, Adriana; Lobreglio, Giambattista; Pizzolante, Maria

    2015-01-01

    Bloodstream infection due to Rhodotorula glutinis is extremely rare and mostly associated with underlying immunosuppression or cancer. Vascular access devices provide the necessary surfaces for biofilm formation and are currently responsible for a significant percentage of human infections. In this work, we describe a rare case of central venous catheter-related Rhodotorula glutinis fungemia in a female patient with acute myelogenous leukemia in remission. The timely removal of central venous catheter was an essential element for overcoming this CVC-related Rhodotorula fungemia.

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

    International Nuclear Information System (INIS)

    Shroff, G.S.; Guirguis, M.S.; Ferguson, E.C.; Oldham, S.A.A.; Kantharia, B.K.

    2014-01-01

    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

  11. Cost-effectiveness of a central venous catheter care bundle.

    Directory of Open Access Journals (Sweden)

    Kate A Halton

    Full Text Available BACKGROUND: A bundled approach to central venous catheter care is currently being promoted as an effective way of preventing catheter-related bloodstream infection (CR-BSI. Consumables used in the bundled approach are relatively inexpensive which may lead to the conclusion that the bundle is cost-effective. However, this fails to consider the nontrivial costs of the monitoring and education activities required to implement the bundle, or that alternative strategies are available to prevent CR-BSI. We evaluated the cost-effectiveness of a bundle to prevent CR-BSI in Australian intensive care patients. METHODS AND FINDINGS: A Markov decision model was used to evaluate the cost-effectiveness of the bundle relative to remaining with current practice (a non-bundled approach to catheter care and uncoated catheters, or use of antimicrobial catheters. We assumed the bundle reduced relative risk of CR-BSI to 0.34. Given uncertainty about the cost of the bundle, threshold analyses were used to determine the maximum cost at which the bundle remained cost-effective relative to the other approaches to infection control. Sensitivity analyses explored how this threshold alters under different assumptions about the economic value placed on bed-days and health benefits gained by preventing infection. If clinicians are prepared to use antimicrobial catheters, the bundle is cost-effective if national 18-month implementation costs are below $1.1 million. If antimicrobial catheters are not an option the bundle must cost less than $4.3 million. If decision makers are only interested in obtaining cash-savings for the unit, and place no economic value on either the bed-days or the health benefits gained through preventing infection, these cost thresholds are reduced by two-thirds. CONCLUSIONS: A catheter care bundle has the potential to be cost-effective in the Australian intensive care setting. Rather than anticipating cash-savings from this intervention, decision

  12. Evaluation of the safety of latrogenic lntestinal perforation during placement of percutaneous drainage catheter in rabbit

    International Nuclear Information System (INIS)

    Lee, Choon Hyeong; Oh, Joo Hyung; Park, Ga Young; Shin, Hong Sub; Kim, In Sub; Yoon, Yup; Lee, Dong Ho; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won

    1996-01-01

    To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. Eight 8-F straight catheters were percutaneously inserted into the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed in all animals ten days after catheter placement, and gross and microscopic examination was carried out. Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. Although further study is warranted, our study with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications

  13. Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

    International Nuclear Information System (INIS)

    Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook

    1995-01-01

    To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy

  14. Radiologic interventional retrieval of retained central venous catheter fragment in prematurity: case report

    International Nuclear Information System (INIS)

    Park, Jee Won; Jo, Jung Hyun; Park, Byeong Ho

    2007-01-01

    The fracture of a central venous catheter is a rare but potentially serious complication. Moreover, removal of the broken catheter pieces is considerably challenging, especially for premature infants. We report 3 case studies of the percutaneous transcatheter retrieval of broken catheter parts in 3 premature infants. We confirmed the location of the catheter fragments via a DSA venogram with diluted contrast media. Using the minimum amount of contrast, and extreme caution, we made certain no contrast-induced nephrotoxicity of air embolism occurred during catheter manipulation. In addition, when the broken fragment was curled or attached to the cardiac wall, we used a hook-shaped catheter to facilitate the capturing of the catheter with a loopsnare. This report demonstrates the feasibility of removing a retained catheter fragment in a premature infant using a percutaneous transcatheter approach

  15. Evaluation of the safety of latrogenic lntestinal perforation during placement of percutaneous drainage catheter in rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Choon Hyeong; Oh, Joo Hyung; Park, Ga Young; Shin, Hong Sub; Kim, In Sub; Yoon, Yup; Lee, Dong Ho; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. Eight 8-F straight catheters were percutaneously inserted into the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed in all animals ten days after catheter placement, and gross and microscopic examination was carried out. Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. Although further study is warranted, our study with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications.

  16. Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.

  17. EDITORIAL: Permanent revolution - or evolution?

    Science.gov (United States)

    Dobson, Ken

    1998-03-01

    Honorary Editor It was that temporary Bolshevik Leon Trotsky who developed the principle of `permanent revolution', a principle that perhaps characterizes the recent history of education in (south) Britain more than does, say, principles traditionally associated with the Conservative or Labour parties. As this editorial is being written, changes are being made to primary school education, and the long-awaited details of the post-Dearing reorganizing of post-16 education are yet to hit the overful bookshelves and filing cabinets of school heads and examination board officials. But something unique has happened recently which might have surprised even Trotsky. The Secretary of State for Education has set up targets for primary school pupils' attainment and threatened (or promised) to resign if they are not met within the lifetime of our newly elected parliament. Of course, if Mr Blunkett is still in a position to resign at that stage he will have been the longest serving Secretary of State since time immemorial. But we should not carp: this is truly a revolutionary idea. Not the promise to resign - although this idea is not so fashionable now as it once was. The revolutionary idea is that a major change to an educational process is actually being made that carries with it a predicted and testable outcome. By contrast, when school physics was refreshed a generation ago by the introduction of Nuffield courses at both pre- and post-16 stages, no `targets' were set. I and many other physics teachers certainly preferred teaching these to teaching their predecessor syllabuses, and might even dare to assert that the pupils liked them too. But we still don't really know whether or not they learned more - or even better - physics. Very little happened as far as the outside world was concerned: the usual fraction of students gave up physics at the usual ages, and those who were examined didn't really get a better reward for their more up-to-date and more enjoyably learned

  18. Workplace bullying a risk for permanent employees.

    Science.gov (United States)

    Keuskamp, Dominic; Ziersch, Anna M; Baum, Fran E; Lamontagne, Anthony D

    2012-04-01

    We tested the hypothesis that the risk of experiencing workplace bullying was greater for those employed on casual contracts compared to permanent or ongoing employees. A cross-sectional population-based telephone survey was conducted in South Australia in 2009. Employment arrangements were classified by self-report into four categories: permanent, casual, fixed-term and self-employed. Self-report of workplace bullying was modelled using multiple logistic regression in relation to employment arrangement, controlling for sex, age, working hours, years in job, occupational skill level, marital status and a proxy for socioeconomic status. Workplace bullying was reported by 174 respondents (15.2%). Risk of workplace bullying was higher for being in a professional occupation, having a university education and being separated, divorced or widowed, but did not vary significantly by sex, age or job tenure. In adjusted multivariate logistic regression models, casual workers were significantly less likely than workers on permanent or fixed-term contracts to report bullying. Those separated, divorced or widowed had higher odds of reporting bullying than married, de facto or never-married workers. Contrary to expectation, workplace bullying was more often reported by permanent than casual employees. It may represent an exposure pathway not previously linked with the more idealised permanent employment arrangement. A finer understanding of psycho-social hazards across all employment arrangements is needed, with equal attention to the hazards associated with permanent as well as casual employment. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  19. A qualitative descriptive study of self-management issues in people with long-term intermittent urinary catheters.

    Science.gov (United States)

    Wilde, Mary H; Brasch, Judith; Zhang, Yi

    2011-06-01

    The study was to identify and describe issues of intermittent urinary catheter users for future self-management research and/or training programmes. Limited studies were found of how people using clean intermittent catheterization manage their daily routines or troubleshoot problems. Self-management research related to intermittent catheterization could lead to improved compliance with the method and better quality of life. This qualitative descriptive study involved in-depth tape-recorded telephone interviews in 2008-2009 with 34 people in the United States of America using permanent intermittent catheterization, mostly individuals with spinal cord injury or multiple sclerosis. Recruitment was through Internet sites where individuals could link to the study website and then contact the researchers. The sample included 13 men and 21 women aged 21-72 years (mean 42 years). Content analysis for qualitative data involved iterative comparisons of transcripts, summaries and memos. Coding, key quotes and tables were developed to determine themes. Six major themes were identified: Knowing the Body, Practising Intermittent Catheterization, Limited Options in Catheters and Equipment, Inaccessible Bathrooms, Hassles, and Adjustment in Making Intermittent Catheterization a Part of Life. While some persons had choices in catheters, many did not because of insurance constraints. Some individuals developed knowledge of how to balance the procedure with fluid intake and activities. The lack of acceptable bathrooms can interfere with being able to go to work, travel or be with friends and family. All using intermittent catheterization should have adequate insurance coverage when this is needed. Research into training programmes could incorporate knowledge of experienced users. © 2011 Blackwell Publishing Ltd.

  20. Catheter placement for lysis of spontaneous intracerebral hematomas: does a catheter position in the core of the hematoma allow more effective and faster hematoma lysis?

    Science.gov (United States)

    Malinova, Vesna; Schlegel, Anna; Rohde, Veit; Mielke, Dorothee

    2017-07-01

    For the fibrinolytic therapy of intracerebral hematomas (ICH) using recombinant tissue plasminogen activator (rtPA), a catheter position in the core of the hematoma along the largest clot diameter was assumed to be optimal for an effective clot lysis. However, it never had been proven that core position indeed enhances clot lysis if compared with less optimal catheter positions. In this study, the impact of the catheter position on the effectiveness and on the time course of clot lysis was evaluated. We analyzed the catheter position using a relative error calculating the distance perpendicular to the catheter's center in relation to hematoma's diameter and evaluated the relative hematoma volume reduction (RVR). The correlation of the RVR with the catheter position was evaluated. Additionally, we tried to identify patterns of clot lysis with different catheter positions. The patient's outcome at discharge was evaluated using the Glasgow outcome score. A total of 105 patients were included in the study. The mean hematoma volume was 56 ml. The overall RVR was 62.7 %. In 69 patients, a catheter position in the core of the clot was achieved. We found no significant correlation between catheter position and hematoma RVR (linear regression, p = 0.14). Core catheter position leads to more symmetrical hematoma RVR. Faster clot lysis happens in the vicinity of the catheter openings. We found no significant difference in the patient's outcome dependent on the catheter position (linear regression, p = 0.90). The catheter position in the core of the hematoma along its largest diameter does not significantly influence the effectiveness of clot lysis after rtPA application.

  1. More than just a urinary catheter — Haemorrhage control by using a Foley catheter in a penetrating aortic root injury

    Directory of Open Access Journals (Sweden)

    Adel Elmoghrabi

    2016-08-01

    Full Text Available The prevalence of great vessel injuries in thoracic trauma is reported at 0.3–10%, predominantly due to a penetrating mechanism. Thoracic aortic injuries, more specifically those within proximity of the aortic root are challenging to manage and unceasing bleeding hampers adequate visualisation for performing repair. We report a case of a 31-year-old male that presented to the emergency department 1 h after sustaining a stab wound injury within proximity of the left upper sternal border. Vital signs were stable on presentation. Physical examination revealed a 1.5 cm laceration in the 3rd intercostal space. Chest X-ray revealed a small left pneumothorax, FAST scan was negative, and CT of the chest revealed left sided haemopneumothorax and haemopericardium. The patient was emergently transferred to the operating room where median thoracotomy was performed. A significant amount of bleeding was observed originating from a 1 cm laceration of the aortic root. Bleeding was controlled using a Foley catheter after unsuccessful attempts of digital compression, and the laceration was repaired using pledgeted sutures. Postoperative echocardiography and CT scan of the chest revealed normal cardiac functions with resolution of haemopericardium and haemopneumothorax, and the patient was discharged in a stable condition. High index of suspicion should be maintained for injury to the great vessels in patients with penetrating chest injuries, despite apparent haemodynamic stability. In this case, balloon tamponade using a Foley catheter served as a quick and simple technique that resulted in an almost bloodless field, facilitating adequate visualisation for definitive repair. Although the use of this technique has been previously described, this report serves as a reminder that a Foley catheter can be successfully used for balloon catheter tamponade in injuries to the aortic root. Keywords: Aortic root, Injury, Foley's catheter, Balloon catheter, Aorta

  2. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review

    Science.gov (United States)

    Meddings, Jennifer; Rogers, Mary A M; Krein, Sarah L; Fakih, Mohamad G; Olmsted, Russell N; Saint, Sanjay

    2014-01-01

    Background Catheter-associated urinary tract infections (CAUTI) are costly, common and often preventable by reducing unnecessary urinary catheter (UC) use. Methods To summarise interventions to reduce UC use and CAUTIs, we updated a prior systematic review (through October 2012), and a meta-analysis regarding interventions prompting UC removal by reminders or stop orders. A narrative review summarises other CAUTI prevention strategies including aseptic insertion, catheter maintenance, antimicrobial UCs, and bladder bundle implementation. Results 30 studies were identified and summarised with interventions to prompt removal of UCs, with potential for inclusion in the meta-analyses. By meta-analysis (11 studies), the rate of CAUTI (episodes per 1000 catheter-days) was reduced by 53% (rate ratio 0.47; 95% CI 0.30 to 0.64, p<0.001) using a reminder or stop order, with five studies also including interventions to decrease initial UC placement. The pooled (nine studies) standardised mean difference (SMD) in catheterisation duration (days) was −1.06 overall (p=0.065) including a statistically significant decrease in stop-order studies (SMD −0.37; p<0.001) but not in reminder studies (SMD, −1.54; p=0.071). No significant harm from catheter removal strategies is supported. Limited research is available regarding the impact of UC insertion and maintenance technique. A recent randomised controlled trial indicates antimicrobial catheters provide no significant benefit in preventing symptomatic CAUTIs. Conclusions UC reminders and stop orders appear to reduce CAUTI rates and should be used to improve patient safety. Several evidence-based guidelines have evaluated CAUTI preventive strategies as well as emerging evidence regarding intervention bundles. Implementation strategies are important because reducing UC use involves changing well-established habits. PMID:24077850

  3. A novel suture method to place and adjust peripheral nerve catheters

    DEFF Research Database (Denmark)

    Rothe, C.; Steen-Hansen, C.; Madsen, M. H.

    2015-01-01

    We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in-plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial...

  4. Placing of tunneled central venous catheters prior to induction chemotherapy in children with acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Frydenberg, Morten

    2010-01-01

    BACKGROUND: Tunneled central venous catheters (CVCs) are inevitable in children with acute lymphoid leukemia (ALL). The aim of this study was to evaluate the risk of CVC-related complications in children with ALL in relation to timing of catheter placement and type of catheter. PROCEDURE: All...

  5. Peripherally inserted central catheters in infants and children - indications, techniques, complications and clinical recommendations

    DEFF Research Database (Denmark)

    Westergaard, B; Classen, V; Walther-Larsen, S

    2013-01-01

    of perioperative complications. Assisted visualisation, preferably with ultrasound, yields high rates of insertion success. With good catheter care, rates of mechanical, infectious and thrombotic complications are low and compare favourably with those of traditional central venous catheters. Even in the case...... of occlusion or infection, fibrinolytics and antibiotic locks often allow the catheter to be retained....

  6. Ultrasonic Guided Insertion of Central Venous Catheter in Infants ...

    African Journals Online (AJOL)

    Background/Purpose: ultrasound is licensed for application of regional blocks and insertion of vascular access. We aimed to compare ultrasonic guided (USG) and anatomical landmark technique (ALT) for insertion of central venous catheter (CVC) as regard success rate and rate of complications in infants and children.

  7. Chronic Obstructive Pulmonary Disease in Patients with Catheter ...

    African Journals Online (AJOL)

    of COPD in CAD patients. Methods: A cross sectional study that included consecutive adults with catheter diagnosed CAD recruited from two cardiac centers. Patients completed a COPD diagnosis validated questionnaire and performed spirometry using an electronic spirometer. COPD was diagnosed if patient score placed ...

  8. Minimizing Hemodialysis Catheter Dysfunction: An Ounce of Prevention

    Directory of Open Access Journals (Sweden)

    Timmy Lee

    2012-01-01

    Full Text Available The maintenance of tunneled catheter (TC patency is critical for the provision of adequate hemodialysis in patients who are TC-dependent. TC dysfunction results in the need for costly and inconvenient interventions, and reduced quality of life. Since the introduction of TCs in the late 1980s, heparin catheter lock has been the standard prophylactic regimen for the prevention of TC dysfunction. More recently, alternative catheter locking agents have emerged, and in some cases have shown to be superior to heparin lock with respect to improving TC patency and reducing TC-associated infections. These include citrate, tissue plasminogen activator, and a novel agent containing sodium citrate, methylene blue, methylparaben, and propylparaben. In addition, prophylaxis using oral anticoagulants/antiplatelet agents, including warfarin, aspirin, ticlodipine, as well as the use of modified heparin-coated catheters have also been studied for the prevention of TC dysfunction with variable results. The use of oral anticoagulants and/or antiplatelet agents as primary or secondary prevention of TC dysfunction must be weighed against their potential adverse effects, and should be individualized for each patient.

  9. EVALUATION OF A NEW CATHETER FOR ESOPHAGEAL PH MONITORING

    NARCIS (Netherlands)

    KUIT, JA; SCHEPEL, SJ; BIJLEVELD, CMA; KLEIBEUKER, JH

    A new catheter, provided with an Ion Sensitive Field Effect Transistor as a pH sensor and incorporating a reference electrode, was evaluated for esophageal pH recording. The pH-sensitivity was 54 mV/pH in vitro, with a linear response between pH 2 and pH 9. Clinical semi-ambulatory 24-hour

  10. Anatomical and procedural determinants of catheter-based renal denervation

    NARCIS (Netherlands)

    Ewen, Sebastian; Ukena, Christian; Lüscher, Thomas Felix; Bergmann, Martin; Blankestijn, Peter J; Blessing, Erwin; Cremers, Bodo; Dörr, Oliver; Hering, Dagmara; Kaiser, Lukas; Nef, Holger; Noory, Elias; Schlaich, Markus; Sharif, Faisal; Sudano, Isabella; Vogel, Britta; Voskuil, Michiel; Zeller, Thomas; Tzafriri, Abraham R; Edelman, Elazer R; Lauder, Lucas; Scheller, Bruno; Böhm, Michael; Mahfoud, Felix

    2016-01-01

    BACKGROUND/PURPOSE: Catheter-based renal sympathetic denervation (RDN) can reduce blood pressure (BP) and sympathetic activity in certain patients with uncontrolled hypertension. Less is known about the impact of renal anatomy and procedural parameters on subsequent BP response. METHODS/MATERIALS: A

  11. Prophylactic ciprofloxacin for catheter-associated urinary-tract infection

    NARCIS (Netherlands)

    Wall, E. van der; Verkooyen, R.P.; Mintjes-de Groot, J.; Oostinga, J.; Dijk, Arie van; Hustinx, W.N.M.; Verbrugh, H.A.

    1992-01-01

    Patients receiving antibiotics during bladder drainage have a lower incidence of urinary-tract infections compared with similar patients not on antibiotics. However, antibiotic prophylaxis in patients with a urinary catheter is opposed because of the fear of inducing resistant bacterial strains. We

  12. Bi-layer sandwich film for antibacterial catheters.

    Science.gov (United States)

    Franz, Gerhard; Schamberger, Florian; Zare, Hamideh Heidari; Bröskamp, Sara Felicitas; Jocham, Dieter

    2017-01-01

    Background: Approximately one quarter of all nosocomial infections can be attributed to the urinary tract. The infections are supposed to be mainly caused by implantations of urethral catheters and stents. A new catheter design is introduced with the aim to lower the high number of nosocomial urethral infections. In order to avoid limitations to use, the design is first applied to conventional commercially available balloon catheters. Results: The main feature of the design is a sandwich layer on both sides of the catheter wall, which is composed of a fragmented base layer of silver capped by a thin film of poly( p -xylylene). This top layer is mainly designed to release a controlled amount of Ag + ions, which is bactericidal, but not toxic to humans. Simultaneously, the lifetime is prolonged to at least one year. The base layer is electrolessly deposited applying Tollens' reagens, the cap layer is deposited by using chemical vapor deposition. Conclusion: The three main problems of this process, electroless deposition of a fragmented silver film on the surface of an electrically insulating organic polymer, irreproducible evaporation during heating of the precursor, and exponential decrease of the layer thickness along the capillary, have been solved trough the application of a simple electrochemical reaction and two standard principles of physics: Papin's pot and the principle of Le Chatelier.

  13. Bi-layer sandwich film for antibacterial catheters

    Directory of Open Access Journals (Sweden)

    Gerhard Franz

    2017-09-01

    Full Text Available Background: Approximately one quarter of all nosocomial infections can be attributed to the urinary tract. The infections are supposed to be mainly caused by implantations of urethral catheters and stents. A new catheter design is introduced with the aim to lower the high number of nosocomial urethral infections. In order to avoid limitations to use, the design is first applied to conventional commercially available balloon catheters.Results: The main feature of the design is a sandwich layer on both sides of the catheter wall, which is composed of a fragmented base layer of silver capped by a thin film of poly(p-xylylene. This top layer is mainly designed to release a controlled amount of Ag+ ions, which is bactericidal, but not toxic to humans. Simultaneously, the lifetime is prolonged to at least one year. The base layer is electrolessly deposited applying Tollens’ reagens, the cap layer is deposited by using chemical vapor deposition.Conclusion: The three main problems of this process, electroless deposition of a fragmented silver film on the surface of an electrically insulating organic polymer, irreproducible evaporation during heating of the precursor, and exponential decrease of the layer thickness along the capillary, have been solved trough the application of a simple electrochemical reaction and two standard principles of physics: Papin’s pot and the principle of Le Chatelier.

  14. A Tight Spot After Pulmonary Vein Catheter Ablation

    NARCIS (Netherlands)

    Amir, Rabia; Yeh, Lu; Montealegre-Gallegos, Mario; Saraf, Rabya; Matyal, Robina; Mahmood, Feroze

    2016-01-01

    A 52-YEAR-OLD woman with a history of embolic stroke due to paroxysmal atrial fibrillation was referred to the authors’ institution for epicardial surgical pulmonary vein isolation with left atrial appendage resection. The patient had 2 previous failed pulmonary vein catheter ablations. Dense

  15. Use of urethral catheters for diagnostic peritoneal lavage in blunt ...

    African Journals Online (AJOL)

    Background: Diagnostic peritoneal lavage (DPL) has been reported to be a reliable diagnostic tool in assessing the need for liparotomy in blunt abdominal trauma (BAT) with a diagnostic accuracy of more thin 95% when using a peritoneal lavage catheter (PLC). The aim of this study was to determine the diagnostic ...

  16. Management of non-catheter-associated complicated urinary tract infection.

    Science.gov (United States)

    Dielubanza, Elodi J; Mazur, Daniel J; Schaeffer, Anthony J

    2014-03-01

    This article presents an overview of non-catheter-associated complicated urinary tract infection (UTI) from a urologic point of view. Discussion includes the evaluation and workup a complicated UTI through history, physical examination, laboratory analysis, and radiographic studies. Specific types of complicated UTI, such as urinary obstruction and renal abscess, are reviewed. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Clinical experience with the Monorail balloon catheter for coronary angioplasty.

    Science.gov (United States)

    Finci, L; Meier, B; Roy, P; Steffenino, G; Rutishauser, W

    1988-01-01

    The Monorail balloon catheter is distinctly different from other current balloon catheters: the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the guiding catheter. Monorail coronary angioplasty was attempted in 61 patients on 73 lesions with balloons from 2.0 to 3.7 mm. Angiographic success was obtained in 66 lesions (90%). For 15 lesions, balloon exchanges were needed. In three lesions, the Monorail balloon failed to cross the lesion, while a standard balloon succeeded; two lesions could not be crossed with any balloon. Vessel occlusion occurred in four patients: two had emergency surgery without infarct (one died suddenly 4 days later and one had a stroke 1 day later), one was recanalized with a standard balloon, and one had a myocardial infarct. Continuous infusion of urokinase was used until patient 3 in whom problems with the delivery system led to cardiocerebral air embolization (with complete recovery). No thrombotic complications were observed in the subsequent 58 patients with only a bolus of 10,000 U of heparin. The Monorail balloon facilitates contrast injections and balloon exchanges but appears more difficult to pass through tight lesions. Omission of the previously recommended infusion with a thrombolytic agent proved safe.

  18. Intravascular catheter-related infection – current concepts

    African Journals Online (AJOL)

    2006-08-28

    Aug 28, 2006 ... They have been shown to lower the risk of catheter colonisation and CRBSI in critically ill patients.42,43 The anti-infective effect is short-lived, however, as the collagen to which the silver ions are chelated is biodegradable. Other drawbacks include cost and the need for specialised training. Antiseptic hubs.

  19. Percutaneous placement of peritoneal port-catheter in oncologic patients

    International Nuclear Information System (INIS)

    Orsi, Franco; Vigna, Paolo Della; Bonomo, Guido; Penco, Silvia; Lovati, Elena; Bellomi, Massimo

    2004-01-01

    The aim of this paper is to describe the technique of percutaneous ultrasound (US)-guided placement of a peritoneal port-catheter in an interventional radiological setting. Nineteen patients with peritoneal carcinomatosis were selected for intraperitoneal port-catheter placement in order to perform intracavitary receptor-immuno- or radio-immunotherapy with Ytrium-90. All the procedures were performed percutaneously under US and fluoro guidance; the insertion site for catheters was chosen according to abdominal conditions and US findings: all devices were implanted at the lower abdominal quadrants. All patients were followed up with CT and US according to the therapy protocol. The procedure was successfully completed in 15/19 patients, in 4 being contraindicated by peritoneal adhesions. No procedure-related complications and device occlusions during therapy were observed; one catheter displaced 7 months later the placement. In our experience, this procedure was feasible, reliable and easy to perform, allowing the correct administration of the planned intracavitary therapy. Peritoneal adhesions are the main limitation of peritoneal port placement. (orig.)

  20. 21 CFR 870.1210 - Continuous flush catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continuous flush catheter. 870.1210 Section 870.1210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... that permits continuous intravascular flushing at a slow infusion rate for the purpose of eliminating...

  1. Preventing Inadvertent Placement of Foley Catheter into Prostatic ...

    African Journals Online (AJOL)

    Percutaneous suprapubic trocar cystostomy (SPC) is often needed to drain the bladder when urethral catheterization either fails or is not advisable.[1] It is ... vertical or slightly tilting its tip toward umbilicus during foley placement, prevents the inadvertent migration of catheter into prostatic urethra and further complications.

  2. Catheter ablation as a treatment of atrioventricular block.

    Science.gov (United States)

    Tuohy, Stephen; Saliba, Walid; Pai, Manjunath; Tchou, Patrick

    2018-01-01

    Symptomatic second-degree atrioventricular (AV) block is typically treated by implantation of a pacemaker. An otherwise healthy AV conduction system can nevertheless develop AV block due to interference from junctional extrasystoles. When present with a high burden, these can produce debilitating symptoms from AV block despite an underlying normal AV node and His-Purkinje system properties. The purpose of this study was to describe a catheter ablation approach for alleviating symptomatic AV block due to a ventricular nodal pathway interfering with AV conduction. Common clinical monitoring techniques such as Holter and event recorders were used. Standard electrophysiological study techniques using multipolar recording and ablation catheters were utilized during procedures. A 55-year-old woman presented with highly symptomatic, high-burden second-degree AV block due to concealed and manifest junctional premature beats. Electrophysiological characteristics indicated interference of AV conduction due to a concealed ventricular nodal pathway as the cause of the AV block. The patient's AV nodal and His-Purkinje system conduction characteristics were otherwise normal. Radiofrequency catheter ablation of the pathway was successful in restoring normal AV conduction and eliminating her clinical symptoms. Pathways inserting into the AV junction can interfere with AV conduction. When present at a high burden, this type of AV block can be highly symptomatic. Catheter ablation techniques can be used to alleviate this type of AV block and restore normal AV conduction. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  3. 21 CFR 884.6110 - Assisted reproduction catheters.

    Science.gov (United States)

    2010-04-01

    ... vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), or other assisted reproduction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction catheters. 884.6110 Section 884.6110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  4. Surgical management of Stenson's duct injury using epidural catheter

    African Journals Online (AJOL)

    2012-07-05

    Jul 5, 2012 ... Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of ... Mansarovar Dental College Hospital and Research Centre,. Kolar Road ... A 42-year-old male patient presented to maxillofacial .... catheter, catgut suture, and pediatric intravascular cannula.

  5. Anchor balloons assisted deep intubation of 5F catheters for ...

    African Journals Online (AJOL)

    2015-07-24

    Jul 24, 2015 ... However, cardiologists still encounter some difficult scenarios such as variant coronary artery origins, severely calcified and ... Medical University, 300, Guangzhou Road, Nanjing,. Jiangsu .... (l) The ST segment elevated while the 5F catheter was inserted into the proximal left anterior descending artery d.

  6. Steam-deformed Judkins-left guiding catheter with use of the GuideLiner catheter to deliver stents for anomalous right coronary artery

    Directory of Open Access Journals (Sweden)

    Toshiki Kuno

    2015-10-01

    Full Text Available Objective: Percutaneous coronary intervention for anomalous right coronary artery (RCA originating from the left coronary cusp is challenging because of our current inability to coaxially engage the guiding catheter. Methods: We report a case of an 88-year-old woman with non-ST segment elevation myocardial infarction, with an anomalous RCA origin. Using either the Judkins-Left catheter or Amplatz-Left catheter was difficult because of RCA ostium tortuosity. Thus, we used steam to deform the Judkins-Left catheter, but back-up support was insufficient to deliver the stent. Results: We used GuideLiner®, a novel pediatric catheter with rapid exchange/monorail systems, to enhance back-up support. Conclusions: We were able to successfully stent with both the deformed Judkins-Left guiding catheter and GuideLiner® for an anomalous RCA origin.

  7. Steam-deformed Judkins-left guiding catheter with use of the GuideLiner(®) catheter to deliver stents for anomalous right coronary artery.

    Science.gov (United States)

    Kuno, Toshiki; Fujisawa, Taishi; Yamazaki, Hiroyuki; Motoda, Hiroyuki; Kodaira, Masaki; Numasawa, Yohei

    2015-01-01

    Percutaneous coronary intervention for anomalous right coronary artery (RCA) originating from the left coronary cusp is challenging because of our current inability to coaxially engage the guiding catheter. We report a case of an 88-year-old woman with non-ST segment elevation myocardial infarction, with an anomalous RCA origin. Using either the Judkins-Left catheter or Amplatz-Left catheter was difficult because of RCA ostium tortuosity. Thus, we used steam to deform the Judkins-Left catheter, but back-up support was insufficient to deliver the stent. We used GuideLiner®, a novel pediatric catheter with rapid exchange/monorail systems, to enhance back-up support. We were able to successfully stent with both the deformed Judkins-Left guiding catheter and GuideLiner® for an anomalous RCA origin.

  8. Peripheral intravenous and central catheter algorithm: a proactive quality initiative.

    Science.gov (United States)

    Wilder, Kerry A; Kuehn, Susan C; Moore, James E

    2014-12-01

    Peripheral intravenous (PIV) infiltrations causing tissue damage is a global issue surrounded by situations that make vascular access decisions difficult. The purpose of this quality improvement project was to develop an algorithm and assess its effectiveness in reducing PIV infiltrations in neonates. The targeted subjects were all infants in our neonatal intensive care unit (NICU) with a PIV catheter. We completed a retrospective chart review of the electronic medical record to collect 4th quarter 2012 baseline data. Following adoption of the algorithm, we also performed a daily manual count of all PIV catheters in the 1st and 2nd quarters 2013. Daily PIV days were defined as follows: 1 patient with a PIV catheter equals 1 PIV day. An infant with 2 PIV catheters in place was counted as 2 PIV days. Our rate of infiltration or tissue damage was determined by counting the number of events and dividing by the number of PIV days. The rate of infiltration or tissue damage was reported as the number of events per 100 PIV days. The number of infiltrations and PIV catheters was collected from the electronic medical record and also verified manually by daily assessment after adoption of the algorithm. To reduce the rate of PIV infiltrations leading to grade 4 infiltration and tissue damage by at least 30% in the NICU population. Incidence of PIV infiltrations/100 catheter days. The baseline rate for total infiltrations increased slightly from 5.4 to 5.68/100 PIV days (P = .397) for the NICU. We attributed this increase to heightened awareness and better reporting. Grade 4 infiltrations decreased from 2.8 to 0.83/100 PIV catheter days (P = .00021) after the algorithm was implemented. Tissue damage also decreased from 0.68 to 0.3/100 PIV days (P = .11). Statistical analysis used the Fisher exact test and reported as statistically significant at P < .05. Our findings suggest that utilization of our standardized decision pathway was instrumental in providing guidance for

  9. Reinnervation following catheter-based radio-frequency renal denervation.

    Science.gov (United States)

    Booth, Lindsea C; Nishi, Erika E; Yao, Song T; Ramchandra, Rohit; Lambert, Gavin W; Schlaich, Markus P; May, Clive N

    2015-04-20

    What is the topic of this review? Does catheter-based renal denervation effectively denervate the afferent and efferent renal nerves and does reinnervation occur? What advances does it highlight? Following catheter-based renal denervation, the afferent and efferent responses to electrical stimulation were abolished, renal sympathetic nerve activity was absent, and levels of renal noradrenaline and immunohistochemistry for tyrosine hydroxylase and calcitonin gene-related peptide were significantly reduced. By 11 months after renal denervation, both the functional responses and anatomical markers of afferent and efferent renal nerves had returned to normal, indicating reinnervation. Renal denervation reduces blood pressure in animals with experimental hypertension and, recently, catheter-based renal denervation was shown to cause a prolonged decrease in blood pressure in patients with resistant hypertension. The randomized, sham-controlled Symplicity HTN-3 trial failed to meet its primary efficacy end-point, but there is evidence that renal denervation was incomplete in many patients. Currently, there is little information regarding the effectiveness of catheter-based renal denervation and the extent of reinnervation. We assessed the effectiveness of renal nerve denervation with the Symplicity Flex catheter and the functional and anatomical reinnervation at 5.5 and 11 months postdenervation. In anaesthetized, non-denervated sheep, there was a high level of renal sympathetic nerve activity, and electrical stimulation of the renal nerve increased blood pressure and reduced heart rate (afferent response) and caused renal vasoconstriction and reduced renal blood flow (efferent response). Immediately after renal denervation, renal sympathetic nerve activity and the responses to electrical stimulation were absent, indicating effective denervation. By 11 months after denervation, renal sympathetic nerve activity was present and the responses to electrical stimulation

  10. Number and location of drainage catheter side holes: in vitro evaluation.

    Science.gov (United States)

    Ballard, D H; Alexander, J S; Weisman, J A; Orchard, M A; Williams, J T; D'Agostino, H B

    2015-09-01

    To evaluate the influence of number and location of catheter shaft side holes regarding drainage efficiency in an in vitro model. Three different drainage catheter models were constructed: open-ended model with no side holes (one catheter), unilateral side hole model (six catheters with one to six unilateral side holes), and bilateral side hole model (six catheters with one to six bilateral side holes). Catheters were inserted into a drainage output-measuring device with a constant-pressure reservoir of water. The volume of water evacuated by each of the catheters at 10-second intervals was measured. A total of five trials were performed for each catheter. Data were analysed using one-way analysis of variance. The open-ended catheter had a mean drainage volume comparable to the unilateral model catheters with three, four, and five side holes. Unilateral model catheters had significant drainage volume increases up to three side holes; unilateral model catheters with more than three side holes had no significant improvement in drainage volume. All bilateral model catheters had significantly higher mean drainage volumes than their unilateral counterparts. There was no significant difference between the mean drainage volume with one, two, or three pairs of bilateral side holes. Further, there was no drainage improvement by adding additional bilateral side holes. The present in vitro study suggests that beyond a critical side hole number threshold, adding more distal side holes does not improve catheter drainage efficiency. These results may be used to enhance catheter design towards improving their drainage efficiency. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  11. Permanent magnet materials and their application

    International Nuclear Information System (INIS)

    Campbell, P.

    1994-01-01

    Permanent magnets are of great industrial importance in industrial drives, consumer products, computers, and automobiles. Since 1970, new classes of magnet materials have been developed. This book reviews the older and newer materials and is presented as a comprehensive design text for permanent magnets and their applications. After an initial chapter on the fundamentals of magnetism, the author discusses magnetic physics considerations specific to permanent magnets and describes the fabrications and characteristics of commercial materials: alnico, samarium-cobalt, ferrite, and neodymium-iron-boron. Thermal stability, magnet design procedures, magnetic field analysis methods, and measurement methods are discussed in subsequent chapters, followed by a concluding chapter reviewing commercial and industrial products that use permanent magnets. The chapter on thermal properties of magnet materials is of particular interest, bringing together information not readily found elsewhere. The review of applications is also deserving of attention, specifically the sections on motors and actuators. Although particle accelerator applications are discussed, the use of permanent magnet sextuples in modern ECR ion sources is not mentioned

  12. Cylindrical Hall Thrusters with Permanent Magnets

    International Nuclear Information System (INIS)

    Raitses, Yevgeny; Merino, Enrique; Fisch, Nathaniel J.

    2010-01-01

    The use of permanent magnets instead of electromagnet coils for low power Hall thrusters can offer a significant reduction of both the total electric power consumption and the thruster mass. Two permanent magnet versions of the miniaturized cylindrical Hall thruster (CHT) of different overall dimensions were operated in the power range of 50W-300 W. The discharge and plasma plume measurements revealed that the CHT thrusters with permanent magnets and electromagnet coils operate rather differently. In particular, the angular ion current density distribution from the permanent magnet thrusters has an unusual halo shape, with a majority of high energy ions flowing at large angles with respect to the thruster centerline. Differences in the magnetic field topology outside the thruster channel and in the vicinity of the channel exit are likely responsible for the differences in the plume characteristics measured for the CHTs with electromagnets and permanent magnets. It is shown that the presence of the reversing-direction or cusp-type magnetic field configuration inside the thruster channel without a strong axial magnetic field outside the thruster channel does not lead to the halo plasma plume from the CHT.

  13. CENTRAL VENOUS CATHETER AS A VASCULAR APPROACH TO HEMODIALYSTS

    Directory of Open Access Journals (Sweden)

    Verica Djordjevic

    2001-03-01

    Full Text Available The application of the central venous catheter (CVC as a temporary orpermanent vascular approach to hemodialysis has been practiced in our Center since1994. So far 30 (12,6% patients have been thus treated. The primary application hasbeen done in 25 patients, namely: the first making of the A V fistula has been done in16, the ABT in 6, while the vascular approach correction in 3 patients. The secondaryapplication has been done in 5 patients. The infection episode incidence concerningthe CVC application is 20 infections per 1.000 patients. This is the upper limitaccording to the data given in the literature (5, rang 3-20. The average duration of thecatheter is 21 + - 13 days (rang 1-47. Two-volume catheters have been used for ajugular approach though less often for a femoral one. The unsuccessful placing due tothe catheter thrombosis has occurred in 4 patients, the catheter drop-out and itsreplacing have been done in 2 patients, while no replacement has happened in onečaše. The treatment has been stopped in one patient. Tn four patients the cerebrovascularinsult has happened after placing the CVC. The mortality rate is 26,6%,that is, K patients, namely: 4 due to cerebrovascular insult, one due to lung emboly,one due to heart weakness and one due to the sepsis from the V fistula. One patientdied at home for unknown reason. A high infection episode incidence rate is related toinadequate patients' placing so that their location in the rooms for intensive care is away of reducing it. It is necessary to provide for general aseptic procedure at work aswell as for betterment of the accompanying procedures (hemoculture, antibiograms,sterilization in order to maintain a safe catheter function.

  14. Stabilization of a percutaneously implanted port catheter system for hepatic artery chemotherapy infusion

    International Nuclear Information System (INIS)

    Shindoh, Noboru; Ozaki, Yutaka; Kyogoku, Shinsuke; Yamana, Daigo; Sumi, Yukiharu; Katayama, Hitoshi

    1999-01-01

    A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

  15. Safety profile of multielectrode-phased radiofrequency pulmonary vein ablation catheter and irrigated radiofrequency catheter.

    Science.gov (United States)

    Wasmer, K; Foraita, P; Leitz, P; Güner, F; Pott, C; Lange, P S; Eckardt, L; Mönnig, G

    2016-01-01

    Silent cerebral lesions with the multielectrode-phased radiofrequency (RF) pulmonary vein ablation catheter (PVAC(®)) have recently been investigated. However, comparative data on safety in relation to irrigated RF ablation are missing. One hundred and fifty consecutive patients (58 ± 12 years, 56 female) underwent first pulmonary vein isolation (PVI) for atrial fibrillation (61% paroxysmal) using PVAC(®) (PVAC). Procedure data as well as in-hospital complications were compared with 300 matched patients who underwent PVI using irrigated RF (iRF). Procedure duration (148 ± 63 vs. 208 ± 70 min; P drainage n = 0 vs. n = 6] occurred more frequently using iRF. Two patients in each group developed a TIA (1.3% vs. 0.6%). Of note, four of five thromboembolic events in the PVAC group (two TIAs and three transient ST elevations during ablation) occurred when all 10 electrodes were used for ablation. Pulmonary vein isolation using PVAC as a 'one-shot-system' has a comparable complication rate but a different risk profile. Pericardial effusion and tamponade occurred more frequently using iRF, whereas thromboembolic events were more prevalent using PVAC. Occurrence of clinically relevant thromboembolic events might be reduced by avoidance of electrode 1 and 10 interaction and uninterrupted anticoagulation, whereas contact force sensing for iRF might minimize pericardial effusion. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  16. The effect of peripherally inserted central catheter (PICC) valve technology on catheter occlusion rates--the 'ELeCTRiC' study.

    Science.gov (United States)

    Johnston, Andrew J; Streater, Carmel T; Noorani, Remy; Crofts, Joanne L; Del Mundo, Aldwin B; Parker, Richard A

    2012-01-01

    Peripherally Inserted Central Catheters (PICCs) are increasingly being used to provide short to medium-term central venous access. The current study was designed to test the hypothesis that PICC valve technology does not influence PICC occlusion rates. Intensive care unit (ICU) patients who required a PICC were randomized to one of three types of dual lumen PICC (open ended non-valved, Groshong valve, PASV valve). PICC occlusions were recorded and managed with a protocol that used urokinase. A total of 102 patients were recruited to the study. The overall risk of occlusion per catheter was 35% (95% CI 26% to 44%). The overall rate of occlusion was 76 occlusions per 1000 catheter days (95% CI 61 to 95). Presence or type of valve did not significantly influence this rate (open-ended non-valved PICC 38% of catheters, 79 occlusions per 1000 catheter days; Groshong 38% of catheters, 60 occlusions per 1000 catheter days; PASV 27% of catheters, 99 occlusions per 1000 catheter days). The dose of urokinase required to treat PICC occlusions did not significantly differ between PICC types. Valved PICCs do not appear to influence PICC occlusion rates.

  17. 31 CFR 515.335 - Permanent resident alien.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  18. 13 CFR 120.900 - Sources of permanent financing.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Sources of permanent financing... Development Company Loan Program (504) Permanent Financing § 120.900 Sources of permanent financing. Permanent financing for each Project must come from three sources: the Borrower's contribution, Third-Party Loans, and...

  19. Static devices with new permanent magnets

    International Nuclear Information System (INIS)

    Chavanne, J.; Laforest, J.; Pauthenet, R.

    1987-01-01

    The high remanence and coercivity of the new permanent magnet materials are of special interest in the static applications. High ordering temperature and are uniaxial anisotropy at the origin of their good permanent magnet properties are obtained in rare earth-transition metal compounds. Binary SmCo/sub 5/ and Sm/sub 2/Co/sub 17/ and ternary Nd/sub 2/Fe/sub 14/B compounds are the basis materials of the best permanent magnets. new concepts of calculations of static devices with these magnets can be applied: the magnetization can be considered as ridig, the density of the surface Amperian current is constant, the relative permeability is approximately 1 and the induction calculations are linear. Examples of hexapoles with Sm-Co and NdFeB magnets are described and the performances are compared. The problems of temperature behavior and corrosion resistance are underlined

  20. The history of permanent magnet materials

    International Nuclear Information System (INIS)

    Livingston, J.D.

    1990-01-01

    Permanent-magnet materials play a large and growing, but largely unseen, role in today's technology. Many common devices in the home and elsewhere, including appliances, computers and printers, contain permanent-magnet motors and actuators. The growth of applications for permanent magnets results in large part from the improvements in magnetic properties, which allow the engineer to design smaller, lighter and more efficient devices. The properties of the greatest technological interest are remanence, coercivity and maximum energy product. All are non-equilibrium and high structure-sensitive. Coercivity is particularly sensitive to microstructure, while remanence is sensitive to texture (crystallographic alignment). The energy product depends on both coercivity and remanence. The more than one hundredfold increase in the available energy product in this century, and the corresponding amount of magnet required for a specific application, are shown

  1. Trans-jugular catheter-directed thrombolysis combined with trans-dorsalis pedis vein thrombolysis for the treatment of deep venous thrombosis of the lower limbs

    International Nuclear Information System (INIS)

    Qian Jiesheng; Li Zhengran; Jiang Zaibo; Zhu Kangshun; Guan Shouhai; Zhou Bing; Xu Changmou; He Keke; Shang Hong

    2009-01-01

    Objective: To investigate the feasibility and efficacy of trans-jugular catheter-directed thrombolysis (CDT) together with trans-dorsalis pedis vein thrombolysis for the treatment of deep venous thrombosis (DVT) of the lower limbs. Methods: Jugular vein puncture, indwelling catheter and placement of IVC filter were performed in 18 patients with DVT (study group) followed by continuous trans-jugular CDT together with trans-dorsalis pedis vein thrombolysis. During the corresponding period, 16 patients with DVT (control group) received trans-dorsalis pedis vein thrombolysis only. Results: The thrombolytic time and total dose of urokinase in study group and control group were (6.6 ± 2.3) days, (5.52 ± 2.24) x 106 units and (8.2 ± 1.4) days, (7.00 ± 1.66) x 106 units respectively. The thrombolytic time and total dose of urokinase in study group were significantly lower than that in control group (P < 0.05). After the treatment the thigh circumference and calf circumference in study group showed a reduction of (4.6 ± 2.1) cm and (4.0 ± 2.1) cm respectively, which were (3.2 ± 1.7) cm and (2.7 ± 1.5) cm respectively in control group, the difference between two groups was statistically significant (P < 0.05). The complete patent of the veins was 66.7% in study group and 31.3% in control group, the difference between two groups was significant (P < 0.05). In four cases of the study group, the filters were withdrawn through the original puncture site after the thrombus was completely dissolved. Conclusion: Trans-jugular CDT combined with trans-dorsalis pedis vein thrombolysis is an effective and safe therapeutic technique for the treatment of deep venous thrombosis of the lower extremities, moreover, the filter can be taken back via the original puncture site when the thrombus is completely dissolved. (authors)

  2. Efficacy of pudendal nerve block for alleviation of catheter-related bladder discomfort in male patients undergoing lower urinary tract surgeries: A randomized, controlled, double-blind trial.

    Science.gov (United States)

    Xiaoqiang, Li; Xuerong, Zhang; Juan, Liu; Mathew, Bechu Shelley; Xiaorong, Yin; Qin, Wan; Lili, Luo; Yingying, Zhu; Jun, Luo

    2017-12-01

    Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle. Based on this theoretical knowledge, we formed a hypothesis that CRBD could be prevented by pudendal nerve block. To evaluate if bilateral nerve stimulator-guided pudendal nerve block could relieve CRBD through urethra discomfort alleviation. Single-center randomized parallel controlled, double blind trial conducted at West China Hospital, Sichuan University, China. One hundred and eighty 2 male adult patients under general anesthesia undergoing elective trans-urethral resection of prostate (TURP) or trans-urethral resection of bladder tumor (TURBT). Around 4 out of 182 were excluded, 178 patients were randomly allocated into pudendal and control groups, using computer-generated randomized numbers in a sealed envelope method. A total of 175 patients completed the study. Pudendal group received general anesthesia along with nerve-stimulator-guided bilateral pudendal nerve block and control group received general anesthesia only. Incidence and severity of CRBD; and postoperative VAS score of pain. CRBD incidences were significantly lower in pudendal group at 30 minutes (63% vs 82%, P = .004), 2 hours (64% vs 90%, P < .000), 8 hours (58% vs 79%, P = .003) and 12 hours (52% vs 69%, P = .028) also significantly lower incidence of moderate to severe CRBD in pudendal group at 30 minutes (29% vs 57%, P < .001), 2 hours (22

  3. Initial experience with the Europass: a new ultra-low profile monorail balloon catheter.

    Science.gov (United States)

    Zimarino, M; Corcos, T; Favereau, X; Tamburino, C; Toussaint, M; Spaulding, C; Guérin, Y

    1994-09-01

    One of the causes for percutaneous transluminal coronary angioplasty (PTCA) failure is the inability to cross the lesion with the balloon catheter after guidewire positioning. The Europass coronary angioplasty catheter is a monorail Duralyn balloon catheter developed to enhance lesion crossability and to overcome this limitation. This system was evaluated in 50 patients in which target lesions were chronic total coronary occlusions (12 cases) or stenoses that could not be reached or crossed by other new monorail balloon catheters. Overall procedural success was obtained in 49/50 patients (98%), using a single Europass balloon catheter in 46/50 patients (92%), with no in-hospital complications. Its low profile, small distal shaft, and excellent trackability allowed successful angioplasty in cases where other catheters failed. This balloon catheter represents a significant advance in angioplasty technology and can be considered as a first-choice device for a safe and expeditious single-operator procedure.

  4. Analysis of a spherical permanent magnet actuator

    International Nuclear Information System (INIS)

    Wang, J.; Jewell, G.W.; Howe, D.

    1997-01-01

    This paper describes a new form of actuator with a spherical permanent magnet rotor and a simple winding arrangement, which is capable of a high specific torque by utilizing a rare-earth permanent magnet. The magnetic-field distribution is established using an analytical technique formulated in spherical coordinates, and the results are validated by finite element analysis. The analytical field solution allows the prediction of the actuator torque and back emf in closed forms. In turn, these facilitate the characterization of the actuator and provide a firm basis for design optimization, system dynamic modeling, and closed-loop control law development. copyright 1997 American Institute of Physics

  5. Treatment of ectopic first permanent molar teeth.

    LENUS (Irish Health Repository)

    Hennessy, Joe

    2012-11-01

    Ectopic eruption of the first permanent molar is a relatively common occurence in the developing dentition. A range of treatment options are available to the clinician provided that diagnosis is made early. Non-treatment can result in premature exfoliation of the second primary molar, space loss and impaction of the second premolar. This paper will describe the management of ectopic first permanent molars, using clinical examples to illustrate the available treatment options. CLINICAL RELEVANCE: This paper is relevant to every general dental practitioner who treats patients in mixed dentition.

  6. Permanent isolation surface barrier: Functional performance

    International Nuclear Information System (INIS)

    Wing, N.R.

    1993-10-01

    This document presents the functional performance parameters for permanent isolation surface barriers. Permanent isolation surface barriers have been proposed for use at the Hanford Site (and elsewhere) to isolate and dispose of certain types of waste in place. Much of the waste that would be disposed of using in-place isolation techniques is located in subsurface structures, such as solid waste burial grounds, tanks, vaults, and cribs. Unless protected in some way, the wastes could be transported to the accessible environment via transport pathways, such as water infiltration, biointrusion, wind and water erosion, human interference, and/or gaseous release

  7. Magnetic guns with cylindrical permanent magnets

    DEFF Research Database (Denmark)

    Vokoun, David; Beleggia, Marco; Heller, Luděk

    2012-01-01

    The motion of a cylindrical permanent magnet (projectile) inside a tubular permanent magnet, with both magnets magnetized axially, illustrates nicely the physical principles behind the operation of magnetic guns. The force acting upon the projectile is expressed semi-analytically as derivative...... of the magnetostatic interaction energy. For comparison, the forces involved are also calculated numerically using finite elements methods. Based on the conservation of the magnetostatic and kinetic energies, the exit and asymptotic velocities are determined. The derived formulas can be used to optimize the generated...... forces and motion of the inner cylindrical magnet....

  8. Treatment of ectopic first permanent molar teeth.

    Science.gov (United States)

    Hennessy, Joe; Al-Awadhi, E A; Dwyer, Lian O; Leith, Rona

    2012-11-01

    Ectopic eruption of the first permanent molar is a relatively common occurence in the developing dentition. A range of treatment options are available to the clinician provided that diagnosis is made early. Non-treatment can result in premature exfoliation of the second primary molar, space loss and impaction of the second premolar. This paper will describe the management of ectopic first permanent molars, using clinical examples to illustrate the available treatment options. This paper is relevant to every general dental practitioner who treats patients in mixed dentition.

  9. Accuracy of image-guided radiotherapy of prostate cancer based on the BeamCath urethral catheter technique

    DEFF Research Database (Denmark)

    Poulsen, Per Rugaard; Fokdal, Lars; Petersen, Jørgen B.B.

    2007-01-01

    BACKGROUND AND PURPOSE: To examine the accuracy of the BeamCath urethral catheter technique for prostate localization during radiotherapy. MATERIALS AND METHODS: Sixty-four patients were CT scanned twice with the BeamCath catheter, and once without the catheter. The catheter contains radiopaque...

  10. Permanent Lateral Deviation and Stenosis of the Cervix in an Infertile Jennet.

    Science.gov (United States)

    Quartuccio, M; Marino, G; Mannarino, C; Cristarella, S

    2016-04-01

    Congenital abnormalities of the uterus and the cervix are rare in horses, often associated with infertility, despite normal ovarian activity and sexual behaviour. An abnormality of the cervix in a 5-year-old jennet with a history of infertility was described. Clinical and ultrasound examination of the genital tract showed a normal development of the uterus with regular cyclic activity in both the ovaries. Vaginoscopy revealed a normal development of the vagina and a cervix deviated on the left side of the vagina by a thick dorsoventral fold. The lateral deviation was permanent in any stage of oestrus cycle. Furthermore, the cervical os was narrow and digital penetration was not realizable. Using a 5-mm catheter, the full penetration was not possible even during oestrus; moreover, the inoculation of fluid could be revealed in uterus by ultrasound (fluid was not present before inoculation), demonstrating a minimal patency. An abnormal and permanent lateral displacement of a stenotic cervix was suspected as the primary cause of infertility in the jennet. © 2015 Blackwell Verlag GmbH.

  11. SU-F-T-20: Novel Catheter Lumen Recognition Algorithm for Rapid Digitization

    International Nuclear Information System (INIS)

    Dise, J; McDonald, D; Ashenafi, M; Peng, J; Mart, C; Koch, N; Vanek, K

    2016-01-01

    Purpose: Manual catheter recognition remains a time-consuming aspect of high-dose-rate brachytherapy (HDR) treatment planning. In this work, a novel catheter lumen recognition algorithm was created for accurate and rapid digitization. Methods: MatLab v8.5 was used to create the catheter recognition algorithm. Initially, the algorithm searches the patient CT dataset using an intensity based k-means filter designed to locate catheters. Once the catheters have been located, seed points are manually selected to initialize digitization of each catheter. From each seed point, the algorithm searches locally in order to automatically digitize the remaining catheter. This digitization is accomplished by finding pixels with similar image curvature and divergence parameters compared to the seed pixel. Newly digitized pixels are treated as new seed positions, and hessian image analysis is used to direct the algorithm toward neighboring catheter pixels, and to make the algorithm insensitive to adjacent catheters that are unresolvable on CT, air pockets, and high Z artifacts. The algorithm was tested using 11 HDR treatment plans, including the Syed template, tandem and ovoid applicator, and multi-catheter lung brachytherapy. Digitization error was calculated by comparing manually determined catheter positions to those determined by the algorithm. Results: he digitization error was 0.23 mm ± 0.14 mm axially and 0.62 mm ± 0.13 mm longitudinally at the tip. The time of digitization, following initial seed placement was less than 1 second per catheter. The maximum total time required to digitize all tested applicators was 4 minutes (Syed template with 15 needles). Conclusion: This algorithm successfully digitizes HDR catheters for a variety of applicators with or without CT markers. The minimal axial error demonstrates the accuracy of the algorithm, and its insensitivity to image artifacts and challenging catheter positioning. Future work to automatically place initial seed

  12. SU-F-T-20: Novel Catheter Lumen Recognition Algorithm for Rapid Digitization

    Energy Technology Data Exchange (ETDEWEB)

    Dise, J; McDonald, D; Ashenafi, M; Peng, J; Mart, C; Koch, N; Vanek, K [Medical University of South Carolina, Charleston, SC (United States)

    2016-06-15

    Purpose: Manual catheter recognition remains a time-consuming aspect of high-dose-rate brachytherapy (HDR) treatment planning. In this work, a novel catheter lumen recognition algorithm was created for accurate and rapid digitization. Methods: MatLab v8.5 was used to create the catheter recognition algorithm. Initially, the algorithm searches the patient CT dataset using an intensity based k-means filter designed to locate catheters. Once the catheters have been located, seed points are manually selected to initialize digitization of each catheter. From each seed point, the algorithm searches locally in order to automatically digitize the remaining catheter. This digitization is accomplished by finding pixels with similar image curvature and divergence parameters compared to the seed pixel. Newly digitized pixels are treated as new seed positions, and hessian image analysis is used to direct the algorithm toward neighboring catheter pixels, and to make the algorithm insensitive to adjacent catheters that are unresolvable on CT, air pockets, and high Z artifacts. The algorithm was tested using 11 HDR treatment plans, including the Syed template, tandem and ovoid applicator, and multi-catheter lung brachytherapy. Digitization error was calculated by comparing manually determined catheter positions to those determined by the algorithm. Results: he digitization error was 0.23 mm ± 0.14 mm axially and 0.62 mm ± 0.13 mm longitudinally at the tip. The time of digitization, following initial seed placement was less than 1 second per catheter. The maximum total time required to digitize all tested applicators was 4 minutes (Syed template with 15 needles). Conclusion: This algorithm successfully digitizes HDR catheters for a variety of applicators with or without CT markers. The minimal axial error demonstrates the accuracy of the algorithm, and its insensitivity to image artifacts and challenging catheter positioning. Future work to automatically place initial seed

  13. Successful Retrieval of a Dismembered Central Venous Catheter Stuck to the Right Pulmonary Artery Using a Stepwise Approach

    Directory of Open Access Journals (Sweden)

    Keisuke Nakabayashi

    2016-01-01

    Full Text Available Recent advances in anticancer chemotherapy have resulted in an increase in the number of patients requiring a central venous port catheter, and the incidence of catheter pinch-off syndrome has been increasing. Catheter pinch-off syndrome is a rare and unusual complication. It is difficult to retrieve dislodged catheters from the pulmonary artery, especially if the catheter is stuck to the peripheral pulmonary artery. We herein describe the successful removal of a catheter stuck in the pulmonary artery with a stepwise approach. First, a pigtail catheter was used to tug the dislodged catheter in order to free the unilateral end. Then, a gooseneck snare was used to catch and pull the catheter out of the patient. The key to success is to free the end of the catheter.

  14. Tubular permanent magnet actuators: cogging forces characterization

    NARCIS (Netherlands)

    Paulides, J.J.H.; Janssen, J.L.G.; Encica, L.; Lomonova, E.A.

    2009-01-01

    Tubular permanent magnet actuators are evermore used in demanding industrial and automotive applications. However, these actuators can suffer from large cogging forces, which have a destabilizing effect on the servo control system and compromise position and speed control accuracy. This paper

  15. Laced permanent magnet quadrupole drift tube magnets

    International Nuclear Information System (INIS)

    Feinberg, B.; Behrsing, G.U.; Halbach, K.; Marks, J.S.; Morrison, M.E.; Nelson, D.H.

    1988-10-01

    A laced permanent magnet quadrupole drift tube magnet has been constructed for a proof-of-principle test. The magnet is a conventional tape-wound quadrupole electromagnet, using iron pole- pieces, with the addition of permanent magnet material (neodymium iron) between the poles to reduce the effects of saturation. The iron is preloaded with magnetic flux generated by the permanent magnet material, resulting in an asymmetrical saturation curve. Since the polarity of the quadrupole magnets in a drift tube linac is not reversed we can take advantage of this asymmetrical saturation to provide greater focusing strength. The magnet configuration has been optimized and the vanadium permendur poles needed in a conventional quadrupole have been replaced with iron poles. The use of permanent magnet material has allowed us to increase the focusing strength of the magnet by about 20% over that of a conventional tape-wound quadrupole. Comparisons will be made between this magnet and the conventional tape-wound quadrupole. 3 refs., 5 figs

  16. Standards on the permanence of recording materials

    Science.gov (United States)

    Adelstein, Peter Z.

    1996-02-01

    The permanence of recording materials is dependent upon many factors, and these differ for photographic materials, magnetic tape and optical disks. Photographic permanence is affected by the (1) stability of the material, (2) the photographic processing and (3) the storage conditions. American National Standards on the material and the processing have been published for different types of film and standard test methods have been established for color film. The third feature of photographic permanence is the storage requirements and these have been established for photographic film, prints and plates. Standardization on the permanence of electronic recording materials is more complicated. As with photographic materials, stability is dependent upon (1) the material itself and (2) the storage environment. In addition, retention of the necessary (3) hardware and (4) software is also a prerequisite. American National Standards activity in these areas has been underway for the past six years. A test method for the material which determines the life expectancy of CD-ROMs has been standardized. The problems of determining the expected life of magnetic tape have been more formidable but the critical physical properties have been determined. A specification for the storage environment of magnetic tape has been finalized and one on the storage of optical disks is being worked on. Critical but unsolved problems are the obsolescence of both the hardware and the software necessary to read digital images.

  17. resonant inverter supplied interior permanent magnet (ipm)

    African Journals Online (AJOL)

    user

    [5] Zhenyue Hong, “DC-voltage link resonant inverters”, Department of Electrical and. Electronic Engineering University of. Canterbury, New Zealand. [6] Kalyan Kumar Halder, Naruttam Kumar Roy and B.C. Ghosh, “Position Sensorless. Control for an Interior Permanent Magnet. Synchronous Motor SVM Drive with ANN.

  18. 78 FR 14122 - Revocation of Permanent Variances

    Science.gov (United States)

    2013-03-04

    ... Douglas Fir planking had to have at least a 1,900 fiber stress and 1,900,000 modulus of elasticity, while the Yellow Pine planking had to have at least 2,500 fiber stress and 2,000,000 modulus of elasticity... the permanent variances, and affected employees, to submit written data, views, and arguments...

  19. Sexism and Permanent Exclusion from School

    Science.gov (United States)

    Carlile, Anna

    2009-01-01

    Focussing on narratives collected during a two year participant observation research project in the children's services department of an urban local authority, this article addresses the intersection between incidents of permanent exclusion from school and assumptions made on the basis of a young person's gender. The article considers gendered…

  20. Pupil Dilation and Object Permanence in Infants

    Science.gov (United States)

    Sirois, Sylvain; Jackson, Iain R.

    2012-01-01

    This paper examines the relative merits of looking time and pupil diameter measures in the study of early cognitive abilities of infants. Ten-month-old infants took part in a modified version of the classic drawbridge experiment used to study object permanence (Baillargeon, Spelke, & Wasserman, 1985). The study involved a factorial design where…