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Sample records for systematic venous blood

  1. How does the blood leave the brain? A systematic ultrasound analysis of cerebral venous drainage patterns

    International Nuclear Information System (INIS)

    Doepp, Florian; Schreiber, Stephan J.; Muenster, Thomas von; Rademacher, Joerg; Valdueza, Jose M.; Klingebiel, Randolf

    2004-01-01

    The internal jugular veins are considered to be the main pathways of cerebral blood drainage. However, angiographic and anatomical studies show a wide anatomical variability and varying degrees of jugular and non-jugular venous drainage. The study systematically analyses the types and prevalence of human cerebral venous outflow patterns by ultrasound and MRI. Fifty healthy volunteers (21 females; 29 males; mean age 27±7 years) were studied by color-coded duplex sonography. Venous blood volume flow was measured in both internal jugular and vertebral veins in the supine position. Furthermore, the global arterial cerebral blood volume flow was calculated as the sum of volume flows in both internal carotid and vertebral arteries. Three types of venous drainage patterns were defined: a total jugular volume flow of more than 2/3 (type 1), between 1/3 and 2/3 (type 2) and less than 1/3 (type 3) of the global arterial blood flow. 2D TOF MR-venography was performed exemplarily in one subject with type-1 and in two subjects with type-3 drainage. Type-1 drainage was present in 36 subjects (72%), type 2 in 11 subjects (22%) and type 3 in 3 subjects (6%). In the majority of subjects in our study population, the internal jugular veins were indeed the main drainage vessels in the supine body position. However, a predominantly non-jugular drainage pattern was found in approximately 6% of subjects. (orig.)

  2. 21 CFR 870.1140 - Venous blood pressure manometer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Venous blood pressure manometer. 870.1140 Section 870.1140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous...

  3. Systematic review of topic treatment for venous ulcers

    OpenAIRE

    Borges, Eline Lima; Caliri, Maria Helena Larcher; Haas, Vanderlei José

    2007-01-01

    Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. T...

  4. Travel and venous thrombosis: a systematic review

    NARCIS (Netherlands)

    Kuipers, S.; Schreijer, A. J. M.; Cannegieter, S. C.; Bueller, H. R.; Rosendaal, F. R.; Middeldorp, S.

    2007-01-01

    In the past decade, numerous publications on the association between venous thrombosis (VT) and travel have been published. Relative and absolute risks of VT after travel, and particularly after travel by air, have been studied in case-control and observational follow-up studies, whereas the effect

  5. Fish Intake and Venous Thromboembolism: A Systematic Literature Review.

    Science.gov (United States)

    Mattiuzzi, Camilla; Cervellin, Gianfranco; Franchini, Massimo; Lippi, Giuseppe

    2016-05-01

    Diet plays an important role in modulating the risk of arterial and venous thrombosis. Several lines of evidence attest that consumption of fish and its compounds, especially omega-3 fatty acids, may be effective to decrease the cardiovascular risk. Since the pathogenesis of arterial and venous thrombosis share some common aspects, we performed a systematic review of published clinical studies that investigated the association between fish intake and venous thrombosis. An electronic search was carried out in Medline, Scopus, and ISI Web of Science using the key words "fish" OR "seafood" AND "venous thromboembolism" OR "deep vein thrombosis" OR "pulmonary embolism", with no language or date restriction. Overall, 6 studies (5 prospective and 1 case-control) were finally identified. In only 1 small case-control study, a larger intake of total fish was found to be negatively associated with the risk of venous thromboembolism. No association was found in 4 large prospective studies, whereas a positive association was observed in the remaining. No substantial difference was also noticed between intake of fatty or lean fish. Taken together, the current epidemiological evidence does not support the existence of a significant effect of total fish consumption on the risk of venous thromboembolism. © The Author(s) 2015.

  6. Substitution of Fingertip Blood for Venous Blood in the Measurement of Hematocrit and Hemoglobin Following Exercise

    Science.gov (United States)

    Fahey, Thomas D.; And Others

    1977-01-01

    Results from comparative testing indicate that fingertip blood is a valid indicator of antecubital venous hematocrit (hct) and hemoglobin (hgb), and that hct ratios determined on the Coulter counter are comparable to those found by the microhematocrit method. (MB)

  7. Correlation of central venous pressure with venous blood gas analysis parameters; a diagnostic study

    Directory of Open Access Journals (Sweden)

    Sima Rahim-Taleghani

    2017-03-01

    Full Text Available Objective: This study was conducted to assess the correlation between central venous pressure (CVP and venous blood gas (VBG analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. Material and methods: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG was calculated. All the mentioned parameters were measured again after infusion of 500 cc of normal saline 0.9% in about 1 h. Results: Totally, 93 patients with septic shock were enrolled, 63 male and 30 female. The mean age was 72.53 ± 13.03 and the mean Shock Index (SI before fluid therapy was 0.79 ± 0.30. AG and pH showed significant negative correlations with CVP, While HCO3 showed a significant positive correlation with CVP. These relations can be affected by the treatment modalities used in shock management such as fluid therapy, mechanical ventilation and vasopressor treatment. Conclusion: It is likely that there is a significant statistical correlation between VBG parameters and AG with CVP, but further research is needed before implementation of the results of this study. Keywords: Shock, Septic, Central venous pressure, Blood gas analysis, Emergency department, Emergency medicine

  8. Effectiveness of Sclerotherapy, Surgery, and Laser Therapy in Patients With Venous Malformations: A Systematic Review

    NARCIS (Netherlands)

    Vleuten, C.J.M. van der; Kater, A.; Wijnen, M.H.W.A.; Schultze Kool, L.J.; Rovers, M.M.

    2014-01-01

    Because the best possible treatment for venous malformations is unclear, this study systematically reviews the available literature regarding the effectiveness of different treatment options for the patient group. Venous malformations result from incorrect development of the veins during

  9. The collateral venous system in late pregnancy: A systematic review of the literature.

    Science.gov (United States)

    Humphries, Aimee; Stone, Peter; Mirjalili, S Ali

    2017-11-01

    Recent literature has reported an association between maternal supine sleep position and stillbirth during late pregnancy. In this position the gravid uterus almost completely obstructs the inferior vena cava. A small number of women experience supine hypotension, thought to be due in part to inadequate collateral venous circulation. The aim of this paper is to review the literature describing the anatomy of the collateral venous system and in particular the azygos system, the abdominal portion of which has not been well studied. A systematic review was conducted using the electronic databases: Medline, Embase, Scopus, and Google Scholar. Relevant anatomical and radiological literature concerning the azygos system in particular was reviewed. The search was limited to adult human studies only. The collateral venous system can be divided into superficial, intermediate and deep systems. The azygos system in particular provides immediate collateral venous circulation in the event of acute inferior vena caval obstruction. The abdominal portion of this pathway, including the ascending lumbar vein, has not been well studied and there are certain variations that can render it ineffective. In conclusion, the collateral venous system provides an alternative route for blood to flow back to the systemic circulation when acute occlusion of the inferior vena cava occurs in the supine position during late pregnancy. However, certain anatomical variations can render this pathway ineffective, and this could have implications for the development of supine hypotension and stillbirth in late pregnancy. Clin. Anat. 30:1087-1095, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  10. Pharmacological adjuncts for chronic venous ulcer healing: a systematic review.

    Science.gov (United States)

    Varatharajan, Lavanya; Thapar, Ankur; Lane, Tristan; Munster, Alex B; Davies, Alun Huw

    2016-06-01

    The aim of this study was to systematically review the current evidence and determine whether there is a clinical benefit for using pharmacological agents as adjunctive treatment for chronic venous ulcers. A systematic review of the MEDLINE and EMBASE (from 1 January 1947 through 15 August 2013) and Cochrane databases (from inception through 15 August 2013) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were all randomised controlled trials investigating pharmacological adjuncts for the treatment of venous ulcers with a minimum sample size of 20 patients for each treatment arm. Ten relevant articles were identified; one pilot randomised controlled trial and four Cochrane reviews were included. Pentoxifylline, aspirin, sulodexide, mesoglycan, flavonoids, thromboxane A2 antagonist (ifetroban), zinc, prostaglandin and prostacyclin analogues were the drugs reviewed. Pentoxifylline was found to be more effective than placebo in terms of complete ulcer healing or in causing a significant improvement (greater than 60% reduction in ulcer size) (RR 1.70, 95% CI 1.30 to 2.24). Aspirin and flavonoids show potential to be effective adjuncts but methodological shortcomings and issues with bias limit the validity of results from trials involving each of these drugs, respectively. There was no significant difference between placebo and Ifetroban and likewise pooled results from trials investigating sulodexide and zinc showed no benefit in comparison to placebo. Many systemic pharmacological agents have been investigated as adjuncts to venous ulcer healing; however, pentoxifylline (400 mg, three times a day) is currently the only drug that has promising evidence to support its use. Other compounds are in early stage research. © The Author(s) 2015.

  11. Combination of phlebography and sanguinous measurement of venous blood pressure

    International Nuclear Information System (INIS)

    Weber, J.

    1988-01-01

    Phlebographic visualisation offers the highest spatial resolution of all imaging methods both in respect of veins of the leg and pelvis and of the abdomen. Phlebography offers optimal conditions for assessing morphological changes at the veins and in their direct neighbourhood. No quantitative information is available via phlebography if haemodynamics are disturbed; qualitative information is yielded merely to a restricted extent (by assessing flow velocity and collaterals). Direct sanguinous measurement of venous blood pressure is particularly suitable for the quantitative and qualitative assessment of disturbed haemodynamic conditions; in this respect it stands out among the function tests based on the employment of apparatures. If it is combined with phlebography, it is possible not only to optimise the diagnostic yield in the hands of one investigator, but also to reduce the invasiveness of both methods to one single puncture, since the puncture needle is at the same time also an instrument to measure the pressure. The article points out the possibilities and limitations of combining a) ascending phlebography of the leg and pelvis with peripheral venous pressure measurement (phlebodynamometry) and b) visualisation of the veins of the pelvis and vena cava inferior with central sanguinous venous pressure measurement (CP). Indicatious and technical execution are described. (orig.) [de

  12. Blood pressure normalization post-jugular venous balloon angioplasty.

    Science.gov (United States)

    Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael

    2015-05-01

    This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the

  13. Arterialized and venous blood lactate concentration difference during different exercise intensities

    Directory of Open Access Journals (Sweden)

    Leandro C. Felippe

    2017-06-01

    Conclusion: These results suggest a delayed lactate appearance in the venous blood, which is accentuated at higher exercise intensities. The lactate measured in arterialized and venous blood is interchangeable only when blood samples are collected at least 10 minutes after the exercise starts.

  14. Gene expression profiles are different in venous and capillary blood: Implications for vaccine studies.

    Science.gov (United States)

    Stein, D F; O'Connor, D; Blohmke, C J; Sadarangani, M; Pollard, A J

    2016-10-17

    Detailed analysis of the immunological pathways leading to robust vaccine responses has become possible with the application of systems biology, including transcriptomic analysis. Venous blood is usually obtained for such studies but others have obtained capillary blood (e.g. finger-prick). Capillary samples are practically advantageous, especially in children. The aim of this study was to compare gene expression profiles in venous and capillary blood before, 12h and 24h after vaccination with 23-valent pneumococcal polysaccharide or trivalent inactivated seasonal influenza vaccines. Gene expression at baseline was markedly different between venous and capillary samples, with 4940 genes differentially expressed, and followed a different pattern of changes after vaccination. At baseline, multiple pathways were upregulated in venous compared to capillary blood, including transforming growth factor-beta receptor signalling and toll-like receptor cascades. After vaccination with the influenza vaccine, there was enrichment for T and NK cell related signatures in capillary blood, and monocyte signatures in venous blood. By contrast, after vaccination with the pneumococcal vaccination, there was enrichment of dendritic cells, monocytes and interferon related signatures in capillary blood, whilst at 24h there was enrichment for T and NK cell related signatures in venous blood. These data show differences between venous and capillary gene expression both at baseline, and post vaccination, which may impact on the conclusions regarding immunological mechanisms drawn from studies using these different sampling methodologies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Cerebral venous thrombosis and thrombophilia: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Lauw, Mandy N.; Barco, Stefano; Coutinho, Jonathan M.; Middeldorp, Saskia

    2013-01-01

    Cerebral venous thrombosis (CVT) is a rare manifestation of venous thromboembolism (VTE) and stroke. The aim of our systematic review was to provide an updated summary of the strength of association between CVT and thrombophilia and to explore the relevance of thrombophilia for recurrence of CVT or

  16. Ammonia concentrations in arterial blood, venous blood, and cerebrospinal fluid of dogs with and without congenital extrahepatic portosystemic shunts.

    Science.gov (United States)

    Or, Matan; Devriendt, Nausikaa; Kitshoff, Adriaan M; Peremans, Kathelijne; Vandermeulen, Eva; Paepe, Dominique; Polis, Ingeborgh; Martlé, Valentine; de Rooster, Hilde

    2017-11-01

    OBJECTIVE To compare ammonia concentrations in arterial blood, venous blood, and CSF samples of dogs with and without extrahepatic portosystemic shunts (EHPSS). ANIMALS 19 dogs with congenital EHPSS and 6 healthy control dogs. PROCEDURES All dogs underwent a physical examination and then were anesthetized for transsplenic portal scintigraphy to confirm the presence or absence of EHPSS. While dogs were anesthetized, arterial and venous blood samples and a CSF sample were simultaneously collected for determination of ammonia concentration, which was measured by use of a portable blood ammonia analyzer (device A) and a nonportable biochemical analyzer (device B). Results were compared between dogs with EHPSS and control dogs. RESULTS Arterial, venous, and CSF ammonia concentrations for dogs with EHPSS were significantly greater than those for control dogs. For dogs with EHPSS, ammonia concentrations in both arterial and venous blood samples were markedly increased from the reference range. There was a strong positive correlation between arterial and venous ammonia concentrations and between blood (arterial or venous) and CSF ammonia concentrations. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that blood and CSF ammonia concentrations in dogs with EHPSS were greater than those for healthy dogs and were strongly and positively correlated, albeit in a nonlinear manner. This suggested that the permeability of the blood-brain barrier to ammonia may be abnormally increased in dogs with EHPSS, but further investigation of the relationship between blood or CSF ammonia concentration and clinical signs of hepatic encephalopathy or the surgical outcome for dogs with EHPSS is warranted.

  17. Venous thromboembolism prevention in gynecologic cancer surgery: a systematic review.

    Science.gov (United States)

    Einstein, M Heather; Pritts, Elizabeth A; Hartenbach, Ellen M

    2007-06-01

    Advanced age, pelvic surgery, and the presence of malignancy place gynecologic oncology patients at high risk for venous thromboembolism (VTE). This study was designed to systematically analyze the world's literature on VTE in these patients and determine the optimal prophylaxis regimen. Computerized searches of Pubmed, Ovid, DARE, ACP Journal Club, Cochrane Database of Systematic Reviews, and Cochrane Controlled Trials Registry 1966-2005 were performed, as well as EMBASE 1980-2005. Major conferences and target references were hand-searched. Inclusion criteria were randomized controlled trials (RCTs) evaluating VTE prophylaxis with heparin, low-molecular-weight heparin (LMWH), and sequential compression devices (SCD). The search yielded 278 articles; 11 met inclusion criteria. Data were abstracted by one author and analyzed with the Mantel-Haenszel method. The analysis of heparin-versus-control revealed a significant decrease in DVT in patients receiving heparin (RR=0.58, 95% CI 0.35-0.95). There were no significant differences in EBL or transfusions between the two groups. In the 320 patients in the heparin vs. LMWH studies, there was no significant difference in DVT (RR 0.91, 95% CI 0.38-2.17), although power analysis demonstrated insufficient numbers to show a difference. No patient in either group required re-exploration for bleeding. All gynecologic cancer patients should receive VTE prophylaxis. Although heparin, LMWH, and SCD have been shown to be safe and effective, due to the paucity of data in the gynecologic oncology literature, no one prevention modality can be considered superior at this time. Adequately powered RCTs are urgently needed to determine the optimal regimen in these high-risk patients.

  18. Factor V Leiden Is Associated with Higher Risk of Deep Venous Thrombosis of Large Blood Vessels

    Science.gov (United States)

    Arsov, Todor; Miladinova, Daniela; Spiroski, Mirko

    2006-01-01

    Aim To determine the prevalence of factor V Leiden mutation in patients with different presentation of venous thromboembolic disease and healthy individuals in the Republic of Macedonia. Methods The retrospective case-control study involved 190 patients with venous thromboembolic disease and 200 healthy individuals, who were screened for the presence of factor V Leiden mutation, using a polymerase chain reaction-restriction fragment length polymorphism method. The prevalence of factor V Leiden was analyzed according to the localization of thrombosis, presence of risk factors, and family history of thrombosis. The odds of deep venous thrombosis were calculated with respect to the presence of factor V Leiden mutation. Results The prevalence of factor V Leiden mutation among patients with venous thromboembolic disease was 21.1%, compared with 5.5% in the healthy individuals. Factor V Leiden positive patients had the first episode of deep venous thrombosis at a younger age, and the prevalence of the mutation was the highest among patients with a positive family history of thrombosis (33.9%, P = 0.003) and in patients with deep venous thrombosis affecting a large blood vessel (37.7%, P = 0.001). The prevalence of factor V Leiden mutation was lower in patients with calf deep venous thrombosis and primary thromboembolism (13.3% and 13.1%, respectively; P>0.05). The odds ratio for iliofemoral or femoral deep venous thrombosis in factor V Leiden carriers was 10.4 (95% confidence interval, 4.7-23.1). Conclusion The prevalence of factor V Leiden mutation was high in patients with venous thromboembolic disease and healthy individuals in the Republic of Macedonia. Factor V Leiden carriers have the highest odds of developing deep venous thrombosis affecting a large venous blood vessel. PMID:16758522

  19. Cerebral Blood and CSF Flow Patterns in Patients Diagnosed for Cerebral Venous Thrombosis - An Observational Study

    Directory of Open Access Journals (Sweden)

    Souraya ElSankari

    2012-01-01

    Full Text Available Background and Purpose: Recent studies of the organization of the cerebral venous system in healthy subjects using phase contrast magnetic resonance imaging (PC-MRI show its structural complexity and inter-individual variations. Our objective was to study the venous blood and CSF flows in cerebral venous thrombosis (CVT. Materials and Methods: PC-MRI sequences were added to brain MRI conventional protocol in 19 patients suspected of CVT, among whom 6 patients had CVT diagnosis confirmed by MR venography. Results were compared with 18 healthy age-matched volunteers (HV. Results: In patients without CVT (NoCVT confirmed by venography, we found heterogeneous individual venous flows, and variable side dominance in paired veins and sinuses, comparable to those in healthy volunteers. In CVT patients, PC-MRI detected no venous flow in the veins and/or sinuses with thrombosis. Arterial flows were preserved. CSF aqueductal and cervical stroke volumes were increased in a patient with secondary cerebral infarction, and decreased in 4 patients with extended thrombosis in the superior sagittal and transverse sinuses. These results suggest the main role of the venous system in the regulation of the dynamic intracranial equilibrium. Conclusions: CVT produces highly individualized pattern of disturbance in venous blood drainage. Complementary to MRI venography, PC-MRI provides non-invasive data about venous blockage consequences on CSF flow disturbances.

  20. A content validated questionnaire for assessment of self reported venous blood sampling practices

    Directory of Open Access Journals (Sweden)

    Bölenius Karin

    2012-01-01

    Full Text Available Abstract Background Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability. Findings We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria. Conclusions The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward.

  1. Brightness of venous blood in South American camelids: implications for jugular catheterization.

    Science.gov (United States)

    Grint, Nicola; Dugdale, Alexandra

    2009-01-01

    To compare the brightness of South American camelid venous blood to that of Equidae. Prospective clinical evaluation. Twelve South American camelids (eight llamas, four alpacas), eight horses and ponies (control group). Appropriately sized catheters were placed in the jugular vein of each animal under local anaesthesia. The blood spilt before the catheter was capped was caught on a white tile. A sample of blood was drawn for blood-gas analysis. The brightness of the blood (both on the tile and in the syringe) was matched to a colour chart (1 = darkest red, 8 = brightest red) by a single observer under bright light conditions. Packed cell volume (PCV) and partial pressure of oxygen (PvO(2)) in the blood were also measured on the syringe blood. Normally distributed data were compared using a two tailed t-test, and non-normally distributed data were compared using a Mann-Whitney U-test. Significance was set at p Camelid venous blood was significantly brighter red than that of horses and ponies both on the white tile (p = 0.0003) and in the syringe (p = 0.0001). PCV was significantly lower in camelids (32 +/- 4%) compared with horses (37 +/- 5%). Partial pressure of oxygen values were similar between groups. Jugular venous blood in alpacas and llamas is significantly brighter red than that of horses. Colour should not be used as a sole determinant of venous or arterial catheterization in this species.

  2. Leukocytic Response and Peripheral Venous Blood Lymphocyte Apoptosis as a Marker of Tissue Ischemia in Acute Massive Blood Loss

    Directory of Open Access Journals (Sweden)

    N. V. Borovkova

    2013-01-01

    Full Text Available Objective: to estimate the level of peripheral venous blood lymphocyte apoptosis and intraoperative hypoxia in victims with acute massive blood loss. Subjects and methods. Twenty-two patients with open and close chest and abdominal traumas complicated by acute massive blood loss were examined. All the patients were emergently operated on to stop bleeding. Tissue metabolism was evaluated from gases, acid-base parameters, and plasma lactate, glucose, potassium, and sodium levels. Apoptosis of mononuclear cells was studied and dead leukocytes were counted using flow cytometry. Results. Preoperatively, the victims were found to have venous hypoxemia, hyperlactatemia, hyperglycemia, moderate leukocytosis, and higher dead leukocyte counts. There were also raised counts of lymphocytes coming into the process of apoptosis. A significant relationship was found between monocyte counts and hypoxia values. At the end of surgery, oxygen balance values became stable and exerted an effect on the count of leukocytes, the relative level of granulocytes, the relative and absolute counts of dead and damaged leukocytes, and the concentration of lymphocytes in the victims’ venous blood during the early stages of apoptosis, as evidenced by nonlinear regression models. Conclusion. The indicators of immunocompetent cell apoptosis and the count of venous blood dead leukocytes along with lactate levels and venous hypoxemia parameters reflect the degree of tissue hypoxia and may be used as specific markers.

  3. Femoral Venous Blood pH Changes in Response to External ...

    African Journals Online (AJOL)

    Aim: To measure in vivo the femoral venous blood pH in response to external lower limb compression in cardiac catheterization patients. Patients and Method: The pH was measured in discrete samples of blood withdrawn from the femoral vein before, during and after insertion of the catheterized leg into the graduated ...

  4. The sloping alveolar plateau of tracer gases washed out from mixed venous blood in man

    NARCIS (Netherlands)

    Schrikker, A.C.M.; Vries, W.R. de; Zwart, A.; Luijendijk, S.C.M.

    1989-01-01

    We have investigated the slope of the alveolar plateau for inert tracer gases that were washed out from mixed venous blood. Two pairs of tracer gases were used (He, SFe) and (C2H2, Freon 22). The gases of each pair share almost the same blood-gas partition coefïicient but they have different

  5. Superficial venous disease and combined hormonal contraceptives: a systematic review.

    Science.gov (United States)

    Tepper, Naomi K; Marchbanks, Polly A; Curtis, Kathryn M

    2016-09-01

    Superficial venous disease, which includes superficial venous thrombosis (SVT) and varicose veins, may be associated with a higher risk of venous thromboembolism (VTE). Use of combined hormonal contraceptives (CHCs) has been associated with an increased risk of VTE compared with nonuse. Little is known about whether use of CHCs by women with superficial venous disease may further elevate the risk of VTE. To investigate evidence regarding risk of VTE in women with SVT or varicose veins who use CHCs compared with non-CHC users. We searched the PubMed database for all English-language articles published from database inception through September 2014. We included primary research studies that examined women with SVT or varicose veins who used CHCs compared to women with these conditions who did not use CHCs. Outcomes of interest included VTE (among women with SVT or varicose veins) and SVT (for those with varicose veins). Two studies were identified that met inclusion criteria. One fair-quality case-control study reported an odds ratio (OR) for VTE of 43.0 (95% confidence interval [CI] 15.5-119.3) among women with SVT using oral contraceptives (OCs) compared with nonusers without SVT. The OR for VTE was also increased for women with SVT not using OCs (OR 5.1; 95% CI 2.8-9.5) and for women without SVT using OCs (OR 4.0; 95% CI 3.3-4.7), compared with nonusers without SVT. One fair-quality cohort study demonstrated that women with varicose veins had an increased rate of VTE with use of OCs (1.85 per 1000 women-years [WY]), compared with users without varicose veins (0.84 per 1000 WY), nonusers with varicose veins (0.31 per 1000 WY) and nonusers without varicose veins (0.19 per 1000 WY). This study also demonstrated that women with varicose veins had an increased rate of SVT with use of OCs (10.63 per 1000 WY), compared with nonusers with varicose veins (7.59 per 1000 WY), users without varicose veins (1.89 per 1000 WY) and nonusers without varicose veins (0.77 per 1000

  6. Peripheral venous distension elicits a blood pressure raising reflex in young and middle-aged adults.

    Science.gov (United States)

    Matthews, Evan L; Brian, Michael S; Coyle, Dana E; Edwards, David G; Stocker, Sean D; Wenner, Megan M; Farquhar, William B

    2016-06-01

    Distension of peripheral veins in humans elicits a pressor and sympathoexcitatory response that is mediated through group III/IV skeletal muscle afferents. There is some evidence that autonomic reflexes mediated by these sensory fibers are blunted with increasing age, yet to date the venous distension reflex has only been studied in young adults. Therefore, we tested the hypothesis that the venous distension reflex would be attenuated in middle-aged compared with young adults. Nineteen young (14 men/5 women, 25 ± 1 yr) and 13 middle-aged (9 men/4 women, 50 ± 2 yr) healthy normotensive participants underwent venous distension via saline infusion through a retrograde intravenous catheter in an antecubital vein during limb occlusion. Beat-by-beat blood pressure, muscle sympathetic nerve activity (MSNA), and model flow-derived cardiac output (Q), and total peripheral resistance (TPR) were recorded throughout the trial. Mean arterial pressure (MAP) increased during the venous distension in both young (baseline 83 ± 2, peak 94 ± 3 mmHg; P blood pressure, MSNA, and TPR were similar between young and middle-aged adults. Additionally, no correlation was found between age and the response to venous distension (all P > 0.05). These findings suggest that peripheral venous distension elicits a pressor and sympathetic response in middle-aged adults similar to the response observed in young adults. Copyright © 2016 the American Physiological Society.

  7. Investigation of venous blood cells parameters among 1180 healthy people in Tianjin area

    International Nuclear Information System (INIS)

    Jiang Liping; Hao Jianxiu; Li Jin; Xing Zhiwei; Zhao Xinran; Jiang Bo; Wang Xiaoguang; Jiang Enhai

    2013-01-01

    Objective: To investigate the reference values of 18 parameters of venous blood cells among healthy adults in Tianjin area. Methods: The values of 18 parameters of venous blood from 1180 healthy adults in Tianjin area were measured by Sysmex KX-21 hematology analyzer and the results were analyzed. Results: The statistical analysis of the test reveals that significant differences exist in most parameters of venous blood cells according to the gender and age of people. Except the parameters of mean corpuscular volume, lymphocytes percentage, mean platelet volume, platelet distribution width,there were significant differences in the remaining parameters between the males group and the females group. Except the parameters of white blood count,platelet count, mean corpuscular hemoglobin, neutrophil percentage,absolute neutrophil count, mean platelet volume, platelet distribution width, there were significant differences in the remaining parameters between the old male group and the adult male group. Except the parameters of white blood count, mean corpuscular volume, mean corpuscular hemoglobin, there was no significant difference in the remaining parameters between the old female group and the adult female group. Conclusions: There are some differences between the findings and the reference range provided by the National Guide to Clinical laboratory Procedure. Therefore, it is necessary for laboratory to establish the reference values of venous blood cells according to concrete conditions. (authors)

  8. Thrombosis prophylaxis in patient populations with a central venous catheter - A systematic review

    NARCIS (Netherlands)

    Klerk, Clara P. W.; Smorenburg, Susanne M.; Büller, Harry R.

    2003-01-01

    Background: Central venous catheters (CVCs) are used in a wide variety of patients. Associated complications are thrombosis and infection. It is a matter of debate whether thromboprophylaxis is beneficial. Methods: We performed a systematic review of 3 different patient populations to render the

  9. Can umbilical cord blood counts substitute venous blood counts done in the first six hours of life in term neonates?

    Directory of Open Access Journals (Sweden)

    Navneet Nath

    2014-01-01

    Materials & Methods: This retrospective, one-year study included full-term neonates with conditions that can be predicted before birth (infection in the infant of a mother with prolonged rupture of membranes, Rh negative mothers′ infant, Intra-uterine growth retardation, transient tachypnoea ofnewborn following caesarean section or at birth (birth asphyxia. Umbilical cord blood hemoglobin, total and differential leukocyte counts and platelet counts were compared with the same parameters obtainedfrom venous blood drawn from neonates within six hours of birth. Results: A total of 49 neonates were eligible and included. The mean (s.d. values of parameters for cord blood were 15.49 gm/dL (3.36 for hemoglobin; 12695.26/dL (6181.49 for total leukocyte count; Ploymorphs 48.61% (15.97; Lymphocytes 39.46% (15.83; Eosinophils 4.17% (2.2 and Monocytes 4.7% (2.27 while mean platelet count was 254.4 × 103/dL (91.5. The same parameters for venous blood were mean hemoglobin of15.78 gm/dl (2.76; TLC13373.47/dL (6499.16; Ploymorphs50.04% (14.45;Lymphocytes41.08% (15.26; Eosinophils 4.14% (2.2 and Monocytes 4.7% (2.19 while mean platelet count in venous blood was 265.76 × 103/dL (88.54. There was no significant difference between the cord blood value and the venous blood value of any of the above hematological parameters. Conclusions: This study shows that there is no difference in the hematological parameters tested in cord blood or venous blood collected within six hours of birth in full-term neonates. Larger studies are needed to confirm this finding and evaluate the benefits to neonates after which cord blood testing can routinely substitute venous blood testing for these hematological parameters in neonates with conditions as described in this study.

  10. Thermographic venous blood flow characterization with external cooling stimulation

    Science.gov (United States)

    Saxena, Ashish; Ng, E. Y. K.; Raman, Vignesh

    2018-05-01

    Experimental characterization of blood flow in a human forearm is done with the application of continuous external cooling based active thermography method. Qualitative and quantitative detection of the blood vessel in a thermal image is done, along with the evaluation of blood vessel diameter, blood flow direction, and velocity in the target blood vessel. Subtraction based image manipulation is performed to enhance the feature contrast of the thermal image acquired after the removal of external cooling. To demonstrate the effect of occlusion diseases (obstruction), an external cuff based occlusion is applied after the removal of cooling and its effect on the skin rewarming is studied. Using external cooling, a transit time method based blood flow velocity estimation is done. From the results obtained, it is evident that an external cooling based active thermography method can be used to develop a diagnosis tool for superficial blood vessel diseases.

  11. Reliable rapid blood test for the exclusion of venous thromboembolism in symptomatic outpatients

    NARCIS (Netherlands)

    Turkstra, F.; van Beek, E. J.; ten Cate, J. W.; Büller, H. R.

    1996-01-01

    In this study we assessed the reliability of a rapid bed-side whole blood D-dimer assay prospectively in patients with clinically suspected venous thromboembolism, referred to the Academic Medical Centre, Amsterdam. In consecutive outpatients with clinically suspected deep vein thrombosis or

  12. A comparison of plasma pyridoxal 5'-phosphate concentrations in capillary (finger prick) and venous blood.

    Science.gov (United States)

    Andon, M B; Reynolds, R D

    1987-06-01

    The purpose of our study was to investigate the validity of using capillary blood plasma to estimate the pyridoxal 5'-phosphate (PLP) concentration of venous blood plasma. To accommodate the small volumes of capillary blood usually obtained, we modified the experimental conditions of the L-tyrosine apodecarboxylase (TDC) assay for PLP by increasing both the specific activity of 14C-tyrosine and the reaction incubation time. Plasma PLP concentrations determined by the TDC assay and the micro-modified TDC assay were highly correlated (r = 0.995, p = 4.0 X 10(-6)). Using the micro-modified TDC assay, we observed no significant difference between the plasma PLP concentrations of venous and capillary (finger prick) blood from 10 healthy adults. Thus, capillary blood plasma can be used to estimate the PLP concentration of venous blood plasma. This observation will aid in verifying data concerning the vitamin B-6 status assessment of individuals as determined by capillary blood plasma PLP concentrations.

  13. A systematic review of the efficacy and limitations of venous intervention in stasis ulceration.

    Science.gov (United States)

    Montminy, Myriam L; Jayaraj, Arjun; Raju, Seshadri

    2018-05-01

    Surgical techniques to address various components of chronic venous disease are rapidly evolving. Their efficacy and generally good results in treating superficial venous reflux (SVR) have been documented and compared in patients presenting with pain and swelling. A growing amount of literature is now available suggesting their efficacy in patients with venous leg ulcer (VLU). This review attempts to summarize the efficacy and limitations of commonly used venous interventions in the treatment of SVR and incompetent perforator veins (IPVs) in patients with VLU. A systematic review of the published literature was performed. Two different searches were conducted in MEDLINE, Embase, and EBSCOhost to identify studies that examined the efficacy of SVR ablation and IPV ablation on healing rate and recurrence rate of VLU. In the whole review, 1940 articles were screened. Of those, 45 were included in the SVR ablation review and 4 in the IPV ablation review. Data were too heterogeneous to perform an adequate meta-analysis. The quality of evidence assessed by the Grading of Recommendations Assessment, Development, and Evaluation for the two outcomes varied from very low to moderate. Ulcer healing rate and recurrence rate were between 70% and 100% and 0% and 49% in the SVR ablation review and between 59% and 93% and 4% and 33% in the IPV ablation review, respectively. To explain those variable results, limitations such as inadequate diagnostic techniques, saphenous size, concomitant calf pump dysfunction, and associated deep venous reflux are discussed. Currently available minimally invasive techniques correct most venous pathologic processes in chronic venous disease with a good sustainable healing rate. There are still specific diagnostic and efficacy limitations that mandate proper match of individual patients with the planned approach. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  14. The impact of venous occlusion per se on forearm muscle blood flow: implications for the near-infrared spectroscopy venous occlusion technique.

    Science.gov (United States)

    Cross, Troy J; Sabapathy, Surendran

    2017-05-01

    The purpose of this study was to examine the effect of venous occlusion per se on forearm muscle blood flow, as determined by the near-infrared spectroscopy (NIRS) venous occlusion technique (NIRS-VOT). NIRS data were obtained from the flexor digitorum superficialis (FDS) muscle on the dominant arm of 16 young, ostensibly healthy participants (14 men and two women; 30 ± 6 year; 73 ± 7 kg). Participants completed a series of five venous occlusion trials while seated at rest, and a series of 12 venous occlusion trials during a reactive hyperaemia induced by 5 min of forearm arterial occlusion. The NIRS-VOT was used to assess FDS muscle blood flow (Q˙mus), beat-by-beat, over the first four cardiac beats during venous occlusions. Q˙mus was also reported as a cumulative value, wherein the first two, first three and first four cardiac beats were used to calculate muscle blood flow. We observed that Q˙mus was highest when calculated over the first cardiac beat during venous occlusions performed at rest and throughout reactive hyperaemia (P<0·05). Moreover, the inclusion of more than one cardiac beat in the calculation of Q˙mus underestimated muscle blood flows, irrespective of the prevailing level of arterial inflow. These findings support the idea that venous occlusion per se affects the measurement of Q˙mus via the NIRS-VOT. Accordingly, it is recommended that Q˙mus is determined over the first cardiac beat when using the NIRS-VOT to assess microvascular blood flow of human forearm muscles. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion. Nonlinear decay of adult red blood cells

    Energy Technology Data Exchange (ETDEWEB)

    Gemert, Martin J C van; Wijngaard, Jeroen P H M van den [Laser Centre and Department of Obstetrics, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Pasman, Suzanne A; Vandenbussche, Frank P H A [Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Centre, Leiden (Netherlands); Lopriore, Enrico [Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden (Netherlands)], E-mail: m.j.vangemert@amc.uva.nl

    2008-07-07

    Recently, we derived equations relating the flow of adult red blood cells through a placental arterio-venous anastomosis with intra-uterine and post-natal measured adult hemoglobin concentrations. In this letter, we re-derived the equations, now including a more realistic nonlinear decay of adult red blood cells, and re-evaluated the measurement accuracy of the arterio-venous flow and the lifetime of the red blood cells. (letter to the editor)

  16. Calculating acid-base and oxygenation status during COPD exacerbation using mathematically arterialised venous blood

    DEFF Research Database (Denmark)

    Rees, Stephen Edward; Rychwicka-Kielek, Beate A; Andersen, Bjarne F

    2012-01-01

    Abstract Background: Repeated arterial puncture is painful. A mathematical method exists for transforming peripheral venous pH, PCO2 and PO2 to arterial eliminating the need for arterial sampling. This study evaluates this method to monitor acid-base and oxygenation during admission...... for exacerbation of chronic obstructive pulmonary disease (COPD). Methods: Simultaneous arterial and peripheral venous blood was analysed. Venous values were used to calculate arterial pH, PCO2 and PO2, with these compared to measured values using Bland-Altman analysis and scatter plots. Calculated values of PO2......H, PCO2 and PO2 were 7.432±0.047, 6.8±1.7 kPa and 9.2±1.5 kPa, respectively. Calculated and measured arterial pH and PCO2 agreed well, differences having small bias and SD (0.000±0.022 pH, -0.06±0.50 kPa PCO2), significantly better than venous blood alone. Calculated PO2 obeyed the clinical rules...

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

    OpenAIRE

    Rosado, Viviane; Camargos, Paulo A.M.; Anchieta, Lêni M.; Bouzada, Maria C.F.; Oliveira, Gabriela M. de; Clemente, Wanessa T.; Romanelli, Roberta M. de C.

    2018-01-01

    Abstract 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 wer...

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

    OpenAIRE

    Viviane Rosado; Paulo A.M. Camargos; Lêni M. Anchieta; Maria C.F. Bouzada; Gabriela M. de Oliveira; Wanessa T. Clemente; Roberta M. de C. Romanelli

    2018-01-01

    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 sele...

  19. Mercury levels in cord blood and meconium of healthy newborns and venous blood of their mothers: Clinical, prospective cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Unuvar, Emin [Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Istanbul (Turkey)]. E-mail: Eunuvar@superonline.com; Ahmadov, Hasan [Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Istanbul (Turkey); Kiziler, Ali Riza [Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Istanbul (Turkey); Istanbul University, Cerrahpasa Medical Faculty, Department of Biophysics, Istanbul (Turkey); Aydemir, Birsen [Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Istanbul (Turkey); Istanbul University, Cerrahpasa Medical Faculty, Department of Biophysics, Istanbul (Turkey); Toprak, Sadik [Gazi Osman Pasa University, Department of Forensic Pathology, Tokat (Turkey); Ulker, Volkan [Bakirkoy Government Hospital, Istanbul (Turkey); Ark, Cemal [Bakirkoy Government Hospital, Istanbul (Turkey)

    2007-03-01

    Objectives: The purpose of this study is to investigate the chronic mercury intoxication in pregnant women and newborns living in Istanbul, Turkey. Methods: The research was carried out as a prospective with 143 pregnant women and their newborns. Venous blood from the mother, cord blood from the neonate, and meconium were collected for mercury analysis. Frequency of fish and vegetable-eating and the number of teeth filled were investigated. Analyses were made in cold vapor Atomic Absorption Spectrophotometer (AAS, {mu}g/L). Results: Mercury levels were 0.38 {+-} 0.5 {mu}g/L (0-2.34) in venous blood of pregnant women, 0.50 {+-} 0.64 {mu}g/L (0-2.36) in umbilical cord blood and 9.45 {+-} 13.8 {mu}g/g (0-66.5) in meconium. Maternal blood mercury level was lower than the known toxic limit for humans (EPA, 5 {mu}g/L). Mercury levels of the maternal venous blood were significantly correlated with umbilical cord blood. The primary risk factors affecting mercury levels were eating fishmeals more than twice a week and having filled teeth more than five. The fact that the mother had a regular vegetable diet everyday reduced the mercury levels. Increased levels of mercury in the mother and umbilical cord blood could lead to retarded newborns' weight and height. Conclusion: Pregnant women living in Istanbul may be not under the risk of chronic mercury intoxication. Fish consumption more than twice per week and tooth-filling of mother more than five may increase mercury level. On the contrary, regular diet rich in vegetable decreases the mercury level.

  20. Mercury levels in cord blood and meconium of healthy newborns and venous blood of their mothers: Clinical, prospective cohort study

    International Nuclear Information System (INIS)

    Unuvar, Emin; Ahmadov, Hasan; Kiziler, Ali Riza; Aydemir, Birsen; Toprak, Sadik; Ulker, Volkan; Ark, Cemal

    2007-01-01

    Objectives: The purpose of this study is to investigate the chronic mercury intoxication in pregnant women and newborns living in Istanbul, Turkey. Methods: The research was carried out as a prospective with 143 pregnant women and their newborns. Venous blood from the mother, cord blood from the neonate, and meconium were collected for mercury analysis. Frequency of fish and vegetable-eating and the number of teeth filled were investigated. Analyses were made in cold vapor Atomic Absorption Spectrophotometer (AAS, μg/L). Results: Mercury levels were 0.38 ± 0.5 μg/L (0-2.34) in venous blood of pregnant women, 0.50 ± 0.64 μg/L (0-2.36) in umbilical cord blood and 9.45 ± 13.8 μg/g (0-66.5) in meconium. Maternal blood mercury level was lower than the known toxic limit for humans (EPA, 5 μg/L). Mercury levels of the maternal venous blood were significantly correlated with umbilical cord blood. The primary risk factors affecting mercury levels were eating fishmeals more than twice a week and having filled teeth more than five. The fact that the mother had a regular vegetable diet everyday reduced the mercury levels. Increased levels of mercury in the mother and umbilical cord blood could lead to retarded newborns' weight and height. Conclusion: Pregnant women living in Istanbul may be not under the risk of chronic mercury intoxication. Fish consumption more than twice per week and tooth-filling of mother more than five may increase mercury level. On the contrary, regular diet rich in vegetable decreases the mercury level

  1. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis.

    Science.gov (United States)

    Egan, Grace; Healy, Donagh; O'Neill, Heidi; Clarke-Moloney, Mary; Grace, Pierce A; Walsh, Stewart R

    2013-07-01

    Establishing intravenous access is often vital in an acute hospital setting but can be difficult. Ultrasound-guided cannulation increases success rates in prospective studies. However, these studies have often lacked a comparative group. This systematic review and meta-analysis aimed to determine the clinical effectiveness of Ultrasound-guided peripheral intravenous cannulation compared with the standard technique in patients known to have difficult access. Electronic abstract databases, trial registries, article reference lists and internet repositories were searched using the following search terms: 'peripheral venous cannulation', 'peripheral venous access'. Studies meeting the following criteria were included: randomised controlled trial patients of all ages who required peripheral intravenous access; interventions were Ultrasound-guided versus standard cannulation technique; patients were identified as having difficult venous access; inclusion of at least one defined outcome (procedural success time to cannula placement; number of attempts). 7 trials were identified (289 participants). Ultrasound guidance increases the likelihood of successful cannulation (pooled OR 2.42; 95% CI 1.26 to 4.68; p=0.008). There were no differences in time to successful cannulation, or number of percutaneous skin punctures. Ultrasound guidance increases the likelihood of successful peripheral cannulation in difficult access patients. We recommend its use in patients who have difficult venous access, and have failed venous cannulation by standard methods. Further randomised controlled trials (RCTs) with larger sample sizes would be of benefit to investigate if Ultrasound has any additional advantages in terms of reducing the procedure time and the number of skin punctures required for successful venous cannulation.

  2. [Correlation between indices of 24-h monitoring of blood pressure and disturbed venous cerebral outflow in hypertensive patients].

    Science.gov (United States)

    Afanas'eva, N L; Mordovin, V F; Semke, G V; Luk'ianenok, P I

    2008-01-01

    To study relations between disturbances of cerebral venous circulation and parameters of 24-h blood pressure monitoring in hypertensive patients. A total of 72 patients aged 28 to 60 years with essential hypertension of stage II have undergone 24-h blood pressure monitoring and MR-venography of the brachiocephalic veins on a low-field MR-tomograph using 2D TOF angiography. Symptoms of disturbed cerebral venous circulation were found in 60% patients. Major venous collectors were asymmetric in 79.2% patients, 40.3% had marked asymmetry, 14% had severe asymmetry. Disturbances of venous outflow significantly more frequently occurred in non-dippers and night-peakers as well as in high variability of blood pressure. Patients with marked asymmetry of venous collectors had elevated nocturnal systolic and diastolic blood pressure, high load indices of nocturnal systolic and diastolic pressure, a low degree of nocturnal fall of blood pressure. Disturbance of venous cerebral outflow in hypertensive patients is closely related with alterations of a circadian profile of blood pressure: circadian index of blood pressure, variability of blood pressure.

  3. Midazolam sedates Passeriformes for field sampling but affects multiple venous blood analytes

    Directory of Open Access Journals (Sweden)

    Heatley JJ

    2015-01-01

    Full Text Available J Jill Heatley,1 Jennifer Cary,2,3 Lyndsey Kingsley,1 Hughes Beaufrere,4 Karen E Russell,5 Gary Voelker2,3 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, 2Department of Wildlife and Fisheries Sciences, 3Texas A&M Biodiversity Research and Teaching Collections, Texas A&M University, College Station, TX, USA; 4Health Sciences Centre, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada; 5Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA Abstract: Feasibility and effect of midazolam administration on blood analytes and for sedation of Passeriformes being collected in a larger study of genetic biodiversity was assessed. Midazolam (5.6±2.7 mg/kg was administered intranasally prior to sampling, euthanasia, and specimen preparation of 104 passerine birds. Each bird was assessed for sedation score and then multiple analytes were determined from jugular blood samples using the i-STAT® point of care analyzer at “bird side”. Most birds were acceptably sedated, sedation became more pronounced as midazolam dose increased, and only a single bird died. Electrolyte concentrations and venous blood gas analytes were affected by midazolam administration while blood pH, packed cell volume, hemoglobin, and calculated hematocrit were not. Intranasal midazolam gives adequate sedation and is safe for short-term use in free-living Passeriformes. Based on venous blood analyte data, sedation of Passeriformes prior to handling appears to reduce stress but also produces venous blood gas differences consistent with hypoventilation relative to birds which were not given midazolam. Further study is recommended to investigate midazolam's continued use in free-living avian species. Studies should include safety, reversal and recovery, effect upon additional endogenous analytes, and compatibility with studies of ecology and toxicology

  4. Clinicopathologic analysis of Passeriform venous blood reflects transitions in elevation and habitat

    Directory of Open Access Journals (Sweden)

    Heatley JJ

    2013-06-01

    Full Text Available J Jill Heatley,1 Jennifer Cary,2 Karen E Russell,3 Gary Voelker2 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, 2Department of Wildlife and Fisheries Sciences and Texas A&M Biodiversity Research and Teaching Collections, Texas A&M University, 3Department of Pathobiology, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, USA Abstract: Jugular blood samples from 110 Passeriformes collected at several Texas locations were analyzed for multiple clinicopathologic parameters between April 2010 and August 2011. Electrolyte, blood gas, and select erythrocyte parameters were analyzed on site with a point of care analyzer, and gender, age, body condition score, location, and species were recorded. Many analytes exhibited a Gaussian distribution across species and are reported as a single range. Taxon affected electrolyte and red blood cell parameters, but not most blood gas or acid base variables. Migratory status affected select electrolytes but few blood gas variables. Red blood cell parameters were affected the most by variables of age, taxonomic group, and gender, but not migratory life history. We found significant changes in glucose and numerous acid base analytes in birds sampled from habitats with evolutionarily recent ecologic degradation. We advocate the use of these analytes, particularly venous blood gas values, as determined by a point of care analyzer, as reasonable biomarkers for determination of Passeriform population health, but also recommend that red blood cell parameters and electrolyte concentrations be controlled for age, species, and gender in future studies. Further, based on our investigation, venous blood gas values and acid base balance in Passeriformes can assess the health of an ecosystem. Keywords: avian, biochemistry, blood gas, electrolyte, hematology, Passerine

  5. Association of varicosities and concomitant deep venous thrombosis in patients with superficial venous thrombosis, a systematic review

    NARCIS (Netherlands)

    Baggen, Vivan J M; Chung, Kaman; Koole, Koos; Sarneel, Michelle H J; Rutten, Frans H|info:eu-repo/dai/nl/189152753; Hajer, Gideon R

    2015-01-01

    BACKGROUND: In patients with superficial venous thrombosis (SVT) co-existence of deep venous thrombosis (DVT) can be present. Varicosities are considered as a risk factor for both SVT and DVT separately. However, current evidence is contradictory whether varicosities are associated with an increased

  6. 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

  7. Systematic review of the association of venous oxygenation and outcome in adult hospitalized patients

    DEFF Research Database (Denmark)

    Chemtob, R A; Eskesen, T G; Møller-Sørensen, H

    2016-01-01

    BACKGROUND: Adequate tissue oxygenation is necessary to maintain organ function. Low venous oxygen saturation may reflect impaired tissue oxygenation, and may be used as a predictive tool and a therapeutic target to improve the care of critically ill patients. We therefore conducted a systematic...... in 5590 papers of which 42 studies were deemed relevant. The majority of the studies in cardiac and abdominal surgery patients showed associations between low venous oxygen saturation and increased mortality and morbidity, in particular increased length of intensive care. However, the cut-off level...... mortality, morbidity and length of intensive care in patients following cardiac or abdominal surgery. However, the wide range of cut-off levels and low quality of evidence hampers the clinical application. In patients with septic shock, the present evidence does not support goal-directed therapy using...

  8. ABO blood groups and risk of deep venous thromboembolism in Chinese Han population from Chaoshan region in South China.

    Science.gov (United States)

    Yu, Min; Wang, Cantian; Chen, Tingting; Hu, Shuang; Yi, Kaihong; Tan, Xuerui

    2017-04-01

     Objectives: To demonstrate the prevalence of ABO blood groups with deep venous thromboembolism in Chinese Han population. A retrospective study was conducted between January 2010 and March 2015 in The First Affiliated Hospital of Shantou University Medical College in Chaoshan District of Guangdong Province in South China. Eighty nine patients with confirmed diagnosis of deep venous thromboembolism were included. Frequency of blood groups was determined. Results: Of 89 patients with deep venous thromboembolism, 28 patients had blood group A (31.5%), 28 patients had blood group B (31.5%), 13 patients had blood group AB (14.6%), and 20 patients had blood group O (22.5%). Compared with O blood type, the odds ratios of deep venous thromboembolism for A, B and AB were 2.23 (95% CI, 1.27-3.91), 2.34 (95% CI, 1.34-4.09) and  4.43 (95% CI, 2.24-8.76). Conclusion: There is a higher risk of venous thromboembolism in non-O blood groups than O group.

  9. ABO blood groups and risk of deep venous thromboembolism in Chinese Han population from Chaoshan region in South China

    Directory of Open Access Journals (Sweden)

    Min Yu

    2017-04-01

    Full Text Available Objectives: To demonstrate the prevalence of ABO blood groups with deep venous thromboembolism in Chinese Han population. Methods: A retrospective study was conducted between January 2010 and March 2015 in The First Affiliated Hospital of Shantou University Medical College in Chaoshan District of Guangdong Province in South China. Eighty nine patients with confirmed diagnosis of deep venous thromboembolism were included. Frequency of blood groups was determined. Results: Of 89 patients with deep venous thromboembolism, 28 patients had blood group A (31.5%, 28 patients had blood group B (31.5%, 13 patients had blood group AB (14.6%, and 20 patients had blood group O (22.5%. Compared with O blood type, the odds ratios of deep venous thromboembolism for A, B and AB were 2.23 (95% CI, 1.27-3.91, 2.34 (95% CI, 1.34-4.09 and 4.43 (95% CI, 2.24-8.76. Conclusion: There is a higher risk of venous thromboembolism in non-O blood groups than O group.

  10. Advantages and disadvantages of peripherally inserted central venous catheters (PICC) compared to other central venous lines: a systematic review of the literature.

    Science.gov (United States)

    Johansson, Eva; Hammarskjöld, Fredrik; Lundberg, Dag; Arnlind, Marianne Heibert

    2013-06-01

    The use of central venous lines carries a significant risk for serious complications and high economic costs. Lately, the peripherally inserted central venous catheter (PICC) has gained in popularity due to presumed advantages over other central venous lines. The aim of this systematic literature review was to identify scientific evidence justifying the use of PICC. The literature review was performed according to the principles of Cochrane Collaboration. The electronic literature search included common databases up to March 2011. Only those studies rated as high or moderate quality were used for grading of evidence and conclusions. The search resulted in 827 abstracts, 48 articles were read in full text, and 11 met the inclusion criteria. None of the articles was classified as high quality and two had moderate quality. The results of these two studies indicate that PICC increases the risk for deep venous thrombosis (DVT), but decreases the risk for catheter occlusion. The quality of scientific evidence behind these conclusions, however, was limited. Due to the lack of studies with sufficiently high quality, questions such as early complications, patient satisfaction and costs could not be answered. We conclude that although PICCs are frequently used in oncology, scientific evidence supporting any advantage or disadvantage of PICC when comparing PICC with traditional central venous lines is limited, apart from a tendency towards increased risk for DVT and a decreased risk for catheter occlusion with PICC.

  11. Diurnal variations in lower leg subcutaneous blood flow rate in patients with chronic venous leg ulcers

    DEFF Research Database (Denmark)

    Sindrup, J H; Kastrup, J; Kristensen, J K

    1991-01-01

    The blood flow rate in subcutaneous adipose tissue was measured on the lower legs of 11 patients with chronic lower-leg venous insufficiency and ulceration and in eight age-matched control subjects for 12-20 h, under ambulatory conditions, using the 133Xe wash-out technique with portable Cadmium...... telluride (CdTe(Cl)) detectors. In both groups, the change from an upright to a supine position at the beginning of the night period elicited an instantaneous increment in the blood flow rate of 30-40% with a decrease in the central and local postural sympathetic vasoconstrictor activity. After...... approximately 1 h of sleep, a considerable increase in blood flow rate was seen in both patient and control groups which persisted for nearly 100 min. In the patient group, the mean increase was 137% compared to a mean increase of 68% in the control group (P less than 0.01). The blood flow then returned...

  12. Capillary versus Venous Hemoglobin Determination in the Assessment of Healthy Blood Donors

    Science.gov (United States)

    Patel, Abhilasha J.; Wesley, Robert; Leitman, Susan F.; Bryant, Barbara J.

    2013-01-01

    Background and Objectives To determine the accuracy of fingerstick hemoglobin assessment in blood donors, the performance of a portable hemoglobinometer (HemoCue Hb 201+) was prospectively compared with that of an automated hematology analyzer (Cell-Dyn 4000). Hemoglobin values obtained by the latter were used as the “true” result. Material and Methods Capillary fingerstick samples were assayed by HemoCue in 150 donors. Fingerstick samples from two sites, one on each hand, were obtained from a subset of 50 subjects. Concurrent venous samples were tested using both HemoCue and Cell-Dyn devices. Results Capillary hemoglobin values (HemoCue) were significantly greater than venous hemoglobin values (HemoCue), which in turn were significantly greater than venous hemoglobin values by Cell-Dyn (mean ± SD: 14.05 ± 1.51, 13.89 ± 1.31, 13.62 ± 1.23, respectively; phemoglobin screening criteria (≥12.5 g/dL) by capillary HemoCue, but were deferred by Cell-Dyn values (false-pass). Five donors (3%) were deferred by capillary sampling, but passed by Cell-Dyn (false-fail). Substantial variability in repeated fingerstick HemoCue results was seen (mean hemoglobin 13.72 vs. 13.70 g/dL, absolute mean difference between paired samples 0.76 g/dL). Hand dominance was not a factor. Conclusions Capillary samples assessed via a portable device yielded higher hemoglobin values than venous samples assessed on an automated analyzer. False-pass and false-fail rates were low and acceptable in the donor screening setting, with “true” values not differing by a clinically significant degree from threshold values used to assess acceptability for blood donation. PMID:23294266

  13. The quantitative regional cerebral blood flow measurement with autoradiography method using 123I-IMP SPECT. Evaluation of arterialized venous blood sampling as a substitute for arterial blood sampling

    International Nuclear Information System (INIS)

    Ohnishi, Takashi; Yano, Takao; Nakano, Shinichi; Jinnouchi, Seishi; Nagamachi, Shigeki; Flores, L. II; Nakahara, Hiroshi; Watanabe, Katsushi.

    1996-01-01

    The purpose of this study is validation of calibrating a standard input function in autoradiography (ARG) method by one point venous blood sampling as a substitute for that by one point arterial blood sampling. Ten and 20 minutes after intravenous constant infusion of 123 I-IMP, arterialized venous blood sampling from a dorsal vein were performed on 15 patients having ischemic cerebrovascular disease. And arterial blood sampling from radial artery was performed 10 min after 123 I-IMP infusion. The mean difference rates of integrated input function between calibrated standard input function by arterial blood sampling at 10 min and that by venous blood sampling were 4.1±3% and 9.3±5.4% at 10 and 20 min after 123 I-IMP infusion, respectively. The ratio of venous blood radioactivity to arterial blood radioactivity at 10 min after 123 I-IMP infusion was 0.96±0.02. There was an excellent correlation between ARG method CBF values obtained by arterial blood sampling at 10 min and those obtained by arterialized venous blood sampling at 10 min. In conclusion, a substitution by arterialized venous blood sampling from dorsal hand vein for artery can be possible. The optimized time for arterialized venous blood sampling was 10 min after 123 I-IMP infusion. (author)

  14. Quantitative assessment of limb blood flow using Tc-99m labeled red blood cells. Radionuclide venous occlusion plethysmography (RAVOP)

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Kazuo; Shougase, Takashi; Kawamura, Naoyuki; Tsukamoto, Eriko; Nakada, Kunihiro; Sakuma, Makoto; Furudate, Masayori

    1987-10-01

    A quantitative assessment of limb blood flow using a non-diffusible radioindicator, Tc-99m labeled red blood cells, was reported. This was an application of venous occlusion plethysmography using radionuclide which was originally proposed by M. Fukuoka et al. The peripheral blood flow (mean +- s.e.) of 30 legs in a normal control group was 1.87 +- 0.08 ml/100 ml/min. In heart diseases (46 legs), it was 1.49 +- 0.13 ml/100 ml/min. The limb blood flow between a control group and heart diseases was statistically significant (p < 0.01) in the t-test. The peripheral blood flow at rest between diseased legs and normal legs in occlusive arterial disorders was also statistically significant (p < 0.01) in a paired t-test. RAVOP was done after the completion of objective studies such as radionuclide angiography or ventriculography. Technique and calculation of a blood flow were very easy and simple. RAVOP study which was originally proposed by Fukuoka et al. was reappraised to be hopeful for quantitative measurement of limb blood flow as a non-invasive technique using Tc-99m labeled red blood cells.

  15. Correlation between arterial and venous blood gas analysis parameters in patients with acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Novović Miloš

    2012-01-01

    Full Text Available Introduction. Arterial blood gas (ABG analyses have an important role in the assessment and monitoring of the metabolic and oxygen status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD. Arterial puncture could have a lot of adverse effects, while sampling of venous blood is simpler and is not so invasive. Objective. The aim of this study was to evaluate whether venous blood gas (VBG values of pH, partial pressure of carbon dioxide (PCO2, partial oxygen pressure (PO2, bicarbonate (HCO3, and venous and arterial blood oxygen saturation (SO2 can reliably predict ABG levels in patients with acute exacerbation of COPD. Methods. Forty-seven patients with a prior diagnosis of COPD were included in this prospective study. The patients with acute exacerbation of this disease were examined at the General Hospital EMS Department in Prijepolje. ABG samples were taken immediately after venous sampling, and both were analyzed. Results. The Pearson correlation coefficients between arterial and venous parameters were 0.828, 0.877, 0.599, 0.896 and 0.312 for pH, PCO2, PO2, HCO3 and SO2, respectively. The statistically significant correlation between arterial and venous pH, PCO2 and HCO3, values was found in patients with acute exacerbation of COPD (p<0.001. Conclusion. When we cannot provide arterial blood for analysis, venous values of the pH, Pv,CO2 and HCO3 parameters can be an alternative to their arterial equivalents in the interpretation of the metabolic status in patients with acute exacerbation of COPD, while the values of venous Pv,O2 and Sv,O2 cannot be used as predictors in the assessment of oxygen status of such patients.

  16. The influence of venous blood flow on the retinal ganglion cell complex in patients with primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    N. I. Kurysheva

    2014-07-01

    Full Text Available Purpose: To study the influence of venous blood flow on the ganglion cell complex (GCC in patients with preperimetric and perimetric open angle glaucoma.Methods: 74 patients were included in the research. 59 eyes and 62 eyes were diagnosed with preperimetric and perimetric open angle glaucoma respectively. The mean age was 56.5±10.5 years. 22 (12 female and 10 male healthy individuals constituted the control group. The ganglion cell complex and retinal nerve fibre layer were evaluated with the help of optical coherence tomography (RTVue-100 OCT, Optovue, Inc., Fremont, CA. Ocular blood flow was measured by Color Doppler Imaging (multifunctional VOLUSON 730 ProSystem. The statistical analysis included correlation between GCC and RNFL thickness in both glaucoma groups.Results: The results showed a statistically significant reduction of venous blood flow velocity in both glaucoma groups compared to the control group. No difference in venous blood flow parameters between two glaucoma groups was found, except resistance index, which was higher in perimetric group in comparison to preperimetric group. A correlation was also obtained between venous blood flow parameters and GCC and RNFL thickness in both glaucoma groups.Conclusion: Early GCC damage in glaucoma might occur due to venous blood flow reduction. This fact may be of great value in understanding glaucoma pathogenesis and search for novel treatment options.

  17. Comparison of two analyzers to determine selected venous blood analytes of Quaker parrots (Myiopsitta monachus).

    Science.gov (United States)

    Rettenmund, Christy L; Heatley, J Jill; Russell, Karen E

    2014-06-01

    Point of care devices can assess electrolyte, blood gas, biochemical, and hematologic values in a critical care setting. Although these devices are commonly used in humans and companion mammals, few studies have assessed their use in avian species. This study compares electrolyte, hemoglobin (Hgb), hematocrit (Hct), acid-base, and venous blood gas parameters between the i-STAT and IRMA TruPoint blood gas analysis systems for 35 Quaker parrots. Agreement between the two analyzers and the effect of gender, time lag between sample analysis, and cartridge expiration were evaluated. Male birds had increased Hgb and Hct compared with females, independent of analyzer method. In expired i-STAT cartridges, only glucose significantly increased. Packed cell volume determined by centrifugation was higher than Hct, as calculated by either analyzer. The analyzers had good agreement for total carbon dioxide, bicarbonate, pH, and Hgb, fair agreement for potassium (K), ionized calcium (iCa), venous partial pressure of carbon dioxide, and base excess, and poor agreement for sodium (Na), venous partial pressure of oxygen (PO2), and oxygen saturation (SO2). Values for Na, iCa, PO2, and SO2 were significantly higher on the IRMA than the i-STAT, while K was significantly lower on the IRMA when compared with the i-STAT. The time lag between sample analyses on the i-STAT and IRMA did not be correlate to any analyte changes. Despite these differences, both the i-STAT and the IRMA appear to be acceptable clinical tools in avian critical care, although reference ranges for each analyzer should be created.

  18. THE EXPERIMENTAL STUDY OF STRESS-RELATED PATHOLOGICAL CHANGES IN CEREBRAL VENOUS BLOOD FLOW IN NEWBORN RATS ASSESSED BY DOCT

    Directory of Open Access Journals (Sweden)

    OXANA V. SEMYACHKINA-GLUSHKOVSKAYA

    2013-07-01

    Full Text Available In experiments on newborn rats with stress-related intracranial hemorrhage (ICH using Doppler optical coherence tomography (DOCT we have shown that latent stage of ICH (4 h after stress is characterized by decrease of venous blood outflow and the loss of sensitivity of sagittal vein to vasoconstrictor effect of adrenaline. The incidence of ICH (24 h after stress was accompanied by progression of early pathological changes in cerebral venous blood flow (CVBF and development of venous insufficiency. Taking into consideration of this fact, we suggest that the suppression of CVBF related to the severity to the deleterious effect of stress on the brain hemodynamics in newborn rats. These facts allow us to conclude that the venous insufficiency with the loss of vasoconstrictor response to adrenaline is an informative and sensitive component of pattern of CVBF that can be important diagnostic criteria of risk of ICH development in newborns.

  19. Evaluation of a new venous catheter blood draw device and its impact on specimen hemolysis rates.

    Science.gov (United States)

    Natali, Ruth; Wand, Cara; Doyle, Kelly; Noguez, Jaime H

    2018-03-01

    Blood collections from peripheral intravenous catheters offer several benefits to patients, including reduced needle punctures and patient discomfort, but they risk reducing the quality of blood specimens analyzed by the laboratory. In an effort to balance analytical quality of test results with patient-centered care initiatives, a needle-less blood collection device called PIVO™ was evaluated at two institutions. The primary objective of this study was to assess the ability of the PIVO™ device to provide high-quality blood specimens for laboratory testing compared to current blood collection methods. Blood specimens drawn using the PIVO™ device were prospectively flagged. A retrospective review was performed comparing the degree and rate of hemolysis for PIVO™ blood collections to both concurrent and historical hemolysis rates for other collection methods. Approximately 7600 PIVO™ blood draws were performed across the two institutions. The hemolysis rates of samples collected with PIVO™ were evaluated using 2380 flagged collections, containing approximately 1200 test orders requiring hemolysis index measurements. The hemolysis rate of PIVO™-flagged samples (1.8%) was statistically superior to the venipuncture and central line blood collection methods (3.3%), reducing the risk of hemolysis during a venous blood draw by 39%. PIVO™ collections facilitated improvement in the rate and degree of sample hemolysis when compared to venipuncture and central line blood collections. These findings suggest that PIVO™ is capable of delivering samples that are superior to current blood collection methods in terms of hemolysis rate as well as reducing the number of invasive venipunctures required for laboratory testing.

  20. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe.

    Science.gov (United States)

    Brøndum, E; Hasenkam, J M; Secher, N H; Bertelsen, M F; Grøndahl, C; Petersen, K K; Buhl, R; Aalkjaer, C; Baandrup, U; Nygaard, H; Smerup, M; Stegmann, F; Sloth, E; Ostergaard, K H; Nissen, P; Runge, M; Pitsillides, K; Wang, T

    2009-10-01

    How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was 0.7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow remained unchanged. Cardiac output was reduced by 30%, CVP decreased to -1 +/- 2 mmHg (P blood in the veins. When the head was raised, the jugular veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head is lowered, blood accumulates in the vein, affecting MAP.

  1. Measurement of central venous pressure and determination of hormones in blood serum during weightlessness

    Science.gov (United States)

    Kirsch, K.

    1981-01-01

    A Spacelab experiment is described which proposes to obtain data on the degree of engorgement of the cephalad circulation during weightlessness by recording central venous pressure. Of practical importance is the question of how close the astronauts are to pulmonary edema and whether the pressure falls toward normal during the time of the mission. Another experiment to investigate deviations from normal fluid and mineral metabolism, possibly initiated by the central engorgement of the low pressure system, is discussed. Hormones responsible for the control of water and mineral balance (vasopressin, catecholamines, renin, aldosterone, corticosteroids, and prostaglandin E1) will be analyzed from blood samples.

  2. Blood flow, volume and arterio-venous passages in induced mammary tumours of the rat.

    Science.gov (United States)

    Hultborn, Ragnar

    2018-03-01

    To study blood flow, vascular volume and arterio-venous passages in induced mammary tumours of the rat to characterize parameters possibly responsible for tumour hyponutrition. Dimethylbenzanthracene-induced mammary tumours in Sprague-Dawley rats were studied. Regional blood flow was studied by use of the radioactive microsphere tracer technique using 141 Cerium-labelled 15μm spheres coinjected into the left cardiac ventricle with 125 Iodine-labelled 25μm spheres. Blood volume was studied by use of 125 Iodine- or 99m Technetium-labelled human serum albumin, the latter allowing autoradiography of tumour sections for visualization of flow and volume. Twenty-seven rats with 170 tumours had a mean tumour blood flow of 48 and 67mL×min -1 ×100g -1 using 15 and 25μm sphere data, respectively, indicating a significant passage through vessels between 15 and 25μm. The lungs showed a "nominal bronchial" blood flow of 260 and 135mL×min -1 ×100g -1 for the 15 and 25μm spheres, respectively, indicating pulmonary trapping, particularly of small spheres passing the systemic circulation in vessels larger than 15μm. There was a positive correlation between the total tumour blood flow within individual rats and trapped spheres of both dimensions in the lungs, indicating shunts also larger than 25μm. Normal tissues disclosed only small differences in regional blood flow as measured by the two spheres. Blood volume was studied in 20 rats with 120 tumours, with a vascular volume of 3.6mL×100g -1 representing a blood turnover >15 times/min. Blood volume co-localized with perfusion as seen in autoradiographs. In induced rat mammary tumours, a high fraction of blood, 28%, passes arterio-venous vessels between 15 and 25μm and there also exist passages >25μm. These findings indicate that the functional capacity of the tumour vascular bed might be impaired, adding to the abnormal microenvironment of tumours. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Risk of venous thromboembolism and myocardial infarction associated with factor V Leiden and prothrombin mutations and blood type

    DEFF Research Database (Denmark)

    Sode, Birgitte F; Allin, Kristine H; Dahl, Morten

    2013-01-01

    ABO blood type locus has been reported to be an important genetic determinant of venous and arterial thrombosis in genome-wide association studies. We tested the hypothesis that ABO blood type alone and in combination with mutations in factor V Leiden R506Q and prothrombin G20210A is associated...

  4. Influence of different storage times and temperatures on blood gas and acid-base balance in ovine venous blood.

    Science.gov (United States)

    Hussein, H A; Aamer, A A

    2013-01-01

    The present study was designed to investigate the effects of storage temperature and time on blood gas and acid-base balance of ovine venous blood. Ten clinically healthy sheep were used in this study. A total number of 30 blood samples, were divided into three different groups, and were stored in a refrigerator adjusted to +4 ºC (Group I, n = 10), at RT of about 22-25 ºC (Group II, n = 10) and in an incubator adjusted to 37 ºC (Group III, n = 10) for up to 48 h. Blood samples were analysed for blood gas and acid-base indices at 0, 1, 2, 3, 4, 5, 6, 12, 24 and 48 h of storage. In comparison to the baseline value (0), there were significant decreases of blood pH of samples stored at RT and in the incubator after 1 h (ppO2 values were significantly higher for Group I after 2 h and for Groups II and III after 1 h (preference range and it may be of clinical diagnostic use for up to 6 h.

  5. ABO blood group related venous thrombosis risk in patients with peripherally inserted central catheters.

    Science.gov (United States)

    Koo, Chung Mo; Vissapragada, Ravi; Sharp, Rebecca; Nguyen, Phi; Ung, Thomas; Solanki, Chrismin; Esterman, Adrian

    2018-02-01

    To investigate the association between ABO blood group and upper limb venous thrombosis (VT) risk in patients with peripherally inserted central catheters (PICC). Single centre retrospective cohort study. A cohort of patients who underwent PICC insertion from September 2010 to August 2014 were followed up for symptomatic VT presentations diagnosed by ultrasound. Blood group status was identified from hospital information systems. 2270 participants had 3020 PICCs inserted. There were 124 cases of symptomatic VT, an incident rate of 4% [95% confidence interval, CI (3-5%)]. Univariate analysis adjusting for the clustered sample showed that having chemotherapy, two or more previous PICCs, a larger catheter size, a diagnosis of cancer and having a blood group B were all associated with an increased risk of a VT. In the multivariate analysis, PICC diameter, cancer diagnosis and blood group B were all independently associated with increased risk of VT. Patients undergoing PICC insertion with a blood group B appear to have a higher risk of VT, independent of risks attached to the PICC procedure and cancer diagnosis. Without any existing guidelines for PICC-related VT, this investigation creates a platform for further research to be conducted in order to establish guidelines. Advances in knowledge: Previous studies investigating VT risk associated with blood group status related to large heterogeneous populations. In this article, we look at patients specifically with PICC, which reduces the heterogeneity in the cohort. In addition, due to the substantial number of patients enrolled, we had a chance to perform multivariate analyses with statistical significance.

  6. Factors associated with nursing students' adherence to venous blood collection practice guidelines - A cross sectional study.

    Science.gov (United States)

    Nilsson, Karin; Brulin, Christine; Grankvist, Kjell; Juthberg, Christina

    2017-03-01

    Venous blood specimen collection is a common procedure that nursing students perform during pre-registration courses, and training for such collections takes place on campus as well as at clinical placements. However, levels of adherence to practice guidelines are still suboptimal among both nursing students and healthcare staff. We aimed to explore nursing students' adherence to the Swedish national venous blood specimen collection practice guidelines regarding patient identification and test request management and how this adherence is related to clinical experience, capability beliefs, research use, and the perceived social climate in clinical contexts. A survey with a cross-sectional design was conducted among 305 nursing students at a medium-sized university in Sweden. Descriptive statistics and logistic regression were used for data analysis. The survey showed that 82% of the students adhered to patient identification guideline practices and 80% to test request management practices. Factors associated with correct patient identification procedures were semester and frequency of research use. Factors associated with correct test request management were previous healthcare work experience, semester, and capability beliefs regarding academic abilities and evidence-based practice. We conclude that there is a need to develop educational tools to train students in research use and evidence-based practice in order to enhance guideline practice adherence and improve patient safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Central and peripheral venous lines-associated blood stream infections in the critically ill surgical patients.

    Science.gov (United States)

    Ugas, Mohamed Ali; Cho, Hyongyu; Trilling, Gregory M; Tahir, Zainab; Raja, Humaera Farrukh; Ramadan, Sami; Jerjes, Waseem; Giannoudis, Peter V

    2012-09-04

    Critically ill surgical patients are always at increased risk of actual or potentially life-threatening health complications. Central/peripheral venous lines form a key part of their care. We review the current evidence on incidence of central and peripheral venous catheter-related bloodstream infections in critically ill surgical patients, and outline pathways for prevention and intervention. An extensive systematic electronic search was carried out on the relevant databases. Articles were considered suitable for inclusion if they investigated catheter colonisation and catheter-related bloodstream infection. Two independent reviewers engaged in selecting the appropriate articles in line with our protocol retrieved 8 articles published from 1999 to 2011. Outcomes on CVC colonisation and infections were investigated in six studies; four of which were prospective cohort studies, one prospective longitudinal study and one retrospective cohort study. Outcomes relating only to PICCs were reported in one prospective randomised trial. We identified only one study that compared CVC- and PICC-related complications in surgical intensive care units. Although our search protocol may not have yielded an exhaustive list we have identified a key deficiency in the literature, namely a paucity of studies investigating the incidence of CVC- and PICC-related bloodstream infection in exclusively critically ill surgical populations. In summary, the diverse definitions for the diagnosis of central and peripheral venous catheter-related bloodstream infections along with the vastly different sample size and extremely small PICC population size has, predictably, yielded inconsistent findings. Our current understanding is still limited; the studies we have identified do point us towards some tentative understanding that the CVC/PICC performance remains inconclusive.

  8. Importance of Blood Cultures from Peripheral Veins in Pediatric Patients with Cancer and a Central Venous Line

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Rutkjær, Cecilie

    2015-01-01

    When an infection is suspected in a child with cancer and a central venous line (CVL), cultures are often only obtained from the CVL and not from a peripheral vein (PV). This study was undertaken to evaluate the importance of concomitant blood cultures from the CVL and a PV.......When an infection is suspected in a child with cancer and a central venous line (CVL), cultures are often only obtained from the CVL and not from a peripheral vein (PV). This study was undertaken to evaluate the importance of concomitant blood cultures from the CVL and a PV....

  9. Performance and safety of femoral central venous catheters in pediatric autologous peripheral blood stem cell collection.

    Science.gov (United States)

    Cooling, Laura; Hoffmann, Sandra; Webb, Dawn; Yamada, Chisa; Davenport, Robertson; Choi, Sung Won

    2017-12-01

    Autologous peripheral blood hematopoietic progenitor cell collection (A-HPCC) in children typically requires placement of a central venous catheter (CVC) for venous access. There is scant published data regarding the performance and safety of femoral CVCs in pediatric A-HPCC. Seven-year, retrospective study of A-HPCC in pediatric patients collected between 2009 and January 2017. Inclusion criteria were an age ≤ 21 years and A-HPCC using a femoral CVC for venous access. Femoral CVC performance was examined by CD34 collection rate, inlet rate, collection efficiency (MNC-FE, CD34-FE), bleeding, flow-related adverse events (AE), CVC removal, and product sterility testing. Statistical analysis and graphing were performed with commercial software. A total of 75/119 (63%) pediatric patients (median age 3 years) met study criteria. Only 16% of children required a CVC for ≥ 3 days. The CD34 collect rate and CD34-FE was stable over time whereas MNC-FE decreased after day 4 in 80% of patients. CD34-FE and MNC-FE showed inter- and intra-patient variability over time and appeared sensitive to plerixafor administration. Femoral CVC showed fewer flow-related AE compared to thoracic CVC, especially in pediatric patients (6.7% vs. 37%, P = 0.0005; OR = 0.12 (95%CI: 0.03-0.45). CVC removal was uneventful in 73/75 (97%) patients with hemostasis achieved after 20-30 min of pressure. In a 10-year period, there were no instances of product contamination associated with femoral CVC colonization. Femoral CVC are safe and effective for A-HPCC in young pediatric patients. Femoral CVC performance was maintained over several days with few flow-related alarms when compared to thoracic CVCs. © 2017 Wiley Periodicals, Inc.

  10. CARCINOEMBRYONIC ANTIGEN LEVELS IN THE PERIPHERAL AND MESENTERIC VENOUS BLOOD OF PATIENTS WITH RECTAL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Herminio Cabral de REZENDE JUNIOR

    2013-12-01

    Full Text Available Context The serum carcinoembryonic antigen (CEA is an important prognostic factor in colorectal cancer, however the rectum presents different routes of venous drainage, stating that the level of CEA in peripheral and mesenteric rectal tumors may be different, depending on the location of the tumor in the rectal segment. Objective The goal of this study was to evaluate the relationship between the peripheral and mesenteric venous levels of CEA and the association between these levels and the tumour location in the rectums of patients successfully operated on for rectal carcinoma. Methods Thirty-two patients who were surgically treated for rectal carcinoma were divided into patients with tumours located in the upper rectum (n = 11 or lower rectum (n = 21. The CEA values were assessed by electrochemiluminescence immunoassay. Serum and mesenteric CEA levels were associated with the tumour anatomopathological characteristics: location, histological type, cellular differentiation grade, depth of invasion into the rectal wall, angiolymphatic invasion, tumour, node, and metastasis staging; and the CEA index (≤1.0 or ≥1.0 ng /mL. Results Analysis of the serum CEA values using clinical and anatomopathological parameters revealed no significant association with tumour location, histological type, cellular differentiation grade, depth of invasion into the intestinal wall, and tumour, node, and metastasis staging. The mesenteric CEA levels were significantly associated with the tumour location (P = 0.01. The CEA values in the mesenteric venous blood and the presence of angiolymphatic invasion (P = 0.047 were significantly different. A significant relationship was found between the CEA index value and the rectal tumour location (P = 0.0001. Conclusions The CEA levels were higher in the mesenteric vein in tumours located in the upper rectum and in the presence of angiolymphatic invasion. CEA drainage from lower rectum adenocarcinomas preferentially occurs

  11. Clinical significance of intra-host variability of Dengue-1 virus in venous and capillary blood.

    Science.gov (United States)

    Descloux, E; La Fuentez, C; Roca, Y; De Lamballerie, X

    2014-03-01

    Dengue fever represents a major public health problem. Both viral and host immune factors are involved in severe infections. Humans and mosquito-vectors are infected with diverse viral populations that may play a role in viral adaptation and disease pathogenesis. Our objective was to analyse the intra-host genetic variability of dengue virus type 1 (DENV-1) in the venous and capillary blood and its relationships with the clinical presentation of dengue fever. Early serum samples were collected in 2009 from ten DENV-1-infected patients hospitalized in Santa Cruz de la Sierra, Bolivia. Partial viral envelope sequences were analysed at the inter-host and intra-host level. For each patient, an average of 56 clone sequences was analysed both in the venous sector and the capillary sector (from right and left hands). The ten consensus sequences were highly similar. The intra-host DENV-1 genetic variability was significantly lower in the venous sector than in the capillary sector, and in patients with haemorrhagic symptoms than in those without haemorrhagic symptoms, particularly in capillary samples. No relation was found with sex, age, dengue IgG-serological status, day of serum sampling, or viral load. Significant relationships were found between the clinical presentation of dengue fever and the variability of viral populations within hosts, particularly in capillary samples. The observed variability of envelope sequences at the early phase of dengue infection was not critically influenced by the previous dengue serological status of patients. An important part of viral microevolution may occur in the capillary sector and influence the mechanisms of severe forms. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  12. Influence of different storage times and temperatures on blood gas and acid-base balance in ovine venous blood

    Directory of Open Access Journals (Sweden)

    H.A. Hussein

    2013-01-01

    Full Text Available The present study was designed to investigate the effects of storage temperature and time on blood gas and acid-base balance of ovine venous blood. Ten clinically healthy sheep were used in this study. A total number of 30 blood samples, were divided into three different groups, and were stored in a refrigerator adjusted to +4 ºC (Group I, n = 10, at RT of about 22-25 ºC (Group II, n = 10 and in an incubator adjusted to 37 ºC (Group III, n = 10 for up to 48 h. Blood samples were analysed for blood gas and acid-base indices at 0, 1, 2, 3, 4, 5, 6, 12, 24 and 48 h of storage. In comparison to the baseline value (0, there were significant decreases of blood pH of samples stored at RT and in the incubator after 1 h (p<0.05, the pH value of refrigerated blood samples exhibited insignificant changes during the study (p<0.05. Mean values of pCO2 showed a significant increase in Group I and Group III after 1 h then a progressive decrease after 12 h in all Groups. Mean pO2 values were significantly higher for Group I after 2 h and for Groups II and III after 1 h (p<0.05. In general, base excess decreased significantly for all the groups during the study especially in Groups II and III. In comparison with baseline values, in all groups, bicarbonate (HCO3 increased between 1 h and 6 h (p<0.05, and later decreased at the end of the study (p<0.05. In conclusion, status of acid-base indices of the samples stored at refrigerator and RT were found within normal reference range and it may be of clinical diagnostic use for up to 6 h.

  13. Septic transfusion reactions during blood transfusion via indwelling central venous catheters.

    Science.gov (United States)

    Ricci, Kristin S; Martinez, Fernando; Lichtiger, Benjamin; Han, Xiang Y

    2014-10-01

    Transfusion of blood products requires a vascular port. Use of an indwelling central venous catheter (CVC) provides this port readily and safely in general; however, potential risks require assessment. The objective was to examine septic reactions to blood transfusions performed via CVCs owing to subclinical microbial catheter colonization. All transfusion reactions that occurred from 2007 to 2011 at The University of Texas MD Anderson Cancer Center were analyzed and correlated with microbiology culture results. Data on the reactions, including vascular access via a catheter or peripheral venipuncture, were collected prospectively. A total of 999 reactions were reported, with an incidence of two per 1000 transfusion events. A total of 738 reactions occurred in 642 patients during transfusion through a CVC. Among them, 606 reactions occurred in patients that had cultures of blood samples drawn within 7 days before or after reaction. Sixty of these (9.9%) had at least one significant microorganism isolated from their catheters and/or peripheral blood. The blood culture results and timing suggested that these patients likely had catheter-related bloodstream infections caused by transfusion through a CVC with subclinical microbial colonization. Fever and chills occurred in 35 of these patients (58%), which resembled febrile nonhemolytic transfusion reactions. Culture results of the transfused blood products, although not performed in all cases, were mostly negative in these CVC-related reactions. Blood transfusion through an indwelling CVC may lead to septic reaction owing to subclinical microbial colonization. This risk should be considered before transfusion and during investigation of transfusion reactions. © 2014 AABB.

  14. Risk of venous thromboembolism and myocardial infarction associated with factor V Leiden and prothrombin mutations and blood type.

    Science.gov (United States)

    Sode, Birgitte F; Allin, Kristine H; Dahl, Morten; Gyntelberg, Finn; Nordestgaard, Børge G

    2013-03-19

    ABO blood type locus has been reported to be an important genetic determinant of venous and arterial thrombosis in genome-wide association studies. We tested the hypothesis that ABO blood type alone and in combination with mutations in factor V Leiden R506Q and prothrombin G20210A is associated with the risk of venous thromboembolism and myocardial infarction in the general population. We used data from 2 Danish studies that followed members of the general public from 1977 through 2010. We obtained the genotype of 66 001 white participants for ABO blood type, factor V Leiden R506Q and prothrombin G20210A. We calculated hazard ratios (HRs) and population attributable risk. Our main outcome measures were venous thromboembolism and myocardial infarction. The multivariable adjusted HR for venous thromboembolism was 1.4 (95% confidence interval [CI] 1.3-1.5) for non-O blood type (v. O blood type). For the factor V Leiden R506Q mutation, the adjusted HR was 2.2 (95% CI 2.0-2.5) for heterozygous participants and 7.0 (95%CI 4.8-10) for homozygous participants (v. participants without the mutation). For prothrombin G20210A, the adjusted HR was 1.5 (95%CI 1.2-1.9) for heterozygous participants and 11 (95% CI 2.8-44) for homozygous participants (v. participants without the mutation). When we combined ABO blood type and factor V Leiden R506Q or prothrombin G20210A genotype, there was a stepwise increase in the risk of venous thromboembolism (trend, pfactor V Leiden R506Q and 1% for prothrombin G20210A. Multivariable adjusted HRs for myocardial infarction by genotypes did not differ from 1.0. ABO blood type had an additive effect on the risk of venous thromboembolism when combined with factor V Leiden R506Q and prothrombin G20210A mutations; blood type was the most important risk factor for venous thromboembolism in the general population.

  15. Abrupt changes in mixed venous blood gas composition after the onset of exercise.

    Science.gov (United States)

    Casaburi, R; Daly, J; Hansen, J E; Effros, R M

    1989-09-01

    It has been assumed that increases in both O2 uptake and ventilation occurring within the first few seconds after the onset of exercise cannot be the result of changes in blood gas composition reaching the central circulation because of the circulatory delay from the exercising limbs (A. Krogh and J. Lindhard, J. Physiol. Lond. 42: 112-136, 1913). We sought to validate this assumption by measuring the time course of pulmonary arterial blood gases during the transition from rest to exercise. Six healthy men underwent pulmonary arterial catheterization and then performed transitions from rest to moderate cycle ergometer exercise. An anaerobic sampling manifold withdrew 19 samples of blood during the rest-to-exercise transition; sampling interval was usually 4 s. Blood gas analysis showed that, on average, from rest-to-steady-state exercise, O2 saturation (Svo2) fell from 71 to 41% and mixed venous PCO2 (PvCO2) rose from 42 to 59 Torr. Contrary to our expectations, Svo2 decreased and PvCO2 increased with no discernible latency after exercise onset (by 10% and 2 Torr, respectively, within 6 s). The half time for the Svo2 decrease was 32 s, whereas for the PvCO2 increase it was 80 s. The time course of superior vena cava blood gas composition was determined in several experiments; no rapid changes after exercise onset were found. We conclude that at exercise onset there is a rapid fall in Svo2 and rise in PvCO2 well in advance of arrival of blood produced by exercising legs.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Continuous monitoring of the partial pressure of oxygen in cerebral venous blood.

    Science.gov (United States)

    Rieger, A; Menzel, M; Rainov, N G; Sanchin, L; Rot, S; Furka, I; Görömbey, Z; Burkert, W

    1997-08-01

    Clinical oxygen monitoring in the injured brain is somewhat difficult. However, ischemia is one of the major factors responsible for secondary tissue damage after head injury or subarachnoid hemorrhage. Therefore, the aim of the present study was to investigate the value of continuously monitoring the partial pressure of oxygen in cerebral venous blood (PcvO2) during changes in intracranial pressure (ICP). In eight domestic pigs with Clark type probes placed in the posterior third of the superior sagittal sinus, PcvO2 was continuously registered while ICP was stepwise elevated by an inflatable balloon placed below the tentorium. Arterial blood pressure was continuously monitored, cerebral perfusion pressure (CPP) was calculated, and arterial partial carbon dioxide pressure and partial pressure of oxygen were registered intermittently. The mean intraparenchymal ICP before the start of balloon inflation was 5 +/- 1 mm Hg, the mean CPP was 80 +/- 15 mm Hg, and the mean PcvO2 was 36 +/- 3 mm Hg. At maximum ICP elevation, CPP decreased to 20 +/- 12 mm Hg, PcvO2 decreased to 10 +/- 6 mm Hg, and ICP increased to 90 +/- 10 mm Hg. Strong linear correlations between ICP and PcvO2 and between CPP and PcvO2 were revealed, and mean correlation coefficients of 0.89 for ICP/PcvO2 and 0.73 for CPP/PcvO2 were calculated. The present study demonstrates that polarographic PcvO2 monitoring in the superior sagittal sinus is a reliable method for the early detection of reduced CPP during ICP elevation. This technique is capable of registering the global oxygen supply and oxygen consumption of the brain. It seems superior to jugular venous oxymetry and is better suited for clinical use because of a somewhat low artifact susceptibility.

  17. [Digital blood flow measurement by venous occlusion plethysmography in Raynaud's phenomenon. Value of the rewarming test].

    Science.gov (United States)

    Cristol, R; Debray, J

    1986-01-01

    The fingertip blood flow measured by mercury strain gauge plethysmography with venous occlusion, at 22 degrees C room temperature, had significantly lower mean values in 190 patients with Raynaud's phenomenon (55 men aged 49 yrs +/- 16, 135 women aged 48 yrs +/- 16) than in 40 age and sex matched controls: 18 ml/100 ml/minute +/- 14.6 versus 35 ml/100 ml/minute +/- 15 at level p less than 0.01. The mean fingertip blood flow was significantly lower (p less than 0.01) in 31 cases of scleroderma and 32 cases of pulpar necrosis (respectively 13 ml +/- 13 and 11 ml +/- 8) than in 55 cases of primary Raynaud's disease (no detectable etiology and normal capillaroscopy 5 years after onset) or in 34 cases of mild Raynaud's phenomenon (respectively 21.6 +/- 16 and 24.4 +/- 18). A warming test (both hands in water at 45 degrees C during 3 minutes) was performed in 50 cases with low basal fingertip blood flow. It induced a "normalized" flow in 22 cases (mostly primary or mild Raynaud), a partly improved flow in 20 cases (mostly secondary Raynaud) and no improvement in 8 cases (scleroderma). The warming test appears to be clinically useful to assess the vasospasm and the vasodilating capabilities.

  18. CD4+ LYMPHOCYTES IMPROVE VENOUS BLOOD FLOW IN EXPERIMENTAL ARTERIOVENOUS FISTULAE

    Science.gov (United States)

    Duque, Juan C.; Martinez, Laisel; Mesa, Annia; Wei, Yuntao; Tabbara, Marwan; Salman, Loay H.; Vazquez-Padron, Roberto I.

    2015-01-01

    Background The role of immune cells in arteriovenous fistulae (AVF) maturation is poorly understood and has received, until quite recently, little attention. This study examines the role of T lymphocytes in AVF vascular remodeling. Methods Experimental fistulae were created in athymic rnu nude rats lacking mature T lymphocytes and euthymic control animals by anastomosing the left superior epigastric vein to the nearby femoral artery. Blood flow rates, wall morphology and histological changes were assessed in AVF 21 days after creation. The effect of CD4+ lymphocytes on AVF maturation in athymic animals was analyzed by adoptive transfer of cells after fistula creation. Results The absence of T lymphocytes compromised blood flow in experimental fistulae. Histopathological inspection of AVF from athymic rats revealed that T cell immunodeficiency negatively affected venous vascular remodeling, as evidenced by a reduced lumen, a thick muscular layer and a low number of inflammatory cells compared to control animals. Adoptive transfer of CD4+ lymphocytes from euthymic rats into athymic animals before and after fistula creation improved blood flow and reduced intima-media thickness. Conclusion These results point at the protective role of CD4+ lymphocytes in the remodeling of the AVF vascular wall. PMID:25999254

  19. Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease.

    Science.gov (United States)

    McCanny, Peter; Bennett, Kath; Staunton, Paul; McMahon, Geraldine

    2012-07-01

    The purpose of this study was to investigate the clinical correlation between arterial and venous blood gas (VBG) values in patients presenting to the emergency department (ED) with acute exacerbation of chronic obstructive pulmonary disease. A prospective study of patients with chronic obstructive pulmonary disease presenting to the ED with acute ventilatory compromise was done. Patients were included if their attending physician considered arterial blood gas sampling important in their initial assessment. Data from arterial and venous samples were compared using Spearman correlation and bias plot (Bland-Altman) methods. Ninety-four patients were enrolled in the study. Eighty-nine patients had complete data sets for analysis. Arterial hypercarbia was present in 30 patients (33.7%; range, 51-140.19 mm Hg). All cases of arterial hypercarbia were detected using VBG sampling when a screening cutoff of 45 mm Hg was applied (sensitivity, 100%; 95% confidence interval, 88.7%-100% and specificity, 34%; 95% confidence interval, 23.1%-46.6%). Bias plot revealed moderate agreement between arterial and venous Pco(2) with an average difference of 8.6 mm Hg and 95% limits of agreement of -7.84 to 25.05 mm Hg. For pH, mean difference between each group was 0.039 (range, -0.12 to 0.03). Linear regression analysis for pH demonstrated very close equivalence with a regression coefficient of 0.955, and Spearman correlation showed significant correlation of 0.826 (P = .001). Venous pH and HCO(3) values show excellent correlation with arterial values. Using a previously validated screening cutoff of 45 mm Hg, venous CO(2) has 100% sensitivity in detecting arterial hypercarbia. There is insufficient agreement between venous and arterial CO(2) for VBG to replace arterial blood gas in determining the degree of hypercarbia. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Testing for thrombophilia in mesenteric venous thrombosis - Retrospective original study and systematic review.

    Science.gov (United States)

    Zarrouk, M; Salim, S; Elf, J; Gottsäter, A; Acosta, S

    2017-02-01

    The aim was to perform a local study of risk factors and thrombophilia in mesenteric venous thrombosis (MVT), and to review the literature concerning thrombophilia testing in MVT. Patients hospitalized for surgical or medical treatment of MVT at our center 2000-2015. A systematic review of observational studies was performed. In the local study, the most frequently identified risk factor was Factor V Leiden mutation. The systematic review included 14 original studies. The highest pooled percentage of any inherited thrombophilic factor were: Factor V Leiden mutation 9% (CI 2.9-16.1), prothrombin gene mutation 7% (CI 2.7-11.8). The highest pooled percentage of acquired thrombophilic factors were JAK2 V617F mutation 14% (CI -1.9-28.1). The wide range of frequency of inherited and acquired thrombophilic factors in different populations indicates the necessity to relate these factors to background population based data in order to estimate their overrepresentation in MVT. There is a need to develop guidelines for when and how thrombophilia testing should be performed in MVT. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. [Concordance between central venous and arterial blood gases in post-surgical myocardial revascularization patients in stable condition].

    Science.gov (United States)

    Santos-Martínez, Luis Efren; Guevara-Carrasco, Marlene; Naranjo-Ricoy, Guillermo; Baranda-Tovar, Francisco Martín; Moreno-Ruíz, Luis Antonio; Herrera-Velázquez, Marco Antonio; Magaña-Serrano, José Antonio; Valencia-Sánchez, Jesús Salvador; Calderón-Abbo, Moisés Cutiel

    2014-01-01

    The concordance between the parameters of arterial and central venous blood gases has not been defined yet. We studied the concordance between both parameters in post-surgical myocardial revascularization patients in stable condition. Consecutive subjects were studied in a cross-sectional design. The position of the central venous catheter was performed and simultaneously we obtained arterial and central venous blood samples prior to discharge from the intensive care unit. Data are expressed according to Bland-Altman statistical method and the intraclass correlation coefficient. Statistical result was accepted at P<.05. Two hundred and six samples were studied of 103 post-surgical patients, pH and lactate had a mean difference (limits of agreement) 0.029±0.048 (-0018, 0.077) and -0.12±0.22 (-0.57, 0.33) respectively. The magnitude of the intraclass correlation coefficient was 0.904 and 0.943 respectively. The values related to oxygen pressure were 27.86±6.08 (15.9, 39.8) and oxygen saturation 33.02±6.13 (21, 45), with magnitude of 0.258 and 0.418 respectively. The best matching parameters between arterial and central venous blood samples were pH and lactate. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  2. Effect of prewarming the forearm on the measurement of regional cerebral blood flow with one-point venous sampling by autoradiography method

    International Nuclear Information System (INIS)

    Itoh, Youko H.; Kurabe, Teruhisa; Kazaoka, Yoshiaki; Ishiguchi, Tsuneo; Kawashima, Sadao

    2004-01-01

    Autoradiography (ARG) using 123 I-iodoamphetamine ( 123 I-IMP) is widely performed as an efficient method of measuring local cerebral blood flow. Recently, ARG by a single collection of venous blood has been appreciated as a simple method. In this study, we investigated the effect of warming of the site for collecting venous blood (forearm). The coefficient of correlation of the local cerebral blood flow value obtained from arterial and venous blood samples was 0.766 (p<0.05) in the group without warming (38 patients). The coefficient of correlation similarly obtained in the group with warming (53 patients) was 0.908 (p<0.05). The difference in the correlation efficient was significant (p<0.05) between the two groups. From these results it was concluded that warming the blood-collecting site decreased the difference between the arterial and venous radioactive concentrations and increased the precision of the test. (author)

  3. Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk

    Science.gov (United States)

    Rezende, Suely Meireles; Lijfering, Willem M.; Rosendaal, Frits R.; Cannegieter, Suzanne C.

    2014-01-01

    Recent studies suggest that leukocytes and erythrocytes play a role in coagulation. However, whether leukocytes, erythrocytes and other hematologic variables are associated with risk of venous thrombosis is not well known. To study this, we used data from 2473 patients with venous thrombosis and 2935 controls. The variables assessed were: total leukocytes, granulocytes, lymphocytes, monocytes, hematocrit, hemoglobin, erythrocytes and red cell indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and red cell distribution width). We found a strong dose-response relation for higher red cell distribution width and monocyte count with risk of venous thrombosis, with odds ratios of 3.1 (95% confidence interval, 2.0–4.8) and 2.8 (95% confidence interval, 1.3–5.8), respectively, after adjustment for age, sex, C-reactive protein level, malignancy and co-morbidities. Monocyte count and red cell distribution width were associated with venous thrombosis even within reference ranges. A low monocyte count (thrombosis after full adjustment (odds ratios 0.6; 95% confidence interval, 0.4–0.8). In summary, high red cell distribution width and blood monocyte count, two parameters that are inexpensive and easily obtainable, were clearly associated with an increased risk of venous thrombosis. Future studies should evaluate the underlying mechanism and the use of these variables in prediction models for first and recurrent thrombosis. PMID:23894011

  4. LETTER TO THE EDITOR: Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion. Nonlinear decay of adult red blood cells

    Science.gov (United States)

    van Gemert, Martin J. C.; Pasman, Suzanne A.; van den Wijngaard, Jeroen P. H. M.; Lopriore, Enrico; Vandenbussche, Frank P. H. A.

    2008-07-01

    Recently, we derived equations relating the flow of adult red blood cells through a placental arterio-venous anastomosis with intra-uterine and post-natal measured adult hemoglobin concentrations. In this letter, we re-derived the equations, now including a more realistic nonlinear decay of adult red blood cells, and re-evaluated the measurement accuracy of the arterio-venous flow and the lifetime of the red blood cells.

  5. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: A systematic review

    DEFF Research Database (Denmark)

    Kruse, Ole; Grunnet, Niels; Barfod, Charlotte

    2011-01-01

    setting, i.e. patients assessed pre-hospitally, in the trauma centre, emergency department, or intensive care unit. 2) To examine the agreement between arterial, peripheral venous, and capillary blood lactate levels in patients in the acute setting. METHODS: We performed a systematic search using Pub...... to the hospital, or serial lactate measurements. Furthermore there is no consensus whether the sample should be drawn from arterial, peripheral venous, or capillary blood. The aim of this review was: 1) To examine whether blood lactate levels are predictive for in-hospital mortality in patients in the acute...... lactate monitoring as being useful for risk assessment in patients admitted acutely to hospital, and especially the trend, achieved by serial lactate sampling, is valuable in predicting in-hospital mortality. All patients with a lactate at admission above 2.5 mM should be closely monitored for signs...

  6. Mesenteric venous thrombosis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001157.htm Mesenteric venous thrombosis To use the sharing features on this page, please enable JavaScript. Mesenteric venous thrombosis (MVT) is a blood clot in one or ...

  7. Risk of venous thromboembolism in patients with celiac disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Ungprasert, Patompong; Wijarnpreecha, Karn; Tanratana, Pansakorn

    2016-07-01

    Patients with celiac disease (CD) might be at an increased risk of developing venous thromboembolism (VTE) due to chronic inflammation and vitamin deficiency. However, epidemiologic studies attempting to investigate this risk have yielded inconsistent results. We conducted this meta-analysis with the aims to better characterize this possible association. We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of VTE in patients with CD versus participants without CD. Generic inverse variance method of DerSimonian and Laird was used to calculate the pooled risk ratio. Out of 279 potentially relevant articles, four studies met the inclusion criteria and were included in the meta-analysis. We found a statistically significant increased risk of VTE among patients with CD with the pooled risk ratio of 1.25 (95% confidence interval, 1.02-1.53). The statistical heterogeneity was moderate with an I(2) of 69%. A significantly increased risk of VTE among patients with CD was demonstrated in this meta-analysis. Further studies are required to clarify how this risk should be addressed in clinical practice. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  8. The humanistic and economic burden of venous thromboembolism in cancer patients: a systematic review.

    Science.gov (United States)

    Kourlaba, Georgia; Relakis, John; Mylonas, Charalambos; Kapaki, Vasiliki; Kontodimas, Stathis; Holm, Majbrit V; Maniadakis, Nikos

    2015-01-01

    The objective of this study was to present evidence on the epidemiology, health outcomes and economic burden of cancer-related venous thromboembolism (VTE). Medline, Cochrane Central Register of Controlled Trials, Econlit, Science Direct, JSTOR, Oxford Journals and Cambridge Journals were searched. The systematic literature search was limited to manuscripts published from January 2000 to December 2012. On the basis of the literature, cancer patients experience between two-fold and 20-fold higher risk of developing VTE than noncancer patients. They are more likely to experience a VTE event during the first 3-6 months after cancer diagnosis. In addition, an increased risk of VTE in patients with distant metastases and certain types of cancer (i.e. pancreatic or lung) was revealed. VTE was found to be a leading cause of mortality in cancer patients. The annual average total cost for cancer patients with VTE was found to be almost 50% higher than that of cancer patients without VTE. Inpatient care costs accounted for more than 60% of total cost. The existing evidence assessed in the present review demonstrated the significant health and economic consequences of cancer-related VTE, which make a strong case for the importance of its proper and efficient prevention and management.

  9. Quantifying cerebral hypoxia by near-infrared spectroscopy tissue oximetry: the role of arterial-to-venous blood volume ratio

    Science.gov (United States)

    Rasmussen, Martin B.; Eriksen, Vibeke R.; Andresen, Bjørn; Hyttel-Sørensen, Simon; Greisen, Gorm

    2017-02-01

    Tissue oxygenation estimated by near-infrared spectroscopy (NIRS) is a volume-weighted mean of the arterial and venous hemoglobin oxygenation. In vivo validation assumes a fixed arterial-to-venous volume-ratio (AV-ratio). Regulatory cerebro-vascular mechanisms may change the AV-ratio. We used hypotension to investigate the influence of blood volume distribution on cerebral NIRS in a newborn piglet model. Hypotension was induced gradually by inflating a balloon-catheter in the inferior vena cava and the regional tissue oxygenation from NIRS (rStO) was then compared to a reference (rStO) calculated from superior sagittal sinus and aortic blood sample co-oximetry with a fixed AV-ratio. Apparent changes in the AV-ratio and cerebral blood volume (CBV) were also calculated. The mean arterial blood pressure (MABP) range was 14 to 82 mmHg. PaCO2 and SaO2 were stable during measurements. rStO mirrored only 25% (95% Cl: 21% to 28%, pNIRS estimates that CBV decreased with decreasing MABP (slope: 0.008 ml/100 g/mmHg, pNIRS oximetry responded poorly to changes in tissue oxygenation during hypotension induced by decreased preload. An increase in the AV-ratio during hypotension due to arterial vasodilation and, possibly, cerebral venous collapse may be a part of the explanation.

  10. Comparison of Interstitial Fluid pH, PCO2, PO2 with Venous Blood Values During Repetitive Handgrip Exercise

    Science.gov (United States)

    Hagan, Ronald Donald; Soller, Babs R.; Shear, Michael; Walz, Matthias; Landry, Michelle; Heard, Stephen

    2006-01-01

    We evaluated the use of a small, fiber optic sensor to measure pH, PCO2 and PO2 from forearm muscle interstitial fluid (IF) during handgrip dynamometry. PURPOSE: Compare pH, PCO2 and PO2 values obtained from venous blood with those from the IF of the flexor digitorum superficialis (FDS) during three levels of exercise intensity. METHODS: Six subjects (5M/1F), average age 29+/-5 yrs, participated in the study. A venous catheter was placed in the retrograde direction in the antecubital space and a fiber optic sensor (Paratrend, Diametrics Medical, Inc.) was placed through a 22 G catheter into the FDS muscle under ultrasound guidance. After a 45 min rest period, subjects performed three 5-min bouts of repetitive handgrip exercise (2s contraction/1 s relaxation) at attempted levels of 15%, 30% and 45% of maximal voluntary contraction. The order of the exercise bouts was random with the second and third bouts started after blood lactate had returned to baseline. Venous blood was sampled every minute during exercise and analyzed with an I-Stat CG-4+ cartridge, while IF fiber optic sensor measurements were obtained every 2 s. Change from pre-exercise baseline to end of exercise was computed for pH, PCO2 and PO2. Blood and IF values were compared with a paired t-test. RESULTS: Baseline values for pH, PCO2 and PO2 were 7.37+/-0.02, 46+/-4 mm Hg, and 36+/-6 mm Hg respectively in blood and 7.39+/-0.02, 44+/-6 mm Hg, and 35+/-14 mm Hg in IF. Average changes over all exercise levels are noted in the Table below. For each parameter the exercise-induced change was at least twice as great in IF as in blood. In blood and IF, pH and PCO2 increases were directly related to exercise intensity. Change in venous PO2 was unrelated to exercise intensity, while IF PO2 decreased with increases in exercise intensity. CONCLUSIONS: Measurement of IF pH, PCO2 and PO2 is more sensitive to exercise intensity than measurement of the same parameters in venous blood and provides continuous

  11. The investigation of complete blood counting parameters in deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Ahmet Çalışkan

    2014-03-01

    Full Text Available Objective: The role of inflammation in the deep venous thrombosis (DVT process has been explained in various studies. Hence, the role of inflammatory markers in this illness has been researched previouslyin the literature. Recent years, such as parameters, neutrophil lymphocyte ratio (NLR and platelet lymphocyte ratio (PLR, among complete blood count have been frequently started to use as an expression of inflammatory marker. In the current study, the relation between complete blood count parameters and DVT was investigated. Methods: 50 patients admitted to our clinic with the diagnosis of acute DVT (28 female, 22 male were included in the study. The patients were diagnosed by clinical symptoms and Doppler USG. Patients with additional illness that can form an inflammatory response were excluded. 30 healthy volunteers were included as a control group. Routine complete blood counts of these patients were examined retrospectively. Routine complete blood counts and nonselective inflammatory markers, red cell distribution width (RDW, white cells (WBC, NLR, and PLR measurements were examined statistically. Results: The mean age of patients included in study was 46.2±14.2 and 53% of them were female. When the groups were examined in terms of hematological parameters, lymphocyte (2.6±0.8 and 2.1±0.7, p=0.003 and platelet (322±144 and 264±66, p=0.042 values were detected to be higher. Hemoglobin (13.2±2.0 and 14.6±1.5, p=0.002 and hematocrit (38.7±5.1 and 42.8±6.9, p<0.001 values were detected to be less while the WBC, neutrophil, NLR, RDW and PLR were similar. Regarding the two groups with and without anticoagulant therapy, in the DVT group, there were no significant differences detected in terms of age, gender, and hematological parameters. Conclusion: In this study, there were no significant differences between healthy volunteers blood count parameters of patients taken into consideration with pure DVT. There is no significant change shown.

  12. Peripheral and central venous blood glucose concentrations in dogs and cats with acute arterial thromboembolism.

    Science.gov (United States)

    Klainbart, S; Kelmer, E; Vidmayer, B; Bdolah-Abram, T; Segev, G; Aroch, I

    2014-01-01

    Acute limb paralysis because of arterial thromboembolism (ATE) occurs in cats and less commonly in dogs. ATE is diagnosed based on physical examination findings and, occasionally, advanced imaging. Peripheral, affected limb venous glucose concentration is decreased in ATE, whereas its systemic concentration is within or above reference interval. Client-owned cats and dogs were divided into 3 respective groups: acute limb paralysis because of ATE (22 cats and 9 dogs); acute limb paralysis secondary to orthopedic or neurologic conditions (nonambulatory controls; 10 cats and 11 dogs); ambulatory animals presented because of various diseases (ambulatory controls; 10 cats and 9 dogs). Prospective observational, clinical study. Systemic and local (affected limb) blood glucose concentrations were measured. Their absolute and relative differences (ΔGlu and %ΔGlu, respectively) were compared among groups. ΔGlu and %ΔGlu were significantly higher in the ATE cats and dogs groups, compared to both of their respective controls (P cats, respectively, and 1.00 and 1.00, in dogs, respectively. ΔGlu cutoffs of 30 mg/dL and 16 mg/dL, in cats and dogs, respectively, corresponded to sensitivity and specificity of 100% and 90% in cats, respectively, and 100% in dogs. ΔGlu and %ΔGlu are accurate, readily available, diagnostic markers of acute ATE in paralyzed cats and dogs. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  13. Infections and inflammatory diseases as risk factors for venous thrombosis A systematic review

    NARCIS (Netherlands)

    Tichelaar, Y. I. G. Vladimir; Kluin-Nelemans, Hanneke J. C.; Meijer, Karina

    Inflammation and venous thrombosis are intertwined. Only in the recent 15 years clinical epidemiological studies have focussed on inflammatory or infectious diseases as risk factors for venous thrombosis. Although a few reviews and many case reports or studies on these topic has been written, a

  14. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis

    Science.gov (United States)

    Stegeman, Bernardine H; de Bastos, Marcos; Rosendaal, Frits R; van Hylckama Vlieg, A; Helmerhorst, Frans M; Stijnen, Theo

    2013-01-01

    Objective To provide a comprehensive overview of the risk of venous thrombosis in women using different combined oral contraceptives. Design Systematic review and network meta-analysis. Data sources PubMed, Embase, Web of Science, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Academic Search Premier, and ScienceDirect up to 22 April 2013. Review methods Observational studies that assessed the effect of combined oral contraceptives on venous thrombosis in healthy women. The primary outcome of interest was a fatal or non-fatal first event of venous thrombosis with the main focus on deep venous thrombosis or pulmonary embolism. Publications with at least 10 events in total were eligible. The network meta-analysis was performed using an extension of frequentist random effects models for mixed multiple treatment comparisons. Unadjusted relative risks with 95% confidence intervals were reported. The requirement for crude numbers did not allow adjustment for potential confounding variables. Results 3110 publications were retrieved through a search strategy; 25 publications reporting on 26 studies were included. Incidence of venous thrombosis in non-users from two included cohorts was 1.9 and 3.7 per 10 000 woman years, in line with previously reported incidences of 1-6 per 10 000 woman years. Use of combined oral contraceptives increased the risk of venous thrombosis compared with non-use (relative risk 3.5, 95% confidence interval 2.9 to 4.3). The relative risk of venous thrombosis for combined oral contraceptives with 30-35 µg ethinylestradiol and gestodene, desogestrel, cyproterone acetate, or drospirenone were similar and about 50-80% higher than for combined oral contraceptives with levonorgestrel. A dose related effect of ethinylestradiol was observed for gestodene, desogestrel, and levonorgestrel, with higher doses being associated with higher thrombosis risk. Conclusion All combined oral contraceptives investigated in this analysis were

  15. Analysis of ochratoxin A in dried blood spots - Correlation between venous and finger-prick blood, the influence of hematocrit and spotted volume.

    Science.gov (United States)

    Osteresch, Bernd; Cramer, Benedikt; Humpf, Hans-Ulrich

    2016-05-01

    We report the improvement of a method for the detection of ochratoxin A (OTA) and its thermal degradation product 2'R-ochratoxin A in dried blood spots (DBS) by high performance liquid chromatographic (HPLC) tandem mass spectrometry (MS/MS). The DBS technique was advanced for the analysis of these two compounds in DBS with unknown amounts of blood as well as varying hematocrit values. Furthermore the comparability of venous vs. capillary blood was investigated. Human whole blood samples were spotted, dried, and extracted with a solvent consisting of acetone, acetonitrile and water for analysis by HPLC-MS/MS. Quantification was carried out by stable isotope labelled internal standards. Blood samples of volunteers (n=50) were used to further optimize and simplify the procedure. Ochratoxin A and 2'R-ochratoxin A concentrations found in the entire spots (approx. 100 μL blood) were compared with punched DBS discs of 8.8mm size containing approximately 20 μL blood. As a result the amounts of both toxins in a punched 8.8mm disc correlate well with the entire DBS. Also the use of capillary blood from finger-pricks versus venous blood was evaluated. The analyte levels correlate as well indicating that the less invasive finger-prick sampling gives also reliable results. The influence of hematocrit was investigated in a range of 25-55% according to the hematocrit in the used real blood samples (34-46% hematocrit). However no significant hematocrit effect was observed for the utilized real blood samples. Moreover different blood volumes were spotted and punched as a minimal spot size is usually recommended for accurate analysis. In this experiment finger-prick samples typically consist of about 90 μL blood. Therefore spots of 75, 100 and 125 μL blood were prepared and analyzed. Similar to the hematocrit effect, no considerable influence was observed. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Dietary sodium bicarbonate, cool temperatures, and feed withdrawal: impact on arterial and venous blood-gas values in broilers.

    Science.gov (United States)

    Wideman, R F; Hooge, D M; Cummings, K R

    2003-04-01

    Sodium bicarbonate (NaHCO3) has been used successfully in mammals and birds to alleviate pulmonary hypertension. Experiment 1 was designed to provide measurements of arterial and venous blood-gas values from unanesthetized male broilers subjected to a cool temperature (16 degrees C) challenge and fed either a control diet or the same diet alkalinized by dilution with 1% NaHCO3. The incidences of pulmonary hypertension syndrome (PHS, ascites) for broilers fed the control or bicarbonate diets were 15.5 and 10.5%, respectively (P = 0.36, NS). Non-ascitic broilers fed the control diet were heavier than those fed the bicarbonate diet on d 49 (2,671 vs. 2,484 g, respectively); however, other comparisons failed to reveal diet-related differences in heart weight, pulse oximetry values, electrocardiogram amplitudes, or blood-gas values (P > 0.05). When the data were resorted into categories based on right:total ventricular weight ratios (RV:TV) indicative of normal (RV:TV or = 0.28) pulmonary arterial pressures, broilers with elevated RV:TV ratios had poorly oxygenated arterial blood that was more acidic, had high partial pressure of CO2 (PCO2), and had higher HCO3 concentrations when compared with broilers with normal RV:TV ratios. Experiment 2 was conducted to determine if metabolic variations associated with differences in feed intake or environmental temperature potentially could mask an impact of diet composition on blood-gas values. Male broilers maintained at thermoneutral temperature (24 degrees C) either received feed ad libitum or had the feed withdrawn > or = 12 h prior to blood sampling. Broilers fed ad libitum had lower venous saturation of hemoglobin with O2, higher venous PCO2, and higher arterial HCO3 concentrations than broilers subjected to feed withdrawal. Broilers in experiment 2 fed ad libitum and exposed to cool temperatures (16 degrees C) had lower arterial partial pressure of O2 and higher venous PCO2 than broilers fed ad libitum and maintained at 24

  17. Apixaban or Dalteparin in Reducing Blood Clots in Patients With Cancer Related Venous Thromboembolism

    Science.gov (United States)

    2017-12-28

    Cerebral Vein Thrombosis; Deep Vein Thrombosis; Gonadal Thrombosis; Hepatic Thrombosis; Malignant Neoplasm; Mesenteric Thrombosis; Metastatic Malignant Neoplasm; Portal Vein Thrombosis; Pulmonary Embolism; Renal Vein Thrombosis; Splenic Thrombosis; Venous Thromboembolism

  18. Perioperative bleeding and blood transfusion are major risk factors for venous thromboembolism following bariatric surgery.

    Science.gov (United States)

    Nielsen, Alexander W; Helm, Melissa C; Kindel, Tammy; Higgins, Rana; Lak, Kathleen; Helmen, Zachary M; Gould, Jon C

    2018-05-01

    Morbidly obese patients are at increased risk for venous thromboembolism (VTE) after bariatric surgery. Perioperative chemoprophylaxis is used routinely with bariatric surgery to decrease the risk of VTE. When bleeding occurs, routine chemoprophylaxis is often withheld due to concerns about inciting another bleeding event. We sought to evaluate the relationship between perioperative bleeding and postoperative VTE in bariatric surgery. The American College of Surgeons-National Surgical Quality Improvement Program (NSQIP) dataset between 2012 and 2014 was queried to identify patients who underwent bariatric surgery. Gastric bypass (n = 28,145), sleeve gastrectomy (n = 30,080), bariatric revision (n = 324), and biliopancreatic diversion procedures (n = 492) were included. Univariate and multivariate regressions were used to determine perioperative factors predictive of postoperative VTE within 30 days in patients who experience a bleeding complication necessitating transfusion. The rate of bleeding necessitating transfusion was 1.3%. Bleeding was significantly more likely to occur in gastric bypass compared to sleeve gastrectomy (1.6 vs. 1.0%) (p surgeries, increased age, length of stay, operative time, and comorbidities including hypertension, dyspnea with moderate exertion, partially dependent functional status, bleeding disorder, transfusion prior to surgery, ASA class III/IV, and metabolic syndrome increased the perioperative bleeding risk (p Bariatric surgery patients who receive postoperative blood transfusion are at a significantly increased risk for VTE. The etiology of VTE in those who are transfused is likely multifactorial and possibly related to withholding chemoprophylaxis and the potential of a hypercoagulable state induced by the transfusion. In those who bleed, consideration should be given to reinitiating chemoprophylaxis when safe, extending treatment after discharge, and screening ultrasound.

  19. Evaluation of adjusted central venous blood gases versus arterial blood gases of patients in post-operative paediatric cardiac surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Naveen G Singh

    2015-01-01

    Full Text Available Background and Aims: Central venous catheters are in situ in most of the intensive care unit (ICU patients, which may be an alternative for determining acid-base status and can reduce complications from prolonged arterial cannulation. The aim of this study was to examine the reliability between adjusted central venous blood gas (aVBG and arterial blood gas (ABG samples for pH, partial pressure of carbon-di-oxide (pCO2, bicarbonate (HCO3−, base excess (BE and lactates in paediatric cardiac surgical ICU. Methods: We applied blood gas adjustment rule, that is aVBG pH = venous blood gas (VBG pH +0.05, aVBG CO2 = VBG pCO2 - 5 mm Hg from the prior studies. In this study, we validated this relationship with simultaneous arterial and central venous blood obtained from 30 patients with four blood sample pairs each in paediatric cardiac surgical ICU patients. Results: There was a strong correlation (R i.e., Pearson's correlation between ABG and aVBG for pH = 0.9544, pCO2 = 0.8738, lactate = 0.9741, HCO3− = 0.9650 and BE = 0.9778. Intraclass correlation co-efficients (ICCs for agreement improved after applying the adjustment rule to venous pH (0.7505 to 0.9454 and pCO2 (0.4354 to 0.741. Bland Altman showed bias (and limits of agreement for pH: 0.008 (−0.04 to + 0.057, pCO2: −3.52 (–9.68 to +2.65, lactate: −0.10 (−0.51 to +0.30, HCO3−: −2.3 (–5.11 to +0.50 and BE: −0.80 (−3.09 to +1.49. Conclusion: ABG and aVBG samples showed strong correlation, acceptable mean differences and improved agreement (high ICC after adjusting the VBG. Hence, it can be promising to use trend values of VBG instead of ABG in conjunction with a correction factor under stable haemodynamic conditions.

  20. Venous Sampling

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Venous sampling Venous sampling is a diagnostic procedure that uses ... the limitations of venous sampling? What is venous sampling? Venous sampling is a diagnostic procedure that involves ...

  1. Fifty shades of gradients: does the pressure gradient in venous sinus stenting for idiopathic intracranial hypertension matter? A systematic review.

    Science.gov (United States)

    McDougall, Cameron M; Ban, Vin Shen; Beecher, Jeffrey; Pride, Lee; Welch, Babu G

    2018-03-02

    OBJECTIVE The role of venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) is not well understood. The aim of this systematic review is to attempt to identify subsets of patients with IIH who will benefit from VSS based on the pressure gradients of their venous sinus stenosis. METHODS MEDLINE/PubMed was searched for studies reporting venous pressure gradients across the stenotic segment of the venous sinus, pre- and post-stent pressure gradients, and clinical outcomes after VSS. Findings are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS From 32 eligible studies, a total of 186 patients were included in the analysis. Patients who had favorable outcomes had higher mean pressure gradients (22.8 ± 11.5 mm Hg vs 17.4 ± 8.0 mm Hg, p = 0.033) and higher changes in pressure gradients after stent placement (19.4 ± 10.0 mm Hg vs 12.0 ± 6.0 mm Hg, p = 0.006) compared with those with unfavorable outcomes. The post-stent pressure gradients between the 2 groups were not significantly different (2.8 ± 4.0 mm Hg vs 2.7 ± 2.0 mm Hg, p = 0.934). In a multivariate stepwise logistic regression controlling for age, sex, body mass index, CSF opening pressure, pre-stent pressure gradient, and post-stent pressure gradient, the change in pressure gradient with stent placement was found to be an independent predictor of favorable outcome (p = 0.028). Using a pressure gradient of 21 as a cutoff, 81/86 (94.2%) of patients with a gradient > 21 achieved favorable outcomes, compared with 82/100 (82.0%) of patients with a gradient ≤ 21 (p = 0.022). CONCLUSIONS There appears to be a relationship between the pressure gradient of venous sinus stenosis and the success of VSS in IIH. A randomized controlled trial would help elucidate this relationship and potentially guide patient selection.

  2. [Prognostic significance of leukocyte count in the venous blood in the acute stage of cerebral aneurism rupture].

    Science.gov (United States)

    Kalinkin, A A; Petrikov, S S; Khamidova, L T; Krylov, V V

    To determine a prognostic role of leukocyte count in the venous blood in the acute stage of cerebral aneurysm (CA) rupture. Fifty-one patients with CA rupture, aged from 20 to 65 years, hospitalized in the first 72 h over the period from 01.10.12 to 01.02.16 were examined. The severity of disease and anatomical form of hemorrhage was corresponded to III-IV degree on the W. Hunt - R. Hess scale and Fisher scale. All patients underwent surgery. Outcomes after open and endovascular surgeries were similar. Normal leukocyte number in the venous blood at admission was identified in 12 (24%) of patients (on average 7.3±1.4·109/L), leukocytosis in 39 (76%) (14.3±3.1·109/L) (pLeukocyte number in the acute stage of CA rupture was correlated with the frequency and severity of the vessel spasm. In 28 (55%) of patients with ischemic lesions of the brain matter, mean leukocyte number in the first 72 h after hemorrhage was higher by 2-24% (3±4.8·109/L) compared to patients without ischemia (11.9±2.5·109/L) (p=0.06). The level of leukocytes in survivors was lower by 3 - 28% (122±3.4·109/L) compared to patients with fatal outcome and patients with severe neurological deficit after the surgery (14.5±3.9·109/L) (p>0.05). The increase in leukocyte number in the venous blood in the first 72 h after CA rupture ≥10,1·109/L is a reliable risk factor of marked vessel spasm. The level of leukocytes in patients with cerebral ischemia and poor prognosis in the first 72h after aneurysmal hemorrhage was higher by 2-28% compared to survivors without neurological impairment or mild neurological deficit.

  3. Arterio-venous concentration difference of [51Cr]EDTA after a single injection in man. Significance of renal function and local blood flow

    DEFF Research Database (Denmark)

    Rehling, M; Hyldstrup, L; Henriksen, Jens Henrik Sahl

    1989-01-01

    , whereas the difference was very sensitive to even small changes in forearm blood flow within the physiological range. For measurement of renal plasma clearance it is recommended to use one long period: from the time of injection until 300 min p.i. or longer. If the clearance period is too short, the use......, different results may be obtained from venous and arterial samples. The simplified techniques using venous blood samples--which usually include some empirical corrections--should be sufficiently reliable in daily clinical practice provided the forearm blood flow is reasonably high, e.g. exposure to cold...... introduced in the measurement of renal plasma clearance and total plasma clearance by using venous blood samples instead of arterial. In 13 patients with GFR ranging from 29 to 150 ml min-1, Ca was higher than Cv immediately after the injection. After mean 38 min (range 12-82 min) the two curves crossed...

  4. The effect of fluid therapy on hemodynamic and venous blood gas parameters in patients with septic shock

    Directory of Open Access Journals (Sweden)

    Sahar Mirbaha

    2016-11-01

    Full Text Available Background: Hemodynamics and venous blood gas (VBG may be used to guide fluid therapy in septic shock patients. However, the influence of fluid therapy on hemodynamic and blood gas parameters is not fully understood. In this study, we aimed to investigate the effect of fluid therapy on hemodynamic and VBG parameters. Methods: This cross-sectional study was conducted from January to April 2016. All patients with diagnosis of severe sepsis were enrolled in the study. Systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, central venous pressure (CVP shock index, VBG parameters, serum sodium (Na and chloride (Cl levels, anion gap, and oxygen saturation (O2sat were assessed before fluid resuscitation, after resuscitation, and after fluid challenge test. Results: A total of 100 patients were included (mean age were 72.54 ± 12.77 years, 66% male. Fluid therapy significantly increased DBP (df: 2; F= 4.17; p = 0.017, MAP (df: 2; F= 6.06; p= 0.003, and CVP (df: 2; F= 27.54; p < 0.001, while the shock index was significantly reduced After fluid challenge test (df: 2; F= 7.6; p= 0.001. In addition, fluid therapy had no effect on pH (p= 0.90, HCO3 (p= 0.23, base excess (p= 0.13, SCVO2 (p= 0.73, O2sat (p= 0.73, anion gap (p= 0.96, serum Na level (p= 0.71, and serum Cl level (p= 0.64. Conclusion: Administration of fluid therapy in septic shock patients had no significant effect on SBP, heart rate, or blood gas parameters. Future studies on a larger sample of patients should confirm these findings and correlate them to clinical outcomes.

  5. Radioimmunoassay of estrone, estradiol, estriol, progesterone, cortisol and prolactin in maternal venous blood and the cord blood of the newborn child

    International Nuclear Information System (INIS)

    Fritschi, J.

    1980-01-01

    The estrone analyses showed that E 1 levels are not sex-dependent. The Prog/E 2 ratio changed when the children were in states of exceptional stress; analogous findings were obtained in the acidose group. Due to the wide range of variations of E 3 , it was found to be impossible to determine the stage of pregnancy from the E 3 level. Progesterone levels were significantly higher in the blood of the umbilical vein than in the umbilical artery. Prolactine levels of both the umbilical vein and the umbilical artery are significantly higher than in the mother's venous blood. Cortisol levels differed with the type of delivery, especially when comparing Caesareon with normal delivery. Also, differences were found between deliveries with more or less stress. There is no significant difference between E 2 /prog ratios measured during induced labour, immature delivery, application of analgetics; instead, cortisol levels are best correlated with the clinical criteria of birth stress, especially during the expulsion period in which stress factors are highest. Further, there is a correlation between the cortisol levels of the umbilical vein and the mother's venous-blood. (orig./MG) [de

  6. The effects of hypotension on differences between the results of simultaneous venous and arterial blood gas analysis

    Directory of Open Access Journals (Sweden)

    Farhad Shirani

    2011-01-01

    Full Text Available Background: Analysis of venous blood gas (VBG can represent arterial blood gas (ABG analysis in patients with various diseases. The effects of hypotension on differences between the results of simultaneous venous and arterial blood gas analyses were reviewed. Methods: This observational, cross-sectional study was conducted from March to October 2010 in emergency depart-ments of two university hospitals in Tehran (Iran on consecutive adult patients for whom ABG had been indicated for diagnosis/treatment. Arterial and peripheral venous bloods were simultaneously sampled with blood pressure measure-ment. The VBG-ABG amount of difference regarding pH, HCO 3 , PCO 2 , PO 2 , SO 2 , and Base Excess (BE was com-pared between those with and without hypotension. Results: During the study, 192 patients (51.6 ± 23.6 years, 67.7% males were entered into the hypotension (n = 78 and normotensive groups (n = 114. The average VBG-ABG amount of difference (95% limits of agreement in the hypotension versus normotensive group were -0.030 (-0.09 to 0.03 vs. -0.016 (-0.1 to 0.068 for pH (p = 0.01, 1.79 (-1.91 to 5.49 vs. 1.32 (-1.94 to 4.58 mEq/L for HCO 3 (p = 0.032, 2.69 (-20.43 to 25.81 vs. 2.03 (-7.75 to 11.81 mmHg for PCO 2 (p = 0.295, -35.97 (-130.17 to 58.23 vs. -32.65 (-104.79 to 39.49 mmHg for PO 2 (p = 0.293, -18.58 (-14.66 to 51.82 vs. -9.06 (-31.28 to 13.16 percent (p < 0.001 for SO 2 , and 0.25 (-3.73 to 4.23 vs. 0.79 (-2.51 to 4.09 for BE (p = 0.036. Conclusions: Hypotensive status is associated with an increase in the amount of difference between VBG and ABG analysis regarding pH, HCO 3 , and BE, though the amount of increase does not seem to be clinically important. Studying the precise effects of replacing ABG with VBG on the clinical decision-making and the following outcomes is worth-while.

  7. Peripheral and Central Venous Blood Glucose Concentrations in Dogs and Cats with Acute Arterial Thromboembolism

    OpenAIRE

    Klainbart, S.; Kelmer, E.; Vidmayer, B.; Bdolah?Abram, T.; Segev, G.; Aroch, I.

    2014-01-01

    Background Acute limb paralysis because of arterial thromboembolism (ATE) occurs in cats and less commonly in dogs. ATE is diagnosed based on physical examination findings and, occasionally, advanced imaging. Hypothesis/Objectives Peripheral, affected limb venous glucose concentration is decreased in ATE, whereas its systemic concentration is within or above reference interval. Animals Client?owned cats and dogs were divided into 3 respective groups: acute limb paralysis because of ATE (22 ca...

  8. Maternal intrapartum antibiotic treatment continues to exert a bactericidal effect on the umbilical cord and peripheral venous blood of newborn infants.

    Science.gov (United States)

    Hershkovich-Shporen, C; Bardenstein, R; Blickstein, I; Shinwell, E S; Flidel-Rimon, O

    2017-11-01

    It is unclear whether maternal intrapartum antibiotic treatment (IAT) continues to exert a bactericidal effect on common pathogens in neonates. We studied the in vitro bactericidal effect of IAT on the cord and peripheral venous blood of newborn infants. Umbilical cord and peripheral venous blood from newborn infants born at Kaplan Medical Center, Israel, from April to October 2014 were studied for serum bactericidal titres against Group B Streptococcus (GBS) and Escherichia coli (E. coli) strains. We studied 60 samples of umbilical cord blood and 18 samples of peripheral venous blood from 60 newborn infants whose mothers received IAT. The controls were 10 samples of cord blood from mothers without IAT. Cord blood exerted a bactericidal effect against 98% of GBS isolates but only 8% of E.coli isolates. Peripheral blood exerted a bactericidal effect against GBS in 94% of cases, but not against E. coli. No bactericidal effect was seen in the blood from the controls. We found a continued bactericidal effect of umbilical cord blood and neonatal peripheral blood from newborn infants of IAT-treated mothers, mainly against GBS, but rarely against E. Coli. These findings may assist clinicians treating at-risk infants exposed to IAT. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. A simple method for measurement of cerebral blood flow using 123I-IMP SPECT with calibrated standard input function by one point blood sampling. Validation of calibration by one point venous blood sampling as a substitute for arterial blood sampling

    International Nuclear Information System (INIS)

    Ito, Hiroshi; Akaizawa, Takashi; Goto, Ryoui

    1994-01-01

    In a simplified method for measurement of cerebral blood flow using one 123 I-IMP SPECT scan and one point arterial blood sampling (Autoradiography method), input function is obtained by calibrating a standard input function by one point arterial blood sampling. A purpose of this study is validation of calibration by one point venous blood sampling as a substitute for one point arterial blood sampling. After intravenous infusion of 123 I-IMP, frequent arterial and venous blood sampling were simultaneously performed on 12 patients of CNS disease without any heart and lung disease and 5 normal volunteers. The radioactivity ratio of venous whole blood which obtained from cutaneous cubital vein to arterial whole blood were 0.76±0.08, 0.80±0.05, 0.81±0.06, 0.83±0.11 at 10, 20, 30, 50 min after 123 I-IMP infusion, respectively. The venous blood radioactivities were always 20% lower than those of arterial blood radioactivity during 50 min. However, the ratio which obtained from cutaneous dorsal hand vein to artery were 0.93±0.02, 0.94±0.05, 0.98±0.04, 0.98±0.03, at 10, 20, 30, 50 min after 123 I-IMP infusion, respectively. The venous blood radioactivity was consistent with artery. These indicate that arterio-venous difference of radioactivity in a peripheral cutaneous vein like a dorsal hand vein is minimal due to arteriovenous shunt in palm. Therefore, a substitution by blood sampling from cutaneous dorsal hand vein for artery will be possible. Optimized time for venous blood sampling evaluated by error analysis was 20 min after 123 I-IMP infusion, which is 10 min later than that of arterial blood sampling. (author)

  10. Effects of blood transfusion on oxygen extraction ratio and central venous saturation in children after cardiac surgery.

    Science.gov (United States)

    Nasser, Bana; Tageldein, Mohmad; AlMesned, Abdulrahman; Kabbani, Mohammad

    2017-01-01

    Red blood cell transfusion is common in critically ill children after cardiac surgery. Since the threshold for hemoglobin (Hb) transfusion need is not well defined, the threshold Hb level at which dependent critical oxygen uptake-to-delivery (VO2-DO2) status compensation is uncertain. To assess the effects of blood transfusion on the oxygen extraction ratio (O2ER) and central venous oxygen saturation (ScvO2) to identify a critical O2ER value that could help us determine the critical need for blood transfusion. Prospective, observational cohort study. Cardiac Surgical Intensive Care Unit at Prince Sultan Cardiac Center in Qassim, Saudi Arabia. Between January 2013 and December 2015, we included all children with cardiac disease who underwent surgery and needed a blood transfusion. Demographic and laboratory data with physiological parameters before and 1 and 6 hours after transfusion were recorded and O2ER before and 6 hours after transfusion was computed. Cases were divided into two groups based on O2ER: Patients with increased O2ER (O2ER > 40%) and normal patients without increased O2ER (O2ER transfusion. Changes in O2ER and ScvO2 following blood transfusion. Of 103 patients who had blood transfusion, 75 cases had normal O2ER before transfusion while 28 cases had increased O2ER before transfusion. Following blood transfusion, O2ER and ScvO2 improved in the group that had increased O2ER before transfusion, but not in the group that had normal O2ER before transfusion. The clinical and hemodynamic indicators O2ER and ScvO2 may be considered as markers that can indicate a need for blood transfusion. The limitation of this study is the small number of patients that had increased O2ER before transfusion. There were few available variables to assess oxygen consumption.

  11. Biochemical assessment of growth factors and circulation of blood components contained in the different fractions obtained by centrifugation of venous blood.

    Science.gov (United States)

    Corigiano, M; Ciobanu, G; Baldoni, E; Pompa, G

    2014-01-01

    The aim of this study was to evaluate a biochemical marker with different elements of a normal blood serum and centrifuged blood serum after a different rotation system. For this technique, we used five fractions of a blood Concentrated Growth Factors system (bCGF) and a particular device for the different rotation program. Blood samples were collected from 10 volunteers aged between 35 and 55 in the Operative Unit of the “Sapienza” University of Rome with only a fraction of different biochemical elements. Through an individual blood phase separator tube of venous blood, active factions of serum and 4 fractions of red buffy coat were taken. The biochemical markers with 14 elements were examined at times: P1-11 minutes, P2-12minutes, P3-15 minutes. Exclusively biological materials which are normally applied in the regeneration techniques for different defects and lesions were used with this technique. After specific rotation programs, a different result was obtained for each cycle: P1, P2, P3. In test tubes obtained by separated blood, we observed a higher concentration of proteins, ions, and other antigens compared to normal blood plasma. Examining the biochemical results of different elements, we observed an increase (P≤0,01). Since each person’s DNA is different, we could not have the same results in 5 fractions of blood concentration, we did, however, find a good increase in only a fraction of proteins, immunoglobulin and different ions. We obtained five fractions after centrifugation, and we had an increase in different biochemical elements compared to normal blood (P≤0,01) which is significant at different times. These biochemical elements were stimulated by different growth factors, which are used by the immune system, and they induced the formation of hard and soft tissues and good regeneration.

  12. Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study Hemoglobina medida por Hemocue y por un método de referencia en sangre venosa y capilar: estudio de validación

    OpenAIRE

    Lynnette Neufeld; Armando García-Guerra; Domingo Sánchez-Francia; Oscar Newton-Sánchez; María Dolores Ramírez-Villalobos; Juan Rivera-Dommarco

    2002-01-01

    Objective. To assess the comparability of hemoglobin concentration (Hb) in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn) and to document the influence of type of blood (capillary or venous) and analysis method on anemia prevalence estimates. Material and Methods. Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Children's Hospital) in Cuernavaca, Mo...

  13. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis.

    Science.gov (United States)

    Chopra, Vineet; Anand, Sarah; Hickner, Andy; Buist, Michael; Rogers, Mary Am; Saint, Sanjay; Flanders, Scott A

    2013-07-27

    Peripherally inserted central catheters (PICCs) are associated with an increased risk of venous thromboembolism. However, the size of this risk relative to that associated with other central venous catheters (CVCs) is unknown. We did a systematic review and meta-analysis to compare the risk of venous thromboembolism associated with PICCs versus that associated with other CVCs. We searched several databases, including Medline, Embase, Biosis, Cochrane Central Register of Controlled Trials, Conference Papers Index, and Scopus. Additional studies were identified through hand searches of bibliographies and internet searches, and we contacted study authors to obtain unpublished data. All human studies published in full text, abstract, or poster form were eligible for inclusion. All studies were of adult patients aged at least 18 years who underwent insertion of a PICC. Studies were assessed with the Newcastle-Ottawa risk of bias scale. In studies without a comparison group, the pooled frequency of venous thromboembolism was calculated for patients receiving PICCs. In studies comparing PICCs with other CVCs, summary odds ratios (ORs) were calculated with a random effects meta-analysis. Of the 533 citations identified, 64 studies (12 with a comparison group and 52 without) including 29 503 patients met the eligibility criteria. In the non-comparison studies, the weighted frequency of PICC-related deep vein thrombosis was highest in patients who were critically ill (13·91%, 95% CI 7·68-20·14) and those with cancer (6·67%, 4·69-8·64). Our meta-analysis of 11 studies comparing the risk of deep vein thrombosis related to PICCs with that related to CVCs showed that PICCs were associated with an increased risk of deep vein thrombosis (OR 2·55, 1·54-4·23, p<0·0001) but not pulmonary embolism (no events). With the baseline PICC-related deep vein thrombosis rate of 2·7% and pooled OR of 2·55, the number needed to harm relative to CVCs was 26 (95% CI 13-71). PICCs are

  14. External Application of Traditional Chinese Medicine for Venous Ulcers: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Xin Li

    2015-01-01

    Full Text Available Objective. To evaluate the effectiveness of external application of traditional Chinese medicine (EA-TCM on venous ulcers. Methods. Seven databases were searched until April 2015 for randomized controlled trials (RCTs of EA-TCM for venous ulcers. Risk of bias was assessed using Cochrane Handbook guidelines. Study outcomes were presented as risk ratios (RRs for dichotomous data or mean differences (MDs for continuous data. Results. Sixteen of 193 potentially relevant trials met the inclusion criteria; however, their methodological qualities were low. Comparison of the same intervention strategies revealed significant differences in total effectiveness rates between EA-TCM and conventional therapy groups (RR = 1.22, 95% confidence interval [CI] = 1.16–1.29, and P<0.00001. Compared to conventional therapy, EA-TCM combined with conventional therapy had a superior total effectiveness rate (RR = 1.11, 95% CI = 1.04–1.19, and P=0.003. There were no significant differences in recurrence rates during followup and final pain measurements between the experimental and those in the control groups (RR = 0.86, 95% CI = 0.31–2.39, and P=0.85; MD −0.75, 95% CI = −2.15–0.65, and P=0.29. Conclusion. The evidence that EA-TCM is an effective treatment for venous ulcers is encouraging, but not conclusive due to the low methodological quality of the RCTs. Therefore, more high-quality RCTs with larger sample sizes are required.

  15. Regional cerebral blood flow measurements in schizophrenics by /sup 133/Xe inhalation and intra-venous injection method

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Seki, Hiroyasu; Sumiya, Hisashi; Ishida, Hiroko; Taki, Junichi; Hisada, Kinichi; Kurachi, Masayoshi; Kobayashi, Katsuji; Yamaguchi, Nariyoshi (Kanazawa Univ. (Japan). School of Medicine)

    1984-12-01

    Regional cerebral blood flow measurements were performed in 25 schizophrenic patients and 25 healthy volunteers by /sup 133/Xe inhalation and intra-venous injection method. Schizophrenic patients were classified into the following three groups. Group I: 8 patients without auditory hallucination measured by 2-dimensional /sup 133/Xe inhalation method. Group II: 6 patients with auditory hallucination measured by the same method as in Group I. Group III: 11 patients, including 2 patients with auditory hallucination measured by 3-dimensional /sup 133/Xe intra-venous injection method at the level of OM+5 cm. Bilateral regional percent values, which were obtained by dividing regional values by hemispheric mean or sectional mean values, for frontal lobes in Group I and II were significantly lower than those in the controls. In addition, bilateral regional percent values for bilateral temporal lobes in Group II were significantly higher than those in the controls. In Group III, regional percent values for right frontal lobes and those for posterior part of central gray matter showed significant decrease and increase, respectively. These findings would suggest that the negative symptoms of schizophrenia are related to the hypofrontal and positive ones to the hypertemporoparietal activity.

  16. Second-Generation central venous catheter in the prevention of bloodstream infection: a systematic review.

    Science.gov (United States)

    Stocco, Janislei Gislei Dorociaki; Hoers, Hellen; Pott, Franciele Soares; Crozeta, Karla; Barbosa, Dulce Aparecida; Meier, Marineli Joaquim

    2016-08-08

    to evaluate the effectiveness and safety in the use of second-generation central venous catheters impregnated in clorhexidine and silver sulfadiazine when compared with other catheters, being them impregnated or not, in order to prevent the bloodstream infection prevention. systematic review with meta-analysis. Databases searched: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; search in Congress Proceedings and records from Clinical Trials. 1.235 studies were identified, 97 were pre-selected and 4 were included. In catheter-related bloodstream infection, there was no statistical significance between second-generation impregnated catheter compared with the non-impregnated ones, absolute relative risk 1,5% confidence interval 95% (3%-1%), relative risk 0,68 (confidence interval 95%, 0,40-1,15) and number needed to treat 66. In the sensitivity analysis, there was less bloodstream infection in impregnated catheters (relative risk 0,50, confidence interval 95%, 0,26-0,96). Lower colonization, absolute relative risk 9,6% (confidence interval 95%, 10% to 4%), relative risk 0,51 (confidence interval 95% from 0,38-0,85) and number needed to treat 5. the use of second-generation catheters was effective in reducing the catheter colonization and infection when a sensitivity analysis is performed. Future clinical trials are suggested to evaluate sepsis rates, mortality and adverse effects. evaluar la efectividad y seguridad del uso de catéteres venosos centrales de segunda generación, impregnados en clorhexidina y sulfadiazina de plata, comparados con otros catéteres impregnados o no impregnados, para prevención de infección de la corriente sanguínea. revisión sistemática con metaanálisis. La búsqueda fue realizada en las bases: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; fueron consultados anales de congresos y registros de ensayos clínicos. fueron identificados 1.235 estudios, 97 preseleccionados y cuatro incluidos. En la infección de la

  17. Determination of reference intervals and comparison of venous blood gas parameters using a standard and nonstandard collection method in 51 dogs.

    Science.gov (United States)

    Bachmann, K; Kutter, A; Jud Schefer, R S; Sigrist, N

    2018-03-01

    The aim of this study was to determine reference intervals (RI) for venous blood parameters determined with the RAPIDPoint 500 (RP500) blood gas analyzer using blood gas syringes (BGS) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGS. The null hypothesis was that canine venous blood samples collected in BGS and in LH tubes are comparable. Jugular blood was collected from 51 healthy dogs into a BGS and a LH tube. The BGS was immediately analyzed followed by the LH tube. The RI were calculated from BGS results. The BGS and LH tubes results were compared using paired t-test or Wilcoxon matched-pairs signed-rank test and Bland-Altman analysis. To assess clinical relevance, the bias between BGS and LH tubes was compared with the allowable total error (TEa). Values derived from LH tubes showed no significant difference for standard bicarbonate (HCO3std), whole blood base excess (BE B), Na, K, Cl, glucose and hemoglobin (tHb). The pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionized Ca, anion gap and lactate were significantly (p.

  18. Evaluation of a portable clinical analyzer for the determination of blood gas partial pressures, electrolyte concentrations, and hematocrit in venous blood samples collected from cattle, horses, and sheep.

    Science.gov (United States)

    Peiró, Juliana R; Borges, Alexandre S; Gonçalves, Roberto C; Mendes, Luiz Claudio N

    2010-05-01

    To compare results reported for blood gas partial pressures, electrolyte concentrations, and Hct in venous blood samples collected from cattle, horses, and sheep and analyzed by use of a portable clinical analyzer (PCA) and reference analyzer (RA). Clinically normal animals (24 cattle, 22 horses, and 22 sheep). pH; Pco(2); Po(2); total carbon dioxide concentration; oxygen saturation; base excess; concentrations of HCO(3)(-), Na(+), K(+), and ionized calcium; Hct; and hemoglobin concentration were determined with a PCA. Results were compared with those obtained for the same blood sample with an RA. Bias (mean difference) and variability (95% confidence interval) were determined for all data reported. Data were also subjected to analyses by Deming regression and Pearson correlation. Analysis of Bland-Altman plots revealed good agreement between results obtained with the PCA and those obtained with the RA for pH and total carbon dioxide concentration in cattle, K(+) concentration in horses and sheep, and base excess in horses. Except for Na(+) concentration and Hct in horses and sheep, correlation was good or excellent for most variables reported. Data from blood gas and electrolyte analyses obtained by use of the PCA can be used to evaluate the health status of cattle, horses, and sheep. Furthermore, the handheld PCA device may have a great advantage over the RA device as a result of the ability to analyze blood samples on farms that may be located far from urban centers.

  19. Venous plethysmography

    International Nuclear Information System (INIS)

    Barnes, R.W.; Middleton, J.; Turley, D.G.

    1984-01-01

    Venous plethysmography provides an objective, versatile, and accurate method of defining those alterations that may result from acute or chronic venous disease, namely venous outflow obstruction and venous reflux through incompetent venous valves. Impedance or strain-gauge plethysmography provides the most accurate means of quantifying abnormal venous outflow in acute deep venous thrombosis. Venous volume plethysmography, using the phleborheograph, provides very sensitive determination of altered venous hemodynamics in acute deep venous thrombosis; it also serves to assess some patients with chronic venous insufficiency. Combinations of strain-gauge and photoplethysmography lead to useful measures of venous reflux in deep, perforating, and superficial veins. This information, along with measurements of maximum venous outflow, may provide the most versatile means of establishing altered hemodynamics in patients with chronic venous insufficiency

  20. Heparin Versus Normal Saline: Flushing Effectiveness in Managing Central Venous Catheters in Patients Undergoing Blood and Marrow Transplantation

    Science.gov (United States)

    Klein, John; Jepsen, Amelia; Patterson, Amy; Reich, Richard R; Mason, Tina M

    2018-04-01

    Patients undergoing blood and marrow transplantation (BMT) use a central venous catheter (CVC); heparin is often employed to maintain patency but may increase the risk of complications. Research has not provided conclusive differences in efficacy and safety regarding heparin flushing versus normal saline flushing in CVC maintenance. Minimal research is specific to this patient population. This study aimed to determine if differences exist in CVC patency, tissue plasminogen activator usage, and the incidence of central line-associated bloodstream infections when flushing with normal saline only versus heparin and normal saline among patients undergoing BMT. A convenience sample of 30 patients undergoing allogeneic or autologous transplantation with a new non-port/non-peripherally inserted CVC were evaluated. Elimination of routine heparin use could positively affect outcomes in this patient population.

  1. Detailed examination of the adrenal glands by angiography and radioimmunologic measurement of hormones in adrenal venous blood

    International Nuclear Information System (INIS)

    Yugrinov, O.G.; Slavnov, V.N.; Komissarenko, I.V.; Olejnik, V.A.; Benikova, E.A.

    1984-01-01

    In 222 patients the adrenal glands were examined in detail by arteriography and venography, and if indicated also the ovaries, kidneys, bladder and other organs were checked up. Blood samples were taken from the adrenal glands, renal veins and the vena cava inferior in the bifurcational and subdiaphragmatic region. According to the clinical requirements cortisol, corticotropine, aldosterone, adrenaline, noradrenaline and renine activity were determined. Comprehensive angiographic and radioimmunologic studies revealed in 54 patients tumors of the adrenal cortex. Tumors of the adrenal medulla were detected in 43 of the cases. In 103 cases a morbus Icenko-Cushing was found. The basic examination of the diagnostic schedule was selective adrenal venography. Adrenal arteriography and measurement of venous hormone levels were complementary investigations and were rarely used as independent methods. (author)

  2. Reverse Trendelenburg position is a safer technique for lowering central venous pressure without decreasing blood pressure than clamping of the inferior vena cava below the liver.

    Science.gov (United States)

    Yoneda, Godai; Katagiri, Satoshi; Yamamoto, Masakazu

    2015-06-01

    anesthesia was not significantly lower than that during supine position (P = 0.9934). Mean systolic blood pressure was significantly decreased during inferior vena cava clamping (P = 0.0024), but not during reverse Trendelenburg position (P = 0.6344). Reverse Trendelenburg position decreased central venous pressure without significantly decreasing the systolic blood pressure, suggesting that it is possible to perform hepatectomy with reverse Trendelenburg position more safely than with inferior vena cava clamping. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  3. Prediction of risk of recurrence of venous thromboembolism following treatment for a first unprovoked venous thromboembolism: systematic review, prognostic model and clinical decision rule, and economic evaluation.

    Science.gov (United States)

    Ensor, Joie; Riley, Richard D; Jowett, Sue; Monahan, Mark; Snell, Kym Ie; Bayliss, Susan; Moore, David; Fitzmaurice, David

    2016-02-01

    Unprovoked first venous thromboembolism (VTE) is defined as VTE in the absence of a temporary provoking factor such as surgery, immobility and other temporary factors. Recurrent VTE in unprovoked patients is highly prevalent, but easily preventable with oral anticoagulant (OAC) therapy. The unprovoked population is highly heterogeneous in terms of risk of recurrent VTE. The first aim of the project is to review existing prognostic models which stratify individuals by their recurrence risk, therefore potentially allowing tailored treatment strategies. The second aim is to enhance the existing research in this field, by developing and externally validating a new prognostic model for individual risk prediction, using a pooled database containing individual patient data (IPD) from several studies. The final aim is to assess the economic cost-effectiveness of the proposed prognostic model if it is used as a decision rule for resuming OAC therapy, compared with current standard treatment strategies. Standard systematic review methodology was used to identify relevant prognostic model development, validation and cost-effectiveness studies. Bibliographic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched using terms relating to the clinical area and prognosis. Reviewing was undertaken by two reviewers independently using pre-defined criteria. Included full-text articles were data extracted and quality assessed. Critical appraisal of included full texts was undertaken and comparisons made of model performance. A prognostic model was developed using IPD from the pooled database of seven trials. A novel internal-external cross-validation (IECV) approach was used to develop and validate a prognostic model, with external validation undertaken in each of the trials iteratively. Given good performance in the IECV approach, a final model was developed using all trials data. A Markov patient-level simulation was used to consider the economic cost

  4. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe

    DEFF Research Database (Denmark)

    Brøndum, E.; Hasenkam, John Michael; Secher, Niels H.

    2009-01-01

    How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended...... unchanged. Cardiac output was reduced by 30%, CVP decreased to -1 +/- 2 mmHg (P blood in the veins. When the head was raised, the jugular...... veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head...

  5. Diagnostic Accuracy of Central Venous Catheter Confirmation by Bedside Ultrasound Versus Chest Radiography in Critically Ill Patients: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ablordeppey, Enyo A; Drewry, Anne M; Beyer, Alexander B; Theodoro, Daniel L; Fowler, Susan A; Fuller, Brian M; Carpenter, Christopher R

    2017-04-01

    We performed a systematic review and meta-analysis to examine the accuracy of bedside ultrasound for confirmation of central venous catheter position and exclusion of pneumothorax compared with chest radiography. PubMed, Embase, Cochrane Central Register of Controlled Trials, reference lists, conference proceedings and ClinicalTrials.gov. Articles and abstracts describing the diagnostic accuracy of bedside ultrasound compared with chest radiography for confirmation of central venous catheters in sufficient detail to reconstruct 2 × 2 contingency tables were reviewed. Primary outcomes included the accuracy of confirming catheter positioning and detecting a pneumothorax. Secondary outcomes included feasibility, interrater reliability, and efficiency to complete bedside ultrasound confirmation of central venous catheter position. Investigators abstracted study details including research design and sonographic imaging technique to detect catheter malposition and procedure-related pneumothorax. Diagnostic accuracy measures included pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Fifteen studies with 1,553 central venous catheter placements were identified with a pooled sensitivity and specificity of catheter malposition by ultrasound of 0.82 (0.77-0.86) and 0.98 (0.97-0.99), respectively. The pooled positive and negative likelihood ratios of catheter malposition by ultrasound were 31.12 (14.72-65.78) and 0.25 (0.13-0.47). The sensitivity and specificity of ultrasound for pneumothorax detection was nearly 100% in the participating studies. Bedside ultrasound reduced mean central venous catheter confirmation time by 58.3 minutes. Risk of bias and clinical heterogeneity in the studies were high. Bedside ultrasound is faster than radiography at identifying pneumothorax after central venous catheter insertion. When a central venous catheter malposition exists, bedside ultrasound will identify four out of every five earlier than

  6. Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

    OpenAIRE

    Kazufumi Tachi; Masanori Mori; Reiko Tsukuura; Rintaro Hirai

    2018-01-01

    Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the...

  7. Therapeutic drug monitoring of methotrexate on the pediatric oncology ward: can blood sampling from central venous accesses substitute for capillary finger punctures?

    Science.gov (United States)

    Ritzmo, Carina; Albertioni, Freidoun; Cosic, Karin; Söderhäll, Stefan; Eksborg, Staffan

    2007-08-01

    Intravenous methotrexate therapy with subsequent calcium folinate rescue is widely used for treatment of various neoplastic diseases, both in adults and in children. The optimization of the methotrexate dose and/or the calcium folinate rescue is based on pharmacokinetic data calculated from plasma concentrations collected after cessation of the methotrexate infusion. The aim of the present study was to evaluate the possibility of substituting capillary blood samples with blood samples drawn from central venous catheters (PORT-A-CATH) for therapeutic drug monitoring of methotrexate on the pediatric oncology ward. Nine cancer patients (4 females and 5 males; median age: 15 years; range: 5-20 years) were included. The quantitative analysis of methotrexate was carried out by fluorescence polarization immunoassay (FPIA). The concentrations of methotrexate in venous and capillary samples were closely correlated (rs = 0.98; P plasma concentration ratio was 1.00 [median value; interquartile range (IQR): 0.882-1.094]; for 85% of the data points the ratio was 0.8 to 1.2, independent of drug concentration. The observed plasma concentration differences in blood samples drawn from central venous accesses and obtained from capillary blood samples in this study could have altered the calcium folinate rescue at 1 treatment occasion only. Plotting all measured methotrexate concentration time data for the individual patients during the elimination phase, on a chart including a normal elimination curve, is mandatory to enable proper handling of the subsequent rescue after high-dose methotrexate therapy. Blood sampling from the central venous access can be used only under certain circumstances for therapeutic drug monitoring of methotrexate. Carefully evaluated standardized instructions regarding rinsing, flushing, and discarding waste volumes, as well as precautions to minimize the required blood volume, are needed.

  8. Natural history of venous thromboembolism in patients from the Mediterranean region. A systematic review.

    Science.gov (United States)

    Sánchez Muñoz-Torrero, J F; Lorenzo-Hernández, A; Trujillo-Santos, J; Fernández-Capitán, C; Zamorano, J; Monreal, M

    2014-05-01

    Patients with cardiovascular diseases living in the Mediterranean area have a better outcome than those in other parts of the world, but it is not known whether these differences also occur with venous thromboembolism (VTE). We searched the Medline and EMBASE databases to identify clinical trials and cohort studies of patients with VTE who had been treated with anticoagulant therapy for 3 months. Two reviewers independently extracted the data in a standardized manner. A total of 24 studies that included 7,225 patients (2,414 from the Mediterranean region and 4,811 from other regions) were analyzed. The patients from the Mediterranean area were predominately women and older, and the idiopathic VTE was less frequent than in other regions. Compared with patients from other regions, patients from the Mediterranean region had an increased rate of recurrent deep vein thrombosis (4.35% vs. 2.68%; odds ratio [OR], 1.65; 95% confidence interval [95% CI] 1.27-2.15), fatal recurrent VTE (0.75% vs. 0.35%; OR, 2.11; 95% CI 1.09-4.12) and fatal bleeding (0.25% vs. 0.06%; odds ratio: 3.99; 95% CI 1.00-16.0). The case-fatality rate (CFR) for recurrent VTE was 12.8% (95% CI 7.99-19.1) in the Mediterranean region and 8.41% (5.15-12.9) in other areas. The CFR for major bleeding was 11.3% (95% CI 4.72-22.1) and 3.22% (95% CI 0.83-8.53), respectively. Compared to other regions, patients with VTE from the Mediterranean region have greater mortality during the first 3 months of treatment due to a greater incidence of recurrent VTE and severe hemorrhaging. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. Blood transfusion indications in neurosurgical patients: A systematic review.

    Science.gov (United States)

    Bagwe, Shefali; Chung, Lawrance K; Lagman, Carlito; Voth, Brittany L; Barnette, Natalie E; Elhajjmoussa, Lekaa; Yang, Isaac

    2017-04-01

    Neurosurgical procedures can be complicated by significant blood losses that have the potential to decrease tissue perfusion to critical brain tissue. Red blood cell transfusion is used in a variety of capacities both inside, and outside, of the operating room to prevent untoward neurologic damage. However, evidence-based guidelines concerning thresholds and indications for transfusion in neurosurgery remain limited. Consequently, transfusion practices in neurosurgical patients are highly variable and based on institutional experiences. Recently, a paradigm shift has occurred in neurocritical intensive care units, whereby restrictive transfusion is increasingly favored over liberal transfusion but the ideal strategy remains in clinical equipoise. The authors of this study perform a systematic review of the literature with the objective of capturing the changing landscape of blood transfusion indications in neurosurgical patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Estimation and comparison of intra operative blood loss in patients with and without venous thromboembolism prophylaxis

    International Nuclear Information System (INIS)

    Ahsin, S.; Bashir, A.; Faiz, S.A.; Tahir, J.; Ijaz, A.

    2014-01-01

    To estimate and compare intraoperative blood loss in surgical patients with and without deep vein thrombosis (DVT) prophylaxis using unfractionated heparin Study Design: Clinical Trial Place and Duration: Surgery Department of Fauji Foundation Hospital and Physiology Department Foundation University Medical College from October 2011 to August 2012 Patients and Methodology: Patients were selected by non probability purposive sampling. Patients fulfilling the inclusion criteria were divided into 2 groups 25 each on the basis of order of presentation at Fauji Foundation Hospital until cohort numbers were reached. Group I received no heparin whereas group II received heparin. Written informed consent was taken from the patient after explaining the procedure of the study. Coagulation profile was done for both groups before the planned surgery. Heparin in a dose of 5000 units was administered subcutaneously to group II on the morning of the planned surgery and it was stopped 24 hours post operatively. Blood loss was estimated in both groups by weighing cotton swabs pre and post operatively. Data was analyzed by SPSS version 17. Results: Demographic data and surgical procedure time between the two groups did not differ. Blood loss between the two groups did not show any statistically significant difference. Conclusion: DVT prophylaxis using unfractionated heparin did not lead to any significant overt blood loss when compared with those without it. (author)

  11. Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

    Directory of Open Access Journals (Sweden)

    Kazufumi Tachi

    2018-03-01

    Full Text Available Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the replanted region. The patient presented to our hospital with an upper lip avulsion that was caused by a dog bite. The lip was replanted by the microvascular anastomoses of one artery and two veins using interposed vein grafts. The replanted lip showed signs of congestion on postoperative day one; exsanguination using medicinal leeches was attempted, while blood glucose levels were measured every three hours. Critical congestion, which did not occur in this patient, was defined as a blood glucose level lower than 40 mg/dL. Lip replantation was successful without any complications in this patient.

  12. The effect of phenylephrine on arterial and venous cerebral blood flow in healthy subjects

    DEFF Research Database (Denmark)

    Ogoh, Shigehiko; Sato, Kohei; Fisher, James P

    2011-01-01

    Sympathetic regulation of the cerebral circulation remains controversial. Although intravenous phenylephrine (PE) infusion reduces the near-infrared spectroscopy (NIRS)-determined measure of frontal lobe oxygenation (S(c) O(2) ) and increases middle cerebral artery mean blood velocity (MCA V...

  13. Determination of reference intervals and comparison of venous blood gas parameters using standard and non-standard collection methods in 24 cats.

    Science.gov (United States)

    Bachmann, Karin; Kutter, Annette Pn; Schefer, Rahel Jud; Marly-Voquer, Charlotte; Sigrist, Nadja

    2017-08-01

    Objectives The aim of this study was to determine in-house reference intervals (RIs) for venous blood analysis with the RAPIDPoint 500 blood gas analyser using blood gas syringes (BGSs) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGSs. Methods Venous blood was collected from 24 healthy cats and directly transferred into a BGS and an LH tube. The BGS was immediately analysed on the RAPIDPoint 500 followed by the LH tube. The BGSs and LH tubes were compared using paired t-test or Wilcoxon matched-pairs signed-rank test, Bland-Altman and Passing-Bablok analysis. To assess clinical relevance, bias or percentage bias between BGSs and LH tubes was compared with the allowable total error (TEa) recommended for the respective parameter. Results Based on the values obtained from the BGSs, RIs were calculated for the evaluated parameters, including blood gases, electrolytes, glucose and lactate. Values derived from LH tubes showed no significant difference for standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate, while pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionised calcium and anion gap were significantly different to the samples collected in BGSs ( P glucose and lactate can be made based on blood collected in LH tubes and analysed within 5 mins. For pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, anion gap and ionised calcium the clinically relevant alterations have to be considered if analysed in LH tubes.

  14. Current and former smoking and risk for venous thromboembolism: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yun-Jiu Cheng

    Full Text Available BACKGROUND: Smoking is a well-established risk factor for atherosclerotic disease, but its role as an independent risk factor for venous thromboembolism (VTE remains controversial. We conducted a meta-analysis to summarize all published prospective studies and case-control studies to update the risk for VTE in smokers and determine whether a dose-response relationship exists. METHODS AND FINDINGS: We performed a literature search using MEDLINE (source PubMed, January 1, 1966 to June 15, 2013 and EMBASE (January 1, 1980 to June 15, 2013 with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. Thirty-two observational studies involving 3,966,184 participants and 35,151 VTE events were identified. Compared with never smokers, the overall combined relative risks (RRs for developing VTE were 1.17 (95% CI 1.09-1.25 for ever smokers, 1.23 (95% CI 1.14-1.33 for current smokers, and 1.10 (95% CI 1.03-1.17 for former smokers, respectively. The risk increased by 10.2% (95% CI 8.6%-11.8% for every additional ten cigarettes per day smoked or by 6.1% (95% CI 3.8%-8.5% for every additional ten pack-years. Analysis of 13 studies adjusted for body mass index (BMI yielded a relatively higher RR (1.30; 95% CI 1.24-1.37 for current smokers. The population attributable fractions of VTE were 8.7% (95% CI 4.8%-12.3% for ever smoking, 5.8% (95% CI 3.6%-8.2% for current smoking, and 2.7% (95% CI 0.8%-4.5% for former smoking. Smoking was associated with an absolute risk increase of 24.3 (95% CI 15.4-26.7 cases per 100,000 person-years. CONCLUSIONS: Cigarette smoking is associated with a slightly increased risk for VTE. BMI appears to be a confounding factor in the risk estimates. The relationship between VTE and smoking has clinical relevance with respect to individual screening, risk factor modification, and the primary and secondary prevention of VTE. Please see later in the article for the Editors' Summary.

  15. The post-occipital spinal venous sinus of the Nile crocodile (Crocodylus niloticus: Its anatomy and use for blood sample collection and intravenous infusions

    Directory of Open Access Journals (Sweden)

    Jan G. Myburgh

    2014-05-01

    Full Text Available The post-occipital sinus of the spinal vein is often used for the collection of blood samples from crocodilians. Although this sampling method has been reported for several crocodilian species, the technique and associated anatomy has not been described in detail in any crocodilian, including the Nile crocodile (Crocodylus niloticus. The anatomy of the cranial neck region was investigated macroscopically, microscopically, radiographically and by means of computed tomography. Latex was injected into the spinal vein and spinal venous sinus of crocodiles to visualise the regional vasculature. The spinal vein ran within the vertebral canal, dorsal to and closely associated with the spinal cord and changed into a venous sinus cranially in the post-occipital region. For blood collection, the spinal venous sinus was accessed through the interarcuate space between the atlas and axis (C1 and C2 by inserting a needle angled just off the perpendicular in the midline through the craniodorsal cervical skin, just cranial to the cranial borders of the first cervical osteoderms. The most convenient method of blood collection was with a syringe and hypodermic needle. In addition, the suitability of the spinal venous sinus for intravenous injections and infusions in live crocodiles was evaluated. The internal diameter of the commercial human epidural catheters used during these investigations was relatively small, resulting in very slow infusion rates. Care should be taken not to puncture the spinal cord or to lacerate the blood vessel wall using this route for blood collection or intravenous infusions.

  16. Blood venous sample collection: Recommendations overview and a checklist to improve quality.

    Science.gov (United States)

    Giavarina, Davide; Lippi, Giuseppe

    2017-07-01

    The extra-analytical phases of the total testing process have substantial impact on managed care, as well as an inherent high risk of vulnerability to errors which is often greater than that of the analytical phase. The collection of biological samples is a crucial preanalytical activity. Problems or errors occurring shortly before, or soon after, this preanalytical step may impair sample quality and characteristics, or else modify the final results of testing. The standardization of fasting requirements, rest, patient position and psychological state of the patient are therefore crucial for mitigating the impact of preanalytical variability. Moreover, the quality of materials used for collecting specimens, along with their compatibility, can guarantee sample quality and persistence of chemical and physical characteristics of the analytes over time, so safeguarding the reliability of testing. Appropriate techniques and sampling procedures are effective to prevent problems such as hemolysis, undue clotting in the blood tube, draw of insufficient sample volume and modification of analyte concentration. An accurate identification of both patient and blood samples is a key priority as for other healthcare activities. Good laboratory practice and appropriate training of operators, by specifically targeting collection of biological samples, blood in particular, may greatly improve this issue, thus lowering the risk of errors and their adverse clinical consequences. The implementation of a simple and rapid check-list, including verification of blood collection devices, patient preparation and sampling techniques, was found to be effective for enhancing sample quality and reducing some preanalytical errors associated with these procedures. The use of this tool, along with implementation of objective and standardized systems for detecting non-conformities related to unsuitable samples, can be helpful for standardizing preanalytical activities and improving the quality of

  17. Arterial and venous blood pressure and blood flow following femoral angiography with a new non-ionic contrast medium

    International Nuclear Information System (INIS)

    Nyman, U.; Almen, T.

    1978-01-01

    At femoral angiography in dogs the effects of a new non-ionic contrast medium (C29) were compared with those of one non-ionic medium (metrizamide) and one ionic medium (meglumine/sodium diatrizoate) in current use. In the leg subjected to angiography the pressure gradient over the peripheral vessels decreased and the femoral blood flow increased. The changes induced by the ionic medium were significantly greater than those induced by metrizamide and C29, whereas no significant difference between the two non-ionic media was recorded. (Auth.)

  18. The increase in the cardiodepressant activity and vasopressin concentration in the sella turcica venous blood during vagal afferents stimulation or after angiotensin II infusion

    International Nuclear Information System (INIS)

    Goraca, A.; Orlowska-Majdak, M.; Traczyk, W.Z.

    1996-01-01

    It has previously been demonstrated that the cardiodepressant activity is present in the bovine hypothalamic extract and in the fluid incubating the posterior pituitary lobe i n situ . The present study was an attempt to reveal if the cardiodepressant factor and vasopressin were simultaneously released from the pituitary into blood. The samples of venous blood flowing from the sella turcica and, for comparison, from the posterior paw were collected in anesthetized rats. Blood from the sella turcica was collected with a fine cannula inserted into the internal maxillary vein. The concentration of vasopressin in blood plasma was determined by radioimmunoassay and cardiodepressant activity-using a biological test on a spontaneously discharged pacemaker tissue of the right auricle of the right heart atrium. Stimulation of the central ends of the cut vagus nerves or intra-arterial infusion of angiotensin II simultaneously caused an increase in the cardiodepressant activity and vasopressin concentration in the sella turcica venous blood. The cardiodepressant activity and vasopressin concentration was also enhanced to some degree in blood outflowing from the posterior paw. Present results indicate that both vasopressin and the cardiodepressant factor are released into blood from the posterior pituitary lobe. (author). 37 refs, 4 figs

  19. Thromboelastometry versus standard coagulation tests versus restrictive protocol to guide blood transfusion prior to central venous catheterization in cirrhosis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Rocha, Leonardo Lima; Pessoa, Camila Menezes Souza; Neto, Ary Serpa; do Prado, Rogerio Ruscitto; Silva, Eliezer; de Almeida, Marcio Dias; Correa, Thiago Domingos

    2017-02-27

    Liver failure patients have traditionally been empirically transfused prior to invasive procedures. Blood transfusion is associated with immunologic and nonimmunologic reactions, increased risk of adverse outcomes and high costs. Scientific evidence supporting empirical transfusion is lacking, and the best approach for blood transfusion prior to invasive procedures in cirrhotic patients has not been established so far. The aim of this study is to compare three transfusion strategies (routine coagulation test-guided - ordinary or restrictive, or thromboelastometry-guided) prior to central venous catheterization in critically ill patients with cirrhosis. Design and setting: a double-blinded, parallel-group, single-center, randomized controlled clinical trial in a tertiary private hospital in São Paulo, Brazil. adults (aged 18 years or older) admitted to the intensive care unit with cirrhosis and an indication for central venous line insertion. Patients will be randomly assigned to three groups for blood transfusion strategy prior to central venous catheterization: standard coagulation tests-based, thromboelastometry-based, or restrictive. The primary efficacy endpoint will be the proportion of patients transfused with any blood product prior to central venous catheterization. The primary safety endpoint will be the incidence of major bleeding. Secondary endpoints will be the proportion of transfusion of fresh frozen plasma, platelets and cryoprecipitate; infused volume of blood products; hemoglobin and hematocrit before and after the procedure; intensive care unit and hospital length of stay; 28-day and hospital mortality; incidence of minor bleeding; transfusion-related adverse reactions; and cost analysis. This study will evaluate three strategies to guide blood transfusion prior to central venous line placement in severely ill patients with cirrhosis. We hypothesized that thromboelastometry-based and/or restrictive protocols are safe and would significantly

  20. The effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.

    LENUS (Irish Health Repository)

    Coleman, E T

    2012-02-03

    The cannulation method and cardioplegia solution used during cardiopulmonary bypass (CPB) may both influence plasma potassium concentrations ([K+]) and mean arterial blood pressure (MAP). Bi-caval or right atrial cannulation methods are routinely used in conjunction with crystalloid or blood cardioplegia. We investigated the influence of cannulation method and cardioplegia solutions on plasma [K+] and MAP during cardiopulmonary bypass. Sixty consecutive patients undergoing elective coronary artery bypass grafting (CABG) using CPB were studied. They were randomly divided into three groups of 20 patients. Patients in Group A underwent bi-caval venous cannulation and received crystalloid cardioplegia. Group B patients underwent right atrial cannulation and received crystalloid cardioplegia. Group C patients underwent right atrial cannulation and received blood cardioplegia. In each case. cardioplegia was administered antegrade via the aortic root. Plasma [K+], MAP. and hemoglobin concentration (Hb) were measured over an 8-min period following cardioplegia administration (pilot studies indicated pressure changes occuring post cardioplegia administration up to this time). The combination of bi-caval cannulation and crystalloid cardioplegia (Group A) was associated with the least increase in plasma [K+] and no decrease in MAP. The maximum [K+] for this Group was 4.2 mmol\\/L (4.6% increase). The minimum mean pressure was 57 mmHg (13.6% increase). Both right atrial cannulation groups (B and C) showed a large rise in plasma [K+] and a decrease in MAP. Group B maximum [K+] was 5.2 mmol\\/L (27.5% increase). Group C was also 5.2 mmol\\/L (26.0% increase). Group C showed the largest pressure decrease, the minimum mean pressure was 45 mmHg (21.3% decrease). The Group B minimum mean pressure was 45 mmHg (8.7% decrease). Our results show that patients undergoing CPB operations who are deemed to be at increased risk of suffering adverse effects from hypotensive episodes may

  1. What is the effect of exercise on wound healing in patients with venous leg ulcers? A systematic review.

    Science.gov (United States)

    Smith, Daisy; Lane, Rebecca; McGinnes, Rosemary; O'Brien, Jane; Johnston, Renea; Bugeja, Lyndal; Team, Victoria; Weller, Carolina

    2018-02-15

    Standard best practice for the treatment of venous leg ulcers (VLUs) is compression bandaging of the lower leg to reduce hydrostatic pressure. There is considerable variation in reported healing rates when using this gold-standard approach; therefore, a systematic and robust evaluation of other interventions is required. Exercise interventions, in addition to standard compression therapy, could improve wound-healing time and prevent their recurrence. We have conducted a systematic review to examine the effects of exercise on wound characteristics, including time to heal, size and recurrence, pain, quality of life, adverse events, and economic outcomes. This review was registered with PROSPERO 2016:CRD42016046407. A systematic search of Ovid Medline, Ovid EMBASE, Ovid CINAHL, The Cochrane Library, PsycINFO, Web of Science, and PEDro was conducted on January 30, 2017, for randomised control trials to examine the effects of exercise on time to heal, size and recurrence, pain, quality of life, adverse events, and economic outcomes. Six studies met the inclusion criteria, but all had design flaws leading to biases, most commonly performance and selective reporting bias. Three studies compared a progressive resistance exercise programme (PREG) plus compression with compression alone for a period of 12 weeks. Low-quality evidence indicates the following: possibly no difference in the proportion of ulcers healed (risk ratio [RR] 1.14, 95% CI 0.71 to 1.84, I 2 36%; 3 trials, 116 participants); probably no difference in quality of life (mean difference [MD] 3 points better on 100 point scale with exercise, 95% CI -1.89 to 7.89, 1 trial, 59 participants); possible increase in the risk of adverse events with exercise (OR 1.32, 95% CI 0.95 to 1.85, 1 RCT, 40 participants); and no difference in ankle range of motion and calf muscle pump. Evidence was downgraded due to susceptibility to bias and imprecision. Recurrence, pain, and economic outcomes were not measured in these

  2. Reduced Venous Blood Basophil Count and Anxious Depression in Patients with Major Depressive Disorder

    Science.gov (United States)

    Baek, Ji Hyun; Kim, Hee-Jin; Fava, Maurizio; Mischoulon, David; Papakostas, George I; Nierenberg, Andrew; Heo, Jung-Yoon

    2016-01-01

    Objective Anxious depression has a distinct neurobiology, clinical course and treatment response from non-anxious depression. Role of inflammation in anxious depression has not been examined. As an exploratory study to characterize the role of inflammation on a development of anxious depression, we aimed to determine the relationship between white blood cell (WBC) subset counts and anxiety in individuals with major depressive disorder (MDD). Methods A total of 709 patients who were newly diagnosed with MDD were recruited. Anxiety levels of participants were evaluated using the Anxiety/ Somatization subitem of the Hamilton Depression Rating Scale. The association between WBC subset fraction and anxiety was evaluated. Results Basophil and eosinophil sub-fractions showed significant negative correlations with HAM-D anxiety/somatization factor scores (basophils: r=-0.092, p=0.014 and eosinophils: r=-0.075, p=0.046). When an anxiety score (a sum of somatic and psychic anxiety) was entered as a dependent variable, only basophils showed significant negative association with the anxiety scores after adjusting for all other WBC subset counts and demographic factors (t=-2.57, p=0.010). Conclusion This study showed that anxious depression had a decreased basophil subfraction, which might be associated with involvement of inflammation in development of anxious depression. PMID:27247599

  3. 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.

  4. Central venous pressure monitoring via peripherally or centrally inserted central catheters: a systematic review and meta-analysis.

    Science.gov (United States)

    Sanfilippo, Filippo; Noto, Alberto; Martucci, Gennaro; Farbo, Marco; Burgio, Gaetano; Biasucci, Daniele G

    2017-07-14

    The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95%CI -0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95%CI -1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0%). Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

  5. Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: a protocol for a systematic survey of the literature.

    Science.gov (United States)

    Abbade, Luciana P F; Wang, Mei; Sriganesh, Kamath; Mbuagbaw, Lawrence; Thabane, Lehana

    2016-11-11

    Although venous ulcers have a great social and economic impact, there is a lack of evidence from randomised controlled trials (RCTs) to support appropriate management for this disease. Framing the research question using the Population; Intervention; Comparator; Outcome; Time frame (PICOT) format in RCTs can improve the quality of the research design. To evaluate how the PICOT format is used to frame a research question in reports of RCTs of venous ulcer disease and to determine the factors associated with better adherence to the PICOT format in framing the research question. We will conduct a systematic survey of RCTs on venous ulcers published in the National Institute of Health, PubMed database between January 2009 and May 2016. We will include all RCTs addressing therapeutic intervention for venous ulcer disease involving human subjects, and published in the English language. The selection process will be carried out in duplicate by two independent investigators. First, titles and abstracts will be screened, then full-text articles. We will examine whether the five elements of the PICOT format are used in formulating the research question and give a score between 0 and 5. The primary outcome will be the proportion of studies that have adequately reported all five PICOT elements. This will be the first survey to assess how the PICOT format is used to frame research questions on the management of venous ulcers in reports of RCTs. On completion, this review will be submitted to a peer-reviewed biomedical journal for publication and the findings will also be presented at scientific conferences. 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/.

  6. Diagnostic accuracy of serological diagnosis of hepatitis C and B using dried blood spot samples (DBS: two systematic reviews and meta-analyses

    Directory of Open Access Journals (Sweden)

    Berit Lange

    2017-11-01

    Full Text Available Abstract Background Dried blood spots (DBS are a convenient tool to enable diagnostic testing for viral diseases due to transport, handling and logistical advantages over conventional venous blood sampling. A better understanding of the performance of serological testing for hepatitis C (HCV and hepatitis B virus (HBV from DBS is important to enable more widespread use of this sampling approach in resource limited settings, and to inform the 2017 World Health Organization (WHO guidance on testing for HBV/HCV. Methods We conducted two systematic reviews and meta-analyses on the diagnostic accuracy of HCV antibody (HCV-Ab and HBV surface antigen (HBsAg from DBS samples compared to venous blood samples. MEDLINE, EMBASE, Global Health and Cochrane library were searched for studies that assessed diagnostic accuracy with DBS and agreement between DBS and venous sampling. Heterogeneity of results was assessed and where possible a pooled analysis of sensitivity and specificity was performed using a bivariate analysis with maximum likelihood estimate and 95% confidence intervals (95%CI. We conducted a narrative review on the impact of varying storage conditions or limits of detection in subsets of samples. The QUADAS-2 tool was used to assess risk of bias. Results For the diagnostic accuracy of HBsAg from DBS compared to venous blood, 19 studies were included in a quantitative meta-analysis, and 23 in a narrative review. Pooled sensitivity and specificity were 98% (95%CI:95%–99% and 100% (95%CI:99–100%, respectively. For the diagnostic accuracy of HCV-Ab from DBS, 19 studies were included in a pooled quantitative meta-analysis, and 23 studies were included in a narrative review. Pooled estimates of sensitivity and specificity were 98% (CI95%:95–99 and 99% (CI95%:98–100, respectively. Overall quality of studies and heterogeneity were rated as moderate in both systematic reviews. Conclusion HCV-Ab and HBsAg testing using DBS compared to venous

  7. Diagnostic accuracy of serological diagnosis of hepatitis C and B using dried blood spot samples (DBS): two systematic reviews and meta-analyses.

    Science.gov (United States)

    Lange, Berit; Cohn, Jennifer; Roberts, Teri; Camp, Johannes; Chauffour, Jeanne; Gummadi, Nina; Ishizaki, Azumi; Nagarathnam, Anupriya; Tuaillon, Edouard; van de Perre, Philippe; Pichler, Christine; Easterbrook, Philippa; Denkinger, Claudia M

    2017-11-01

    Dried blood spots (DBS) are a convenient tool to enable diagnostic testing for viral diseases due to transport, handling and logistical advantages over conventional venous blood sampling. A better understanding of the performance of serological testing for hepatitis C (HCV) and hepatitis B virus (HBV) from DBS is important to enable more widespread use of this sampling approach in resource limited settings, and to inform the 2017 World Health Organization (WHO) guidance on testing for HBV/HCV. We conducted two systematic reviews and meta-analyses on the diagnostic accuracy of HCV antibody (HCV-Ab) and HBV surface antigen (HBsAg) from DBS samples compared to venous blood samples. MEDLINE, EMBASE, Global Health and Cochrane library were searched for studies that assessed diagnostic accuracy with DBS and agreement between DBS and venous sampling. Heterogeneity of results was assessed and where possible a pooled analysis of sensitivity and specificity was performed using a bivariate analysis with maximum likelihood estimate and 95% confidence intervals (95%CI). We conducted a narrative review on the impact of varying storage conditions or limits of detection in subsets of samples. The QUADAS-2 tool was used to assess risk of bias. For the diagnostic accuracy of HBsAg from DBS compared to venous blood, 19 studies were included in a quantitative meta-analysis, and 23 in a narrative review. Pooled sensitivity and specificity were 98% (95%CI:95%-99%) and 100% (95%CI:99-100%), respectively. For the diagnostic accuracy of HCV-Ab from DBS, 19 studies were included in a pooled quantitative meta-analysis, and 23 studies were included in a narrative review. Pooled estimates of sensitivity and specificity were 98% (CI95%:95-99) and 99% (CI95%:98-100), respectively. Overall quality of studies and heterogeneity were rated as moderate in both systematic reviews. HCV-Ab and HBsAg testing using DBS compared to venous blood sampling was associated with excellent diagnostic accuracy

  8. Bedside ultrasound to detect central venous catheter misplacement and associated iatrogenic complications: a systematic review and meta-analysis.

    Science.gov (United States)

    Smit, Jasper M; Raadsen, Reinder; Blans, Michiel J; Petjak, Manfred; Van de Ven, Peter M; Tuinman, Pieter R

    2018-03-13

    Insertion of a central venous catheter (CVC) is common practice in critical care medicine. Complications arising from CVC placement are mostly due to a pneumothorax or malposition. Correct position is currently confirmed by chest x-ray, while ultrasonography might be a more suitable option. We performed a meta-analysis of the available studies with the primary aim of synthesizing information regarding detection of CVC-related complications and misplacement using ultrasound (US). This is a systematic review and meta-analysis registered at PROSPERO (CRD42016050698). PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched. Articles which reported the diagnostic accuracy of US in detecting the position of CVCs and the mechanical complications associated with insertion were included. Primary outcomes were specificity and sensitivity of US. Secondary outcomes included prevalence of malposition and pneumothorax, feasibility of US examination, and time to perform and interpret both US and chest x-ray. A qualitative assessment was performed using the QUADAS-2 tool. We included 25 studies with a total of 2548 patients and 2602 CVC placements. Analysis yielded a pooled specificity of 98.9 (95% confidence interval (CI): 97.8-99.5) and sensitivity of 68.2 (95% CI: 54.4-79.4). US examination was feasible in 96.8% of the cases. The prevalence of CVC malposition and pneumothorax was 6.8% and 1.1%, respectively. The mean time for US performance was 2.83 min (95% CI: 2.77-2.89 min) min, while chest x-ray performance took 34.7 min (95% CI: 32.6-36.7 min). US was feasible in 97%. Further analyses were performed by defining subgroups based on the different utilized US protocols and on intra-atrial and extra-atrial misplacement. Vascular US combined with transthoracic echocardiography was most accurate. US is an accurate and feasible diagnostic modality to detect CVC malposition and iatrogenic pneumothorax

  9. The framing of research questions using the PICOT format in randomized controlled trials of venous ulcer disease is suboptimal: A systematic survey.

    Science.gov (United States)

    Abbade, Luciana P F; Wang, Mei; Sriganesh, Kamath; Jin, Yanling; Mbuagbaw, Lawrence; Thabane, Lehana

    2017-09-01

    Despite several publications on venous ulcers, there is still a lack of evidence from randomized controlled trials (RCTs) to support certain treatments for patients with this disorder. Well-designed research questions using the PICOT (Population; Intervention; Comparator; Outcome; Time-frame) format in RCTs can improve the quality of research. The objectives of this study were to assess how the PICOT format is used to frame research questions in RCTs published on venous ulcer disease and to determine the factors associated with better adherence to the PICOT format. We conducted a systematic survey of RCTs on venous ulcers published in the PubMed database between January 2009 and May 2016. All RCTs published in English addressing therapeutic interventions for venous ulcer disease in human subjects were included. We examined whether the five elements of the PICOT format were used in formulating the research question and scored them between 0 and 5. The primary outcome of this systematic survey was the percentage of studies that adequately reported all five PICOT elements. Eighty-five (85) RCTs were included with median PICOT score of 3 (IQR = 1.5). Four elements of PICOT were present in 28 reports (32.9%) and only 2 RCTS (2.3%) reported all the PICOT elements. Population and intervention were often appropriately described, in (70/85) 82.4% and (83/85) 97.6% of the studies, respectively; however, comparison intervention and outcome were presented in only (53/85) 62.3% and (48/85) 56.5% of studies, respectively. Very few RCTs (7.1%; 6/85) reported the study time frame. No journal or RCT characteristics were found to be significantly associated with better reporting. Use of the PICOT format to frame research questions in RCTs published on venous ulcers is suboptimal, and our study reinforces the importance of framing a good research question to improve the design of trials and quality of evidence in venous ulcer disease. © 2017 by the Wound Healing Society.

  10. Venous leg ulcers.

    Science.gov (United States)

    Nelson, E Andrea; Adderley, Una

    2016-01-15

    Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0 in 1000 people have active leg ulcers. Prevalence increases with age to about 20 in 1000 people aged over 80 years. We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of treatments for venous leg ulcers? What are the effects of organisational interventions for venous leg ulcers? What are the effects of advice about self-help interventions in people receiving usual care for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). At this update, searching of electronic databases retrieved 116 studies. After deduplication and removal of conference abstracts, 63 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 43 studies and the further review of 20 full publications. Of the 20 full articles evaluated, four systematic reviews were updated and four RCTs were added at this update. We performed a GRADE evaluation for 23 PICO combinations. In this systematic overview, we categorised the efficacy for 13 interventions based on information about the effectiveness and safety of advice to elevate leg, advice to keep leg active, compression stockings for prevention of recurrence, compression bandages and stockings to treat venous leg ulcers, laser treatment (low level), leg ulcer clinics, pentoxifylline, skin grafting, superficial vein surgery for prevention of recurrence, superficial vein surgery to treat venous leg ulcers, therapeutic ultrasound, and topical negative pressure.

  11. Effects of Cardiac Hemodynamics on Agreement in the pH, HCO3- and Lactate Levels between Arterial and Venous Blood Samples in Patients with Known or Suspected Chronic Heart Failure.

    Science.gov (United States)

    Kurisu, Satoshi; Watanabe, Noriaki; Ikenaga, Hiroki; Higaki, Tadanao; Shimonaga, Takashi; Iwasaki, Toshitaka; Ishibashi, Ken; Dohi, Yoshihiro; Fukuda, Yukihiro; Kihara, Yasuki

    2015-01-01

    Analyses of arterial blood gas parameters, including pH, HCO3- and lactate, play an important role in assessing the clinical status of patients with heart failure. In the present study, we evaluated the degree of agreement in the pH, HCO3- and lactate levels between arterial and venous blood samples according to the subset of the Forrester classification. The study population consisted of 128 patients with known or suspected heart failure. The subjects were divided into four groups based on the Forrester classification. Arterial blood samples were drawn from the radial or brachial artery, and venous blood samples were drawn from the pulmonary artery. There were 59 patients with a Forrester subset I status, 32 patients with a subset II status, 21 patients with a subset III status and 16 patients with a subset IV status. The pH and HCO3- levels were similar between the four subsets. In all subsets, the pH values were significantly higher and the HCO3- values were significantly lower in the arterial blood samples than in the venous blood samples. There was good correlation and agreement in the pH and HCO3- levels between the arterial and venous blood samples. In contrast, there was a significant difference in the lactate levels in both the arterial and venous blood samples between the four subsets, and the lactate levels were highest in subset IV. In all subsets, there was good correlation and agreement in the lactate levels between the arterial and venous blood samples. These data suggest that the venous pH, HCO3- and lactate levels are acceptable substitutes for arterial parameters, regardless of the cardiac hemodynamics.

  12. Differences in peripheral arterial and venous hemorheologic parameters

    NARCIS (Netherlands)

    Mokken, F. C.; van der Waart, F. J.; Henny, C. P.; Goedhart, P. T.; Gelb, A. W.

    1996-01-01

    To evaluate the comparability of hemorheologic parameters in arterial and venous blood, we measured hematocrit, whole blood viscosity, plasma viscosity, erythrocyte deformability, erythrocyte aggregation, and erythrocyte indices in both arterial and venous blood from 20 consecutive patients

  13. Mean hemoglobin levels in venous blood samples and prevalence of anemia in Japanese elementary and junior high school students

    International Nuclear Information System (INIS)

    Igarashi, Toru; Itoh, Yasuhiko; Maeda, Miho; Igarashi, Tsutomu; Fukunaga, Yoshitaka

    2012-01-01

    Screening for anemia has been performed in schools in Japan for over 30 years. The long-term effect of the nuclear power plant disaster on the prevalence of anemia in school age children is unknown. This research was performed to evaluate the prevalence of anemia in school age children and to determine grade-level and gender-related reference hemoglobin (Hb) levels prior to the nuclear disaster. Data for this research were obtained from results of screening for anemia obtained by venous blood sampling in schools in 2002. Mean Hb levels were calculated for each grade level (elementary school grades 1-6 and junior high school years 1-3) and according to gender, and the prevalence of anemia was determined. In our research, Tokyo Health Service Association guidelines were used to determine reference Hb levels for anemia. We demonstrated that Hb levels in boys increased with age during childhood and adolescence (from 13.1±0.7 g/dL in 7 year olds to 14.9±1.1 g/dL in 15 year olds); in girls, Hb levels peaked at menarche (13.7±0.8 g/dL in 12 year olds), decreasing slightly thereafter (13.4±1.1 g/dL in 15 year olds). The prevalence of anemia was 0.26% in elementary school boys, 0.27% in elementary school girls, and 1.21% in junior high school boys. The prevalence of anemia in second- and third-year junior high school girls was lower than that in first-year junior high school girls. Among all junior high school girls, 5.73% had mild anemia. Iron-deficiency anemia is the commonest type of anemia in high school girls, secondary to the relative lack of iron due to menstruation, the growth spurt and exercise. Appropriate dietary therapy and treatment of anemia, together with education about the dietary prevention of anemia, are important to reduce the prevalence of anemia in high school students. When complete blood counts are performed in regions thought to be affected by the Fukushima nuclear power plant disaster, our report can serve as a reference during evaluation of Hb

  14. Prehospital Blood Product Resuscitation for Trauma: A Systematic Review

    Science.gov (United States)

    Smith, Iain M.; James, Robert H.; Dretzke, Janine; Midwinter, Mark J.

    2016-01-01

    ABSTRACT Introduction: Administration of high ratios of plasma to packed red blood cells is a routine practice for in-hospital trauma resuscitation. Military and civilian emergency teams are increasingly carrying prehospital blood products (PHBP) for trauma resuscitation. This study systematically reviewed the clinical literature to determine the extent to which the available evidence supports this practice. Methods: Bibliographic databases and other sources were searched to July 2015 using keywords and index terms related to the intervention, setting, and condition. Standard systematic review methodology aimed at minimizing bias was used for study selection, data extraction, and quality assessment (protocol registration PROSPERO: CRD42014013794). Synthesis was mainly narrative with random effects model meta-analysis limited to mortality outcomes. Results: No prospective comparative or randomized studies were identified. Sixteen case series and 11 comparative studies were included in the review. Seven studies included mixed populations of trauma and non-trauma patients. Twenty-five of 27 studies provided only very low quality evidence. No association between PHBP and survival was found (OR for mortality: 1.29, 95% CI: 0.84–1.96, P = 0.24). A single study showed improved survival in the first 24 h. No consistent physiological or biochemical benefit was identified, nor was there evidence of reduced in-hospital transfusion requirements. Transfusion reactions were rare, suggesting the short-term safety of PHBP administration. Conclusions: While PHBP resuscitation appears logical, the clinical literature is limited, provides only poor quality evidence, and does not demonstrate improved outcomes. No conclusions as to efficacy can be drawn. The results of randomized controlled trials are awaited. PMID:26825635

  15. A systematic review of health-related quality of life instruments used for people with venous ulcers: an assessment of their suitability and psychometric properties.

    Science.gov (United States)

    Palfreyman, Simon J; Tod, Angela M; Brazier, John E; Michaels, Jonathan A

    2010-10-01

    To review the quality of life questionnaires used to measure the impact of venous ulceration and to evaluate their psychometric properties. Venous leg ulcers have a negative impact on quality of life. Health-related quality of life can be measured using structured questionnaires. Nurses are the primary care providers for patients with venous ulceration and are ideally placed to assess and develop these types of questionnaires. There may also be an opportunity to use such quality of life instruments to measure the impact of nursing interventions in other areas where nurses are the key care providers. Systematic review. Studies were sought that used quality of life instruments to evaluate the impact of venous ulceration. Fourteen electronic bibliographical databases and 11 Internet-based health services research related resources were searched. In addition, grey literature was sought and the reference lists of relevant articles checked. Data were extracted regarding the type of instrument used, sample, number of items and domains and psychometric performance of the instrument. The initial search identified a total of 338 potential citations. After review, a total of 31 studies were included: 17 used generic and 14 used disease-specific instruments. Five different types of generic and seven disease-specific instruments were identified. There was significant heterogeneity between the studies in terms of study design, aetiology of ulceration and times of assessment. The disease-specific instruments showed limitations in relation to their applicability to venous ulcer patients because of flaws in design or validation. The literature on quality of life related to venous ulceration failed to sufficiently distinguish between those with different causes of leg ulceration. There appeared to be problems with the ability of current quality of life instruments to detect changes in quality of life related to ulcer healing. Relevance to clinical practice.  There appears to be an

  16. Venous-to-arterial carbon dioxide difference in the resuscitation of patients with severe sepsis and septic shock: A systematic review.

    Science.gov (United States)

    Diaztagle Fernández, J J; Rodríguez Murcia, J C; Sprockel Díaz, J J

    2017-10-01

    The way to assess tissue perfusion during the resuscitation of patients with severe sepsis and septic shock is a current subject of research and debate. Venous oxygen saturation and lactate concentration have been the most frequently used criteria, though they involve known limitations. The venous-to-arterial difference of carbon dioxide (pCO 2 delta) is a parameter than can be used to indicate tissue perfusion, and its determination therefore may be useful in these patients. A qualitative systematic review of the literature was made, comprising studies that assessed pCO 2 delta in adult patients with severe sepsis or septic shock, and published between January 1966 and November 2016 in the Medline-PubMed, Embase-Elsevier, Cochrane Library, and LILACS databases. There was no language restriction. The PRISMA statement was followed, and methodological quality was evaluated. Twelve articles were included, all of an observational nature, and including 10 prospective studies (9 published since 2010). Five documented greater mortality among patients with high pCO 2 delta values, in 3 cases even when achieving venous oxygen saturation targets. In 4 studies, a high pCO 2 delta was related to lower venous oxygen saturation and higher lactate levels, and another 3 documented lesser percentage lactate reductions. The parameter pCO 2 delta has been more frequently assessed in the management of patients with severe sepsis during the last few years. The studies demonstrate its correlation to mortality and other clinical outcomes, defining pCO 2 delta as a useful tool in the management of these patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  17. Studies Comparing Ambulatory Blood Pressure and Home Blood Pressure on Cardiovascular Disease and Mortality Outcomes: A Systematic Review

    Science.gov (United States)

    Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul

    2015-01-01

    Ambulatory blood pressure monitoring (ABPM) is more commonly recommended for assessing out-of-clinic blood pressure than home blood pressure monitoring (HBPM). We conducted a systematic review to examine whether ABPM or HBPM is more strongly associated with cardiovascular disease events and/or mortality. Of 1,007 abstracts published through July 20, 2015, nine articles, reporting results from seven cohorts, were identified. After adjustment for blood pressure on HBPM, blood pressure on ABPM was associated with an increased risk of outcomes in two of four cohorts for systolic blood pressure and two of three cohorts for diastolic blood pressure. After adjustment for blood pressure on ABPM, systolic blood pressure on HBPM was associated with outcomes in zero of three cohorts; an association was present in one of two cohorts for diastolic blood pressure on HBPM. There is a lack of strong empiric evidence supporting ABPM or HBPM over the other approach for predicting cardiovascular events or mortality. PMID:26822864

  18. Venous ulcer: what is new?

    Science.gov (United States)

    Raffetto, Joseph D; Marston, William A

    2011-01-01

    The pathophysiology of venous dermal abnormality in chronic venous ulcers is reflective of a complex interplay that involves sustained venous hypertension, inflammation, changes in the microcirculation, cytokine and matrix metalloproteinase activation, and altered cellular function. Red blood cells and macromolecules extravasate into the interstitium and activate endothelial cells. Endothelial expression of specific adhesion molecules recruits leukocytes and causes diapedesis of these cells into the dermal microvasculature, promoting an inflammatory response with activation of cytokines and proteinases. Altered cell function enhances a state of vulnerability in the surrounding tissues, initiating specific changes associated with venous disease. Ultimately, the persistent inflammatory-proteinase activity leads to advanced chronic venous insufficiency and ulcer formation. The mainstay of therapy in venous ulcer abnormality is correction of the underlying venous hypertension through compression therapy and/or surgery. Understanding the science involved in the pathophysiology of venous ulcer formation has led to the development of adjunctive treatment directed at the dysregulated molecular pathways. Randomized clinical trials are critical for determining the most effective evidence-based treatments for venous ulcer, and this review discusses important trials that have had a significant impact on venous ulcer healing. In addition, the authors have included subsections referred to as "Translational Implications for Therapy" in the basic science sections of the review to help bridge the basic science knowledge with clinical applications that may help to modulate the molecular abnormalities in the pathophysiologic cascade leading to venous ulcers.

  19. Increased risk of venous thrombosis by AB alleles of the ABO blood group and Factor V Leiden in a Brazilian population

    OpenAIRE

    Lima, Magaly B. P. L. V.; de Oliveira-Filho, Aldemir Branco; Campos, Júlia F.; Melo, Fárida C. B. C.; Neves, Washington Batista das; Melo, Raul Antônio Morais; Lemos, José Alexandre Rodrigues

    2009-01-01

    Most cases of a predisposition to venous thrombosis are caused by resistance to activated protein C, associated in 95% of cases with the Factor V Leiden allele (FVL or R506Q). Several recent studies report a further increased risk of thrombosis by an association between the AB alleles of the ABO blood group and Factor V Leiden. The present study investigated this association with deep vein thrombosis (DVT) in individuals treated at the Hemocentro de Pernambuco in northeastern Brazil. A case-c...

  20. Commercial Hy-Line W-36 pullet and laying hen venous blood gas and chemistry profiles utilizing the portable i-STAT?1 analyzer

    OpenAIRE

    Schaal, T. P.; Arango, J.; Wolc, A.; Brady, J. V.; Fulton, J. E.; Rubinoff, I.; Ehr, I. J.; Persia, M. E.; O'Sullivan, N. P.

    2015-01-01

    Venous blood gas and chemistry reference ranges were determined for commercial Hy-Line W-36 pullets and laying hens utilizing the portable i-STAT?1 analyzer and CG8+ cartridges. A total of 632 samples were analyzed from birds between 4 and 110 wk of age. Reference ranges were established for pullets (4 to 15 wk), first cycle laying hens (20 to 68 wk), and second cycle (post molt) laying hens (70 to 110 wk) for the following traits: sodium (Na mmol/L), potassium (K mmol/L), ionized calcium (iC...

  1. Analysis of the dynamics of venous blood flow in the context of lower limb temperature distribution and tissue composition in the elderly

    Directory of Open Access Journals (Sweden)

    Skomudek A

    2017-08-01

    Full Text Available Aleksandra Skomudek,1,2 Iwona Gilowska,1,3 Ryszard Jasiński,4 Krystyna Rożek-Piechura4 1Department of Physical Education and Physiotherapy, Opole University of Technology, Opolskie, 2Department of Clinical Physiotherapy, 3Department of Biochemistry and Physiology, 4Department of Physiotherapy and Occupational Therapy in Conservative and Interventional Medicine, University of Physical Education in Wroclaw, Wroclaw, Poland Objective: The elderly are particularly vulnerable to degenerative diseases, such as circulatory and respiratory system and vascular system diseases. The objective of this study was therefore to evaluate the distribution of temperature and the dynamics of venous blood flow in the lower limbs (LLs and to assess the interdependence of these parameters in terms of the somatic components in males and females participating in activities at the University of the Third Age. Materials and methods: The study included 60 females (mean age 67.4 years and 40 males (mean age 67.5 years. A body composition assessment was performed using the bioimpedance technique – Tanita BC-418MA. The following parameters were examined: fat%, fat mass, fat-free mass, and total body water. The minimal, maximal, and mean temperature values and their distributions were examined using infrared thermographic camera VarioCAM Head. Measurements of the venous refilling time and the work of the LL venous pump were examined using a Rheo Dopplex II PPG. Results: In males, the mean value of the right LL temperature was 30.58 and the mean value of the left LL was 30.28; the P-value was 0.805769. In females, the mean value of the right LL temperature was 29.58 and the mean value of the left limb was 29.52; the P-value was 0.864773. In males, the right limb blood flow was 34.17 and the left limb blood flow was 34.67; the P-value was 0.359137. In females, the right limb blood flow was 26.89 and the left limb blood flow was 26.09; the P-value was 0.796348. Conclusion

  2. Combined oral contraceptives, thrombophilia and the risk of venous thromboembolism : a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Vlijmen, E. F. W.; Wiewel-Verschueren, S.; Monster, T. B. M.; Meijer, K.

    Background Combined oral contraceptives (COCs) are associated with an increased risk of venous thromboembolism (VTE), which is shown to be more pronounced in women with hereditary thrombophilia. Currently, WHO recommendations state that COC-use in women with hereditary thrombophilias (antithrombin

  3. [Venous ulcer].

    Science.gov (United States)

    Böhler, Kornelia

    2016-06-01

    Venous disorders causing a permanent increase in venous pressure are by far the most frequent reason for ulcers of the lower extremity. With a prevalence of 1 % in the general population rising to 4 % in the elderly over 80 and its chronic character, 1 % of healthcare budgets of the western world are spent on treatment of venous ulcers. A thorough investigation of the underlying venous disorder is the prerequisite for a differenciated therapy. This should comprise elimination of venous reflux as well as local wound management. Chronic ulcers can successfully be treated by shave therapy and split skin grafting. Compression therapy is a basic measure not only in venous ulcer treatment but also in prevention of ulcer recurrence. Differential diagnosis which have to be considered are arterial ulcers, vasculitis and neoplasms.

  4. Clinical overview of venous thromboembolism

    African Journals Online (AJOL)

    Venous thromboembolism (VTE) is the result of a venous blood clot formation which may manifest itself as deep vein thrombosis. (DVT) or pulmonary embolism (PE).1,2 DVT and PE are part of the same syndrome. However, important distinguishing factors in terms of epidemiology, diagnosis and treatment exist between.

  5. Social support and nocturnal blood pressure dipping: a systematic review.

    Science.gov (United States)

    Fortmann, Addie L; Gallo, Linda C

    2013-03-01

    Attenuated nocturnal blood pressure (BP) dipping is a better predictor of cardiovascular disease (CVD) morbidity and mortality than resting BP measurements. Studies have reported associations between social support, variously defined, and BP dipping. A systematic review of the literature was conducted to investigate associations of functional and structural social support with nocturnal BP dipping assessed over a minimum of 24 hours. A total of 297 articles were identified. Of these, 11 met criteria for inclusion; all studies were cross-sectional in design and included adult participants only (mean age = 19 to 72 years). Evidence was most consistent for an association between functional support and BP dipping, such that 5 of 7 studies reported statistically (or marginally) significant positive associations with BP dipping. Statistically significant functional support-BP dipping associations were moderate (standardized effect size (d) = 0.41) to large (d = 2.01) in magnitude. Studies examining structural support were fewer and relatively less consistent; however, preliminary evidence was observed for associations of marital status and social contact frequency with BP dipping. Statistically significant structural support findings were medium (d = 0.53) to large (d = 1.13) in magnitude. Overall, findings suggest a link between higher levels of functional support and greater nocturnal BP dipping; preliminary evidence was also observed for the protective effects of marriage and social contact frequency. Nonetheless, the relatively small number of studies conducted to date and the heterogeneity of findings across meaningful subgroups suggest that additional research is needed to substantiate these conclusions.

  6. In the unloaded lower leg, vibration extrudes venous blood out of the calf muscles probably by direct acceleration and without arterial vasodilation.

    Science.gov (United States)

    Zange, Jochen; Molitor, Sven; Illbruck, Agnes; Müller, Klaus; Schönau, Eckhard; Kohl-Bareis, Matthias; Rittweger, Jörn

    2014-05-01

    During vibration of the whole unloaded lower leg, effects on capillary blood content and blood oxygenation were measured in the calf muscle. The hypotheses predicted extrusion of venous blood by a tonic reflex contraction and that reactive hyperaemia could be observed after vibration. Twelve male subjects sat in front of a vibration platform with their right foot affixed to the platform. In four intervals of 3-min duration vibration was applied with a peak-to-peak displacement of 5 mm at frequencies 15 or 25 Hz, and two foot positions, respectively. Near infrared spectroscopy was used for measuring haemoglobin oxygen saturation (SmO2) and the concentration of total haemoglobin (tHb) in the medial gastrocnemius muscle. Within 30 s of vibration SmO2 increased from 55 ± 1 to 66 ± 1 % (mean ± SE). Within 1.5 min afterwards SmO2 decreased to a steady state (62 ± 1 %). During the following 3 min of recovery SmO2 slowly decreased back to base line. THb decreased within the first 30 s of vibration, remained almost constant until the end of vibration, and slowly recovered to baseline afterwards. No significant differences were found for the two vibration frequencies and the two foot positions. The relaxed and unloaded calf muscles did not respond to vibration with a remarkable reflex contraction. The acceleration by vibration apparently ejected capillary venous blood from the muscle. Subsequent recovery did not match with a reactive hyperaemia indicating that the mere mechanical stress did not cause vasodilation.

  7. A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters.

    Science.gov (United States)

    Loubani, Osama M; Green, Robert S

    2015-06-01

    The aim of this study was to collect and describe all published reports of local tissue injury or extravasation from vasopressor administration via either peripheral intravenous (IV) or central venous catheter. A systematic search of Medline, Embase, and Cochrane databases was performed from inception through January 2014 for reports of adults who received vasopressor intravenously via peripheral IV or central venous catheter for a therapeutic purpose. We included primary studies or case reports of vasopressor administration that resulted in local tissue injury or extravasation of vasopressor solution. Eighty-five articles with 270 patients met all inclusion criteria. A total of 325 separate local tissue injury and extravasation events were identified, with 318 events resulting from peripheral vasopressor administration and 7 events resulting from central administration. There were 204 local tissue injury events from peripheral administration of vasopressors, with an average duration of infusion of 55.9 hours (±68.1), median time of 24 hours, and range of 0.08 to 528 hours. In most of these events (174/204, 85.3%), the infusion site was located distal to the antecubital or popliteal fossae. Published data on tissue injury or extravasation from vasopressor administration via peripheral IVs are derived mainly from case reports. Further study is warranted to clarify the safety of vasopressor administration via peripheral IVs. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Systematic review including re-analyses of 1148 individual data sets of central venous pressure as a predictor of fluid responsiveness

    DEFF Research Database (Denmark)

    Eskesen, T G; Wetterslev, M; Perner, A

    2016-01-01

    PURPOSE: Central venous pressure (CVP) has been shown to have poor predictive value for fluid responsiveness in critically ill patients. We aimed to re-evaluate this in a larger sample subgrouped by baseline CVP values. METHODS: In April 2015, we systematically searched and included all clinical...... studies evaluating the value of CVP in predicting fluid responsiveness. We contacted investigators for patient data sets. We subgrouped data as lower (12 mmHg) baseline CVP. RESULTS: We included 51 studies; in the majority, mean/median CVP values were...... the lower 95% CI crossed 0.50. We identified some positive and negative predictive value for fluid responsiveness for specific low and high values of CVP, respectively, but none of the predictive values were above 66% for any CVPs from 0 to 20 mmHg. There were less data on higher CVPs, in particular >15 mm...

  9. Assessment of liver circulation by quantitative scintiangiography: Evaluation of the relative contribution of the hepatic arterial and portal venous blood flows to liver perfusion

    International Nuclear Information System (INIS)

    Molino, G.; Squadrone, E.; Baccegal, M.; Magnani, C.

    1989-01-01

    Quantitative hepatic scintiangiography was previously used for evaluating the relative contribution of hepatic arterial and portal venous blood flows to the hepatic circulation. The present study compares 3 different procedures (automatic and manual integration, and slope fitting methods) for analyzing the hepatic time activity curves obtained after bolus i.v. injection of 370 MBq 99m Tc-diethylentriaminopentacetic acid. Twenty five subjects were studied: Five controls, ten cirrhotics, and ten portal hypertensive patients previously submitted to side to side portacaval anastomosis. The correspondence between results given by the different methods was satisfactory only in shunted patients, and the reproducibility of computed parameters was quite poor for all procedures. Accordingly, none of the methods can be considered as supporting reliable quantitative pathophysiological evaluations. However, the hepatic arterial/portal venous flow ratio was found to be increased in liver cirrhosis and in shunted patients and therefore, in spite of the limitations underlined before and of the absence of data on the reproducibility of consecutive injections, hepatic scintiangiography may be of some clinical utility. (orig.)

  10. Blood reflects tissue oxidative stress: a systematic review.

    Science.gov (United States)

    Margaritelis, Nikos V; Veskoukis, Aristidis S; Paschalis, Vassilis; Vrabas, Ioannis S; Dipla, Konstantina; Zafeiridis, Andreas; Kyparos, Antonios; Nikolaidis, Michalis G

    2015-03-01

    We examined whether the levels of oxidative stress biomarkers measured in blood reflect the tissue redox status. Data from studies that measured redox biomarkers in blood, heart, liver, kidney and skeletal muscle were analyzed. In seven out of nine investigated redox biomarkers (malondialdehyde, reduced glutathione, superoxide dismutase, catalase, glutathione peroxidase, vitamin C and E) there was generally good qualitative and quantitative agreement between the blood and tissues. In contrast, oxidized glutathione and the reduced to oxidized glutathione ratio showed poor agreement between the blood and tissues. This study suggests that most redox biomarkers measured in blood adequately reflect tissue redox status.

  11. Commercial Hy-Line W-36 pullet and laying hen venous blood gas and chemistry profiles utilizing the portable i-STAT®1 analyzer.

    Science.gov (United States)

    Schaal, T P; Arango, J; Wolc, A; Brady, J V; Fulton, J E; Rubinoff, I; Ehr, I J; Persia, M E; O'Sullivan, N P

    2016-02-01

    Venous blood gas and chemistry reference ranges were determined for commercial Hy-Line W-36 pullets and laying hens utilizing the portable i-STAT®1 analyzer and CG8+ cartridges. A total of 632 samples were analyzed from birds between 4 and 110 wk of age. Reference ranges were established for pullets (4 to 15 wk), first cycle laying hens (20 to 68 wk), and second cycle (post molt) laying hens (70 to 110 wk) for the following traits: sodium (Na mmol/L), potassium (K mmol/L), ionized calcium (iCa mmol/L), glucose (Glu mg/dl), hematocrit (Hct% Packed Cell Volume [PCV]), pH, partial pressure carbon dioxide (PCO2 mm Hg), partial pressure oxygen (PO2 mm Hg), total concentration carbon dioxide (TCO2 mmol/L), bicarbonate (HCO3 mmol/L), base excess (BE mmol/L), oxygen saturation (sO2%), and hemoglobin (Hb g/dl). Data were analyzed using ANOVA to investigate the effect of production status as categorized by bird age. Trait relationships were evaluated by linear correlation and their spectral decomposition. All traits differed significantly among pullets and mature laying hens in both first and second lay cycles. Levels for K, iCa, Hct, pH, TCO2, HCO3, BE, sO2, and Hb differed significantly between first cycle and second cycle laying hens. Many venous blood gas and chemistry parameters were significantly correlated. The first 3 eigenvalues explained ∼2/3 of total variation. The first 2 principal components (PC) explained 51% of the total variation and indicated acid-balance and relationship between blood O2 and CO2. The third PC explained 16% of variation and seems to be related to blood iCa. Establishing reference ranges for pullet and laying hen blood gas and chemistry with the i-STAT®1 handheld unit provides a mechanism to further investigate pullet and layer physiology, evaluate metabolic disturbances, and may potentially serve as a means to select breeder candidates with optimal blood gas or chemistry levels on-farm. © The Author 2015. Published by Oxford University

  12. On-line blood viscosity monitoring in vivo with a central venous catheter, using electrical impedance technique

    NARCIS (Netherlands)

    Pop, G.A.M.; Bisschops, L.L.A.; Iliev, B.; Struijk, P.C.; Hoeven, J.G. van der; Hoedemaekers, C.W.E.

    2013-01-01

    Blood viscosity is an important determinant of microvascular hemodynamics and also reflects systemic inflammation. Viscosity of blood strongly depends on the shear rate and can be characterized by a two parameter power-law model. Other major determinants of blood viscosity are hematocrit, level of

  13. First do no harm: pain relief for the peripheral venous cannulation of adults, a systematic review and network meta-analysis.

    Science.gov (United States)

    Bond, Mary; Crathorne, Louise; Peters, Jaime; Coelho, Helen; Haasova, Marcela; Cooper, Chris; Milner, Quentin; Shawyer, Vicki; Hyde, Christopher; Powell, Roy

    2016-10-01

    Peripheral venous cannulation is an everyday practice in hospitals, which many adults find painful. However, anaesthesia for cannulation is usually only offered to children. Inadequate pain relief is not only unpleasant for patients but may cause anxiety about further treatment and deter patients from seeking medical care in the future. The aim of this study is to discover the most effective local anaesthetic for adult peripheral venous cannulation and to find out how the pain of local anaesthetic application compares with that of unattenuated cannulation. These aims are addressed through a systematic review, network meta-analysis and random-effects meta-analysis. Searching covered 12 databases including MEDLINE and EMBASE from 1990 to August 2015. The main included study design was RCTs. The primary outcome measure is self-reported pain, measured on a 100 mm visual analogue scale. The systematic review found 37 includable studies, 27 of which were suitable for network meta-analysis and two for random-effects meta-analysis. The results of the network meta-analysis indicate that none of the 17 anaesthetic considered had a very high probability of being the most effective when compared to each other; 2 % lidocaine had the highest probability (44 %). When the anaesthetics were compared to no treatment, the network meta-analysis showed that again 2 % lidocaine was estimated to be the most effective (mean difference -25.42 (95 % CI -32.25, -18.57). Other members of the 'caine' family were also estimated to be more effective than no treatment as were Ametop ® , EMLA ® and Rapydan ® patch. The meta-analysis compared the pain of anaesthetic application with the unattenuated pain of cannulation. This found that all applications of local anaesthetic were less painful than cannulation without local anaesthetic. In particular a 1 % lidocaine injection was estimated to be -12.97 (95 % CI -15.71, -10.24) points (100 mm VAS) less painful than unattenuated cannulation

  14. Effects of Ramadan fasting on blood pressure in hypertensive patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Maryam Alinezhad-Namaghi

    2016-03-01

    Full Text Available Ramadan is a holy month for Muslims and fasting in this month is the rule for any healthy matured person. Nutritional and behavioral changes occurred during Ramadan fasting may lead to several physiological change, such as blood pressure (2. Studies evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients, are scarce and reported inadequate results. In this paper a systematic review was performed to accumulate the results of published literature designed to evaluate blood pressure changes in hypertensive patients due to Ramadan fasting. All prospective, English studies which evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients and measured systolic and diastolic blood pressure twice at least ( before Ramadan and during last week of Ramadan or after Ramadan fasting were included in systematic review . Five studies reported the effect of Ramadan fasting on blood pressure in hypertensive patients in full text. Although significant reduction in systolic blood pressure during Ramadan fasting were seen in 3 studies (3-5, other 3 studies reported no significant difference between systolic blood pressure before and after Ramadan fasting (6, 7. Among 6 studies that reviewed in this paper, 4 studies reported no significant changes in diastolic blood pressure (4, 6, 7. While 2 other studies reported significant reduction in systolic blood pressure after Ramadan fasting (3, 5. This systematic review suggested that Ramadan fasting can be safe in treated essential hypertensive patients with continuation of previous medications. Also it can improve systolic and diastolic blood pressures.

  15. Venous insufficiency

    Science.gov (United States)

    ... a large vein in the leg called the superficial saphenous vein. Outlook (Prognosis) Chronic venous insufficiency tends ... the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein should ...

  16. Venous Ulcers

    Science.gov (United States)

    Caprini, J.A.; Partsch, H.; Simman, R.

    2013-01-01

    Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence. PMID:26236636

  17. Venous thromboses

    Energy Technology Data Exchange (ETDEWEB)

    Gebauer, A.; Tosch, U.; Rath, M.

    1985-02-01

    The suspicion of the presence of venous thrombosis is supported by Doppler-sonography. The crucial diagnostic procedure, however, is the conventional x-ray-phlebography. The digital subtraction phlebography adds to the conventional technique in the pelvic and thoracic area if parts of the skeleton or soft tissue are overlapping. The radionuclid-phlebography will be applied in contrast medium incompatibility or in suspicion of pulmonary embolism. Factors of increased prevalence of venous thrombosis can be confirmed by CT or sonography.

  18. Comparison of arterial and venous blood gases and the effects of analysis delay and air contamination on arterial samples in patients with chronic obstructive pulmonary disease and healthy controls.

    LENUS (Irish Health Repository)

    O'Connor, T M

    2012-01-31

    BACKGROUND: Arterial blood gases (ABGs) are often sampled incorrectly, leading to a \\'mixed\\' or venous sample. Delays in analysis and air contamination are common. OBJECTIVES: We measured the effects of these errors in patients with chronic obstructive pulmonary disease (COPD) exacerbations and controls. METHODS: Arterial and venous samples were analyzed from 30 patients with COPD exacerbation and 30 controls. Venous samples were analysed immediately and arterial samples separated into non-air-contaminated and air-contaminated specimens and analysed at 0, 30, 60, 90 and 180 min. RESULTS: Mean venous pH was 7.371 and arterial pH was 7.407 (p < 0.0001). There was a correlation between venous and arterial pH (r = 0.5347, p < 0.0001). The regression equation to predict arterial pH was: arterial pH = 4.2289 + 0.43113 . venous pH. There were no clinically significant differences in arterial PO associated with analysis delay. A statistically significant decline in pH was detected at 30 min in patients with COPD exacerbation (p = 0.0042) and 90 min in controls (p < 0.0001). A clinically significant decline in pH emerged at 73 min in patients with COPD exacerbation and 87 min in controls. Air contamination was associated with a clinically significant increase in PO in all samples, including those that were immediately analyzed. CONCLUSIONS: Arterial and venous pH differ significantly. Venous pH cannot accurately replace arterial pH. Temporal delays in ABG analysis result in a significant decline in measured pH. ABGs should be analysed within 30 min. Air contamination leads to an immediate increase in measured PO, indicating that air-contaminated ABGs should be discarded.

  19. Increased risk of venous thrombosis by AB alleles of the ABO blood group and Factor V Leiden in a Brazilian population

    Directory of Open Access Journals (Sweden)

    Magaly B.P.L.V. Lima

    2009-01-01

    Full Text Available Most cases of a predisposition to venous thrombosis are caused by resistance to activated protein C, associated in 95% of cases with the Factor V Leiden allele (FVL or R506Q. Several recent studies report a further increased risk of thrombosis by an association between the AB alleles of the ABO blood group and Factor V Leiden. The present study investigated this association with deep vein thrombosis (DVT in individuals treated at the Hemocentro de Pernambuco in northeastern Brazil. A case-control comparison showed a significant risk of thrombosis in the presence of Factor V Leiden (OR = 10.1, which was approximately doubled when the AB alleles of the ABO blood group were present as well (OR = 22.3. These results confirm that the increased risk of deep vein thrombosis in the combined presence of AB alleles and Factor V Leiden is also applicable to the Brazilian population suggesting that ABO blood group typing should be routinely added to FVL in studies involving thrombosis.

  20. The Risk of Venous Thromboembolism with Different Generation of Oral Contraceptives; a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Alireza Baratloo

    2014-03-01

    Full Text Available Introduction: Oral contraceptives (OCs are considered as one of the most common risk factor of venous thromboembolism (VTE in child bearing age. Some of the recent researches indicate that the odds of VTE may be even higher with newer generations of OCs. The present meta-analysis was designed to evaluate the effect of different generation of OCs on the occurrence of VTE. Methods: Two researchers independently ran a thorough search in Pubmed, ISI Web of Science, EMBASE, CINAHL and Scopus databases regarding study keywords including thromboembolic event, thromboembolism, embolism, thromboembolic, thrombotic and thrombosis, combined with oral contraceptive. The outcomes were the incidence of diagnosed thromboembolism, such as deep vein thrombosis, pulmonary embolism and cerebral venous thrombosis. Based on the heterogeneity of the studies, random effect model was used and pooled odds ratio was reported. Results: Three cohort and 17 case-control studies with 13,265,228 subjects were entered into meta-analysis. Analysis showed that the odds of VTE in women taking OCs are more than three-fold (OR=3.13; 95% CI: 2.61-3.65. The risk of VTE in women taking first-, second- and third-generation OCs are 3.5 fold (OR=3.48; 95% CI: 2.01-4.94, 3 fold (OR=3.08; 95% CI: 2.43-3.74 and 4.3 fold (OR=4.35; CI: 3.69‒5.01, respectively. Conclusion: It seems that the risk of VTE is not same between different generations of OCs, so that third-generation has highest risk. Taking second and third-generation OCs increases the risk of VTE up to 3 and 4.3 fold, respectively. The researchers of the present study suggest that more clinical trials be designed in relation to the effect of newer generations of OCs in different communities. 

  1. Effect of body position and ventilation on umbilical artery and venous blood flows during delayed umbilical cord clamping in preterm lambs.

    Science.gov (United States)

    Hooper, Stuart B; Crossley, Kelly J; Zahra, Valerie A; van Vonderen, Jeroen; Moxham, Alison; Gill, Andrew W; Kluckow, Martin; Te Pas, Arjan B; Wallace, Euan M; Polglase, Graeme R

    2017-07-01

    While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows. Lambs were placed either 10 cm below or 10 cm above the ewe. Ventilation commenced 2-3 min before UCC and continued for 30 min after UCC. Gravity reduced umbilical and cerebral flows when lambs were placed below the midline, but the reduction in UaBF and UvBF was similar. Ventilation during delayed UCC reduced UvBF and UaBF by similar amounts, irrespective of the lamb's position, such that flows into and out of the placenta remained balanced. The effects of ventilation on umbilical flows were much greater than the effects of gravity, but no net placental to lamb blood transfusion could be detected under any condition. Cardiovascular parameters, cerebral oxygen kinetics and final blood volumes were similar in both groups 5 min after UCC. Gravity caused small transient effects on umbilical and cerebral flow, but given changes were similar in umbilical arteries and veins, no net placental transfusion was detected. Ventilation during delayed UCC has a markedly greater influence on cardiovascular function in the newborn. 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/.

  2. Systematic review of topic treatment for venous ulcers Revisión sistemática del tratamiento tópico de la úlcera venosa Revisão sistemática do tratamento tópico da úlcera venosa

    OpenAIRE

    Eline Lima Borges; Maria Helena Larcher Caliri; Vanderlei José Haas

    2007-01-01

    Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. T...

  3. Phase-contrast MR assessment of pulmonary venous blood flow in children with surgically repaired pulmonary veins

    International Nuclear Information System (INIS)

    Valsangiacomo, Emanuela R.; Yoo, Shi-Joon; Barrea, Catherine; Smallhorn, Jeffrey F.; Macgowan, Christopher K.; Coles, John G.

    2003-01-01

    Pulmonary venous (PV) obstruction may complicate surgical repair of PV abnormalities. By combining phase-contrast cine (PC) imaging and contrast-enhanced angiography, magnetic resonance (MR) imaging can provide physiological information complementing anatomical diagnosis. To compare the PV flow pattern observed after surgical repair of PV abnormalities with normal PV flow pattern and to investigate the changes occurring in the presence of PV stenosis by using PC MR in children. By using PC MR, PV flow was evaluated in 14 patients (3 months-14 years) who underwent surgical repair for PV abnormalities. Eleven children (8-18 years) were studied as normal controls. Peak flow velocities and patterns were compared among three groups: normal veins (n=23), surgically repaired veins without (n=44) and with stenosis (n=10). Normal and unobstructed pulmonary veins after surgery showed a biphasic or triphasic flow pattern with one or two systolic peaks and a diastolic peak. Unobstructed surgically repaired veins showed decreased peak systolic velocity (P =0.001) and an increased peak diastolic velocity (P=0.005) when compared to normal values. Obstructed veins showed decreased systolic and diastolic velocities when measured upstream from the stenosis. PC MR shows different flow patterns among normal, surgically repaired pulmonary veins with and without stenosis. (orig.)

  4. A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency

    Science.gov (United States)

    Chong, Nyuk Jet; Aziz, Zoriah

    2013-01-01

    We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI). We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions. PMID:23533507

  5. A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Nyuk Jet Chong

    2013-01-01

    Full Text Available We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI. We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.

  6. A systematic review and meta-analysis of the epidemiology and burden of venous thromboembolism among pregnant women.

    Science.gov (United States)

    Kourlaba, Georgia; Relakis, John; Kontodimas, Stathis; Holm, Majbrit V; Maniadakis, Nikos

    2016-01-01

    Pregnancy-related venous thromboembolism (VTE) is one of the leading causes of maternal morbidity and mortality. To review the epidemiology, and humanistic and economic burden of pregnancy-related VTE. Medline, the Cochrane Central Register of Controlled Trials, Econlit, Science Direct, JSTOR, Oxford Journals, and Cambridge Journals were searched for reports published between January 2000 and December 2012. Keywords related to VTE, pregnancy, and epidemiology and the humanistic and economic burdens were combined. Eligible studies evaluated the incidence, mortality, recurrence, complications, quality-of-life, and economic burden of VTE among pregnant women, and had been published in English. Background information of the study, participants' characteristics, and study outcomes were collected. Meta-analyses of data were performed. Twenty studies were included, none of which investigated the economic burden. The pooled overall incidence of pregnancy-related VTE was 1.2 per 1000 deliveries. The pooled VTE case fatality rate was 0.68% and the recurrence rate was 4.27%. The pooled risk of major bleeding was 1.05%. Post-thrombotic syndrome seemed to have a negative effect on quality of life. Although the incidence of VTE was found to be relatively low during pregnancy and the postpartum period, the clinical burden is high. Further research is required to assess the economic burden of pregnancy-relate VTE. Copyright © 2015. Published by Elsevier Ireland Ltd.

  7. Portal venous blood flow while breath-holding after inspiration or expiration and during normal respiration in controls and cirrhotics

    International Nuclear Information System (INIS)

    Sugano, Shigeo; Yamamoto, Kunihiro; Sasao, Ken-ichiro; Watanabe, Manabu

    1999-01-01

    In this study, we used magnetic resonance (MR) imaging to measure portal blood flow in 12 healthy controls and 17 cirrhotics while they were breath-holding after inspiration and after expiration. We then compared the results with measurements made during normal respiration in the healthy controls and cirrhotics. Blood flow in the main portal vein under basal fasting conditions was quantitated using the cine phase-contrast MR velocity mapping method. Three measurements were made on one occasion, as follows: throughout the cardiac cycle during normal respiration, with the subject breath-holding after maximal inspiration, and with the subject breath-holding after maximal expiration. During normal respiration, portal blood flow was 1.3±0.2 l/min in controls vs 1.0±0.1 l/min in cirrhotics (P<0.0001); while subjects were breath-holding after inspiration, portal blood flow was 1.0±0.2 l/min in controls vs 0.9±0.1 l/min in cirrhotics; and while subjects were breath-holding after expiration, portal blood flow was 1.5±0.2 l/min in controls vs 1.1±0.2 l/min in cirrhotics (P<0.0001). The differences were primarily due to changes in flow velocity. When the magnitude of these hemodynamic changes in the three respiratory conditions was compared in controls and cirrhotics, analysis of variance (ANOVA) showed a significant difference (P<0.0001). In controls, portal blood flow decreased during maximal inspiration relative to flow during normal respiration (-24.6±8.3%). Changes in portal blood flow in controls were greater than in cirrhotics (-13.5±4.5%) (P<0.0001); however, the difference in blood flow increase associated with maximal expiration between the two groups (+11.8±9.4% vs +5.9±11.5%) was not significant. We found that the respiration-induced hemodynamic variation in portal blood flow was less in cirrhotics than in the healthy controls. Portal blood flow measurements made during normal respiration using MR imaging closely reflect nearly physiologic conditions

  8. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Langer Astrid

    2009-07-01

    Full Text Available Abstract Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Methods On the basis of an extensive explorative search, an appropriate algorithm for a systematic database search was developed. The following databases were searched: BIOSIS Previews, CRD databases, Cochrane Library, EconLit, Embase, Medline, and Web of Science. Only completed and published trial- or model-based studies which contained a full economic evaluation of growth factors and bioengineered skin substitutes for the treatment of chronic wounds were included. Two reviewers independently undertook the assessment of study quality. The relevant studies were assessed by a modified version of the Consensus on Health Economic Criteria (CHEC list and a published checklist for evaluating model-based economic evaluations. Results Eleven health economic evaluations were included. Three biotechnology products were identified for which topical growth factors or bioengineered skin substitutes for the treatment of chronic leg ulceration were economically assessed: (1 Apligraf®, a bilayered living human skin equivalent indicated for the treatment of diabetic foot and venous leg ulcers (five studies; (2 Dermagraft®, a human fibroblast-derived dermal substitute, which is indicated only for use in the treatment of full-thickness diabetic foot ulcers (one study; (3 REGRANEX® Gel, a human platelet-derived growth factor for the treatment of deep neuropathic diabetic foot ulcers (five studies. The studies considered in this review were of varying and partly low

  9. Reduction of central venous catheter associated blood stream infections following implementation of a resident oversight and credentialing policy

    Directory of Open Access Journals (Sweden)

    West Cheri E

    2011-06-01

    Full Text Available Abstract Background This study assesses the impact that a resident oversight and credentialing policy for central venous catheter (CVC placement had on institution-wide central line associated bloodstream infections (CLABSI. We therefore investigated the rate of CLABSI per 1,000 line days during the 12 months before and after implementation of the policy. Methods This is a retrospective analysis of prospectively collected data at an academic medical center with four adult ICUs and a pediatric ICU. All patients undergoing non-tunneled CVC placement were included in the study. Data was collected on CLABSI, line days, and serious adverse events in the year prior to and following policy implementation on 9/01/08. Results A total of 813 supervised central lines were self-reported by residents in four departments. Statistical analysis was performed using paired Wilcoxon signed rank tests. There were reductions in median CLABSI rate (3.52 vs. 2.26; p = 0.015, number of CLBSI per month (16.0 to 10.0; p = 0.012, and line days (4495 vs. 4193; p = 0.019. No serious adverse events reported to the Pennsylvania Patient Safety Authority. Conclusions Implementation of a new CVC resident oversight and credentialing policy has been significantly associated with an institution-wide reduction in the rate of CLABSI per 1,000 central line days and total central line days. No serious adverse events were reported. Similar resident oversight policies may benefit other teaching institutions, and support concurrent organizational efforts to reduce hospital acquired infections.

  10. Arterio-venous fistula for automated red blood cells exchange in patients with sickle cell disease: Complications and outcomes.

    Science.gov (United States)

    Delville, Marianne; Manceau, Sandra; Ait Abdallah, Nassim; Stolba, Jan; Awad, Sameh; Damy, Thibaud; Gellen, Barnabas; Sabbah, Laurent; Debbache, Karima; Audard, Vincent; Beaumont, Jean-Louis; Arnaud, Cécile; Chantalat-Auger, Christelle; Driss, Françoise; Lefrère, François; Cavazzana, Marina; Franco, Gilbert; Galacteros, Frederic; Ribeil, Jean-Antoine; Gellen-Dautremer, Justine

    2017-02-01

    Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French SCD reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected. The inclusion criteria were: SS or Sβ-Thalassemia and AVF surgery for ER. SCD-related complications, transfusion history, details about AVF surgical procedure, echocardiographic data before and after AVF, AVF-related surgical and hemodynamical complications were collected. Twenty-six patients (mean age 20.5 years, mean follow-up 68 months [11-279]) were included. Twenty-three patients (88.5%) required central vascular access before AVF. Fifteen AVFs (58%) were created on the forearm and 11 (42%) on the arm. Nineteen patients (73%) had stenotic, thrombotic or infectious AVF complications. A total of 0.36 stenosis per 1,000 AVF days, 0.37 thrombosis per 1,000 AVF days and 0.078 infections per 1.000 AVF days were observed. The mean AVF lifespan was 51 months [13-218]. One patient with severe pulmonary hypertension worsened after AVF creation and died. We report the first series of SCD patients with AVF for ER, demonstrating that AVFs could be considered as a potential vascular access for ER. Patients with increased risk for hemodynamic intolerance of AVFs must be carefully identified, so that alternative vascular accesses can be considered. Am. J. Hematol. 92:136-140, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Use of simulation-based education to improve outcomes of central venous catheterization: a systematic review and meta-analysis.

    Science.gov (United States)

    Ma, Irene W Y; Brindle, Mary E; Ronksley, Paul E; Lorenzetti, Diane L; Sauve, Reg S; Ghali, William A

    2011-09-01

    Central venous catheterization (CVC) is increasingly taught by simulation. The authors reviewed the literature on the effects of simulation training in CVC on learner and clinical outcomes. The authors searched computerized databases (1950 to May 2010), reference lists, and considered studies with a control group (without simulation education intervention). Two independent assessors reviewed the retrieved citations. Independent data abstraction was performed on study design, study quality score, learner characteristics, sample size, components of interventional curriculum, outcomes assessed, and method of assessment. Learner outcomes included performance measures on simulators, knowledge, and confidence. Patient outcomes included number of needle passes, arterial puncture, pneumothorax, and catheter-related infections. Twenty studies were identified. Simulation-based education was associated with significant improvements in learner outcomes: performance on simulators (standardized mean difference [SMD] 0.60 [95% CI 0.45 to 0.76]), knowledge (SMD 0.60 [95% CI 0.35 to 0.84]), and confidence (SMD 0.41 [95% CI 0.30 to 0.53] for studies with single-group pretest and posttest design; SMD 0.52 (95% CI 0.23 to 0.81) for studies with nonrandomized, two-group design). Furthermore, simulation-based education was associated with improved patient outcomes, including fewer needle passes (SMD -0.58 [95% CI -0.95 to -0.20]), and pneumothorax (relative risk 0.62 [95% CI 0.40 to 0.97]), for studies with nonrandomized, two-group design. However, simulation-based training was not associated with a significant reduction in risk of either arterial puncture or catheter-related infections. Despite some limitations in the literature reviewed, evidence suggests that simulation-based education for CVC provides benefits in learner and select clinical outcomes.

  12. Elevated central venous pressure is associated with impairment of microcirculatory blood flow in sepsis: a hypothesis generating post hoc analysis

    NARCIS (Netherlands)

    Vellinga, Namkje A. R.; Ince, C.; Boerma, E. C.

    2013-01-01

    Microcirculatory driving pressure is defined as the difference between post-arteriolar and venular pressure. In previous research, an absence of correlation between mean arterial blood pressure (MAP) and microcirculatory perfusion has been observed. However, the microcirculation may be considered as

  13. Changes in intracranial venous blood flow and pulsatility in Alzheimer's disease: A 4D flow MRI study.

    Science.gov (United States)

    Rivera-Rivera, Leonardo A; Schubert, Tilman; Turski, Patrick; Johnson, Kevin M; Berman, Sara E; Rowley, Howard A; Carlsson, Cynthia M; Johnson, Sterling C; Wieben, Oliver

    2017-06-01

    Cerebral blood flow, arterial pulsation, and vasomotion may be important indicators of cerebrovascular health in aging and diseases of aging such as Alzheimer's disease. Noninvasive markers that assess these characteristics may be helpful in the study of co-occurrence of these diseases and potential additive and interacting effects. In this study, 4D flow MRI was used to measure intra-cranial flow features with cardiac-gated phase contrast MRI in cranial arteries and veins. Mean blood flow and pulsatility index as well as the transit time of the peak flow from the middle cerebral artery to the superior sagittal sinus were measured in a total of 104 subjects comprising of four groups: (a) subjects with Alzheimer's disease, (b) age-matched controls, (c) subjects with mild cognitive impairment, and (d) a group of late middle-aged with parental history of sporadic Alzheimer's disease. The Alzheimer's disease group exhibited: a significant decrease in mean blood flow in the superior sagittal sinus, transverse sinus, middle cerebral artery, and internal carotid arteries; a significant decrease of the peak and end diastolic blood flow in the middle cerebral artery and superior sagittal sinus; a faster transmission of peak flow from the middle cerebral artery to the superior sagittal sinus and increased pulsatility index along the carotid siphon.

  14. Point-of-care blood gases, electrolytes, chemistries, hemoglobin, and hematocrit measurement in venous samples from pet rabbits.

    Science.gov (United States)

    Selleri, Paolo; Di Girolamo, Nicola

    2014-01-01

    Point-of-care testing is an attractive option in rabbit medicine, because it permits rapid analysis of a panel of electrolytes, chemistries, blood gases, hemoglobin, and hematocrit, requiring only 65 μL of blood. The purpose of this study was to evaluate the performance of a portable clinical analyzer for measurement of pH, partial pressure of CO2, Na, chloride, potassium, blood urea nitrogen, glucose, hematocrit, and hemoglobin in healthy and diseased rabbits. Blood samples obtained from 30 pet rabbits were analyzed immediately after collection by the portable clinical analyzer (PCA) and immediately thereafter (time <20 sec) by a reference analyzer. Bland-Altman plots and Passing-Bablok regression analysis were used to compare the results. Limits of agreement were wide for all the variables studied, with the exception of pH. Most variables presented significant proportional and/or constant bias. The current study provides sufficient evidence that the PCA presents reliability for pH, although its low agreement with a reference analyzer for the other variables does not support their interchangeability. Limits of agreement provided for each variable allow researchers to evaluate if the PCA is reliable enough for their scope. To the authors' knowledge, the present is the first report evaluating a PCA in the rabbit.

  15. Evaluation of venous blood gas levels, blood chemistry and haemocytometric parameters in milk fed veal calves at different periods of livestock cycle.

    Science.gov (United States)

    Giambelluca, S; Fiore, E; Sadocco, A; Gianesella, M; Vazzana, I; Orefice, T; Morgante, M

    2016-12-01

    An evaluation of blood chemistry profile in relation to specific stages of livestock cycle can help better understand variations in physiological conditions in order to adjust management systems to animal needs. In addition to basal hematological investigation, the acid-base balance and blood gases are essential tools in evaluating metabolism in calves. The relationship between blood gas parameters, diet and growth should be further investigated. The aim of this study was to evaluate changes in acid-base status, blood gases, serum chemistry and hematological parameters in veal calves at different periods of livestock cycle. One hundred twenty-eight healthy cross breeding calves were enrolled in a farm in North-East Italy. Blood samplings were carried out from the jugular vein on day 1 (t1), 60 (t2) and 150 (t3) after arrival. Blood gas analysis was performed and hematological parameters were evaluated. One-way ANOVA and Tukey-Kramer post-hoc test were performed to assess differences between blood parameter values at the different periods. The main differences in blood gas parameter levels during the livestock cycle concerned pH, Base Excess and HCO3 with higher values recorded in t3. Urea, creatinine, gamma-glutamyl transpeptidase and bilirubin mean values were significantly higher in t1 than in t2 and t3. Aspartate aminotransferase increased from t1 to t2 and t3. Alkaline Phosphatase was higher in t2. Fe levels severely dropped in t2 and in t3, and the decrease led to a restrained but significant reduction in haemoglobin values. A correspondent decrease in the other haemocytometric parameters was found.

  16. Bleeding Time, Volume of Shed Blood Collected at the Bleeding Time Site, and the Peripheral Venous Hematocrit.

    Science.gov (United States)

    1995-01-10

    Journal of Obstetrics and Gynaecology 1991;98:327-328. 20. Bain B, Forster T. A sex difference in the bleeding time. 21. Smith PS, Baglini R, Meissner GF...Description of a method for determining the bleeding time and coagulation time and report of three cases of hemorrhagic disease relieved by...OFFICE OF NAVAL RESEARCH CONTRACT N00014-88-C-0118 CONTRACT N00014-94-C-0149 TECHNICAL REPORT 95-01 BLEEDING TIME, VOLUME OF SHED BLOOD

  17. The possibility for use of venous flaps in plastic surgery

    International Nuclear Information System (INIS)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-01-01

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required

  18. The possibility for use of venous flaps in plastic surgery

    Science.gov (United States)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-11-01

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  19. The possibility for use of venous flaps in plastic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Baytinger, V. F., E-mail: baitinger@mail.tomsknet.ru; Kurochkina, O. S., E-mail: kurochkinaos@yandex.ru; Selianinov, K. V.; Baytinger, A. V. [Research Institute of Microsurgery, Tomsk (Russian Federation); Dzyuman, A. N. [Siberian State Medical University, Tomsk (Russian Federation)

    2015-11-17

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  20. Effects of Ramadan fasting on blood pressure in hypertensive patients: a systematic review

    OpenAIRE

    Maryam Alinezhad-Namaghi; Maryam Salehi

    2016-01-01

    Ramadan is a holy month for Muslims and fasting in this month is the rule for any healthy matured person. Nutritional and behavioral changes occurred during Ramadan fasting may lead to several physiological change, such as blood pressure (2). Studies evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients, are scarce and reported inadequate results. In this paper a systematic review was performed to accumulate the results of published literature designed to evaluat...

  1. Venous leg ulcers.

    Science.gov (United States)

    Nelson, E Andrea

    2011-12-21

    Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of advice about self-help interventions in people receiving usual care for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 101 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide

  2. Does the preference of peripheral versus central venous access in peripheral blood stem cell collection/yield change stem cell kinetics in autologous stem cell transplantation?

    Science.gov (United States)

    Dogu, Mehmet Hilmi; Kaya, Ali Hakan; Berber, Ilhami; Sari, İsmail; Tekgündüz, Emre; Erkurt, Mehmet Ali; Iskender, Dicle; Kayıkçı, Ömur; Kuku, Irfan; Kaya, Emin; Keskin, Ali; Altuntaş, Fevzi

    2016-02-01

    Central venous access is often used during apheresis procedure in stem cell collection. The aim of the present study was to evaluate whether central or peripheral venous access has an effect on stem cell yield and the kinetics of the procedure and the product in patients undergoing ASCT after high dose therapy. A total of 327 patients were retrospectively reviewed. The use of peripheral venous access for stem cell yield was significantly more frequent in males compared to females (p = 0.005). Total volume of the product was significantly lower in central venous access group (p = 0.046). As being a less invasive procedure, peripheral venous access can be used for stem cell yield in eligible selected patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. A systematic review of the relationship between blood loss and clinical signs.

    Directory of Open Access Journals (Sweden)

    Rodolfo Carvalho Pacagnella

    Full Text Available INTRODUCTION: This systematic review examines the relationship between blood loss and clinical signs and explores its use to trigger clinical interventions in the management of obstetric haemorrhage. METHODS: A systematic review of the literature was carried out using a comprehensive search strategy to identify studies presenting data on the relationship of clinical signs & symptoms and blood loss. Methodological quality was assessed using the STROBE checklist and the general guidelines of MOOSE. RESULTS: 30 studies were included and five were performed in women with pregnancy-related haemorrhage (other studies were carried in non-obstetric populations. Heart rate (HR, systolic blood pressure (SBP and shock index were the parameters most frequently studied. An association between blood loss and HR changes was observed in 22 out of 24 studies, and between blood loss and SBP was observed in 17 out of 23 studies. An association was found in all papers reporting on the relationship of shock index and blood loss. Seven studies have used Receiver Operating Characteristic Curves to determine the accuracy of clinical signs in predicting blood loss. In those studies the AUC ranged from 0.56 to 0.74 for HR, from 0.56 to 0.79 for SBP and from 0.77 to 0.84 for shock index. In some studies, HR, SBP and shock index were associated with increased mortality. CONCLUSION: We found a substantial variability in the relationship between blood loss and clinical signs, making it difficult to establish specific cut-off points for clinical signs that could be used as triggers for clinical interventions. However, the shock index can be an accurate indicator of compensatory changes in the cardiovascular system due to blood loss. Considering that most of the evidence included in this systematic review is derived from studies in non-obstetric populations, further research on the use of the shock index in obstetric populations is needed.

  4. Study of fluid dynamics reveals direct communications between lymphatic vessels and venous blood vessels at lymph nodes of mice.

    Science.gov (United States)

    Takeda, Kazu; Mori, Shiro; Kodama, Tetsuya

    2017-06-01

    Cancer cells metastasize to lymph nodes, with distant metastasis resulting in poor prognosis. The role of lymph node metastasis (LNM) in the spread of cancer to distant organs remain incompletely characterized. The visualization of flow dynamics in the lymphatic and blood vessels of MXH10/Mo-lpr/lpr mice, which develop systemic swelling of lymph nodes up to 10mm in diameter, has revealed that lymph nodes have the potential to be a direct source of systemic metastasis. However, it is not known whether these fluid dynamics characteristics are universal phenomena present in other strains of laboratory mice. Here we show that the fluid dynamics observed in MXH10/Mo-lpr/lpr mice are the same as those observed in C57BL/6J, BALB/cAJcl and NOD/ShiJic-scidJcl mice. Furthermore, when fluorescent solution was injected into a tumor-bearing lymph node, the flow dynamics observed in the efferent lymphatic vessels and thoracoepigastric vein depended on the type of tumor cell. Our results indicate that fluid dynamics in the lymphatic and blood vessels of MXH10/Mo-lpr/lpr mice are generalized phenomena seen in conventional laboratory mice. We anticipate our results can facilitate studies of the progression of lymphatic metastasis to hematogenous metastasis via lymph nodes and the early diagnosis and treatment of LNM. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Integrated analysis of halogenated organic pollutants in sub-millilitre volumes of venous and umbilical cord blood sera

    Energy Technology Data Exchange (ETDEWEB)

    Grimalt, Joan O.; Carrizo, Daniel; Otero, Raquel; Vizcaino, Esther [Institute of Environmental Assessment and Water Research (IDAeA-CSIC), Department of Environmental Chemistry, Barcelona, Catalonia (Spain); Howsam, Mike [Universite de Lille 2, Centre Universitaire de Mesure et d' Analyse, Faculte de Pharmacie, Lille (France); Rodrigues de Marchi, Mary Rosa [Institute of Chemistry UNESP, Department of Analytical Chemistry, Araraquara, SP (Brazil)

    2010-03-15

    A rapid, robust and economical method for the analysis of persistent halogenated organic compounds in small volumes of human serum and umbilical cord blood is described. The pollutants studied cover a broad range of molecules of contemporary epidemiological and legislative concern, including polychlorobiphenyls (PCBs), polychlorobenzenes (CBs), hexachlorocyclohexanes (HCHs), DDTs, polychlorostyrenes (PCSs) and polybromodiphenyl ethers (PBDEs). Extraction and clean-up with n-hexane and concentrated sulphuric acid was followed with analysis by gas chromatography coupled to electron capture (GC-ECD) and GC coupled to negative ion chemical ionisation mass spectrometry (GC-NICI-MS). The advantages of this method rest in the broad range of analytes and its simplicity and robustness, while the use of concentrated sulphuric acid extraction/clean-up destroys viruses that may be present in the samples. Small volumes of reference serum between 50 and 1000{mu}L were extracted and the limits of detection/quantification and repeatability were determined. Recoveries of spiked compounds for the extraction of small volumes ({>=}300 {mu}L) of the spiked reference serum were between 90% and 120%. The coefficients of variation of repeatability ranged from 0.1-14%, depending on the compound. Samples of 4-year-old serum and umbilical cord blood (n=73 and 40, respectively) from a population inhabiting a village near a chloro-alkali plant were screened for the above-mentioned halogenated pollutants using this method and the results are briefly described. (orig.)

  6. [Predictive study of HBsAg in different stages of neonatal venous blood on failure of blocking HBV mother to infant transmission].

    Science.gov (United States)

    Yi, Wei; Li, Ming-Hui; Hu, Yu-Hong; Liu, Feng; Zhang, Yang-Li; Liu, Xue-Jing; Hao, Hong-Xiao; Song, Shu-Jing; Liu, Ying; Li, Xing-Hong; Sun, Ji-Yun; Liu, Min; Cheng, Jun; Xie, Yao

    2011-10-01

    In this study, we discuss the predictive value of different content of HBsAg in different stages of neotal venous blood on failure of blocking mother to infant transmission of HBV. 150 infants born of chronically HBV infected mothers who were positive of both HBsAg and HBeAg and who also had a HBV DNA virus load above 10(5) copies/ml were enrolled. These infants were given hepatitis B virus immune globin (HBIG) 200 IU immediately after birth and were given hepatitis B vaccine 10 or 20 microg at brith, 1 month and 6 months after birth. HBV serological index of these infants were test at birth, 1 month and 7 months after birth respectively. Different content of HBsAg in different stages of neonatal venus blood were analyzed to predict the failure of blocking mother to infant transmission of HBV. 11 infants failed in blocking of HBV mother to infant transmission. The positive rate of HBsAg at birth, 1 month and 7 months after birth were 41.26%, 10.49% and 7.69% respectively, and were 97.90%, 65.73% and 13.29% of HBeAg. The positive predictive value of HBsAg > or = 0.05 and HBsAg > or = 1 IU/ml at birth were 18.64% and 70% respectively, and were 73.33% and 100% one month after birth. Infants with HBsAg > or = 1 IU/ml at birth should be suspicious of failure on blocking HBV mother-to-infant transmission and it should be more credible if the infant has HBsAg > or = 1 IU/ml one month after birth. How to improve the blocking rate of neonates who were positive of HBsAg at birth and one month after birth should be the focus of our future research.

  7. Cerebral blood flow in small vessel disease : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-01-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that

  8. The Effect of Treatment of Anemia with Blood Transfusion on Delirium : A Systematic Review

    NARCIS (Netherlands)

    van der Zanden, Vera; Beishuizen, Sara J.; Swart, Lieke M.; de Rooij, Sophia E.; van Munster, Barbara C.

    ObjectivesTreating the precipitating factors of delirium is the mainstay of the prevention and treatment of delirium. We aim to investigate the role of anemia and blood transfusion within the multicomponent prevention and treatment strategy of delirium. DesignSystematic review. SettingWe included

  9. Changes in plasmahistamine concentration and in blood electrolyte levels affter venous application of non-ionic contrast media

    International Nuclear Information System (INIS)

    Jansen, O.; Weiss, H.D.; Stolle, H.; Schallock, J.

    1990-01-01

    Considering that the different physicochemical properties of the non-ionic contrast media can lead to different conditions concerning histamine release and blood electrolyte levels, the authors made a comparative analysis of the contrast media, and with a placebo, under standardized conditions of application. The monomeric, non-ionic contrast media were found to induce no changes in the release of histamine. Changes in electrolyte levels were all in all discrete after application of the monomeric, non-ionic contrast medium and the dimeric, non-ionic Iotrolan. In-vivo measurements showed a slight Ca ++ -depressing effect of the contrast media, which was strongest with Iohexol. The dimeric Iotrolan had the least hemodilutive effect but the same Ca ++ -depression as the monomeric contrast media. The Ca ++ -depressing effect of the non-ionic contrast media is for one part due to the hemodilution, but it may also be caused in addition by a direct effect on cell membranes. (orig./MG) [de

  10. Correlation between evolution and treatment of hypertension in unilateral renal disease and values of renin activity in renal venous blood.

    Science.gov (United States)

    Zech, P; Sassard, J; Pozet, N; Annat, G

    1978-01-01

    93 patients with renal hypertension and renal vein PRA determination were studied during 1--5 years follow-up. They were separated in two groups of medical and surgical treatment. Medical treatment is able to normalize blood pressure even in cases with high asymmetric PRA. 9 of 16 patients could be cured or improved in the surgical group and 14 of 22 in the medical group. The best results were obtained if beta-blockers were included in the drug regimen: cured or improved were 7 of 33 patients in medical treatment without beta-blockers, 17 of 28 in surgical treatment, and 31 of 32 in medical treatment including beta-blockers with or without hydralazine and/or diuretics.

  11. Venous Thromboembolism in Patients With Thrombocytopenia

    DEFF Research Database (Denmark)

    Bælum, Jens Kristian; Ellingsen Moe, Espen; Nybo, Mads

    2017-01-01

    BACKGROUND: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing. O...

  12. Building the Evidence Base of Blood-Based Biomarkers for Early Detection of Cancer: A Rapid Systematic Mapping Review

    Directory of Open Access Journals (Sweden)

    Lesley Uttley

    2016-08-01

    Interpretation: This study is the first to systematically and comprehensively map blood biomarkers for early detection of cancer. Use of this rapid systematic mapping approach found a broad range of relevant biomarkers allowing an evidence-based approach to identification of promising biomarkers for development of a blood-based cancer screening test in the general population.

  13. Efficacy of anthelminthic control programs against natural Muellerius capillaris infection in sheep in the north-west of Spain. Effect on blood gases and pH in venous blood samples.

    Science.gov (United States)

    López, C M; Cienfuegos, S; Dacal, V; Vázquez, L; Panadero, R; Fernández, G; Díaz, P; Lago, N; Díez-Baños, P; Morrondo, M P

    2010-06-01

    The field efficacy of a single dose treatment against natural M. capillaris infection using different anthelmintic drugs, extensively employed in ovine parasite control programs in Galicia (N.W. Spain), and the effect of protostrongylid infection on ovine respiratory functions, were evaluated. Five groups (n = 5) of ewes were used in this study; animals were treated with injectable ivermectin 10.2 mg/kg), levamisole (7.5 mg/kg) and albendazole (5 mg/kg) and monitored at 0, 7, 21, 42 and 63 days posttreatment (d.p.t.) by enumeration of the lungworm larvae per gram of faeces (l.p.g.) and determination of gas tension and pH in venous blood using an i-Stat portable clinical analyzer. No statistical difference was found either in larval elimination between untreated and treated groups or in the reduction in larval counts in all of the treated groups. A significant increase in partial oxygen tension (pO2) and saturation (sO2) between day 0 and 7 p.t. was observed in all treated animals. These values decreased significantly at day 21 to previous levels. There were no statistical differences in blood gases between uninfected and treated groups. We can conclude that under Galician field conditions, parasitic control programs are not totally effective against M. capillaris infection.

  14. Effects of Handgrip Training With Venous Restriction on Brachial Artery Vasodilation

    OpenAIRE

    Credeur, Daniel P.; Hollis, Brandon C.; Welsch, Michael A.

    2010-01-01

    Previous studies have shown that resistance training with restricted venous blood flow (Kaatsu) results in significant strength gains and muscle hypertrophy. However, few studies have examined the concurrent vascular responses following restrictive venous blood flow training protocols.

  15. Superficial venous disease.

    Science.gov (United States)

    Brown, Kellie R; Rossi, Peter J

    2013-08-01

    Superficial venous disease is a common clinical problem. The concerning disease states of the superficial venous system are venous reflux, varicose veins, and superficial venous thrombosis. Superficial venous reflux can be a significant contributor to chronic venous stasis wounds of the lower extremity, the treatment of which can be costly both in terms of overall health care expenditure and lost working days for affected patients. Although commonly thought of as a benign process, superficial venous thrombosis is associated with several underlying pathologic processes, including malignancy and deep venous thrombosis. Published by Elsevier Inc.

  16. The effect of medical clowning on reducing pain, crying, and anxiety in children aged 2-10 years old undergoing venous blood drawing--a randomized controlled study.

    Science.gov (United States)

    Meiri, N; Ankri, A; Hamad-Saied, M; Konopnicki, M; Pillar, G

    2016-03-01

    Recently, the utilization of medical clowns to reduce anxiety, stress, and even pain associated with hospitalization has become popular. However, the scientific basis of this benefit and outcome is scant. Venipuncture and IV cannulation are very common sources of pain in ill children. To reduce pain, one common approach is to apply a local anesthetic prior to the procedure. In the current study, we sought to compare the utilization of medical clowning in this process with two control groups: (1) local anesthetic cream (EMLA®, Astrazeneca, London, UK) applied prior to the procedure (active control) and (2) the procedure performed with neither clown nor EMLA (control group). We hypothesized that a medical clown will reduce pain, crying, and anxiety in children undergoing this procedure.Children aged 2-10 years who required either venous blood sampling or intravenous cannulation were recruited and randomly assigned to one of the three groups. Outcome measures consisted of the duration of the whole procedure (measured objectively by an independent observer), the duration of crying (measured objectively by an independent observer), subjective assessment of pain level (a commonly used validated scale), and anxiety level regarding future blood exams (by questionnaire). Analysis of variance (ANOVA) was used to compare between the groups. p children participated. Mean age was 5.3 ± 2.5 years (range 2-10 years). The duration of crying was significantly lower with clown than in the control group (1.3 ± 2.0 vs 3.8 ± 5.4 min, p = 0.01). With EMLA, this duration was 2.4 ± 2.9 min. The pain magnitude as assessed by the child was significantly lower with EMLA than in the control group (2.9 ± 3.3 vs 5.3 ± 3.8, p = 0.04), while with clown it was 4.1 ± 3.5, not significant when compared with the other two modalities. Hence, duration of crying was shortest with clown while pain assessment was lowest with EMLA. Furthermore, with clown

  17. Total Anomalous Pulmonary Venous Connection: Preoperative Anatomy, Physiology, Imaging, and Interventional Management of Postoperative Pulmonary Venous Obstruction.

    Science.gov (United States)

    Files, Matthew D; Morray, Brian

    2017-06-01

    Total anomalous pulmonary venous connection refers to a spectrum of cardiac anomalies where the pulmonary veins fail to return to the left atrium and the pulmonary venous blood returns through a systemic vein or directly to the right atrium. There is a wide anatomical variety of venous connections and degrees of pulmonary venous obstruction that affect the presentation, surgical repair, and outcomes. In this review, we explore the preoperative physiology, echocardiographic diagnosis, and approach to postoperative complications.

  18. A field trial of a PCR-based Mansonella ozzardi diagnosis assay detects high-levels of submicroscopic M. ozzardi infections in both venous blood samples and FTA card dried blood spots.

    Science.gov (United States)

    Medeiros, Jansen Fernandes; Almeida, Tatiana Amaral Pires; Silva, Lucyane Bastos Tavares; Rubio, Jose Miguel; Crainey, James Lee; Pessoa, Felipe Arley Costa; Luz, Sergio Luiz Bessa

    2015-05-20

    Mansonella ozzardi is a poorly understood human filarial parasite with a broad distribution throughout Latin America. Most of what is known about its parasitism has come from epidemiological studies that have estimated parasite incidence using light microscopy. Light microscopy can, however, miss lighter, submicroscopic, infections. In this study we have compared M. ozzardi incidence estimates made using light microscopy, with estimates made using PCR. 214 DNA extracts made from Large Volume Venous Blood Samples (LVVBS) were taken from volunteers from two study sites in the Rio Solimões region: Codajás [n = 109] and Tefé [n = 105] and were subsequently assayed for M. ozzardi parasitism using a diagnostic PCR (Mo-dPCR). Peripheral finger-prick blood samples were taken from the same individuals and used for microscopic examination. Finger-prick blood, taken from individuals from Tefé, was also used for the creation of FTAcard dried blood spots (DBS) that were subsequently subjected to Mo-dPCR. Overall M. ozzardi incidence estimates made with LVVBS PCRs were 1.8 times higher than those made using microscopy (44.9% [96/214] compared with 24.3% [52/214]) and 1.5 times higher than the PCR estimates made from FTAcard DBS (48/105 versus 31/105). PCR-based detection of FTAcard DBS proved 1.3 times more sensitive at diagnosing infections from peripheral blood samples than light microscopy did: detecting 24/105 compared with 31/105. PCR of LVVBS reported the fewest number of false negatives, detecting: 44 of 52 (84.6%) individuals diagnosed by microscopy; 27 of 31 (87.1%) of those diagnosed positive from DBSs and 17 out of 18 (94.4%) of those diagnosed as positive by both alternative methodologies. In this study, Mo-dPCR of LVVBS was by far the most sensitive method of detecting M. ozzardi infections and detected submicroscopic infections. Mo-dPCR FTAcard DBS also provided a more sensitive test for M. ozzardi diagnosis than light microscopy based diagnosis did and

  19. Can sibutramine alter systemic blood pressure in obese patients? Systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Hernani Pinto de Lemos Júnior

    Full Text Available CONTEXT: Systemic arterial hypertension is part of the metabolic syndrome resulting from obesity. OBJECTIVE: To evaluate the effect of sibutramine on overweight and obese patients' blood pressure through a systematic review. METHODS: All the studies included needed to be randomized controlled trials. The methodological quality of the selected trials was assessed using the criteria described in the Cochrane Handbook. The participants were overweight and obese patients; the intervention was sibutramine compared with placebo. The primary outcome measurement was systolic and diastolic blood pressure and the secondary measurement was blood pressure. Studies were identified by searching the following sources: Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs, Medline, Cochrane reviews, manual searches, personal communication and contact with the pharmaceutical industry. There were no language, date or other restrictions. Data collection and extraction was performed by two reviewers, who independently obtained the full articles of all eligible papers. RESULTS: Three meta-analyses were produced: 1 systolic blood pressure outcome (eight studies did not show statistical significance between sibutramine and placebo: weighted mean difference (WMD 1.57, confidence interval (CI -0.03 to 3.18; 2 diastolic blood pressure outcome (ten studies did not show statistical significance between sibutramine and placebo: WMD 1.13, CI -0.49 to 2.76; 3 blood pressure outcome (two studies also did not show statistical significance between the groups: relative risk (RR 0.69, CI 0.07 to 7.01. CONCLUSIONS: The meta-analyses presented in this systematic review show that sibutramine does not have a statistically significant effect on blood pressure, compared with placebo.

  20. Neuromuscular electrical stimulation for thromboprophylaxis: A systematic review.

    Science.gov (United States)

    Hajibandeh, S; Hajibandeh, S; Antoniou, G A; Scurr, J R H; Torella, F

    2015-10-01

    To evaluate the effect of neuromuscular electrical stimulation on lower limb venous blood flow and its role in thromboprophylaxis. Systematic review of randomised and non-randomised studies evaluating neuromuscular electrical stimulation, and reporting one or more of the following outcomes: incidence of venous thromboembolism, venous blood flow and discomfort profile. Twenty-one articles were identified. Review of these articles showed that neuromuscular electrical stimulation increases venous blood flow and is generally associated with an acceptable tolerability, potentially leading to good patient compliance. Ten comparative studies reported DVT incidence, ranging from 2% to 50% with neuromuscular electrical stimulation and 6% to 47.1% in controls. There were significant differences, among included studies, in terms of patient population, neuromuscular electrical stimulation delivery, diagnosis of venous thromboembolism and blood flow measurements. Neuromuscular electrical stimulation increases venous blood flow and is well tolerated, but current evidence does not support a role for neuromuscular electrical stimulation in thromboprophylaxis. Randomised controlled trials are required to investigate the clinical utility of neuromuscular electrical stimulation in this setting. © The Author(s) 2015.

  1. Diagnostic accuracy of detection and quantification of HBV-DNA and HCV-RNA using dried blood spot (DBS) samples - a systematic review and meta-analysis.

    Science.gov (United States)

    Lange, Berit; Roberts, Teri; Cohn, Jennifer; Greenman, Jamie; Camp, Johannes; Ishizaki, Azumi; Messac, Luke; Tuaillon, Edouard; van de Perre, Philippe; Pichler, Christine; Denkinger, Claudia M; Easterbrook, Philippa

    2017-11-01

    The detection and quantification of hepatitis B (HBV) DNA and hepatitis C (HCV) RNA in whole blood collected on dried blood spots (DBS) may facilitate access to diagnosis and treatment of HBV and HCV infection in resource-poor settings. We evaluated the diagnostic performance of DBS compared to venous blood samples for detection and quantification of HBV-DNA and HCV-RNA in two systematic reviews and meta-analyses on the diagnostic accuracy of HBV DNA and HCV RNA from DBS compared to venous blood samples. We searched MEDLINE, Embase, Global Health, Web of Science, LILAC and Cochrane library for studies that assessed diagnostic accuracy with DBS. Heterogeneity was assessed and where appropriate pooled estimates of sensitivity and specificity were generated using bivariate analyses with maximum likelihood estimates and 95% confidence intervals. We also conducted a narrative review on the impact of varying storage conditions or different cut-offs for detection from studies that undertook this in a subset of samples. The QUADAS-2 tool was used to assess risk of bias. In the quantitative synthesis for diagnostic accuracy of HBV-DNA using DBS, 521 citations were identified, and 12 studies met the inclusion criteria. Overall quality of studies was rated as low. The pooled estimate of sensitivity and specificity for HBV-DNA was 95% (95% CI: 83-99) and 99% (95% CI: 53-100), respectively. In the two studies that reported on cut-offs and limit of detection (LoD) - one reported a sensitivity of 98% for a cut-off of ≥2000 IU/ml and another reported a LoD of 914 IU/ml using a commercial assay. Varying storage conditions for individual samples did not result in a significant variation of results. In the synthesis for diagnostic accuracy of HCV-RNA using DBS, 15 studies met the inclusion criteria, and this included six additional studies to a previously published review. The pooled sensitivity and specificity was 98% (95% CI:95-99) and 98% (95% CI:95-99.0), respectively

  2. Dietary Interventions and Blood Pressure in Latin America - Systematic Review and Meta-Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mazzaro, Caroline Cantalejo; Klostermann, Flávia Caroline; Erbano, Bruna Olandoski [Faculdade Evangélica do Paraná, Curitiba, PR (Brazil); Schio, Nicolle Amboni; Guarita-Souza, Luiz César; Olandoski, Marcia; Faria-Neto, José Rocha, E-mail: jrochafaria@cardiol.br; Baena, Cristina Pellegrino [Pontifícia Universidade Católica do Paraná (PUC-PR), Curitiba, PR (Brazil)

    2014-04-15

    High blood pressure is the major risk factor for cardiovascular disease. Low blood pressure control rates in Latin American populations emphasize the need for gathering evidence on effective therapies. To evaluate the effects of dietary interventions on blood pressure in Latin American populations. Systematic review. Electronic databases (MEDLINE/PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, SciELO, LILACS and VHL) were searched and manual search for studies published up to April 2013 was performed. Parallel studies about dietary interventions in Latin American adult populations assessing arterial blood pressure (mm Hg) before and after intervention were included. Of the 405 studies identified, 10 randomized controlled trials were included and divided into 3 subgroups according to the proposed dietary intervention. There was a non-significant reduction in systolic blood pressure in the subgroups of mineral replacement (-4.82; 95% CI: -11.36 to 1.73) and complex pattern diets (-3.17; 95% CI: -7.62 to 1.28). Regarding diastolic blood pressure, except for the hyperproteic diet subgroup, all subgroups showed a significant reduction in blood pressure: -4.66 mmHg (95% CI: -9.21 to -0.12) and -4.55 mmHg (95% CI: -7.04 to -2.06) for mineral replacement and complex pattern diets, respectively. Available evidence on the effects of dietary changes on blood pressure in Latin American populations indicates a homogeneous effect of those interventions, although not significant for systolic blood pressure. Samples were small and the quality of the studies was generally low. Larger studies are required to build robust evidence.

  3. Dietary Interventions and Blood Pressure in Latin America - Systematic Review and Meta-Analysis

    International Nuclear Information System (INIS)

    Mazzaro, Caroline Cantalejo; Klostermann, Flávia Caroline; Erbano, Bruna Olandoski; Schio, Nicolle Amboni; Guarita-Souza, Luiz César; Olandoski, Marcia; Faria-Neto, José Rocha; Baena, Cristina Pellegrino

    2014-01-01

    High blood pressure is the major risk factor for cardiovascular disease. Low blood pressure control rates in Latin American populations emphasize the need for gathering evidence on effective therapies. To evaluate the effects of dietary interventions on blood pressure in Latin American populations. Systematic review. Electronic databases (MEDLINE/PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, SciELO, LILACS and VHL) were searched and manual search for studies published up to April 2013 was performed. Parallel studies about dietary interventions in Latin American adult populations assessing arterial blood pressure (mm Hg) before and after intervention were included. Of the 405 studies identified, 10 randomized controlled trials were included and divided into 3 subgroups according to the proposed dietary intervention. There was a non-significant reduction in systolic blood pressure in the subgroups of mineral replacement (-4.82; 95% CI: -11.36 to 1.73) and complex pattern diets (-3.17; 95% CI: -7.62 to 1.28). Regarding diastolic blood pressure, except for the hyperproteic diet subgroup, all subgroups showed a significant reduction in blood pressure: -4.66 mmHg (95% CI: -9.21 to -0.12) and -4.55 mmHg (95% CI: -7.04 to -2.06) for mineral replacement and complex pattern diets, respectively. Available evidence on the effects of dietary changes on blood pressure in Latin American populations indicates a homogeneous effect of those interventions, although not significant for systolic blood pressure. Samples were small and the quality of the studies was generally low. Larger studies are required to build robust evidence

  4. Effects of protein intake on blood pressure, insulin sensitivity and blood lipids in children: a systematic review.

    Science.gov (United States)

    Voortman, Trudy; Vitezova, Anna; Bramer, Wichor M; Ars, Charlotte L; Bautista, Paula K; Buitrago-Lopez, Adriana; Felix, Janine F; Leermakers, Elisabeth T M; Sajjad, Ayesha; Sedaghat, Sanaz; Tharner, Anne; Franco, Oscar H; van den Hooven, Edith H

    2015-02-14

    High protein intake in early childhood is associated with obesity, suggesting possible adverse effects on other cardiometabolic outcomes. However, studies in adults have suggested beneficial effects of protein intake on blood pressure (BP) and lipid profile. Whether dietary protein intake is associated with cardiovascular and metabolic health in children is unclear. Therefore, we aimed to systematically review the evidence on the associations of protein intake with BP, insulin sensitivity and blood lipids in children. We searched the databases Medline, Embase, Cochrane Central and PubMed for interventional and observational studies in healthy children up to the age of 18 years, in which associations of total, animal and/or vegetable protein intake with one or more of the following outcomes were reported: BP; measures of insulin sensitivity; cholesterol levels; or TAG levels. In the search, we identified 6636 abstracts, of which fifty-six studies met all selection criteria. In general, the quality of the included studies was low. Most studies were cross-sectional, and many did not control for potential confounders. No overall associations were observed between protein intake and insulin sensitivity or blood lipids. A few studies suggested an inverse association between dietary protein intake and BP, but evidence was inconclusive. Only four studies examined the effects of vegetable or animal protein intake, but with inconsistent results. In conclusion, the literature, to date provides insufficient evidence for effects of protein intake on BP, insulin sensitivity or blood lipids in children. Future studies could be improved by adequately adjusting for key confounders such as energy intake and obesity.

  5. The efficiency and safety of fibrin sealant for reducing blood loss in primary total hip arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Zhiyuan; Xiao, Lin; Guo, Hao; Zhao, Guanghui; Ma, Jianbing

    2017-01-01

    Total hip arthroplasty (THA) is associated with substantial blood loss. The objective of present systematic review and meta-analysis is to provide evidence from randomized controlled trials (RCTs) on the efficiency and safety of administration of fibrin sealant (FS) for reducing blood loss in patients undergoing primary THA. Potential relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Gray academic studies were also identified from the reference list of included studies. There was no language restriction. Pooling of data was carried out by using RevMan 5.1. Six randomized controlled trials (RCTs) met the inclusion criteria. Current meta-analysis indicated that there were significant differences in terms of total blood loss (MD = -153.77, 95% CI: -287.21 to -20.34, P = 0.02), postoperative hemoglobin level (MD = -0.25, 95% CI: -0.46 to -0.05, P = 0.02) and transfusion rate (RD = -0.12, 95% CI: -0.22 to -0.03, P = 0.01) between groups. No significant differences were found regarding the incidence of deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01to 0.01, P = 0.51) or other side effects. Administration of fibrin sealant in total hip arthroplasty may reduce total blood loss, postoperative hemoglobin decline and transfusion requirements. Moreover, no adverse effect was related to FS. Due to the limited quality of the evidence currently available, higher quality RCTs are required. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  6. What motivates men to donate blood? A systematic review of the evidence.

    Science.gov (United States)

    Carver, A; Chell, K; Davison, T E; Masser, B M

    2018-04-01

    Effective recruitment and retention of male donors are vital for the ongoing provision of blood products. Compared with females, male donors are less likely to be medically deferred or experience vasovagal reactions and are typically preferred for plasmapheresis donation in voluntary non-remunerated settings. However, females outnumber males among donors aged under 40 years. This systematic review aimed to synthesize evidence and identify key motivators for blood donation among males to inform targeted recruitment/retention campaigns. Databases (e.g. EBSCOhost, Web of Science) were searched using terms (dona* OR dono*) AND (blood OR aphaeresis OR apheresis OR plasma* OR platelet* OR platlet*) in title AND (male OR gender OR sex OR female) AND (motivat* OR intention OR attitude OR behavi* OR predictor OR barrier OR deter*) NOT (organ OR sperm OR tissue OR autologous OR oocyte) in text. Two researchers independently systematically scanned quantitative, full-text, English language, peer-reviewed publications from 1990 to 2015 that examined males/females separately with outcomes of blood donation or self-reported intention. Two additional researchers resolved discrepancies. Among 28 identified articles, the most frequently cited motivators for male blood product donation were as follows: altruism; positive attitude towards incentives; health check(s); subjective norms. Altruism was less pronounced among males compared with females and was combined with 'warm glow' in novice males (impure altruism). Perceived health benefits and incentives (e.g. coffee mugs) were stronger motivators of males than females. Marketing campaigns for recruitment/retention of male donors should focus on identified motivators rather than take a 'one-size-fits-all' approach. © 2017 International Society of Blood Transfusion.

  7. A meta-analysis on the utility of peripheral venous blood gas analyses in exacerbations of chronic obstructive pulmonary disease in the emergency department.

    Science.gov (United States)

    Lim, Beng Leong; Kelly, Anne-Maree

    2010-10-01

    The objective of this case-based review is to identify and summarize the relevant evidence for the clinical utility of peripheral venous blood gas (pVBG) analyses in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) treated in the emergency department. Relevant studies were identified using the Cochrane Library, Medline, Embase, and CINAHL databases and by hand searching of references of published articles. Included studies were prospective trials comparing arterial and pVBG results in patients with COPD or respiratory distress that reported at least average differences and/or limits of agreement between the two results in English. Outcomes of interest were agreement between arterial and pVBG values for pH, pCO2, pO2, and HCO3. Eighty-nine studies were identified of which six were relevant. The weighted average difference for pCO2 was 5.92 mmHg, whereas those for pH, pO2, and HCO3 were 0.028, 18.65 mmHg, and 1.34 mEq/l, respectively. Using Bland-Altman analysis, the 95% limits of agreement were in the range of -0.10 to 0.08, -17 to 26 mmHg and, -3.5 to 3.5 mEq/l for pH, pCO2, and HCO3, respectively. Reported cutoff pVBG pCO2 values for screening of arterial hypercarbia ranged from 30 to 46 mmHg. No studies investigated the role of pVBG analysis in treatment alteration or clinical outcomes. Available evidence suggests that there is good agreement for pH and HCO3 values between arterial and pVBG results in patients with COPD, but not for pO2 or pCO2. Widespread clinical use is limited because of the lack of validation studies on clinical outcomes.

  8. ‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England

    Science.gov (United States)

    Bion, Julian; Richardson, Annette; Hibbert, Peter; Beer, Jeanette; Abrusci, Tracy; McCutcheon, Martin; Cassidy, Jane; Eddleston, Jane; Gunning, Kevin; Bellingan, Geoff; Patten, Mark; Harrison, David

    2013-01-01

    Background Bloodstream infections from central venous catheters (CVC-BSIs) increase morbidity and costs in intensive care units (ICUs). Substantial reductions in CVC-BSI rates have been reported using a combination of technical and non-technical interventions. Methods We conducted a 2-year, four-cluster, stepped non-randomised study of technical and non-technical (behavioural) interventions to prevent CVC-BSIs in adult and paediatric ICUs in England. Random-effects Poisson regression modelling was used to compare infection rates. A sample of ICUs participated in data verification. Results Of 223 ICUs in England, 215 (196 adult, 19 paediatric) submitted data on 2479 of 2787 possible months and 147 (66%) provided complete data. The exposure rate was 438 887 (404 252 adult and 34 635 paediatric) CVC-patient days. Over 20 months, 1092 CVC-BSIs were reported. Of these, 884 (81%) were ICU acquired. For adult ICUs, the mean CVC-BSI rate decreased over 20 months from 3.7 in the first cluster to 1.48 CVC-BSIs/1000 CVC-patient days (p<0.0001) for all clusters combined, and for paediatric ICUs from 5.65 to 2.89 (p=0.625). The trend for infection rate reduction did not accelerate following interventions training. CVC utilisation rates remained stable. Pre-ICU infections declined in parallel with ICU-acquired infections. Criterion-referenced case note review showed high agreement between adjudicators (κ 0.706) but wide variation in blood culture sampling rates and CVC utilisation. Generic infection control practices varied widely. Conclusions The marked reduction in CVC-BSI rates in English ICUs found in this study is likely part of a wider secular trend for a system-wide improvement in healthcare-associated infections. Opportunities exist for greater harmonisation of infection control practices. Future studies should investigate causal mechanisms and contextual factors influencing the impact of interventions directed at improving patient care. PMID:22996571

  9. Incentivizing Blood Donation: Systematic Review and Meta-Analysis to Test Titmuss’ Hypotheses

    Science.gov (United States)

    2013-01-01

    Objectives: Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Method: Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. Results: The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91–1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). Conclusion: The limited evidence suggests that Titmuss’ hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PMID:24001244

  10. Incentivizing blood donation: systematic review and meta-analysis to test Titmuss' hypotheses.

    Science.gov (United States)

    Niza, Claudia; Tung, Burcu; Marteau, Theresa M

    2013-09-01

    Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91-1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). The limited evidence suggests that Titmuss' hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  11. Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice: Combined results of a systematic review, expert panel opinion and an international survey

    NARCIS (Netherlands)

    Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

    2017-01-01

    The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians. 10

  12. Safety and efficacy of direct oral anticoagulants compared to warfarin for extended treatment of venous thromboembolism -a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Sindet-Pedersen, Caroline; Pallisgaard, Jannik Langtved; Olesen, Jonas Bjerring

    2015-01-01

    OBJECTIVE: To examine and compare the safety and efficacy of extended treatment with dabigatran, apixaban, rivaroxaban and warfarin in patients with unprovoked venous thromboembolism. METHODS: PubMed and Embase were searched for randomized clinical trials reporting on the use of direct oral antic...

  13. A Systematic Evaluation of Blood Serum and Plasma Pre-Analytics for Metabolomics Cohort Studies

    Directory of Open Access Journals (Sweden)

    Elodie Jobard

    2016-12-01

    Full Text Available The recent thriving development of biobanks and associated high-throughput phenotyping studies requires the elaboration of large-scale approaches for monitoring biological sample quality and compliance with standard protocols. We present a metabolomic investigation of human blood samples that delineates pitfalls and guidelines for the collection, storage and handling procedures for serum and plasma. A series of eight pre-processing technical parameters is systematically investigated along variable ranges commonly encountered across clinical studies. While metabolic fingerprints, as assessed by nuclear magnetic resonance, are not significantly affected by altered centrifugation parameters or delays between sample pre-processing (blood centrifugation and storage, our metabolomic investigation highlights that both the delay and storage temperature between blood draw and centrifugation are the primary parameters impacting serum and plasma metabolic profiles. Storing the blood drawn at 4 °C is shown to be a reliable routine to confine variability associated with idle time prior to sample pre-processing. Based on their fine sensitivity to pre-analytical parameters and protocol variations, metabolic fingerprints could be exploited as valuable ways to determine compliance with standard procedures and quality assessment of blood samples within large multi-omic clinical and translational cohort studies.

  14. Economics of Team-based Care in Controlling Blood Pressure: A Community Guide Systematic Review.

    Science.gov (United States)

    Jacob, Verughese; Chattopadhyay, Sajal K; Thota, Anilkrishna B; Proia, Krista K; Njie, Gibril; Hopkins, David P; Finnie, Ramona K C; Pronk, Nicolaas P; Kottke, Thomas E

    2015-11-01

    High blood pressure is an important risk factor for cardiovascular disease and stroke, the leading cause of death in the U.S., and a substantial national burden through lost productivity and medical care. A recent Community Guide systematic review found strong evidence of effectiveness of team-based care in improving blood pressure control. The objective of the present review is to determine from the economic literature whether team-based care for blood pressure control is cost beneficial or cost effective. Electronic databases of papers published January 1980-May 2012 were searched to find economic evaluations of team-based care interventions to improve blood pressure outcomes, yielding 31 studies for inclusion. In analyses conducted in 2012, intervention cost, healthcare cost averted, benefit-to-cost ratios, and cost effectiveness were abstracted from the studies. The quality of estimates for intervention and healthcare cost from each study were assessed using three elements: intervention focus on blood pressure control, incremental estimates in the intervention group relative to a control group, and inclusion of major cost-driving elements in estimates. Intervention cost per unit reduction in systolic blood pressure was converted to lifetime intervention cost per quality-adjusted life-year (QALY) saved using algorithms from published trials. Team-based care to improve blood pressure control is cost effective based on evidence that 26 of 28 estimates of $/QALY gained from ten studies were below a conservative threshold of $50,000. This finding is salient to recent U.S. healthcare reforms and coordinated patient-centered care through formation of Accountable Care Organizations. Published by Elsevier Inc.

  15. [Physiotherapy potentials improve the calf muscle pump function in chronic venous insufficiency].

    Science.gov (United States)

    Dymarek, Robert; Ptaszkowski, Kuba; Słupska, Lucyna; Rajfur, Joanna; Pasternok, Małgorzata; Taradaj, Jakub; Halski, Tomasz

    2014-01-01

    Mechanism of the calf muscle pump plays a major role in venous blood return from peripheral parts of blood vessels of lower extremities. It enables a smooth venous blood movement from the deep venous system segment located below in a direction to the segment lying above which effectively prevents a distal blood stasis and veno-lymphatic edema of lower limbs. Calf muscle pump dysfunction together with disorders in the construction of blood vessels walls and with endurance weakness of valves, leads to venous hypertension and contributes to the development of venous insufficiency. The aim of this paper is to demonstrate the theoretical basis including venous return physiology and the mechanism of lower limbs venous--muscle pump as well as provide practical application of physiotherapy methods to support the properfunction of presented calf muscle pump. Examples in the field of physical medicine, compression therapy and kinesiotherapy for improving the efficiency of lower extremity muscles, providing a physiological venous return.

  16. Systematic Analysis of Blood Cell Transcriptome in End-Stage Chronic Respiratory Diseases

    Science.gov (United States)

    Botturi, Karine; Reynaud-Gaubert, Martine; Mussot, Sacha; Stern, Marc; Danner-Boucher, Isabelle; Mornex, Jean-François; Pison, Christophe; Dromer, Claire; Kessler, Romain; Dahan, Marcel; Brugière, Olivier; Le Pavec, Jérôme; Perros, Frédéric; Humbert, Marc; Gomez, Carine; Brouard, Sophie; Magnan, Antoine

    2014-01-01

    Background End-stage chronic respiratory diseases (CRD) have systemic consequences, such as weight loss and susceptibility to infection. However the mechanisms of such dysfunctions are as yet poorly explained. We hypothesized that the genes putatively involved in these mechanisms would emerge from a systematic analysis of blood mRNA profiles from pre-transplant patients with cystic fibrosis (CF), pulmonary hypertension (PAH), and chronic obstructive pulmonary disease (COPD). Methods Whole blood was first collected from 13 patients with PAH, 23 patients with CF, and 28 Healthy Controls (HC). Microarray results were validated by quantitative PCR on a second and independent group (7PAH, 9CF, and 11HC). Twelve pre-transplant COPD patients were added to validate the common signature shared by patients with CRD for all causes. To further clarify a role for hypoxia in the candidate gene dysregulation, peripheral blood mononuclear cells from HC were analysed for their mRNA profile under hypoxia. Results Unsupervised hierarchical clustering allowed the identification of 3 gene signatures related to CRD. One was common to CF and PAH, another specific to CF, and the final one was specific to PAH. With the common signature, we validated T-Cell Factor 7 (TCF-7) and Interleukin 7 Receptor (IL-7R), two genes related to T lymphocyte activation, as being under-expressed. We showed a strong impact of the hypoxia on modulation of TCF-7 and IL-7R expression in PBMCs from HC under hypoxia or PBMCs from CRD. In addition, we identified and validated genes upregulated in PAH or CF, including Lectin Galactoside-binding Soluble 3 and Toll Like Receptor 4, respectively. Conclusions Systematic analysis of blood cell transcriptome in CRD patients identified common and specific signatures relevant to the systemic pathologies. TCF-7 and IL-7R were downregulated whatever the cause of CRD and this could play a role in the higher susceptibility to infection of these patients. PMID:25329529

  17. The Effect of Treatment of Anemia with Blood Transfusion on Delirium: A Systematic Review.

    Science.gov (United States)

    van der Zanden, Vera; Beishuizen, Sara J; Swart, Lieke M; de Rooij, Sophia E; van Munster, Barbara C

    2017-04-01

    Treating the precipitating factors of delirium is the mainstay of the prevention and treatment of delirium. We aim to investigate the role of anemia and blood transfusion within the multicomponent prevention and treatment strategy of delirium. Systematic review. We included cohort studies or Randomized Controlled Trials (RCTs) that considered blood transfusion as treatment for delirium or risk factor, and had delirium as outcome. Hospitalized patients above 55 years old. We searched MEDLINE from 1946 through November 2014. Quality assessment and data extraction were performed systematically. We included 23 studies (n = 29,471). The majority of the studies (n = 22) had a limited quality and for one study quality was uncertain. Two studies evaluated the association between transfusion strategy and postoperative delirium and found no association. Twenty-one studies investigated blood transfusion as a risk factor for delirium. In four of the 21 studies it could be assumed that delirium occurred after transfusion. One of these studies stated that transfusion was a significant risk factor for subsequent delirium (odds ratio (OR) = 3.68, 95% confidence interval (CI) = 1.32-10.94). The other three studies found no association between transfusion and delirium. In the remaining 17 studies, it was not clear whether delirium occurred before or after transfusion, so no conclusion could be drawn on the role of transfusion in delirium development. The majority of the included studies was not suited to answer the research question properly as the time course of the beginning of delirium as to transfusion was lacking. Our review shows that there is no good quality evidence available for blood transfusion to be a risk factor for delirium or to be a preventive or treatment option. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. Effect of Aerobic Exercise Training on Blood Pressure in Indians: Systematic Review

    Directory of Open Access Journals (Sweden)

    Sonu Punia

    2016-01-01

    Full Text Available Introduction. High blood pressure (BP is one of the most important modifiable risk factors for cardiovascular diseases, which accounts for one in every eight deaths worldwide. It has been predicted that, by 2020, there would be 111% increase in cardiovascular deaths in India. Aerobic exercise in the form of brisk walking, jogging, running, and cycling would result in reduction in BP. Many meta-analytical studies from western world confirm this. However, there is no such review from Indian subcontinent. Objective. Our objective is to systematically review and report the articles from India in aerobic exercise on blood pressure. Methodology. Study was done in March 2016 in Google Scholar using search terms “Aerobic exercise” AND “Training” AND “Blood pressure” AND “India.” This search produced 3210 titles. Results. 24 articles were identified for this review based on inclusion and exclusion criteria. Total of 1107 subjects participated with median of 25 subjects. Studies vary in duration from +3 weeks to 12 months with each session lasting 15–60 minutes and frequency varies from 3 to 8 times/week. The results suggest that there was mean reduction of −05.00 mmHg in SBP and −03.09 mmHg in DBP after aerobic training. Conclusion. Aerobic training reduces the blood pressure in Indians.

  19. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of a health claim related to Vitis vinifera L. seeds extract and maintenance of normal venous blood flow pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    Following an application from Nutrilinks Sarl, submitted pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Belgium, the Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health cla...... and maintenance of normal venous blood flow. © European Food Safety Authority, 2012...... related to Vitis vinifera L. seeds extract and maintenance of normal venous blood flow. The Panel considers that the food constituent, which is the subject of the health claim, is sufficiently characterised. The claimed effect, maintenance of normal venous blood flow, is a beneficial physiological effect....... The applicant identified two human intervention studies as pertinent to the health claim. Owing to the very limited information provided in relation to one study, and that the second study was conducted with a food not complying with the characterisation of the food which is the subject of the health claim...

  20. Comparison of venous and capillary differential leukocyte counts using a standard hematology analyzer and a novel microfluidic impedance cytometer.

    Directory of Open Access Journals (Sweden)

    Veronica S Hollis

    Full Text Available Capillary blood sampling has been identified as a potentially suitable technique for use in diagnostic testing of the full blood count (FBC at the point-of-care (POC, for which a recent need has been highlighted. In this study we assess the accuracy of capillary blood counts and evaluate the potential of a miniaturized cytometer developed for POC testing. Differential leukocyte counts in the normal clinical range from fingerprick (capillary and venous blood samples were measured and compared using a standard hematology analyzer. The accuracy of our novel microfluidic impedance cytometer (MIC was then tested by comparing same-site measurements to those obtained with the standard analyzer. The concordance between measurements of fingerprick and venous blood samples using the standard hematology analyzer was high, with no clinically relevant differences observed between the mean differential leukocyte counts. Concordance data between the MIC and the standard analyzer on same-site measurements presented significantly lower leukocyte counts determined by the MIC. This systematic undercount was consistent across the measured (normal concentration range, suggesting that an internal correction factor could be applied. Differential leukocyte counts obtained from fingerprick samples accurately reflect those from venous blood, which confirms the potential of capillary blood sampling for POC testing of the FBC. Furthermore, the MIC device demonstrated here presents a realistic technology for the future development of FBC and related tests for use at the site of patient care.

  1. A Systematic Review and Meta-Analysis of the Clinical Appropriateness of Blood Transfusion in China.

    Science.gov (United States)

    Zhu, Changtai; Gao, Yulu; Li, Zhiqiang; Li, Qinyun; Gao, Zongshuai; Liao, Yanqiu; Deng, Zhifeng

    2015-12-01

    The issue of the clinical appropriateness of blood transfusion has become a focus of transfusion medicine worldwide. In China, irrational uses of blood have often been reported in recent years. However, to date there lacks a systematic review of the rational uses of blood. This study aimed to determine the clinical appropriateness of blood transfusion in China. We searched PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, WanFang Database, and Chinese BioMedical Literature Database, and the retrieval cut-off date was June 31, 2015. SPSS 17.0 and MetaAnalyst 3.13 were employed as the statistics tools in this review. A pooled rate of clinical inappropriateness of transfusion was analyzed by DerSimonian-Laird method. In this study, a total of 39 observational studies were included, which related to 75,132 cases of blood transfusion. According to the meta-analysis results, the overall incidence of clinical inappropriateness of transfusion in China was estimated to be 37.3% (95% confidence interval [CI] [32.1, 42.8]). The subgroup analyses revealed that the pooled rates of clinical inappropriateness of transfusion of plasma, red blood cells (RBCs), cryoprecipitate, and platelets were 56.3% (95% CI [45.8, 66.2]), 30.9% (95% CI [27.1, 35.0]), 25.2% (95% CI [13.2, 42.7]), and 14.1% (95% CI [8.8, 21.9]), respectively. However, the pooled incidence of inappropriateness of transfusion in operative departments was 47.5% (95% CI [36.8, 58.3]), which was significantly higher than that in nonoperative departments, 25.8% (95% CI [18.7, 34.4], P  0.05). In conclusion, China has suffered from a disadvantage in the clinical appropriateness of blood transfusion, especially in plasma and RBC use. In future, comprehensive measures should be implemented in order to improve the clinical appropriateness of blood transfusion.

  2. Systematic review and meta-analysis of circulating S100B blood levels in schizophrenia.

    Directory of Open Access Journals (Sweden)

    Katina Aleksovska

    Full Text Available S100B is a calcium-binding protein secreted in central nervous system from astrocytes and other glia cells. High blood S100B levels have been linked to brain damage and psychiatric disorders. S100B levels have been reported to be higher in schizophrenics than healthy controls. To quantify the relationship between S100B blood levels and schizophrenia a systematic literature review of case-control studies published on this topic within July 3rd 2014 was carried out using three bibliographic databases: Medline, Scopus and Web of Science. Studies reporting mean and standard deviation of S100B blood levels both in cases and controls were included in the meta-analysis. The meta-Mean Ratio (mMR of S100B blood levels in cases compared to controls was used as a measure of effect along with its 95% Confidence Intervals (CI. 20 studies were included totaling for 994 cases and 785 controls. Schizophrenia patients showed 76% higher S100B blood levels than controls with mMR = 1.76 95% CI: 1.44-2.15. No difference could be found between drug-free patients with mMR = 1.84 95%CI: 1.24-2.74 and patients on antipsychotic medication with mMR = 1.75 95% CI: 1.41-2.16. Similarly, ethnicity and stage of disease didn't affect results. Although S100B could be regarded as a possible biomarker of schizophrenia, limitations should be accounted when interpreting results, especially because of the high heterogeneity that remained >70%, even after carrying out subgroups analyses. These results point out that approaches based on traditional categorical diagnoses may be too restrictive and new approaches based on the characterization of new complex phenotypes should be considered.

  3. The effect of Metronidazole on reducing blood lipids: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Behzad Jafarinia

    2016-04-01

    Full Text Available Background: Many studies have reported the effect of metronidazole on reducing blood lipids in different ways, but there is no comprehensive estimation about its effect. Therefore, this study aimed to determine the effect of metronidazole on reducing blood lipid by meta-analysis method. Methods: This is a systematic review based on the reliable local and international websites including SID, Magiran, Iranmedex, ISI, Pubmed and Scopus. The keywords used for searching were metronidazole, blood lipid, cholesterol, triglyceride, low density lipoprotein (LDL and height density lipoprotein (HDL. All articles published until the end of March, 2015, about the effect of metronidazole on blood lipids reduction which met the inclusion criteria were reviewed. Three independent reviewers checked studies for quality and eligibility and finally extracted the data. The collected data were analyzed by meta-analysis method (random effects model and by means of Stata, ver. 11.1 (College Station, TX, USA with a significance level of less than 5%. Results: In 10 researches, 292 people had been studied and after taking metronidazole, the calculated amount of reduction in blood lipids was 11% (95% CI: 6%-16% for cholesterol, 14% (95% CI: 4%-24% for triglyceride and 8% (95% CI: 1%-15% for low density lipoprotein (LDL which was statistically significant (P= 0.001. The amount of increase in high density lipoprotein (HDL was also calculated to be 1% (95% CI: 1%-2% which was not statistically significant (P= 0.08. Conclusion: The results of this study showed that, using metronidazole leads to decrease in the amount of cholesterol, triglyceride and low density lipoprotein (LDL but it seems that it has not any effect on the increase in high density lipoprotein (HDL.

  4. Blood-borne biomarkers of mortality risk: systematic review of cohort studies.

    Directory of Open Access Journals (Sweden)

    Evelyn Barron

    Full Text Available Lifespan and the proportion of older people in the population are increasing, with far reaching consequences for the social, political and economic landscape. Unless accompanied by an increase in health span, increases in age-related diseases will increase the burden on health care resources. Intervention studies to enhance healthy ageing need appropriate outcome measures, such as blood-borne biomarkers, which are easily obtainable, cost-effective, and widely accepted. To date there have been no systematic reviews of blood-borne biomarkers of mortality.To conduct a systematic review to identify available blood-borne biomarkers of mortality that can be used to predict healthy ageing post-retirement.Four databases (Medline, Embase, Scopus, Web of Science were searched. We included prospective cohort studies with a minimum of two years follow up and data available for participants with a mean age of 50 to 75 years at baseline.From a total of 11,555 studies identified in initial searches, 23 fulfilled the inclusion criteria. Fifty-one blood borne biomarkers potentially predictive of mortality risk were identified. In total, 20 biomarkers were associated with mortality risk. Meta-analyses of mortality risk showed significant associations with C-reactive protein (Hazard ratios for all-cause mortality 1.42, p<0.001; Cancer-mortality 1.62, p<0.009; CVD-mortality 1.31, p = 0.033, N Terminal-pro brain natriuretic peptide (Hazard ratios for all-cause mortality 1.43, p<0.001; CHD-mortality 1.58, p<0.001; CVD-mortality 1.67, p<0.001 and white blood cell count (Hazard ratios for all-cause mortality 1.36, p = 0.001. There was also evidence that brain natriuretic peptide, cholesterol fractions, erythrocyte sedimentation rate, fibrinogen, granulocytes, homocysteine, intercellular adhesion molecule-1, neutrophils, osteoprotegerin, procollagen type III aminoterminal peptide, serum uric acid, soluble urokinase plasminogen activator receptor, tissue inhibitor of

  5. Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study Hemoglobina medida por Hemocue y por un método de referencia en sangre venosa y capilar: estudio de validación

    Directory of Open Access Journals (Sweden)

    Lynnette Neufeld

    2002-06-01

    Full Text Available Objective. To assess the comparability of hemoglobin concentration (Hb in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn and to document the influence of type of blood (capillary or venous and analysis method on anemia prevalence estimates. Material and Methods. Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Children's Hospital in Cuernavaca, Morelos, Mexico, and assessed for Hb using the Hemocue and Celldyn methods. Estimated Hb levels were compared using the concordance correlation coefficient and Student's t test for paired data. The sensitivity and specificity for anemia diagnosis were estimated and compared between type of blood and method of assessment. Results. Capillary blood had higher Hb (+0.5g/dl than venous blood in adults and children, as did samples assessed by Celldyn compared to Hemocue (+0.3g/dl. Specificity to detect anemia was adequate (>0.90 but sensitivity was low for capillary blood assessed by Hemocue (Objetivo. Evaluar la comparabilidad de la concentración de hemoglobina (Hb en sangre venosa y capilar medida por Hemocue y por espectrofotómetro automatizado (Celldyn, así como documentar la influencia del tipo de sangre (capilar o venosa y del método de análisis sobre la prevalencia de anemia. Material y métodos. De febrero a mayo de 2000, se recolectaron muestras de sangre capilar y venosa en 72 adultos y niños en el Hospital del Niño Morelense, Cuernavaca, Morelos, México. Se determinaron los niveles de Hb con los métodos Hemocue y Celldyn. Las cifras de Hb estimadas se compararon con el coeficiente de concordancia y la prueba pareada de t de Student. También se comparó la sensibilidad y especificidad para el diagnóstico de anemia, utilizando sangre de los dos tipos y métodos de análisis. Resultados. La Hb fue mayor en sangre capilar comparada con sangre venosa

  6. Oscillometric and auscultatory blood pressure measurement methods in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Duncombe, Stephanie L; Voss, Christine; Harris, Kevin C

    2017-02-01

    The phase-out of mercury from clinical settings calls for valid alternatives to assess blood pressure (BP) in children. Aneroid devices provide a mercury-free alternative to BP measurements by auscultation, whereas oscillometric (automated) devices are increasingly becoming the norm in clinical practice due to their ease of use. The aim of this systematic review and meta-analysis was to investigate the accuracy of oscillometric and aneroid BP devices compared with the mercury sphygmomanometer for the measurement of BP in children. We systematically searched four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) and relevant journals for eligible articles published before 30 July 2015. We screened 1415 articles, and two authors independently reviewed 92 full-text articles. We included 29 articles (38 studies) with 26 879 children. Random-effects model meta-analyses revealed that oscillometric devices yield higher measurements of SBP than auscultation with a mercury sphygmomanometer (pooled effect estimate 2.53 mmHg; 95% CI 0.57-4.50; P devices and found comparable results. Oscillometric devices may serve as a suitable alternative to auscultation for initial BP screening in the pediatric population.

  7. Diagnosis of venous disorders

    International Nuclear Information System (INIS)

    Minar, E.

    1993-01-01

    Limited accuracy in the clinic diagnosis of deep vein thrombosis (VT) makes such diagnostic tests such as duplex sonography or venography necessary. Exact information on the age and extent of the thrombus are necessary for the clinician to optimize the therapeutric management. The correct diagnosis of calf vein thrombosis and of recurrent VT in patients with postphlebitis changes also has implications for treatment. After exclusion of thrombosis, the radiologist should evaluate the leg for other possible causes of symptoms besides VT. Investigation of the venous sytem also has a role in the diagnosis in patients with suspected pulmonary embolism. In patients with chronic venous insuffficiency the deep venous system should assessed for patency and venous valve function. The superficial veins should be differentiated in segments with sufficient or insufficient venous valves, and it is also necessary to look for insufficiency of the perforrating veins. In patients with superficial phlebitis there is risk of propagation into the deep venous system. (orig.) [de

  8. Blood pressure lowering efficacy of renin inhibitors for primary hypertension: a Cochrane systematic review.

    Science.gov (United States)

    Musini, V M; Fortin, P M; Bassett, K; Wright, J M

    2009-08-01

    We conducted a systematic review and meta-analysis of double-blind randomized controlled trials to quantify the dose-related systolic (SBP) and diastolic blood pressure (DBP) lowering efficacy of renin inhibitors vs placebo in the treatment of adults with primary hypertension. Databases searched were Medline (1966-March 2008), EMBASE (1988-March 2008) and Cochrane Central Register of Controlled Trials (CENTRAL). Six trials in 3694 patients met the inclusion criteria. All examined aliskiren, the only renin inhibitor licensed for marketing in Canada and the United States. Aliskiren caused a dose-related SBP/DBP lowering effect compared to placebo: weighted mean difference with 95% CI: aliskiren 75 mg, -2.9 (-4.6, -1.3)/-2.3 (-3.3, -1.3) mm Hg; aliskiren 150 mg, -5.5 (-6.5, -4.4)/-3.0 (-3.7, -2.3) mm Hg; aliskiren 300 mg, -8.7 (-9.7,-7.6)/-5.0 (-5.6, -4.3) and aliskiren 600 mg, -11.4 (-13.5, -9.2)/-6.6 (-7.9, -5.2) mm Hg. Aliskiren 300 mg significantly lowered both SBP -3.0 (-4.0, -2.0) and DBP -1.7 (-2.3, -1.0) as compared to aliskiren 150 mg. Aliskiren has no effect on blood pressure variability. No data were available to assess the effect of aliskiren on heart rate or pulse pressure. This review found weak evidence that during 4- to 8-week use, aliskiren did not increase withdrawals due to adverse effects as compared to placebo. We concluded that aliskiren has a dose-related blood pressure lowering effect better than placebo and magnitude of effect is similar to that determined for angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.

  9. Patients' and health care professionals' perceptions of blood transfusion: a systematic review.

    Science.gov (United States)

    Abdul-Aziz, Brittannia; Lorencatto, Fabiana; Stanworth, Simon J; Francis, Jill J

    2018-02-01

    Blood transfusions are frequently prescribed for acute and chronic conditions; however, the extent to which patients' and health care professionals' (HCPs') perceptions of transfusion have been investigated is unclear. Patients' treatment perceptions influence how patients cope with illnesses or symptoms. HCPs' perceptions may influence treatment decision making. This was a systematic review of studies post-1984 reporting adult patients' and HCPs' perceptions of blood transfusion. Seven databases were searched using a three-domain search strategy capturing synonyms relating to: 1) blood transfusion, 2) perceptions, and 3) participant group (patients or HCPs). Study and sample characteristics were extracted and narratively summarized. Reported perceptions were extracted and synthesized using inductive qualitative methods to identify key themes. Thirty-two studies were included: 14 investigated patients' perceptions and 18 HCPs' perceptions. Surgical patients were the highest represented patient group. HCPs were from a wide range of professions. Transfusions were perceived by patients and HCPs as being of low-to-moderate risk. Risk and negative emotions were perceived to influence preference for alternatives. Five themes emerged from the synthesis, classified as Safety/risk, Negative emotions, Alternatives (e.g., autologous, monitoring), Health benefits, and Decision making. "Safety/risk" and "Negative emotions" were most frequently investigated over time, yet periods of research inactivity are apparent. The literature has identified themes on how transfusions are perceived by patients and HCPs, which overlap with recognized discussion points for transfusion specialists. These themes may help HCPs when educating patients about transfusion or consenting patients. Theory-based qualitative methods may add an important dimension to this work. © 2017 AABB.

  10. Systematic instrumental errors between oxygen saturation analysers in fetal blood during deep hypoxemia.

    Science.gov (United States)

    Porath, M; Sinha, P; Dudenhausen, J W; Luttkus, A K

    2001-05-01

    During a study of artificially produced deep hypoxemia in fetal cord blood, systematic errors of three different oxygen saturation analysers were evaluated against a reference CO oximeter. The oxygen tensions (PO2) of 83 pre-heparinized fetal blood samples from umbilical veins were reduced by tonometry to 1.3 kPa (10 mm Hg) and 2.7 kPa (20 mm Hg). The oxygen saturation (SO2) was determined (n=1328) on a reference CO oximeter (ABL625, Radiometer Copenhagen) and on three tested instruments (two CO oximeters: Chiron865, Bayer Diagnostics; ABL700, Radiometer Copenhagen, and a portable blood gas analyser, i-STAT, Abbott). The CO oximeters measure the oxyhemoglobin and the reduced hemoglobin fractions by absorption spectrophotometry. The i-STAT system calculates the oxygen saturation from the measured pH, PO2, and PCO2. The measurements were performed in duplicate. Statistical evaluation focused on the differences between duplicate measurements and on systematic instrumental errors in oxygen saturation analysis compared to the reference CO oximeter. After tonometry, the median saturation dropped to 32.9% at a PO2=2.7 kPa (20 mm Hg), defined as saturation range 1, and to 10% SO2 at a PO2=1.3 kPa (10 mm Hg), defined as range 2. With decreasing SO2, all devices showed an increased difference between duplicate measurements. ABL625 and ABL700 showed the closest agreement between instruments (0.25% SO2 bias at saturation range 1 and -0.33% SO2 bias at saturation range 2). Chiron865 indicated higher saturation values than ABL 625 (3.07% SO2 bias at saturation range 1 and 2.28% SO2 bias at saturation range 2). Calculated saturation values (i-STAT) were more than 30% lower than the measured values of ABL625. The disagreement among CO oximeters was small but increasing under deep hypoxemia. Calculation found unacceptably low saturation.

  11. Central venous oxygen saturation during hypovolaemic shock in humans

    DEFF Research Database (Denmark)

    Madsen, P; Iversen, H; Secher, N H

    1993-01-01

    We compared central venous oxygen saturation and central venous pressure (CVP) as indices of the effective blood volume during 50 degrees head-up tilt (anti-Trendelenburg's position) induced hypovolaemic shock in eight healthy subjects. Head-up tilt increased thoracic electrical impedance from 31...

  12. Effect of cheese consumption on blood lipids: a systematic review and meta-analysisi of randomized controlled trials

    NARCIS (Netherlands)

    Goede, de J.; Geleijnse, J.M.; Ding, E.L.; Soedamah-Muthu, S.S.

    2015-01-01

    Context: Cheese may affect lipids and lipoproteins differently than other high-fat dairy foods. Objective: The present systematic review and meta-analysis was performed to evaluate randomized controlled trials that examined the effect of cheese consumption compared with another food product on blood

  13. The Essentials of Parathyroid Hormone Venous Sampling

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [NYU Langone Medical Center, Department of Radiology, NYU School of Medicine (United States); Trerotola, Scott O., E-mail: streroto@uphs.upenn.edu [Perelman School of Medicine of the University of Pennsylvania, Department of Radiology (United States); Sacks, Barry, E-mail: bsacks@bidmc.harvard.edu [Beth Israel Deaconess Medical Center, Department of Interventional Radiology (United States); Oklu, Rahmi, E-mail: oklu.rahmi@mayo.edu [Mayo Clinic, Department of Interventional Radiology (United States); Deipolyi, Amy, E-mail: deipolya@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States)

    2017-01-15

    Hyperparathyroidism is an excess of parathyroid hormone in the blood due to over-activity of one or more parathyroid gland. Localization of abnormal glands with noninvasive imaging modalities, such as technetium sestamibi scan and cross-sectional imaging, has a high success rate. Parathyroid venous sampling is performed for patients with persistent or recurrent disease after previous parathyroid surgery, when repeat noninvasive imaging studies are negative or discordant. The success of invasive localization studies and results interpretation is dependent on the interventional radiologist’s understanding of the normal and ectopic anatomic locations of parathyroid glands, as well as their blood supply and venous drainage. Anatomic and technical considerations for selective parathyroid venous sampling are reviewed.

  14. Mortality outcomes in trauma patients undergoing prehospital red blood cell transfusion: a systematic literature review.

    Science.gov (United States)

    Huang, Gregory S; Dunham, C Michael

    2017-01-01

    The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. Eligible studies were combined for meta-analysis when tests for heterogeneity were insignificant. The synthesized mortality was 35.6% for systolic blood pressure ≤ 90 mmHg; 51.1% for ≤ 80 mmHg; and 63.9% for ≤ 70 mmHg. For patients with either hypotension or emergency trauma center transfused RBCs, the synthesized Injury Severity Score (ISS) was 27.0 and mortality was 36.2%; the ISS and mortality correlation was r = 0.766 ( P = 0.0096). For civilian patients receiving prehospital RBC transfusions, the synthesized ISS was 27.5 and mortality was 39.5%. One civilian study suggested a decrement in mortality with prehospital RBC transfusion; however, patient recruitment was only one per center per year and mortality was undergoing prehospital RBC transfusion and a matched control subset showed that the synthesized mortality was similar for those transfused (37.5%) and not transfused (38.7%; P = 0.8933). A study of civilian helicopter patients demonstrated a similar 30-day mortality for those with and without prehospital blood product availability (22% versus 21%; P = 0.626). Mortality in a study of matched military patients was better for those receiving prehospital blood or plasma (8%) than the controls (20%; P = 0.013). However, transfused patients had a shorter prehospital time, more advanced airway procedures, and higher hospital RBC transfusion ( P 16 showed similar mortality with and without prehospital RBC availability (27.6% versus 32.0%; P = 0.343). Trauma patient mortality increases with the magnitude of hemodynamic instability and anatomic injury. Some literature evidence indicates no survival advantage with prehospital RBC

  15. Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion

    OpenAIRE

    Nkohkwo, Asa?ah; Agbor, Gabriel; Asongalem, Emmanuel; Tagny, Claude; Asonganyi, Tazoacha

    2016-01-01

    Background: Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. Objective: This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. Method: The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinic...

  16. ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis.

    Science.gov (United States)

    Chen, Zhuo; Yang, Sheng-Hua; Xu, Hao; Li, Jian-Jun

    2016-03-18

    ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship between ABO blood group and coronary artery disease (CAD) is still controversial. We here performed an updated meta-analysis of the related studies and tried to elucidate the potential role of ABO blood group as a risk factor for CAD. All detectable case-control and cohort studies comparing the risk of CAD in different ABO blood groups were collected for this analysis through searching PubMed, Embase, and the Cochrane Library. Ultimately, 17 studies covering 225,810 participants were included. The combined results showed that the risk of CAD was significantly higher in blood group A (OR = 1.14, 95% CI = 1.03 to 1.26, p = 0.01) and lower in blood group O (OR = 0.85, 95% CI = 0.78 to 0.94, p = 0.0008). Even when studies merely about myocardial infarction (MI) were removed, the risk of CAD was still significantly higher in blood group A (OR = 1.05, 95% CI = 1.00 to 1.10, p = 0.03) and lower in blood group O (OR = 0.89, 95% CI = 0.85 to 0.93, p < 0.00001). This updated systematic review and meta-analysis indicated that both blood group A and non-O were the risk factors of CAD.

  17. Chronic venous disorders

    African Journals Online (AJOL)

    engage in social and occupational activities, reduce QoL, and impose financial constraints. CVD has a significant financial ... 'heaviness or aching' aggravated by prolonged standing and relieved by elevation. Additionally, chronic .... of image acquisition based on venous filling. Abnormalities in venous flow are depicted.

  18. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Qiong; Li, Changchang; Guo, Yanfang; Barnett, Adrian G; Tong, Shilu; Phung, Dung; Chu, Cordia; Dear, Keith; Wang, Xuemei; Huang, Cunrui

    2017-01-01

    Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research. We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1°C reduction in temperature were pooled using a random-effects meta-analysis. Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1°C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26mmHg (95% CI: 0.18-0.33) and 0.13 (95% CI: 0.11-0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1°C decrease in indoor temperature was associated with 0.38mmHg (0.18-0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved. Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted. Copyright © 2016 Elsevier B

  19. High Blood Pressure Combined with Sedentary Behavior in Young People: A Systematic Review.

    Science.gov (United States)

    Silveira, Loreana Sanches; Inoue, Daniela Sayuri; Rodrigues da Silva, Jose Messias; Cayres, Suziane Ungari; Christofaro, Diego Giulliano Destro

    2016-01-01

    High blood pressure (HBP) is a cardiovascular risk factor that can initiate in childhood and adolescence and may be associated with other risk factors such as sedentary lifestyles. Therefore, verifying if these associations occur from the earliest ages is of fundamental importance. to report the prevalence of HBP combined with sedentary behavior through a systematic review. The research was performed based on studies published between 2010 and 2016 in Medline, Web of Science, Excerpta Medica (EMBASE), and Scielo, using terms related to: 'sedentary behavior' OR 'screen time' AND 'high blood pressure'. In the initial search, 821 studies were found and after exclusions twelve studies were included in the review. Twelve studies addressing the relationship between sedentary behavior and HBP were found. Eighty-three percent of the studies evaluated sedentary behavior using a questionnaire (n = 10). The majority of studies analyzed in the review were conducted in North America (41.6%). Only four studies presented the prevalence of HBP related to sedentary behavior (variation 1-22.9%). In seven studies a close relationship between sedentary behavior and HBP was observed. Although most studies observed a relationship between sedentary behavior and HBP, the results still need to be further explained. Based on the findings of this review, follow-up studies and objective measurements of time spent in sedentary behavior in young people could help to determine the cause-effect relationship between sedentary behavior and HBP in pediatric populations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Efficiency and safety of tranexamic acid in reducing blood loss in total shoulder arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Sun, Chuan-Xiu; Zhang, Lu; Mi, Li-Dong; Du, Guang-Yu; Sun, Xue-Gang; He, Sheng-Wei

    2017-06-01

    This meta-analysis aimed to evaluate the efficiency and safety of tranexamic acid for reducing blood loss and transfusion requirements in patients undergoing total shoulder arthroplasty. A systematic search was performed in Embase (1980-2017.04, embase.com), Medline (1966-2017.04, medline.com), PubMed (1966-2017.04, pubmed.com), ScienceDirect (1985-2017.04, sciencedirect.com), and Web of Science (1950-2017.04, webofknowledge.com). Study which assessed the efficiency and safety of tranexamic acid in total shoulder arthroplasty was selected. Meta-analysis was performed using Stata 11.0 software. In all, 484 patients from 2 randomized controlled trials (RCTs) and 2 non-RCTs were subjected to meta-analysis. The present meta-analysis demonstrated that there was less total blood loss (mean difference [MD] -172.16, 95% confidence interval [CI] -35.46 to -308.87, P = .01, d = 0.33) and transfusion rate (odds ratio 0.34, 95% CI 0.13 to 0.91, P = .03, d = 0.29) in tranexamic acid groups compared with the control groups. There were no significant differences in duration of surgery (MD 0.02, 95% CI -0.12 to 0.22, P = .89, d = 0.19), length of stay (MD -0.06, 95% CI -0.26 to 0.14, P = .56, d = 0.20), or incidence of adverse effects such as deep venous thrombosis (odds ratio 1.15, 95% CI 0.33 to 4.00, P = .83, d = 0.53). Clinical application of tranexamic acid seemed to result in significant reductions in total blood loss, hemoglobin decline and transfusion requirements following total shoulder arthroplasty. Moreover, no increased risk of the thrombotic events was identified. Due to the limited quality of the evidence currently available, higher quality RCTs are required.

  1. Thermodilution-determined Internal Jugular Venous Flow

    DEFF Research Database (Denmark)

    Rasmussen, Peter; Widmer, Mario; Hilty, Matthias P

    2017-01-01

    PURPOSE: Cerebral blood flow (CBF) increases ~20% during whole body exercise although a Kety-Schmidt-determined CBF is reported to remain stable; a discrepancy that could reflect evaluation of arterial vs. internal jugular venous (IJV) flow and/or that CBF is influenced by posture. Here we test...

  2. Comprehensive Interpretation of Central Venous Oxygen Saturation and Blood Lactate Levels During Resuscitation of Patients With Severe Sepsis and Septic Shock in the Emergency Department.

    Science.gov (United States)

    Shin, Tae Gun; Jo, Ik Joon; Hwang, Sung Yeon; Jeon, Kyeongman; Suh, Gee Young; Choe, Euna; Lee, Young Kun; Lee, Tae Rim; Cha, Won Chul; Sim, Min Seob

    2016-01-01

    We evaluated central venous oxygen saturation (Scvo2) and lactate levels as a combination measure to predict mortality in patients with severe sepsis or septic shock. We included patients older than 18 years of age who presented to a single tertiary emergency center with septic shock or severe sepsis and received early goal-directed therapy. We classified the sample into four groups according to lactate (cut-off: 4 mmol/L) and Scvo2 (cut-off: 70%) levels at the time of initial resuscitation: Group 1, high-Scvo2, and low-lactate; Group 2, low-Scvo2, and low-lactate; Group 3, high-Scvo2, and high-lactate; Group 4, low-Scvo2, and high-lactate. The primary outcome was 28-day mortality determined by multivariable Cox-regression analysis. A total of 880 patients were included in this study. The 28-day mortality was 6.7% in Group 1, 15.7% in Group 2, 26.7% in Group 3, and 25.5% in Group 4 (P septic shock. Associations between Scvo2 ≥70% and 28-day survival were observed only in patients without severe lactic acidosis.

  3. Systematic Review of Chinese Traditional Exercise Baduanjin Modulating the Blood Lipid Metabolism

    Directory of Open Access Journals (Sweden)

    Lijuan Mei

    2012-01-01

    Full Text Available Background. Baduanjin exercise is considered to be beneficial to modulate the blood lipid metabolism. The purpose of the systematic review was to assess the potential efficacy and safety of Baduanjin exercise. Methods. MEDLINE, EMBASE, CBM, CNKI, VIP, Chinese Important Conference Papers Database, and Chinese Dissertation Database were searched for all prospective-controlled trials of Baduanjin exercise from their inception to December 31, 2011. Results. A total of 14 studies were included. Comparing with no treatment, Baduanjin exercise significantly reduced the levels of TC, TG, LDL-C in plasma, and elevated plasma HDL-C level for healthy participants, and the pooled MD (95% confidence interval, CI was −0.58 mmol/L (−0.86, −0.30 mmol/L, −0.22 mmol/L (−0.31, −0.13 mmol/L, −0.35 mmol/L (−0.54, −0.17 mmol/L, 0.13 mmol/L (0.06, 0.21 mmol/L, respectively. Baduanjin exercise also obviously decreased the levels of TG, LDL-C in plasma comparing with no treatment for patients, and the pooled MD (95% CI was −0.30 mmol/L (−0.40, −0.19 mmol/L, −0.38 mmol/L (−0.63, −0.13 mmol/L, but there was not obvious to decrease plasma TC level or elevate plasma HDL-C level in patients with the pooled MD (95%CI, −0.39 mmol/L (−1.09, 0.31 mmol/L and 0.22 mmol/L (−0.11, 0.55 mmol/L, respectively. In addition, the obvious advantage was not observed to modulate the blood lipid metabolism in comparing Baduanjin exercise with other exercises, regardless for health participants or patients. Conclusion. Studies indicated that Baduanjin exercise could significantly decrease the levels of TC, TG, LDL-C levels in plasma and elevate plasma HDL-C level for the healthy people. It also was helpful that Baduanjin exercise modulated the blood lipid metabolism for patients. Moreover, the Baduanjin exercise did not have an obvious advantage on modulating the lipid metabolism comparing with other exercises. But the

  4. [Blood pressure and its association with physical activity and obesity in adolescents: a systematic review].

    Science.gov (United States)

    Corrêa Neto, Victor Gonçalves; Palma, Alexandre

    2014-03-01

    In the light of the importance of the impacts that obesity and physical activity may have on blood pressure (BP) among adolescents, and the suggestion that abnormal pressure levels at young ages are maintained into more mature stages of these individuals' lives, the scope of this study is to conduct a systematic review of the associations between obesity and BP and between physical activity and BP among adolescents. The PubMed database was consulted to search for scientific articles relating to this topic and, after applying the appropriate inclusion and exclusion criteria, 30 articles were selected and analyzed. To assess the quality of articles Strengthening the Reporting of Observational Studies in Epidemiology was applied. The results suggest that despite the existence of hegemonic thinking to guide these relationships, BP and physical activity do not always have negative associations, and BP and obesity do not always have positive associations. The conclusion reached is that this situation illustrates the need for more in-depth reflection on these relationships before pre-established paradigms are passively accepted.

  5. Accuracy of Blood Pressure Measurement Devices in Pregnancy: A Systematic Review of Validation Studies.

    Science.gov (United States)

    Bello, Natalie A; Woolley, Jonathan J; Cleary, Kirsten Lawrence; Falzon, Louise; Alpert, Bruce S; Oparil, Suzanne; Cutter, Gary; Wapner, Ronald; Muntner, Paul; Tita, Alan T; Shimbo, Daichi

    2018-02-01

    The accurate measurement of blood pressure (BP) in pregnancy is essential to guide medical decision making that affects both mother and fetus. The aim of this systematic review was to determine the accuracy of ambulatory, home, and clinic BP measurement devices in pregnant women. We searched Ovid MEDLINE, The Cochrane Library, EMBASE, CINAHL EBSCO, ClinicalTrials.gov, International Clinical Trials Registry Platform, and dabl from inception through August 3, 2017 for articles that assessed the validity of an upper arm BP measurement device against a mercury sphygmomanometer in pregnant women. Two independent investigators determined eligibility, extracted data, and adjudicated protocol violations. From 1798 potential articles identified, 41, that assessed 28 devices, met the inclusion criteria. Most articles (n=32) followed a standard or modified American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization, British Hypertension Society, or European Society of Hypertension validation protocol. Several articles described the results of validation studies performed on >1 device (n=7) or in >1 population of pregnant women (n=12), comprising 64 pairwise validity assessments. The device was validated in 61% (32 of 52) of studies which used a standard or modified protocol. Only 34% (11 of 32) of the studies wherein the device was successfully validated were performed without a protocol violation. Given the implications of inaccurate BP measurement in pregnant women, healthcare providers should be aware of and try to use the BP measurement devices which have been properly validated in this population. © 2017 American Heart Association, Inc.

  6. The putative effects of D-Aspartic acid on blood testosterone levels: A systematic review

    Directory of Open Access Journals (Sweden)

    Farzad Roshanzamir

    2017-08-01

    Full Text Available Background: D-Aspartic acid (D-Asp is in invertebrate and vertebrate neuroendocrine tissues, where it carries out important physiological functions. Recently, it has been reported that D-Asp is involved in the synthesis and release of testosterone and is assumed can be used as a testosterone booster for infertile men, and by athletes to increase muscle mass and strength. Objective: The aim of this review is to summarize available evidence related to the effects of D-Asp on serum testosterone levels. Materials and Methods: We conducted a systematic review of all type studies, which evaluated the effect of the D-Asp on blood testosterone including published papers until October 2015, using PubMed, ISI Web of Science, ProQuest and Scopus database. Results: With 396 retrieved records, 23 animal studies and 4 human studies were included. In vivo and in vitro animal studies revealed the effect of D-Asp depending on species, sex and organ-specific. Our results showed that exogenous D-Asp enhances testosterone levels in male animal’s studies, whereas studies in human yielded inconsistent results. The evidence for this association in man is still sparse, mostly because of limited number and poor quality studies. Conclusion: There is an urgent need for more and well-designed human clinical trials with larger sample sizes and longer duration to investigate putative effects of D-Asp on testosterone concentrations.

  7. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... known as venous thromboembolism, are highly preventable (see prevention tips below). The U.S. Surgeon General has issued ... blood conditions and increase research on the causes, prevention, and treatment. Blood clots are also potentially dangerous ...

  8. Understanding Blood Pressure Readings

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Understanding Blood Pressure Readings Updated:Feb 19,2018 What do your ... this chart: English | Spanish | Traditional Chinese Enter Your Blood Pressure Systolic mm Hg (upper #) Diastolic mm Hg (lower #) ...

  9. rCBF measurement by one-point venous sampling with the ARG method

    International Nuclear Information System (INIS)

    Yoshida, Nobuhiro; Okamoto, Toshiaki; Takahashi, Hidekado; Hattori, Teruo

    1997-01-01

    We investigated the possibility of using venous blood sampling instead of arterial blood sampling for the current method of ARG (autoradiography) used to determine regional cerebral blood flow (rCBF) on the basis of one session of arterial blood sampling and SPECT. For this purpose, the ratio of the arterial blood radioactivity count to the venous blood radioactivity count, the coefficient of variation, and the correlation and differences between arterial blood-based rCBF and venous blood-based rCBF were analyzed. The coefficient of variation was lowest (4.1%) 20 minutes after injection into the dorsum manus. When the relationship between venous and arterial blood counts was analyzed, arterial blood counts correlated well with venous blood counts collected at the dorsum manus 20 or 30 minutes after intravenous injection and with venous blood counts collected at the wrist 20 minutes after intravenous injection (r=0.97 or higher). The difference from rCBF determined on the basis of arterial blood was smallest (0.7) for rCBF determined on the basis of venous blood collected at the dorsum manus 20 minutes after intravenous injection. (author)

  10. Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion.

    Science.gov (United States)

    Nkohkwo, Asa'ah; Agbor, Gabriel; Asongalem, Emmanuel; Tagny, Claude; Asonganyi, Tazoacha

    2016-01-01

    Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization's Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. Existing literature suggests that combining PRT with current blood safety measures (such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. Following a detailed appraisal of two leading PRT systems, the Mirasol ® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa.

  11. Effects of red blood cell storage time on transfused patients in the ICU-protocol for a systematic review

    DEFF Research Database (Denmark)

    Rygård, S L; Jonsson, A B; Madsen, M B

    2017-01-01

    BACKGROUND: Patients in the intensive care unit (ICU) are often anaemic due to blood loss, impaired red blood cell (RBC) production and increased RBC destruction. In some studies, more than half of the patients were treated with RBC transfusion. During storage, the RBC and the storage medium...... evidence to assess the effects of shorter vs. longer storage time of transfused RBCs for ICU patients. METHODS: We will conduct a systematic review with meta-analyses and trial sequential analyses of randomised clinical trials, and also include results of severe adverse events from large observational...

  12. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis

    OpenAIRE

    Arirachakaran, Alisara; Sukthuayat, Amnat; Sisayanarane, Thaworn; Laoratanavoraphong, Sorawut; Kanchanatawan, Wichan; Kongtharvonskul, Jatupon

    2015-01-01

    Background Clinical outcomes between the use of platelet-rich plasma (PRP), autologous blood (AB) and corticosteroid (CS) injection in lateral epicondylitis are still controversial. Materials and methods A systematic review and network meta-analysis of randomized controlled trials was conducted with the aim of comparing relevant clinical outcomes between the use of PRP, AB and CS injection. Medline and Scopus databases were searched from inception to January 2015. A network meta-analysis was ...

  13. A Systematic Review on the Relationship of Dietary Habits and Blood Pressure in the Pediatric Age Group

    Directory of Open Access Journals (Sweden)

    Roya kelishadi

    2016-11-01

    Full Text Available Background Tracking of blood pressure from early life to adulthood and the increasing prevalence of elevated blood pressure in the pediatric age group are considered as important health issues. Rapid lifestyle change and dietary habits are considered as important determinants of this problem. This study aimed to systematically review the studies on the association of dietary habits and blood pressure in the pediatric age group.  Materials and Methods The search was conducted from November 2015 to August 2016 .Those papers were included that investigated the association of dietary habits on blood pressure in children and adolescents aged less than 18 years. The following medical subject headings and keywords were used to search all field (Diet OR nutrition OR nutrient OR food OR food habits OR food preferences AND (Blood pressure OR hypertension OR high blood pressure OR systolic pressure OR diastolic pressure OR Systolic Blood Pressure [TIAB] OR Diastolic Blood Pressure [TIAB] AND (child [Mesh] OR children [TIAB] OR adolescent [Mesh] [TIAB] OR pediatrics [Mesh] OR paediatric [TIAB] Results A total of 549 studies were initially identified in the databases. After excluding duplicate studies, 270 articles were retrieved and we reviewed them based on their titles and abstracts; then 161 articles were selected for more detail review. Findings of multiple studies showed the beneficial effect of fruits, vegetables and dairy products on blood pressure in children. Conclusion Increasing evidences indicate that dietary habits, notably daily salt intake of children is directly related to their blood pressure level. Our findings serve as confirmatory evidence on the necessity of paying more attention to primordial and primary prevention of hypertension.

  14. The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Chopra, Vineet; O'Horo, John C; Rogers, Mary A M; Maki, Dennis G; Safdar, Nasia

    2013-09-01

    Peripherally inserted central catheters (PICCs) are associated with central line-associated bloodstream infection (CLABSI). The magnitude of this risk relative to central venous catheters (CVCs) is unknown. To compare risk of CLABSI between PICCs and CVCs. MEDLINE, CinAHL, Scopus, EmBASE, and Cochrane CENTRAL were searched. Full-text studies comparing the risk of CLABSI between PICCs and CVCs were included. Studies involving adults 18 years of age or older who underwent insertion of a PICC or a CVC and reported CLABSI were included in our analysis. Studies were evaluated using the Downs and Black scale for risk of bias. Random effects meta-analyses were used to generate summary estimates of CLABSI risk in patients with PICCs versus CVCs. Of 1,185 studies identified, 23 studies involving 57,250 patients met eligibility criteria. Twenty of 23 eligible studies reported the total number of CLABSI episodes in patients with PICCs and CVCs. Pooled meta-analyses of these studies revealed that PICCs were associated with a lower risk of CLABSI than were CVCs (relative risk [RR], 0.62; 95% confidence interval [CI], 0.40-0.94). Statistical heterogeneity prompted subgroup analysis, which demonstrated that CLABSI reduction was greatest in outpatients (RR [95% CI], 0.22 [0.18-0.27]) compared with hospitalized patients who received PICCs (RR [95% CI], 0.73 [0.54-0.98]). Thirteen of the included 23 studies reported CLABSI per catheter-day. Within these studies, PICC-related CLABSI occurred as frequently as CLABSI from CVCs (incidence rate ratio [95% CI], 0.91 [0.46-1.79]). Only 1 randomized trial met inclusion criteria. CLABSI definition and infection prevention strategies were variably reported. Few studies reported infections by catheter-days. Although PICCs are associated with a lower risk of CLABSI than CVCs in outpatients, hospitalized patients may be just as likely to experience CLABSI with PICCs as with CVCs. Consideration of risks and benefits before PICC use in inpatient

  15. Comparative Efficacy of Antimicrobial Central Venous Catheters in Reducing Catheter-Related Bloodstream Infections in Adults: Abridged Cochrane Systematic Review and Network Meta-Analysis.

    Science.gov (United States)

    Chong, Huey Yi; Lai, Nai Ming; Apisarnthanarak, Anucha; Chaiyakunapruk, Nathorn

    2017-05-15

    The efficacy of antimicrobial central venous catheters (CVCs) remains questionable. In this network meta-analysis, we aimed to assess the comparative efficacy of antimicrobial CVC impregnations in reducing catheter-related infections in adults. We searched 4 electronic databases (Medline, the Cochrane Central Register of Controlled Trials, Embase, CINAHL) and internet sources for randomized controlled trials, ongoing clinical trials, and unpublished studies up to August 2016. Studies that assessed CVCs with antimicrobial impregnation with nonimpregnated catheters or catheters with another impregnation were included. Primary outcomes were clinically diagnosed sepsis, catheter-related bloodstream infection (CRBSI), and all-cause mortality. We performed a network meta-analysis to estimate risk ratio (RR) with 95% confidence interval (CI). Sixty studies with 17255 catheters were included. The effects of 14 impregnations were investigated. Both CRBSI and catheter colonization were the most commonly evaluated outcomes. Silver-impregnated CVCs significantly reduced clinically diagnosed sepsis compared with silver-impregnated cuffs (RR, 0.54 [95% CI, .29-.99]). When compared to no impregnation, significant CRBSI reduction was associated with minocycline-rifampicin (RR, 0.29 [95% CI, .16-.52]) and silver (RR, 0.57 [95% CI, .38-.86]) impregnations. No impregnations significantly reduced all-cause mortality. For catheter colonization, significant decreases were shown by miconazole-rifampicin (RR, 0.14 [95% CI, .05-.36]), 5-fluorouracil (RR, 0.34 [95% CI, .14-.82]), and chlorhexidine-silver sulfadiazine (RR, 0.60 [95% CI, .50-.72]) impregnations compared with no impregnation. None of the studies evaluated antibiotic/antiseptic resistance as the outcome. Current evidence suggests that the minocycline-rifampicin-impregnated CVC appears to be the most effective in preventing CRBSI. However, its overall benefits in reducing clinical sepsis and mortality remain uncertain

  16. Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Bo-Yi; Qian, Zhengmin; Howard, Steven W; Vaughn, Michael G; Fan, Shu-Jun; Liu, Kang-Kang; Dong, Guang-Hui

    2018-04-01

    Although numerous studies have investigated the association of ambient air pollution with hypertension and blood pressure (BP), the results were inconsistent. We performed a comprehensive systematic review and meta-analysis of these studies. Seven international and Chinese databases were searched for studies examining the associations of particulate (diameter10 μm (PM 10 )) and gaseous (sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), nitrogen oxides (NO x ), ozone (O 3 ), carbon monoxide (CO)) air pollutants with hypertension or BP. Odds ratios (OR), regression coefficients (β) and their 95% confidence intervals were calculated to evaluate the strength of the associations. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also conducted. The overall meta-analysis showed significant associations of long-term exposures to PM 2.5 with hypertension (OR = 1.05), and of PM 10 , PM 2.5 , and NO 2 with DBP (β values: 0.47-0.86 mmHg). In addition, short-term exposures to four (PM 10 , PM 2.5 , SO 2 , NO 2 ), two (PM 2.5 and SO 2 ), and four air pollutants (PM 10 , PM 2.5 , SO 2 , and NO 2 ), were significantly associated with hypertension (ORs: 1.05-1.10), SBP (β values: 0.53-0.75 mmHg) and DBP (β values: 0.15-0.64 mmHg), respectively. Stratified analyses showed a generally stronger relationship among studies of men, Asians, North Americans, and areas with higher air pollutant levels. In conclusion, our study indicates a positive association between ambient air pollution and increased BP and hypertension. Geographical and socio-demographic factors may modify the pro-hypertensive effects of air pollutants. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Ambulatory Blood Pressure Monitoring in Individuals with HIV: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kent, Shia T; Bromfield, Samantha G; Burkholder, Greer A; Falzon, Louise; Oparil, Suzanne; Overton, Edgar T; Mugavero, Michael J; Schwartz, Joseph E; Shimbo, Daichi; Muntner, Paul

    2016-01-01

    Abnormal diurnal blood pressure (BP) rhythms may contribute to the high cardiovascular disease risk in HIV-positive (HIV+) individuals. To synthesize the current literature on ambulatory BP monitoring (ABPM) in HIV+ individuals, a systematic literature review and meta-analysis were performed. Medical databases were searched through November 11, 2015 for studies that reported ABPM results in HIV+ individuals. Data were extracted by 2 reviewers and pooled differences between HIV+ and HIV-negative (HIV-) individuals in clinic BP and ABPM measures were calculated using random-effects inverse variance weighted models. Of 597 abstracts reviewed, 8 studies with HIV+ cohorts met the inclusion criteria. The 420 HIV+ and 714 HIV- individuals in 7 studies with HIV- comparison groups were pooled for analyses. The pooled absolute nocturnal systolic and diastolic BP declines were 3.16% (95% confidence interval [CI]: 1.13%, 5.20%) and 2.92% (95% CI: 1.64%, 4.19%) less, respectively, in HIV+ versus HIV- individuals. The pooled odds ratio for non-dipping systolic BP (nocturnal systolic BP decline HIV+ versus HIV- individuals was 2.72 (95% CI: 1.92, 3.85). Differences in mean clinic, 24-hour, daytime, or nighttime BP were not statistically significant. I2 and heterogeneity chi-squared statistics indicated the presence of high heterogeneity for all outcomes except percent DBP dipping and non-dipping SBP pattern. An abnormal diurnal BP pattern may be more common among HIV+ versus HIV- individuals. However, results were heterogeneous for most BP measures, suggesting more research in this area is needed.

  18. Venous thrombosis: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1986-07-01

    Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, /sup 125/I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. 61 references.

  19. [Developmental venous anomaly (DVA)].

    Science.gov (United States)

    Zimmer, A; Hagen, T; Ahlhelm, F; Viera, J; Reith, W; Schulte-Altedorneburg, G

    2007-10-01

    As congenital anatomic variants of venous drainage, developmental venous anomalies (DVA) represent up to 60% of all cerebral vascular malformations. The prior term "venous angioma" is a misnomer implicating an abnormal vascular structure with an increased bleeding risk. They are often found incidentally and are hardly ever symptomatic. Their morphologic characteristics are dilated vessels in the white matter, which converge on a greater collector vein, forming the typical caput medusae. They drain into the superficial or deep venous system. The frequent association with other, potentially bleeding-prone vascular malformations is clinically relevant, in particular cavernous angioma, which might require therapeutic action. Therefore, coincident vascular lesions need to be actively sought by appropriate additional imaging techniques.

  20. Venous thrombosis - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100168.htm Venous thrombosis - series—Normal anatomy To use the sharing features ... Editorial team. Related MedlinePlus Health Topics Deep Vein Thrombosis A.D.A.M., Inc. is accredited by ...

  1. Venous ulcer review

    Science.gov (United States)

    Bevis, Paul; Earnshaw, Jonothan

    2011-01-01

    Clinical question: What is the best treatment for venous ulcers? Results: Compression aids ulcer healing. Pentoxifylline can aid ulcer healing. Artificial skin grafts are more effective than other skin grafts in helping ulcer healing. Correction of underlying venous incompetence reduces ulcer recurrence. Implementation: Potential pitfalls to avoid are: Failure to exclude underlying arterial disease before application of compression.Unusual-looking ulcers or those slow to heal should be biopsied to exclude malignant transformation. PMID:21673869

  2. Venous ulcer review

    OpenAIRE

    Bevis, Paul; Earnshaw, Jonothan

    2011-01-01

    Paul Bevis, Jonothan Earnshaw Department of Vascular Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, UKDate of preparation: 3 February 2011Conflict of interest: None declared.Clinical question: What is the best treatment for venous ulcers?Results: Compression aids ulcer healing. Pentoxifylline can aid ulcer healing. Artificial skin grafts are more effective than other skin grafts in helping ulcer healing. Correction of underlying venous incompetence reduces ulcer recu...

  3. Prophylaxis of Venous Thrombosis.

    Science.gov (United States)

    Goldhaber, Samuel Z.

    2001-06-01

    Mechanical measures such as graduated compression stockings and intermittent compression boots are available for venous thrombosis prophylaxis, but compliance may be limited. Plantar venous pneumatic compression devices have attained widespread acceptance by both patients and nurses because of their comfort and compact size, but their track record for efficacy is poor. Inferior vena cava filters prevent pulmonary embolism, but do not halt the thrombotic process or prevent venous thrombosis. Pharmacologic prophylaxis traditionally has relied upon minidose unfractionated heparin; however, re-examination is warranted in the face of increasingly ill and complex patients. My opinion is that small, fixed doses of once-daily low molecular weight heparin will eventually replace minidose unfractionated heparin as the standard pharmacologic prophylaxis regimen for most surgical and medical patients. Prolongation of prophylaxis after hospital discharge should receive increased emphasis. Most patients being transferred to a skilled nursing facility should receive venous thromboembolism prophylaxis. Similarly, most patients undergoing total hip or knee replacement should receive prolonged preventive regimens, with at least 1 month of anticoagulation. Despite advances, certain aspects of venous thrombosis prophylaxis remain problematic. First, a surprisingly high number of hospitalized patients develop venous thrombosis because of failed (rather than omitted) prophylaxis. Second, many patients in intensive care have a combination of peripheral vascular disease and active bleeding (usually gastrointestinal) that precludes mechanical or pharmacologic prophylaxis. Third, neurosurgical patients undergoing craniotomy for brain tumors suffer a high rate of venous thrombosis and major pulmonary embolism despite the routine use of combined mechanical and pharmacologic prophylaxis. My opinion is that these three areas, in addition to the hospital culture of prophylaxis, should receive

  4. The dynamics of venous return and response to hypervolemia in the toad, Bufo marinus (L.)

    OpenAIRE

    Killorn, Erin E; Toews, Daniel P

    2001-01-01

    Background Venous return from the posterior region of amphibians travels by either two renal portal veins to the kidney or a central abdominal vein that drains into the hepatic portal system. The relative proportions of blood flow in these vessels has never been measured nor has a modification of flow been determined when venous return increases by changes in blood volume during hypervolemia or during increased volume input from the posterior lymph hearts. Results Venous return from the poste...

  5. Effects of blood pressure reduction in mild hypertension : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Sundström, Johan; Arima, Hisatomi; Jackson, Rod; Turnbull, Fiona; Rahimi, Kazem; Chalmers, John; Woodward, Mark; Neal, Bruce; de Zeeuw, Dick

    2015-01-01

    BACKGROUND: Effects of blood pressure reduction in persons with grade 1 hypertension are unclear. PURPOSE: To investigate whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with grade 1 hypertension. DATA SOURCES: Trials included in the BPLTTC (Blood

  6. Venous injury in abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2015-11-15

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  7. Venous injury in abusive head trauma

    International Nuclear Information System (INIS)

    Choudhary, Arabinda K.; Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B.; Dias, Mark S.

    2015-01-01

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  8. Can venous cord gas values predict fetal acidemia?

    Science.gov (United States)

    Swanson, Kate; Whelan, Anna R; Grobman, William A; Miller, Emily S

    2017-09-01

    Umbilical cord arterial blood gas values are used to diagnose fetal acidemia; however, arterial cord blood specimens are frequently not available. We sought to assess whether umbilical cord venous blood gas values can be used to reliably predict fetal acidemia. This is an observational study of women with a singleton gestation at a single tertiary care hospital who delivered from September 2010 through August 2015 and had both umbilical cord arterial and venous blood gas samples measured. Fetal acidemia was defined in 2 ways: (1) umbilical cord arterial pH gas values and the areas under the curve were calculated. Umbilical cord venous blood gas cutoffs associated with gas values. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials.

    Science.gov (United States)

    Kakkos, Stavros K; Allaert, François A

    2017-04-01

    Venoactive drugs (VADs) are considered an important component of the medical (conservative) treatment of chronic venous disorders (CVDs). However, the efficacy of certain VADs on one or more individual leg symptoms may have not been extensively studied to justify a high level or grade of recommendation in guidelines on CVD. The aim of the present systematic review and meta-analysis was to study the effectiveness of VADs containing Ruscus across the spectrum of defined venous symptoms. On November 14 2016, a literature search of the databases MEDLINE and Scopus was performed, supplemented by hand searching, to identify randomized double-blind placebo-controlled trials on Ruscus extracts in patients with CVD. The main outcome measures were the effects of Ruscus on individual symptoms and leg edema, which were expressed as risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI). Trial quality of evidence was graded using the GRADE system. We identified 10 trials, mostly with low risk of bias, on 719 patients. On qualitative analysis, Ruscus significantly improved seven defined leg symptoms, including pain, heaviness, fatigue, feeling of swelling, cramps, itching and paresthesia compared to placebo. On quantitative analysis, Ruscus compared with placebo, assessed as a categorical variable, reduced leg pain (RR=0.35, P=0.01, number needed to treat [NNT] 5, with no heterogeneity), heaviness (RR=0.26, P<0.00001, NNT=2.4, with a small amount of heterogeneity), feeling of swelling (RR=0.53, P<0.0001, NNT=4, with considerable heterogeneity, minimized after sensitivity analysis), paresthesia (RR=0.27, P<0.0001, NNT=1.8), global symptoms (RR=0.54, P<0.00001, NNT=4.3) and the total number of venous symptoms (RR 0.41, P=0.002). Similarly, Ruscus compared to placebo, assessed as a continuous variable reduced pain (SMD=-0.80, 95% CI: -1.21 to -0.39), heaviness (SMD=-1.23, 95% CI: -1.60 to -0.86), fatigue (SMD -1.16, 95% CI: -1.71 to -0.61), feeling

  10. Avaliação das pressões venosa e arterial em cães submetidos a diferentes tipos de hipotensão Evaluation of venous and arterial blood pressures in dogs submitted to hypotension

    Directory of Open Access Journals (Sweden)

    R.C. Rabelo

    2005-12-01

    Full Text Available Estabeleceram-se a pressão venosa periférica (PVP, a pressão venosa central (PVC, a pressão arterial invasiva (PAI e a pressão arterial não invasiva (PANI em cães após diferentes eventos de hipotensão. Foram utilizados 15 cães adultos, distribuídos aleatoriamente em três grupos (G com cinco animais cada, submetidos aos seguintes eventos hipotensores: GI - cloridrato de xilazina a 2%, GII - choque hipovolêmico agudo e GIII - veneno da serpente Bothrops moojeni. Os animais, avaliados durante 30 minutos após o início do evento hipotensor, foram tratados com cloridrato de ioimbina (GI, amido hidroxietílico a 6% (GII e cetoprofeno (GIII e reavaliados por mais 30 minutos. Somente os animais do GII apresentaram redução da PVP após o evento hipotensor e aumento, 25 minutos após tratamento. Os cães dos grupos II e III mostraram redução da PVC após o evento hipotensor, e somente os animais do GII exibiram discreto aumento cinco minutos imediatamente após o tratamento. Houve diminuição da PAI e PANI nos dos grupos II e III após o evento hipotensor, com recuperação gradativa imediata, após o tratamento, somente da PAI.The peripheral venous pressure (PVP, the central venous pressure (CVP, the invasive (IAP and non-invasive blood pressure (NIAP in dogs submitted to different hypotensive events were studied. Fifteen adult mongrel dogs were randomly divided in three groups with five animals each, and submitted to hypotensive event as follow: GI - xylazine chloride 2%, GII - acute hypovolemic shock and GIII - snake venom (Bothrops moojeni. All animals were evaluated for 30 minutes after starting hypotensive event, treated with yoimbine chloride (GI, colloid hetastarch 6% (GII and ketoprofen (GIII and reevaluated for more 30 minutes. Only the group II dogs showed PVP decrease after hypotensive event, and increase 25 minutes after treatment. In animals of groups II and III, the CVP decreased after hypotensive event and only in GII

  11. Mineralocorticoid hypertension: clinical and laboratory studies with special reference to selective percutaneous venography combined with aldosterone assay in the adrenal venous blood

    International Nuclear Information System (INIS)

    Wajchenberg, B.L.; Liberman, B.; Novaes, M.

    1977-01-01

    With the purpose of demonstrating the presence of hypertension, hypokalemia and alkalosis were studied. The presence of daily aldosteronism was verified in five patients; the sixth one presented no daily aldosteronism but an increase of 18-OH-DOCA production, an ACTH dependente mineralocorticoid. The presence of tumor (less than 0.9cm) could not be shown in two patients by bilateral selective adrenal venography. The aldosterone assay during catherization of adrenal vein of those patients permitted to determine the tumoral side. Attention must be given to the fact that the blood collection of adrenal vein must always be made during adrenal venography to demonstrate the presence of short unilateral tumor or bilateral disease [pt

  12. Reflection on Mobile Applications for Blood Pressure Management: A Systematic Review on Potential Effects and Initiatives.

    Science.gov (United States)

    Mohammadi, Reyhaneh; Ayatolahi Tafti, Movahhedeh; Hoveidamanesh, Soodabeh; Ghanavati, Reza; Pournik, Omid

    2018-01-01

    Ischemic heart disease and stroke have been considered as the first global leading cause of death in last decades [1]. Blood pressure (BP) management is one of the easiest ways suggested for preventing and controlling cardiovascular diseases before the patient develops complications and death-following outcomes. Appearance of technology advancements in the health system has motivated researchers and health providers to study its different aspects and applications in order to improve disease prevention and management. Following these efforts, mobile health (mHealth) technologies were presented to provide people with fast and easier-to-use services. Although there are some unsolved challenges, these technologies have become popular among many people. As an important part of mHealth, mobile applications (apps) have been the focused subject of many studies in the last decade. The objective of this systematic review is to assess the potential effects of mobile apps designed for BP management by scrutinizing the related studies. Search methods: We searched the following electronic databases in December 2016: Medline (PubMed), National Center for Biotechnology Information (NCBI), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center(ERIC), Web of Science, ProQuest, and Google Scholar. No language restriction and start point limitation were imposed. We included studies that evaluated and assessed mobile apps for BP management and related clinical trials that considered mobile app as the only difference between intervention and control groups. Two review authors applied the eligibility criteria, extracted data and assessed the quality of included studies. Literature search resulted in 13 included studies and 27 reviews. 12 records of 13 included studies identified as interventional studies. The review showed that the mobile apps may improve individual's BP

  13. Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Pietro Amedeo Modesti

    Full Text Available People of Sub Saharan Africa (SSA and South Asians(SA ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU. Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP and diastolic(DBP blood pressure(BP levels between SSA, SA, and EU.We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66. SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49 but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence.1 The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2 The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3 The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.

  14. Comparison of the Non-VKA Oral Anticoagulants Apixaban, Dabigatran, and Rivaroxaban in the Extended Treatment and Prevention of Venous Thromboembolism: Systematic Review and Network Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    A T Cohen

    Full Text Available Historically, warfarin or aspirin have been the recommended therapeutic options for the extended treatment (>3 months of VTE. Data from Phase III randomised controlled trials (RCTs are now available for non-VKA oral anticoagulants (NOACs in this indication. The current systematic review and network meta-analysis (NMA were conducted to compare the efficacy and safety of anticoagulants for the extended treatment of VTE.Electronic databases (accessed July 2014 and updated April 2016 were systematically searched to identify RCTs evaluating apixaban, aspirin, dabigatran, edoxaban, rivaroxaban, and warfarin for the extended treatment of VTE. Eligible studies included adults with an objectively confirmed deep vein thrombosis, pulmonary embolism or both. A fixed-effect Bayesian NMA was conducted, and results were presented as relative risks (RRs. Sensitivity analyses examining (i the dataset employed according to the time frame for outcome assessment (ii the model used for the NMA were conducted.Eleven Phase III RCTs (examining apixaban, aspirin, dabigatran, rivaroxaban, warfarin and placebo were included. The risk of the composite efficacy outcome (VTE and VTE-related death was statistically significantly lower with the NOACs and warfarin INR 2.0-3.0 compared with aspirin, with no significant differences between the NOACs. Treatment with apixaban (RR 0.23, 95% CrI 0.10, 0.55 or dabigatran (RR 0.55, 95% Crl 0.43, 0.71 was associated with a statistically significantly reduced risk of 'major or clinically relevant non-major bleed' compared with warfarin INR 2.0-3.0. Apixaban also showed a significantly reduced risk compared with dabigatran (RR 0.42, 95% Crl 0.18, 0.97 and rivaroxaban (RR 0.23, 95% Crl 0.09, 0.59. Sensitivity analyses indicate that results were dependent on the dataset, but not on the type of NMA model employed.Results from the NMA indicate that NOACs are an effective treatment for prevention of VTE or VTE-related death in the extended

  15. Changes in blood pressure among users of lay health worker or volunteer operated community-based blood pressure programs over time: a systematic review protocol.

    Science.gov (United States)

    Skar, Pål; Young, Lynne; Gordon, Carol

    2015-10-01

    reducing cardiovascular disease in specific hard-to-reach populations. Several systematic reviews have been conducted to assess different models for delivering services to people living with high blood pressure to assess community-based programs with a focus on cardiovascular disease, and to assess effectiveness of community health workers (CHW) in a variety of settings. These systematic reviews point to the importance of distinguishing between different categories of health care providers, their training and their roles in program delivery when assessing studies for possible inclusion in a systematic review.In a systematic review of studies from the US by Brownstein et al. focusing on the effectiveness of community health workers (CHWs) in the care of people with hypertension, this category of health care providers went under many different names. Community health workers in this review were defined as "any health workers who carried out functions related to health care deliver, were trained as part of an intervention, had no formal paraprofessional or professional designation, and had a relationship with the community being served". One of the findings from this review was the wide variety of formal training of the CHWs. In other parts of the world, a CHW might be defined differently. In their review of CHW-based programs focusing on children's health, Bhattacharyya, Winch, LeBan and Tien found that "in general CHWs are not paid salaries because the MOH (Ministry of Health) or donors do not consider salaries to be sustainable. Yet CHWs are often held accountable and supervised as if they were employees. Community health worker programs must recognize that CHWs are volunteers (emphasis in original), even if they receive small monetary or nonmonetary incentives. They are volunteering their time to serve the community". One Canadian model for delivering a cardiovascular awareness program designed to reach older adults through their primary care provider is based on

  16. Brain venous pathologies: MRI findings

    International Nuclear Information System (INIS)

    Salvatico, Rosana; Gonzalez, Alejandro; Yanez, Paulina; Romero, Carlos; Trejo, Mariano; Lambre, Hector

    2006-01-01

    Purpose: To describe MRI findings of the different brain venous pathologies. Material and Methods: Between January 2002 and March 2004, 18 patients were studied 10 males and 8 females between 6 and 63 years old; with different brain venous pathologies. In all cases brain MRI were performed including morphological sequences with and without gadolinium injection and angiographic venous sequences. Results: 10 venous occlusions were found, 6 venous angiomas, and 2 presented varices secondary to arteriovenous dural fistula. Conclusion: Brain venous pathologies can appear in many different clinical contexts, with different prognosis and treatment. In all the cases brain MRI was the best imaging study to disclose typical morphologic abnormalities. (author) [es

  17. Venous and Arterial Thromboses: Two Sides of the Same Coin?

    Science.gov (United States)

    Lippi, Giuseppe; Favaloro, Emmanuel J

    2018-04-01

    Arterial and venous thromboses are sustained by development of intraluminal thrombi, respectively, within the venous and arterial systems. The composition and structure of arterial and venous thrombi have been historically considered as being very different. Arterial thrombi (conventionally defined as "white") have been traditionally proposed to be composed mainly of fibrin and platelet aggregates, whilst venous thrombi (conventionally defined as "red") have been proposed as mostly being enriched in fibrin and erythrocytes. This archaic dichotomy seems ever more questionable, since it barely reflects the pathophysiology of thrombus formation in vivo. Both types of thrombi are actually composed of a complex fibrin network but, importantly, also contain essentially the same blood-borne cells (i.e., red blood cells, leukocytes, and platelets), and it is only the relative content of these individual elements that differ between venous and arterial clots or, otherwise, between thrombi generated under different conditions of blood flow and shear stress. Convincing evidence now suggests that either white or red intracoronary thrombi may be present in patients with myocardial infarction and, even more importantly, red thrombi may be more prone to distal embolization during percutaneous coronary intervention than those with lower content of erythrocytes. Conversely, it is now accepted that components traditionally considered to be involved "only" in arterial thrombosis are also represented in venous thrombosis. Thus, platelets comprise important components of venous clots, although they may be present in lower amounts here than in arterial thrombi, and von Willebrand factor is also represented in both arterial and venous thrombi. Of importance, such evidence thus supports the concept that adjunctive treatment normally associated to prevention of arterial thrombosis (e.g., aspirin) may have a role also in prevention and treatment of venous thrombosis. Thieme Medical

  18. Arterial versus venous lactate: a measure of sepsis in children.

    Science.gov (United States)

    Samaraweera, Sahan Asela; Gibbons, Berwyck; Gour, Anami; Sedgwick, Philip

    2017-08-01

    This study assessed the agreement between arterial and venous blood lactate and pH levels in children with sepsis. This retrospective, three-year study involved 60 PICU patients, with data collected from electronic or paper patient records. The inclusion criteria comprised of children (≤17 years old) with sepsis and those who had a venous blood gas taken first with an arterial blood gas taken after within one hour. The lactate and pH values measured through each method were analysed. There is close agreement between venous and arterial lactate up to 2 mmol/L. As this value increases, this agreement becomes poor. The limits of agreement (LOA) are too large (±1.90 mmol/L) to allow venous and arterial lactate to be used interchangeably. The mean difference and LOA between both methods would be much smaller if derived using lactate values under 2.0 mmol/L. There is close agreement between arterial and venous pH (MD = -0.056, LOA ± 0.121). However, due to extreme variations in pH readings during sepsis, pH alone is an inadequate marker. A venous lactate ≤2 mmol/L can be used as a surrogate for arterial lactate during early management of sepsis in children. However, if the value exceeds 2 mmol/L, an arterial sample must confirm the venous result. What is known: • In children with septic shock, a blood gas is an important test to show the presence of acidosis and high lactic acid. Hyperlactataemia on admission is an early predictor of outcome and is associated with a greater mortality risk. • An arterial sample is the standard for lactate measurement, however getting a sample may be challenging in the emergency department or a general paediatric ward. Venous samples are quicker and easier to obtain. Adult studies generally advise caution in replacing venous lactate values for the arterial standard, whilst paediatric studies are limited in this area. What is new: • This is the first study assessing the agreement between arterial and peripheral venous

  19. Venous hemodynamic changes in lower limb venous disease

    DEFF Research Database (Denmark)

    Lee, Byung Boong; Nicolaides, Andrew N; Myers, Kenneth

    2016-01-01

    aspects of management for venous disease by evidence-based principles. These included experts from various member societies including the European Venous Forum (EVF), American Venous Forum (AVF), American College of Phlebology (ACP) and Cardiovascular Disease Educational and Research Trust (CDERT...

  20. Direct venous thrombolysis and venous angioplasty in the upper extremity

    International Nuclear Information System (INIS)

    Hollmann, J.P.; Guenther, R.W.

    1987-01-01

    Venous thromboses of stenoses in the upper extremity are often the result of a compression syndrome of the shoulder girdle, the Paget-von Schroetter syndrome, vascular surgery, space-occupying lesions in the mediastinum or the result of catheterisation. Direct venous thrombolysis and venous angioplasty were performed successfully in six patients. (orig.) [de

  1. Chronic venous disease.

    Science.gov (United States)

    Wolinsky, Claire D; Waldorf, Heidi

    2009-11-01

    Identifying characteristic cutaneous findings is important in determining the appropriate management of certain venous diseases. The health care provider should be familiar with the classic description of patterns and distributions of skin manifestations, such as varicose veins, stasis dermatitis, palpable cord, petechiae, and telangiectasias. In addition to the gross appearance of the skin, a skin biopsy may help elucidate a diagnosis. General treatment and prevention of the underlying venous pathology is essential. Furthermore, specific management of skin findings should include therapy to ameliorate progression of disease and symptomatology when warranted.

  2. Blood donation barriers and facilitators of Sub-Saharan African migrants and minorities in Western high-income countries: a systematic review of the literature

    NARCIS (Netherlands)

    Klinkenberg, E. F.; Huis In 't Veld, E. M. J.; de Wit, P. D.; van Dongen, A.; Daams, J. G.; de Kort, W. L. A. M.; Fransen, M. P.

    2018-01-01

    The present study aimed to gain more insight into, and summarise, blood donation determinants among migrants or minorities of Sub-Saharan heritage by systematically reviewing the current literature. Sub-Saharan Africans are under-represented in the blood donor population in Western high-income

  3. Hormonal contraception and venous thromboembolism

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Milsom, Ian; Geirsson, Reynir Tomas

    2012-01-01

    New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published.......New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published....

  4. Central venous catheterization for acute trauma resuscitation: Tip position analysis using routine emergency computed tomography.

    Science.gov (United States)

    Struck, Manuel F; Ewens, Sebastian; Schummer, Wolfram; Busch, Thilo; Bernhard, Michael; Fakler, Johannes K M; Stumpp, Patrick; Stehr, Sebastian N; Josten, Christoph; Wrigge, Hermann

    2018-03-01

    Central venous catheter insertion for acute trauma resuscitation may be associated with mechanical complications, but studies on the exact central venous catheter tip positions are not available. The goal of the study was to analyze central venous catheter tip positions using routine emergency computed tomography. Consecutive acute multiple trauma patients requiring large-bore thoracocervical central venous catheters in the resuscitation room of a university hospital were enrolled retrospectively from 2010 to 2015. Patients who received a routine emergency chest computed tomography were analyzed regarding central venous catheter tip position. The central venous catheter tip position was defined as correct if the catheter tip was placed less than 1 cm inside the right atrium relative to the cavoatrial junction, and the simultaneous angle of the central venous catheter tip compared with the lateral border of the superior vena cava was below 40°. During the 6-year study period, 97 patients were analyzed for the central venous catheter tip position in computed tomography. Malpositions were observed in 29 patients (29.9%). Patients with malpositioned central venous catheters presented with a higher rate of shock (systolic blood pressure central venous catheter tips. Logistic regression revealed injury severity score as a significant predictor for central venous catheter malposition (odds ratio = 1.039, 95% confidence interval = 1.005-1.074, p = 0.024). Multiple trauma patients who underwent emergency central venous catheter placement by experienced anesthetists presented with considerable tip malposition in computed tomography, which was significantly associated with a higher injury severity.

  5. Effect of chlorhexidine/silver sulfadiazine-impregnated central venous catheters in an intensive care unit with a low blood stream infection rate after implementation of an educational program: a before-after trial.

    Science.gov (United States)

    Schuerer, Douglas J E; Zack, Jeanne E; Thomas, James; Borecki, Ingrid B; Sona, Carrie S; Schallom, Marilyn E; Venker, Melissa; Nemeth, Jennifer L; Ward, Myrna R; Verjan, Linda; Warren, David K; Fraser, Victoria J; Mazuski, John E; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M

    2007-08-01

    Current guidelines recommend using antiseptic- or antibiotic-impregnated central venous catheters (CVCs) if, following a comprehensive strategy to prevent catheter-related blood stream infection (CR-BSI), infection rates remain above institutional goals based on benchmark values. The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate. Pre-intervention and post-intervention observational study in a 24-bed surgical/trauma/burn ICU from October, 2002 to August, 2005. All patients requiring CVC placement after March, 2004 had a chlorhexidine/silver sulfadiazine-impregnated catheter inserted (post-intervention period). Twenty-three CR-BSIs occurred in 6,960 catheter days (3.3 per 1,000 catheter days)during the 17-month control period. After introduction of chlorhexidine/silver sulfadiazine-impregnated catheters, 16 CR-BSIs occurred in 7,732 catheter days (2.1 per 1,000 catheter days; p = 0.16). The average length of time required for an infection to become established after catheterization was similar in the two groups (8.4 vs. 8.6 days; p = 0.85). Chlorhexidine/silver sulfadiazine-impregnated catheters did not result in a statistically significant change in the microbiological profile of CR-BSIs, nor did they increase the incidence of resistant organisms. Although chlorhexidine/silver sulfadiazine-impregnated catheters are useful in specific patient populations, they did not result in a statistically significant decrease in the CR-BSI rate in this study, beyond what was achieved with education alone.

  6. Adjustment of Cell-Type Composition Minimizes Systematic Bias in Blood DNA Methylation Profiles Derived by DNA Collection Protocols.

    Science.gov (United States)

    Shiwa, Yuh; Hachiya, Tsuyoshi; Furukawa, Ryohei; Ohmomo, Hideki; Ono, Kanako; Kudo, Hisaaki; Hata, Jun; Hozawa, Atsushi; Iwasaki, Motoki; Matsuda, Koichi; Minegishi, Naoko; Satoh, Mamoru; Tanno, Kozo; Yamaji, Taiki; Wakai, Kenji; Hitomi, Jiro; Kiyohara, Yutaka; Kubo, Michiaki; Tanaka, Hideo; Tsugane, Shoichiro; Yamamoto, Masayuki; Sobue, Kenji; Shimizu, Atsushi

    2016-01-01

    Differences in DNA collection protocols may be a potential confounder in epigenome-wide association studies (EWAS) using a large number of blood specimens from multiple biobanks and/or cohorts. Here we show that pre-analytical procedures involved in DNA collection can induce systematic bias in the DNA methylation profiles of blood cells that can be adjusted by cell-type composition variables. In Experiment 1, whole blood from 16 volunteers was collected to examine the effect of a 24 h storage period at 4°C on DNA methylation profiles as measured using the Infinium HumanMethylation450 BeadChip array. Our statistical analysis showed that the P-value distribution of more than 450,000 CpG sites was similar to the theoretical distribution (in quantile-quantile plot, λ = 1.03) when comparing two control replicates, which was remarkably deviated from the theoretical distribution (λ = 1.50) when comparing control and storage conditions. We then considered cell-type composition as a possible cause of the observed bias in DNA methylation profiles and found that the bias associated with the cold storage condition was largely decreased (λ adjusted = 1.14) by taking into account a cell-type composition variable. As such, we compared four respective sample collection protocols used in large-scale Japanese biobanks or cohorts as well as two control replicates. Systematic biases in DNA methylation profiles were observed between control and three of four protocols without adjustment of cell-type composition (λ = 1.12-1.45) and no remarkable biases were seen after adjusting for cell-type composition in all four protocols (λ adjusted = 1.00-1.17). These results revealed important implications for comparing DNA methylation profiles between blood specimens from different sources and may lead to discovery of disease-associated DNA methylation markers and the development of DNA methylation profile-based predictive risk models.

  7. Adjustment of Cell-Type Composition Minimizes Systematic Bias in Blood DNA Methylation Profiles Derived by DNA Collection Protocols.

    Directory of Open Access Journals (Sweden)

    Yuh Shiwa

    Full Text Available Differences in DNA collection protocols may be a potential confounder in epigenome-wide association studies (EWAS using a large number of blood specimens from multiple biobanks and/or cohorts. Here we show that pre-analytical procedures involved in DNA collection can induce systematic bias in the DNA methylation profiles of blood cells that can be adjusted by cell-type composition variables. In Experiment 1, whole blood from 16 volunteers was collected to examine the effect of a 24 h storage period at 4°C on DNA methylation profiles as measured using the Infinium HumanMethylation450 BeadChip array. Our statistical analysis showed that the P-value distribution of more than 450,000 CpG sites was similar to the theoretical distribution (in quantile-quantile plot, λ = 1.03 when comparing two control replicates, which was remarkably deviated from the theoretical distribution (λ = 1.50 when comparing control and storage conditions. We then considered cell-type composition as a possible cause of the observed bias in DNA methylation profiles and found that the bias associated with the cold storage condition was largely decreased (λ adjusted = 1.14 by taking into account a cell-type composition variable. As such, we compared four respective sample collection protocols used in large-scale Japanese biobanks or cohorts as well as two control replicates. Systematic biases in DNA methylation profiles were observed between control and three of four protocols without adjustment of cell-type composition (λ = 1.12-1.45 and no remarkable biases were seen after adjusting for cell-type composition in all four protocols (λ adjusted = 1.00-1.17. These results revealed important implications for comparing DNA methylation profiles between blood specimens from different sources and may lead to discovery of disease-associated DNA methylation markers and the development of DNA methylation profile-based predictive risk models.

  8. Models of the venous system

    DEFF Research Database (Denmark)

    Mehlsen, J

    2000-01-01

    of the venous system require at least three elements: a resistor, a capacitor and an inductor, with the latter being of more importance in the venous than in the arterial system. Non-linearities must be considered in pressure/flow relations in the small venules, during venous collapse, or low flow conditions...

  9. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Wang, Fenglei; Zheng, Jusheng; Yang, Bo; Jiang, Jiajing; Fu, Yuanqing; Li, Duo

    2015-10-27

    Vegetarian diets exclude all animal flesh and are being widely adopted by an increasing number of people; however, effects on blood lipid concentrations remain unclear. This meta-analysis aimed to quantitatively assess the overall effects of vegetarian diets on blood lipids. We searched PubMed, Scopus, Embase, ISI Web of Knowledge, and the Cochrane Library through March 2015. Studies were included if they described the effectiveness of vegetarian diets on blood lipids (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride). Weighted mean effect sizes were calculated for net changes by using a random-effects model. We performed subgroup and univariate meta-regression analyses to explore sources of heterogeneity. Eleven trials were included in the meta-analysis. Vegetarian diets significantly lowered blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol, and the pooled estimated changes were -0.36 mmol/L (95% CI -0.55 to -0.17; PVegetarian diets did not significantly affect blood triglyceride concentrations, with a pooled estimated mean difference of 0.04 mmol/L (95% CI -0.05 to 0.13; P=0.40). This systematic review and meta-analysis provides evidence that vegetarian diets effectively lower blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol. Such diets could be a useful nonpharmaceutical means of managing dyslipidemia, especially hypercholesterolemia. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  10. A systematic review of the effect of pre-test rest duration on toe and ankle systolic blood pressure measurements

    Science.gov (United States)

    2014-01-01

    Background Measurement of toe and ankle blood pressure is commonly used to evaluate peripheral vascular status, yet the pre-test rest period is inconsistent in published studies and among practitioners, and could affect results. The aim of this systematic review is to evaluate all research that has investigated the effect of different periods of pre-test rest on toe and ankle systolic blood pressure. Methods The following databases were searched up to April 2012: Medline (from 1946), EMBASE (from 1947), CINAHL (from 1937), and Cochrane Central Register of Controlled Trials (CENTRAL) (from 1800). No language or publication restrictions were applied. Eighty-eight content experts and researchers in the field were contacted by email to assist in the identification of published, unpublished, and ongoing studies. Studies evaluating the effect of two or more pre-test rest durations on toe or ankle systolic blood pressure were eligible for inclusion. No restrictions were placed on participant characteristics or the method of blood pressure measurement. Outcomes included toe or ankle systolic blood pressure and adverse effects. Abstracts identified from the search terms were independently assessed by two reviewers for potential inclusion. Results 1658 abstracts were identified by electronic searching. Of the 88 content experts and researchers in the field contacted by email a total of 33 replied and identified five potentially relevant studies. No studies were eligible for inclusion. Conclusions There is no evidence of the effect of different periods of pre-test rest duration on toe and ankle systolic blood pressure measurements. Rigorous trials evaluating the effect of different durations of pre-test rest are required to direct clinical practice and research. PMID:24708870

  11. The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bahadoran, Zahra; Mirmiran, Parvin; Kabir, Ali; Azizi, Fereidoun; Ghasemi, Asghar

    2017-11-01

    Beetroot is considered a complementary treatment for hypertension because of its high content of inorganic NO 3 This systematic review and meta-analysis aimed to clarify several aspects of beetroot juice supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP). We searched PubMed, Scopus, and Embase databases, and the reference lists of previous reviews. Randomized clinical trials that investigated the effects of beetroot juice on resting blood pressure in humans were recruited for quality assessment, meta-analyses, subgroup analyses, and meta-regressions; of these, 22 were conducted between 2009 and 2017 and included a total of 47 intervention ( n = 650) and 43 control ( n = 598) groups. Overall, SBP (-3.55 mm Hg; 95% CI: -4.55, -2.54 mm Hg) and DBP (-1.32 mm Hg; 95% CI: -1.97, -0.68 mm Hg) were significantly lower in the beetroot juice-supplemented groups than in the control groups. The mean difference of SBP was larger between beetroot juice-supplemented and control groups in the longer than in the shorter (≥14 compared with beetroot juice (-4.78 compared with -2.37 mm Hg). A positive correlation was observed between beetroot juice doses and the mean differences of blood pressures. In contrast, a smaller effect size of blood pressures was observed after supplementation with higher NO 3 (milligrams per 100 mL beetroot juice). A weak effect size was observed in a meta-analysis of trials that used NO 3 -depleted beetroot juice as a placebo compared with other interventions (-3.09 compared with -4.51 mm Hg for SBP and -0.81 compared with -2.01 mm Hg for DBP). Our results demonstrate the blood pressure-lowering effects of beetroot juice and highlight its potential NO 3 -independent effects. © 2017 American Society for Nutrition.

  12. Blood

    Science.gov (United States)

    ... production of red blood cells, including: Iron deficiency anemia. Iron deficiency anemia is the most common type of anemia and ... inflammatory bowel disease are especially likely to have iron deficiency anemia. Anemia due to chronic disease. People with chronic ...

  13. Analysis of Arterial Blood Gas Report in Chronic Kidney Diseases - Comparison between Bedside and Multistep Systematic Method.

    Science.gov (United States)

    Ghatak, Ishita; Dhat, Vaishali; Tilak, Mona A; Roy, Indranath

    2016-08-01

    Acid Base Disorders (ABDs) are commonly encountered in critically ill Chronic Kidney Disease (CKD) patients. Timely and correct analysis of Arterial Blood Gases (ABG) is critical for the diagnosis, treatment and prediction of outcome of the patients. The aim was to explore type and prevalence of ABDs in 31 critically ill CKD patients from a tertiary care hospital in Maharashtra, to compare two methods of analysis- bedside and systematic approaches and to clinically correlate the nature of ABDs in these patients. The initial ABG reports of 31 consecutive CKD patients were analysed by two methods. Medica Easy stat analyser was the equipment for analysis with Principle of potentiometry and ion selective electrode for pH and pCO2 and amperometry for pO2. Serum albumin was also measured by Bromocresol green dye binding method using liquixx albumin kit in Erba XL 300 autoanalyser. Chi-square test was used for statistical analysis using Epi Info version 3.5.4 and SPSS 14.0 softwares. The systematic method showed a significantly higher prevalence of mixed disorders (50%) compared to bedside method (12.9%). Most prevalent disorder by bedside method was metabolic acidosis in 15 cases (48.39%). By the systematic method, 3 reports were invalid. As a single category, most prevalent type was both simple respiratory alkalosis and mixed metabolic acidosis with respiratory alkalosis- 6 of 31 cases in each type (19.36% each). As a whole, metabolic acidosis (including both High Anion Gap Metabolic Acidosis or HAGMA and Non Anion Gap Metabolic Acidosis or NAGMA with 4 in each type) was most prevalent- 8 of 31(25.8%). Systematic approach was more effective in diagnosing mixed acid base disorders. By systematic method the findings of analysis in most cases could be correlated with the clinical condition and provisional diagnosis. Thus interpretation of ABDs by using stepwise approach could be useful to the clinicians in early diagnosis and management of the patients.

  14. Cerebral venous thrombosis

    NARCIS (Netherlands)

    Silvis, Suzanne M.; de Sousa, Diana Aguiar; Ferro, José M.; Coutinho, Jonathan M.

    2017-01-01

    Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults. Data from large international registries published in the past two decades have greatly improved our knowledge about the epidemiology, clinical manifestations and prognosis of CVT. The presentation of symptoms is

  15. Venous thromboembolism: The intricacies

    Directory of Open Access Journals (Sweden)

    Dutta T

    2009-01-01

    Full Text Available Venous thromboembolism (VTE has been a subject of great interest of late. Since Rudolph Virchow described the famous Virchow′s triad in 1856, there have been rapid strides in the understanding of the pathogenesis and factors responsible for it. Discovery of various thrombophilic factors, both primary and acquired, in the last 40 years has revolutionized prognostication and management of this potentially life-threatening condition due to its associated complication of pulmonary thromboembolism. Detailed genetic mapping and linkage analyses have been underlining the fact that VTE is a multifactorial disorder and a complex one. There are many gene-gene and gene-environment interactions that alter and magnify the clinical picture in this disorder. Point in case is pregnancy, where the risk of VTE is 100-150 times increased in the presence of Factor V Leiden, prothrombin mutation (Prothrombin 20210A and antithrombin deficiency. Risk of VTE associated with long-haul air flight has now been well recognized. Thrombotic events associated with antiphospholipid syndrome (APS are 70% venous and 30% arterial. Deep venous thrombosis and pulmonary embolism are the most common venous events, though unusual cases of catastrophes due to central vein thrombosis like renal vein thrombosis and Budd-Chiari syndrome (catastrophic APS may occur.

  16. Blood Pressure vs. Heart Rate

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Nov 13,2017 ... This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  17. Direct comparisons of commercial weight-loss programs on weight, waist circumference, and blood pressure: a systematic review

    Directory of Open Access Journals (Sweden)

    Rachit M. Vakil

    2016-06-01

    Full Text Available Abstract Background Obesity is common in the U.S. and many individuals turn to commercial programs to lose weight. Our objective was to directly compare weight loss, waist circumference, and systolic and diastolic blood pressure (SBP, DBP outcomes between commercially available weight-loss programs. Methods We conducted a systematic review by searching MEDLINE and the Cochrane Database of Systematic Reviews from inception to November 2014 and by using references identified by commercial programs. We included randomized, controlled trials (RCTs of at least 12 weeks duration that reported comparisons with other commercial weight-loss programs. Two reviewers extracted information on mean change in weight, waist circumference, SBP and DBP and assessed risk of bias. Results We included seven articles representing three RCTs. Curves participants lost 1.8 kg (95%CI: 0.1, 3.5 kg more than Weight Watchers in one comparison. There was no statistically significant difference in waist circumference change among the included programs. The mean reduction in SBP for SlimFast participants was 4.5 mmHg (95%CI: 0.4, 8.6 mmHg more than that of Atkins participants in one comparison. There was no significant difference in mean DBP changes among programs. Conclusions There is limited evidence that any one of the commercial weight-loss programs has superior results for mean weight change, mean waist circumference change, or mean blood pressure change.

  18. [Effectiveness of systematic self-management education on blood sugar level of patients in the community with type 2 diabetes].

    Science.gov (United States)

    Li, Xuebing; Zhou, Qiuhong; Zou, Fuzhen; Wu, Liaofang; Chen, Huiling; Liu, Zehao

    2012-04-01

    To explore the effectiveness of systematic self-management education on blood sugar level of patients in the community with type 2 diabetes. A total of 248 patients with type 2 diabetes from 10 communities of Changsha were randomized into intervention or control groups in February 2009. The intervention group received systematic self-management education, while the other received routine community education. Before and after intervention, fasting plasma glucose, 2 h postprandial plasma glucose and glycosylated hemoglobin were measured, and evaluated between the 2 groups. Fasting plasma glucose, 2 h postprandial plasma glucose and glycosylated hemoglobin levels of patients with diabetes from the two groups were generally comparable at baseline (P>0.05). After the intervention, these three indicators were all statistically significant between the 2 groups (Pblood sugar levels in the intervention group were obviously improved (Pcontrol group, fasting plasma glucose was not statistically improved (P>0.05), 2 h plasma glucose and glycosylated hemoglobin levels were improved (Pcontrol their blood sugar levels, and deserves further promotion.

  19. Fingertip replantation without venous anastomosis.

    Science.gov (United States)

    Chen, Yi-Chieh; Chan, Fuan Chiang; Hsu, Chung-Chen; Lin, Yu-Te; Chen, Chien-Tzung; Lin, Chih-Hung

    2013-03-01

    Replantation of amputated fingertips is a technical challenge, as many salvage procedures fail because no suitable vein in the fingertip is available for anastomosis. In this study, we examined our experience in fingertip replantation in cases without venous anastomosis with our established fingertip replantation treatment protocol. Between August 2002 and August 2010, a retrospective study examined all patients who had undergone fingertip replantation at Chang-Gung Memorial Hospital. All the patients (n = 24) suffered from complete digital amputations at or distal to the interphalangeal joint of the thumb, or distal to distal interphalangeal joint of the fingers. A total of 30 fingertips that were salvaged by microsurgical anastomosis of the digital arteries but not of digital veins were included in this study. On satisfactory arterial anastomosis, a 2-mm incision was made over the fingertip with a number 11 Scalpel blade, and 0.1 to 0.2 mL heparin (5000 IU/mL) was injected subcutaneously around the incision immediately and once per day thereafter to ensure continuous blood drainage from the replanted fingertip. None of the replanted nail plate was removed, and no medical leeches were used. The perfusion of the replanted digits and patient's hemoglobin level were closely monitored. The wound bleeding was maintained until physiologic venous outflow was restored. Of 30 fingertips, 27 (90%) replanted fingertips survived. The average length needed for maintaining external bleeding by chemical leech was 6.8 days (range, 5-10 days). Twelve patients (including a 2-year-old child) received blood transfusions. The average amount of blood transfusion in the 23 adults was 4.0 units (range, 0-16 units) for each patient or 3.29 units (range, 0-14 units) for each digit. A 2-year-old child received 100 mL blood transfusion or 50 mL for each digit. This study showed that a protocol that promotes controlled bleeding from the fingertip is essential to achieve consistent high

  20. Extrahepatic portal venous obstruction: The effects of early ligation of splenic artery during splenectomy

    Directory of Open Access Journals (Sweden)

    Gazula Suhasini

    2009-01-01

    Full Text Available Aim: To objectively demonstrate the gain in blood volume and blood components following early ligation of splenic artery during splenectomy and splenorenal shunts in children with extra hepatic portal venous obstruction (EHPVO. Methods: Twenty-eight children (20 males and 8 females, mean age: 9.9 (±3.2 years with EHPVO and hypersplenism were recruited. We followed a protocol of systematically locating and ligating the splenic artery first, followed by a 30-minute waiting period to allow the massive spleen to decongest via the splenic vein and venous collaterals and then completing the splenectomy by standard procedure. No intravenous fluid was administered during this 30-minute period. Blood samples were drawn just prior to splenic artery ligation and soon after splenectomy for the estimation of hematological and biochemical parameters. Results: We noticed a highly significant increase in the hemoglobin, hematocrit, leukocyte, platelet, and RBC counts by early ligation of the splenic artery (p < 0.0004. The gain in hemoglobin and hematocrit was equivalent to a transfusion of atleast 100-150 ml of packed RBC. The increase in platelet count was equivalent to a platelet transfusion of atleast 4 units of platelet concentrates in an adult. There is a positive correlation between the splenic weight and the platelet gain (p= 0.0568 and the splenic volume on preoperative imaging and the platelet gain (p= 0.0251. Conclusion: Early ligation of the splenic artery during splenectomy results in passive splenic decongestion and thereby a significant gain in blood components. This protocol appears to be a feasible blood conservation method to avoid blood transfusions in this group of hypersplenic EHPVO patients.

  1. Venous refocusing for volume estimation: VERVE functional magnetic resonance imaging.

    Science.gov (United States)

    Stefanovic, Bojana; Pike, G Bruce

    2005-02-01

    A novel, noninvasive magnetic resonance imaging-based method for measuring changes in venous cerebral blood volume (CBV(v)) is presented. Venous refocusing for volume estimation (VERVE) exploits the dependency of the spin-spin relaxation rate of deoxygenated blood on the refocusing interval. Interleaved CPMG EPI acquisitions following a train of either tightly or sparsely spaced hard refocusing pulses (every 3.7 or 30 msec, respectively) at matched echo time were used to isolate the blood signal while minimizing the intravascular blood oxygenation level dependent (BOLD) signal contribution. The technique was employed to determine the steady-state increase in the CBV(v) in the visual cortex (VC) in seven healthy adult volunteers during flickering checkerboard photic stimulation. A functional activation model and a set of previously collected in vitro human whole blood relaxometry data were used to evaluate the intravascular BOLD effect on the VERVE signal. The average VC venous blood volume change was estimated to be 16 +/- 2%. This method has the potential to provide efficient and continuous monitoring of venous cerebral blood volume, thereby enabling further exploration of the mechanism underlying BOLD signal changes upon physiologic, pathophysiologic, and pharmacologic perturbations.

  2. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... condition is known as deep vein thrombosis (DVT). Pulmonary embolism (PE) is a life-threatening event that ... and travels to the blood vessels of the lungs. DVT and PE, collectively known as venous thromboembolism, ...

  3. Primary care clinicians' attitudes towards point-of-care blood testing: a systematic review of qualitative studies.

    Science.gov (United States)

    Jones, Caroline H D; Howick, Jeremy; Roberts, Nia W; Price, Christopher P; Heneghan, Carl; Plüddemann, Annette; Thompson, Matthew

    2013-08-14

    Point-of-care blood tests are becoming increasingly available and could replace current venipuncture and laboratory testing for many commonly used tests. However, at present very few have been implemented in most primary care settings. Understanding the attitudes of primary care clinicians towards these tests may help to identify the barriers and facilitators to their wider adoption. We aimed to systematically review qualitative studies of primary care clinicians' attitudes to point-of-care blood tests. We systematically searched Medline, Embase, ISI Web of Knowledge, PsycINFO and CINAHL for qualitative studies of primary care clinicians' attitudes towards point-of-care blood tests in high income countries. We conducted a thematic synthesis of included studies. Our search identified seven studies, including around two hundred participants from Europe and Australia. The synthesis generated three main themes: the impact of point-of-care testing on decision-making, diagnosis and treatment; impact on clinical practice more broadly; and impact on patient-clinician relationships and perceived patient experience. Primary care clinicians believed point-of-care testing improved diagnostic certainty, targeting of treatment, self-management of chronic conditions, and clinician-patient communication and relationships. There were concerns about test accuracy, over-reliance on tests, undermining of clinical skills, cost, and limited usefulness. We identified several perceived benefits and barriers regarding point-of-care tests in primary care. These imply that if point-of-care tests are to become more widely adopted, primary care clinicians require evidence of their accuracy, rigorous testing of the impact of introduction on patient pathways and clinical practice, and consideration of test funding.

  4. Venous thromboembolism and pregnancy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2010-03-01

    Full Text Available Maristella D’Uva1, Pierpaolo Di Micco2, Ida Strina1, Giuseppe De Placido1Department of Obstetrics and Gynecology and Human Reproduction, “Federico II” University of Naples, Naples, Italy; 2Internal Medicine Division, Buonconsiglio Fatebenefratelli Hospital of Naples, Naples, ItalyAbstract: In recent decades, the association between a hypercoagulable state and its causes and adverse pregnancy outcome, in particular recurrent pregnancy loss (RPL has been studied extensively. Although the first studies were focused only on the association between thrombophilia and RPL, subsequent studies underlined also a potential role of antithrombotic treatment to prevent vascular complication such as venous thromboembolism (VTE during pregnancy. Thromboprophylaxis should be considered also for pregnant subjects carriers of molecular thrombophilia or that previously experienced VTE, in order to prevent VTE during pregnancy, while antithrombotic treatment for VTE should be performed during all pregnant periods.Keywords: thrombophilia, venous thromboembolism, recurrent pregnancy loss, factor V Leiden

  5. The dynamics of venous return and response to hypervolemia in the toad, Bufo marinus (L.)

    OpenAIRE

    Toews Daniel P; Killorn Erin E

    2001-01-01

    Abstract Background Venous return from the posterior region of amphibians travels by either two renal portal veins to the kidney or a central abdominal vein that drains into the hepatic portal system. The relative proportions of blood flow in these vessels has never been measured nor has a modification of flow been determined when venous return increases by changes in blood volume during hypervolemia or during increased volume input from the posterior lymph hearts. Results Venous return from ...

  6. Effect of Aerobic Exercise Training on Blood Pressure in Indians: Systematic Review

    OpenAIRE

    Punia, Sonu; Kulandaivelan, Sivachidambaram; Singh, Varun; Punia, Vandana

    2016-01-01

    Introduction. High blood pressure (BP) is one of the most important modifiable risk factors for cardiovascular diseases, which accounts for one in every eight deaths worldwide. It has been predicted that, by 2020, there would be 111% increase in cardiovascular deaths in India. Aerobic exercise in the form of brisk walking, jogging, running, and cycling would result in reduction in BP. Many meta-analytical studies from western world confirm this. However, there is no such review from Indian su...

  7. Efficiency of tranexamic acid in perioperative blood loss in hip arthroplasty: a systematic literature review and meta-analysis.

    Science.gov (United States)

    Pinzón-Florez, C E; Vélez Cañas, K M; Díaz Quijano, D M

    2015-05-01

    Tranexamic acid (TXA) is an antifibrinolytic drug used to reduce bleeding in mortality risk situations such as trauma. Our objective was to conduct a systematic literature review to evaluate the effectiveness and safety of TXA in reducing bleeding in hip arthroplasty. A systematic literature review and meta-analysis of primary studies similar to controlled trials was performed. Literature was searched in MEDLINE, Embase, Cochrane, LILACS, SciELO and Google Scholar. The review was proposed and undertaken by 2 reviewers and the inclusion criteria were: a) patients undergoing arthroplasty for primary unilateral hip replacement; b) comparison of a treatment group with TXA to a control group that received a placebo or no treatment at all, and c) outcome measures, total blood loss, number of patients receiving allogeneic transfusion and/or incidence of thromboembolic complications. The search was restricted to studies published from 1966 to June 2013. A total of 16 studies with 246 patients were retrieved for this review. The total blood loss outcome evidenced a weighted mean difference in favor of TXA vs. controls undergoing hip arthroplasty (-0.45 [P<0.001, 95% CI -0.65 to -0.24]). Weighted relative risk was estimated for the allogeneic transfusion requirement outcome, showing a trend in favor the TXA arm, with fewer patients requiring allogeneic transfusion in hip surgery (0.8 [P<0.02, 95% CI 0.57 to 1.11]); however, this trend was not statistically significant. There is a noticeable difference in methods for quantifying total blood loss across the studies reviewed. The need for transfusion outcomes are probably not significant taking into account the number of events in the TXA group. TXA can be routinely used to reduce intra- and post-operative blood loss in primary hip arthroplasty. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. The effect of ankle joint immobilization on lower limb venous flow.

    Science.gov (United States)

    Craik, Johnathan D; Clark, Amanda; Hendry, James; Sott, Andrea H; Hamilton, Paul D

    2015-01-01

    Below-knee cast immobilization is associated with an increased risk of developing deep vein thrombosis secondary to venous stasis. We investigated the effect of weight-bearing in a below-knee cast or pneumatic walking boot on lower limb venous blood flow. Duplex ultrasonography was used to measure venous blood flow in the popliteal vein of 10 healthy volunteers. Venous blood flow was measured while at rest, ambulating non-weight-bearing, partial weight-bearing, and full weight-bearing. Measurements were performed without ankle joint immobilization, with the ankle immobilized in a neutral cast, and with the ankle immobilized in a pneumatic walking boot in both neutral and equinus. There was no significant reduction in venous blood flow measurements between full weight-bearing without ankle joint immobilization and full weight-bearing in a neutral cast or neutral pneumatic walking boot. However, venous blood flow was reduced when partial weight-bearing (50%) and when full weight-bearing in a pneumatic walking boot in equinus. These results demonstrate that venous blood flow returned to normal levels when the subjects were permitted to fully bear weight in below-knee casts or walking boots, provided that the ankle joint was not in equinus. Weight-bearing status and ankle joint position should be appreciated during decisions for the provision of chemical thromboprophylaxis. © The Author(s) 2014.

  9. Near-infrared vascular imaging in peripheral venous and arterial access

    NARCIS (Netherlands)

    Cuper, N.J.

    2012-01-01

    Venous and arterial access are among the most widespread medical procedures performed in children. Especially in young children venous and arterial access can be problematic due to tiny blood vessels that are difficult to localize beneath a layer of baby fat. This thesis describes the development

  10. Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância Comparative study of a portable system for prothrombin monitoring using capillary blood against venous blood measurements in patients using oral anticoagulants: correlation and concordance

    Directory of Open Access Journals (Sweden)

    Tiago Luiz Luz Leiria

    2007-07-01

    Full Text Available FUNDAMENTO: O uso de anticoagulantes orais (ACO é comum na prática cardiológica, tendo como principais indicações a fibrilação atrial e próteses valvares. Os pacientes em uso de ACO necessitam de controle freqüente do tempo de protrombina (TP. Novos sistemas portáteis de monitorização, para medida do tempo de protrombina, sem necessidade da coleta de sangue por venopunção, facilitam a rotina desses pacientes. OBJETIVO: Comparar as medidas do TP realizadas pelo sistema Coaguchek S®, em sangue capilar, com o método padrão em sangue venoso. MÉTODOS: Cento e vinte e sete pacientes em acompanhamento no ambulatório de anticoagulação do Instituto de Cardiologia foram submetidos ao método convencional e coleta de sangue capilar da polpa digital para medida com o sistema Coaguchek S®. RESULTADOS: A idade foi de 58±14 anos, 90% eram brancos. As indicações de ACO foram fibrilação atrial 49,6% e próteses valvares 37,0%. O coeficiente de correlação r s foi 0,90 (p 3,5 foi de Kappa 73,5%. O sistema Coaguchek S® superestimou o INR em 0,15±0,85 unidades. Valores acima de 3,5 unidades de INR mostram discrepância importante entre as duas técnicas. CONCLUSÕES: O sistema Coaguchek S® mostrou boa correlação e bom grau de concordância quando comparado com o controle, com resultados menores que 4. Porém, valores de INR acima de 3,5 ainda necessitam de confirmação com o método padrão.BACKGROUND: Oral anticoagulants (OAC are widely used in cardiology and are mainly indicated in cases of atrial fibrillation and prosthetic heart valves. Regular prothrombin time (PT control is required for patients using OAC. New portable monitoring systems for measuring prothrombin time, eliminate the need to collect blood by venous puncture and facilitate daily life for these patients. OBJECTIVE: To compare PT measurements using the Coaguchek S™ system with capillary blood and the standard method in venous blood. METHODS: One hundred and

  11. Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Ndanuko, Rhoda N; Tapsell, Linda C; Charlton, Karen E; Neale, Elizabeth P; Batterham, Marijka J

    2016-01-01

    Hypertension is a major risk factor for developing cardiovascular disease, stroke, and kidney disease. To lower blood pressure (BP), several lifestyle changes are recommended such as weight loss, exercise, and following a healthy diet. Investigating the effect of single nutrients may have positive results, but food is consumed as part of a whole diet, resulting in nutrient interactions. The aim of this systematic review and meta-analysis was to assess the effect of dietary patterns on BP in adults. Studies that were published between January 1999 and June 2014 were retrieved using Scopus, Web of Science, and the MEDLINE database. Seventeen randomized controlled trials were included in the meta-analysis. The results suggest that healthy dietary patterns such as the Dietary Approaches to Stop Hypertension diet, Nordic diet, and Mediterranean diet significantly lowered systolic BP and diastolic BP by 4.26 mm Hg and 2.38 mm Hg, respectively. These diets are rich in fruit, vegetables, whole grains, legumes, seeds, nuts, fish, and dairy and low in meat, sweets, and alcohol. Lifestyle factors such as exercise and weight loss in combination with dietary changes may also reduce BP. Further research is needed to establish the effect of dietary patterns on BP in different cultures other than those identified in this review. The review was registered on PROSPERO (International prospective register of systematic reviews) as CRD42015016272. © 2016 American Society for Nutrition.

  12. Accuracy of LightCycler® SeptiFast for the detection and identification of pathogens in the blood of patients with suspected sepsis: a systematic review protocol

    OpenAIRE

    Dark, Paul; Wilson, Claire; Blackwood, Bronagh; McAuley, Danny F.; Perkins, Gavin D.; McMullan, Ronan; Gates, Simon; Warhurst, Geoffrey

    2012-01-01

    Background: There is growing interest in the potential utility of molecular diagnostics in improving the detection of life-threatening infection (sepsis). LightCycler® SeptiFast is a multipathogen probebased real-time PCR system targeting DNA sequences of bacteria and fungi present in blood samples within a few hours. We report here the protocol of the first systematic review of published clinical diagnostic accuracy studies of this technology when compared with blood culture in the setting o...

  13. Effect of Childhood Obesity Prevention Programs on Blood Pressure: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Cai, Li; Wu, Yang; Wilson, Renee F.; Segal, Jodi B.; Kim, Miyong T.; Wang, Youfa

    2015-01-01

    Background Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. Methods and Results We searched databases up to April 22, 2013 for relevant randomized controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet and/or physical activity intervention(s) and were followed for ≥1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic blood pressure (SBP) and diastolic blood pressure (DBP) using weighted random effects models. Of the 23 included intervention studies (involving 18,925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on SBP and 18 on DBP. The pooled intervention effect was −1.64 mmHg (95% CI: -2.56, −0.71; P=0.001) for SBP and -1.44 mmHg (95% CI: −2.28, −0.60; P=0.001) for DBP. The combined diet and physical activity interventions led to a significantly greater reduction in both SBP and DBP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP; while 11 interventions (39%) showed a significant desirable effect on BP, but not on adiposity-related outcomes. Conclusions Obesity prevention programs have a moderate effect on reducing BP and those targeting at both diet and physical activity seem to be more effective. PMID:24552832

  14. Toxoplasmosis in Blood Donors: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Foroutan-Rad, Masoud; Majidiani, Hamidreza; Dalvand, Sahar; Daryani, Ahmad; Kooti, Wesam; Saki, Jasem; Hedayati-Rad, Faezeh; Ahmadpour, Ehsan

    2016-07-01

    Transfusion-transmissible infections include pathogens that may cause severe and debilitating diseases. Toxoplasmosis is a cosmopolitan neglected parasitic infection that can lead to severe complications including death in immune-compromised patients or following infection in utero. Multiple studies have demonstrated the transmission of Toxoplasma gondii by blood transfusion. The objective of this review was to comprehensively assess the seroprevalence rate of Toxoplasma in blood donors from a worldwide perspective. Seven electronic databases (PubMed, Science Direct, Web of Science, Scopus, Cochrane, Ovid, and Google Scholar) were searched using medical subject headings terms. A total of 43 records met the inclusion criteria in which 20,964 donors were tested during the period from January 1980 to June 2015. The overall weighted prevalence of exposure to toxoplasmosis in blood donors was 33% (95% confidence interval [CI], 28%-39%). The seroprevalences of immunoglobulin (Ig)M and both IgG and IgM antibodies were 1.8% (95% CI, 1.1%-2.4%) and 1.1% (95% CI, 0.3%-1.8%), respectively. The highest and the lowest seroprevalences of toxoplasmosis were observed in Africa (46%; 95% CI, 14%-78%) and in Asia (29%; 95% CI, 23%-35%), respectively. Brazil (75%) and Ethiopia (73%) were identified as countries with high seroprevalence. Because positive serology does not imply infectiousness and because seroprevalence is high in some nations, a positive serology test result alone cannot be used as an effective method for donor screening. Future research for methods to prevent transfusion-transmitted toxoplasmosis may derive benefit from studies conducted in areas of high endemicity. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The difference between fingerstick and venous hemoglobin and hematocrit varies by sex and iron stores.

    Science.gov (United States)

    Cable, Ritchard G; Steele, Whitney R; Melmed, Russell S; Johnson, Bryce; Mast, Alan E; Carey, Patricia M; Kiss, Joseph E; Kleinman, Steven H; Wright, David J

    2012-05-01

    Fingerstick blood samples are used to estimate donor venous hemoglobin (Hb). Fingerstick Hb or hematocrit (Hct) was determined routinely for 2425 selected donors at six blood centers, along with venous Hb. Using sex and measures of iron status including absent iron stores (AIS; ferritin < 12 ng/mL), linear regression models were developed to predict venous Hb from fingerstick. Across all subjects, fingerstick Hb was higher than venous Hb in the higher part of the clinical range, but lower in the lower part of the range. The relationship varied by sex and iron status. Across centers, a female donor had on average a venous Hb result 0.5 to 0.8 g/dL lower than a male donor with the same fingerstick Hb and iron status. Similarly, a donor with AIS had on average a venous Hb result 0.3 to 1.1 g/dL lower than an iron-replete donor with the same fingerstick value and sex. An iron-replete male donor with a fingerstick result at the cutoff (Hb 12.5 g/dL) had an acceptable expected venous Hb (12.8 to 13.8 g/dL). A female donor with AIS with a fingerstick result at the cutoff had an expected venous Hb below 12.5 g/dL (11.7 to 12.4 g/dL). Of females with AIS, 40.2% donated blood when their venous Hb was less than 12.5 g/dL. Fingerstick is considered a useful estimator of venous Hb. However, in some donor groups, particularly female donors with AIS, fingerstick overestimates venous Hb at the donation cutoff. This significant limitation should be considered in setting donor fingerstick Hb or Hct requirements. © 2011 American Association of Blood Banks.

  17. Red blood cell alloimmunization in transfused patients in sub-Saharan Africa: A systematic review and meta-analysis.

    Science.gov (United States)

    Ngoma, Alain M; Mutombo, Paulin B; Ikeda, Kazuhiko; Nollet, Kenneth E; Natukunda, Bernard; Ohto, Hitoshi

    2016-04-01

    Previous studies of Sub-Saharan Africans show significant alloimmunization to red blood cell (RBC) antigens, but country-specific data are limited. Thus, the aim of this study was to estimate, by meta-analysis, the overall proportion of red blood cell alloantibodies among transfused patients. We systematically searched Medline, Embase, and the Africa-Wide Information database to identify relevant studies in any language. Case reports, comments, letters, conference abstracts, editorials, and review articles were excluded. Of the 269 potentially relevant articles, 11 studies fulfilled our selection criteria. Overall proportions of alloimmunization were 6.7 (95% CI: 5.7, 7.8) per 100 transfused patients. With regard to antibody specificity, among clinically significant antibodies, anti-E ranked as the most common, followed by anti-K, anti-C and anti-D. Meta-analysis of available literature quantifies and qualifies the clinical challenge of RBC alloimmunization among transfused patients in Sub-Saharan Africa. These results should drive policy decisions in favour of routine testing of RBC antigens and irregular antibodies for transfused patients as a standard of care throughout Sub-Saharan Africa. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Varicose Veins: Role of Mechanotransduction of Venous Hypertension

    Science.gov (United States)

    Atta, Hussein M.

    2012-01-01

    Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins. PMID:22489273

  19. The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Khan, K; Jovanovski, E; Ho, H V T; Marques, A C R; Zurbau, A; Mejia, S B; Sievenpiper, J L; Vuksan, V

    2018-01-01

    Dietary fiber intake, especially viscous soluble fiber, has been established as a means to reduce cardiometabolic risk factors. Whether this is true for blood pressure remains controversial. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate the effects of viscous soluble fiber supplementation on blood pressure and quantify the effect of individual fibers. MEDLINE, Embase, and Cochrane databases were searched. We included RCTs of ≥4-weeks in duration assessing viscous fiber supplementation from five types: β-glucan from oats and barley, guar gum, konjac, pectin and psyllium, on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Study data were pooled using the generic inverse variance method with random effects models and expressed as mean differences (MD) with 95% confidence intervals (CIs). Twenty-two (N = 1430) and twenty-one RCTs (N = 1343) were included in the final analysis for SBP and DBP, respectively. Viscous fiber reduced SBP (MD = -1.59 mmHg [95% CI: -2.72,-0.46]) and DBP (MD = -0.39 mmHg [95% CI: -0.76,-0.01]) at a median dose of 8.7 g/day (1.45-30 g/day) over a median follow-up of 7-weeks. Substantial heterogeneity in SBP (I 2  = 72%, P fiber types, SBP reductions were observed only for supplementation using psyllium fiber (MD = -2.39 mmHg [95% CI: -4.62,-0.17]). Viscous soluble fiber has an overall lowering effect on SBP and DBP. Inclusion of viscous fiber to habitual diets may have additional value in reducing CVD risk via improvement in blood pressure. ClinicalTrials.gov identifier-NCT02670967. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  20. Cerebral venous thrombosis.

    Science.gov (United States)

    Ameri, A; Bousser, M G

    1992-02-01

    Neuroimagining facilities allow early recognition of cerebral venous thrombosis (CVT), which now appears far more common than previously assumed. The diagnosis remains difficult because of a wide spectrum of clinical presentation and a highly variable mode of onset. Numerous conditions (presently mostly noninfectious) can cause or predispose to CVT, which therefore requires an extensive etiologic work-up. The functional and vital prognosis is much better than classically thought with, in noninfectious CVT, a fatality rate of less than 10% and a complete recovery in over 70%. Although spontaneous recovery is possible, the efficacy of heparin is now well established.

  1. Correlação entre gasometria atrial direita e índice cardíaco no pós-operatório de cirurgia cardíaca Correlation between right atrial venous blood gasometry and cardiac index in cardiac surgery postoperative period

    Directory of Open Access Journals (Sweden)

    João Jackson Duarte

    2010-06-01

    Full Text Available OBJETIVO: Determinar a confiabilidade em se correlacionar o índice cardíaco com os dados fornecidos pela gasometria do sangue venoso atrial direito em pacientes submetidos à cirurgia cardíaca, durante o período pós-operatório. MÉTODOS: A partir das amostras de sangue arterial e venoso do átrio direito, colhidas no pós-operatório de cirurgia cardíaca, foram determinados os parâmetros de oxigênio do sangue venoso do átrio direito. Estes parâmetros foram então comparados com o índice cardíaco determinado pela termodiluição. RESULTADOS: Houve boa correlação entre a saturação de oxigênio do sangue venoso do átrio direito (SvO2, diferença artério-venosa do conteúdo de oxigênio do sangue colhido no átrio direito e o índice cardíaco aferido pela termodiluição, com boa sensibilidade e especificidade e alto valor preditivo positivo e negativo. A pressão do sangue do átrio direito (PvO2 apresentou baixa sensibilidade na estimativa de baixo débito cardíaco. CONCLUSÃO: No pós-operatório de cirurgia cardíaca, a SvO2e a diferença artério-venosa do conteúdo de oxigênio (C(avO2 apresentaram-se como parâmetros confiáveis correlacionados a baixo débito cardíaco. A PvO2 foi pouco sensível no diagnóstico de baixo débito no pós-operatório de cirurgia cardíaca.OBJECTIVE: To determine, even during postoperative period, the confiability of the cardiac index correlate with the data data given by a central atrial venous blood gasometry in patients who underwent cardiac surgery. METHODS: From the sample of arterial and venous blood of right atrium gathered in postoperative of cardiac surgery, it was determinated the hemoglobin concentration and the gasometric study through what was observed of the venous oxygen saturation (SvO2 and the partial pressure of oxygen from venous blood gathered in right atrium (PvO2, add to the calculation of artery-venous difference of the oxygen content - radial artery / right atrium (C

  2. Transjugular Intrahepatic Portosystemic Shunt for Maintenance of Portal Venous Patency in Liver Transplant Candidates

    Directory of Open Access Journals (Sweden)

    Ron Charles Gaba

    2013-01-01

    Full Text Available Maintenance of portal venous patency is vital to liver transplant candidates, as the presence of portal vein thrombosis (PVT adversely impacts clinical outcomes by increasing surgical complexity and decreasing postoperative survival. By enhancing portal venous blood flow, transjugular intrahepatic portosystemic shunt (TIPS creation may enable clearance of PVT and preservation of portal venous patency in cirrhotic patients. Herein, we describe four cases in which TIPS produced and sustained an open portal venous system in liver transplant candidates with partial PVT. All patients demonstrated rapid and effective flow-enabled clearance of clot and intermediate to long-term preservation of portal venous flow. On this basis, we propose that maintenance of portal venous patency in liver transplant candidates with partial PVT represents a developing indication for TIPS.

  3. Blood Pressure Response to Meditation and Yoga: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Park, Seong-Hi; Han, Kuem Sun

    2017-09-01

    To introduce research that presents scientific evidence regarding the effects of mantra and mindfulness meditation techniques and yoga on decreasing blood pressure (BP) in patients who have hypertension. A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, EMBASE, CINAHL, PsycINFO, KoreaMed, and NDSL by using the following keywords: "hypertension," "blood pressure," "psychotherapy," "relaxation therapy," "meditation," "yoga," and "mind-body therapy." The Cochrane's Risk of Bias was applied to assess the internal validity of the randomized controlled trial studies. Thirteen studies were analyzed in this meta-analysis by using Review Manager 5.3. Among 510 possible studies, 13 met the selection criteria. Seven examined meditation, and six examined yoga. The meta-analysis indicated that meditation and yoga appeared to decrease both systolic and diastolic BP, which were within similar baseline ranges, and the reduction was statistically significant; however, some results showed little difference. After an in-depth analysis of those results, BP range and patient age were revealed as the factors that affected the different results in some reports. In particular, meditation played a noticeable role in decreasing the BP of subjects older than 60 years of age, whereas yoga seemed to contribute to the decrease of subjects aged less than 60 years. While acknowledging the limitations of this research due to the differences in BP and the participants' ages, meditation and yoga are demonstrated to be effective alternatives to pharmacotherapy. Given that BP decreased with the use of meditation and yoga, and this effect varied in different age groups, scientifically measured outcomes indicate that these practices are safe alternatives in some cases.

  4. Deciding between using the first or second drop of blood for the self monitoring of blood glucose.

    Science.gov (United States)

    Li, Min; Wang, Xiaoli; Shan, Zhongyan

    2014-12-01

    To explore whether the first or the second drop of blood is more suitable for the self-monitoring of blood glucose (SMBG). SMBG was employed in hospitalized patients using the first and second drop of blood. Venous blood glucose was measured meanwhile. The differences in blood glucose measurements were then compared in groups with different regions of blood glucose levels. There were 802 groups of blood glucose in 526 patients. There was no significant difference in the blood glucose levels of the first and second drop of blood and venous blood. However, after combining then dividing measurements into six groups according to blood glucose concentration, we found statistically significant differences between the blood glucose levels obtained from the first drop, second drop, and venous blood in the groups containing blood glucose values blood can be used for performing SMBG to assess real-time venous glucose. By categorizing blood glucose into different levels more accurately, we observed that there was no significant difference between the first or second drop of blood and the venous blood glucose value when blood glucose levels were maintained between 10 and 20 mmol/L. When blood glucose levels were below 10 mmol/L, the value obtained from first drop of blood was close to that from venous blood, whereas when the blood glucose level is >20 mmol/L, the blood glucose value from the second drop of blood was more accurate. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  5. Developmental venous anomaly in the newborn brain

    International Nuclear Information System (INIS)

    Horsch, S.; Govaert, P.; Cowan, F.M.; Benders, M.J.N.L.; Groenendaal, F.; Vries, L.S. de; Lequin, M.H.; Saliou, G.

    2014-01-01

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age. (orig.)

  6. Developmental venous anomaly in the newborn brain

    Energy Technology Data Exchange (ETDEWEB)

    Horsch, S. [Erasmus MC-Sophia Children' s Hospital, Department of Neonatology, Rotterdam (Netherlands); Helios Klinikum Berlin-Buch, Department of Neonatology, Berlin (Germany); Govaert, P. [Erasmus MC-Sophia Children' s Hospital, Department of Neonatology, Rotterdam (Netherlands); Cowan, F.M. [Hammersmith Hospital, Department of Paediatrics, Imperial College Healthcare NHS Trust, London (United Kingdom); Benders, M.J.N.L.; Groenendaal, F.; Vries, L.S. de [University Medical Centre Utrecht, Wilhelmina Children' s Hospital, Department of Neonatology, Utrecht (Netherlands); Lequin, M.H. [Erasmus MC/Sophia Children' s Hospital, Department of Paediatric Radiology, Rotterdam (Netherlands); Saliou, G. [University Hospital, Department of Neuroradiology, Le Kremlin-Bicetre (France)

    2014-07-15

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age. (orig.)

  7. Developmental venous anomaly in the newborn brain.

    Science.gov (United States)

    Horsch, S; Govaert, P; Cowan, F M; Benders, M J N L; Groenendaal, F; Lequin, M H; Saliou, G; de Vries, L S

    2014-07-01

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age.

  8. Venous access: options, approaches and issues

    Energy Technology Data Exchange (ETDEWEB)

    Asch, M.R. [Univ. of Toronto, Mount Sinai Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    2001-06-01

    Venous access is an essential part of medical practice. It is needed to obtain blood samples to make the diagnosis and to administer fluids or medicines as part of treatment. Although relatively new in the history of medicine, the placement and maintenance of the various venous access devices now occupies a significant portion of many vascular and interventional radiology practices. Thus, it is important to have a thorough understanding of these devices and their uses. The first long-term venous access devices were used in 1973. These were placed via a surgical cut-down on the subclavian vein. In 1982, the first subcutaneous implantable ports were described. These procedures were initially performed by surgeons, but over the last 5-10 years, both the insertion and management of these devices has shifted to interventional radiologists. Peripherally inserted central catheter (PICC) lines have almost completely supplanted the use of standard central lines (Fig. 1). A number of factors have facilitated this - namely, ready and less expensive room access, outpatient procedure and radiologists' accessibility and familiarity with image-guidance procedures and catheters and guide wires. (author)

  9. Venous access: options, approaches and issues

    International Nuclear Information System (INIS)

    Asch, M.R.

    2001-01-01

    Venous access is an essential part of medical practice. It is needed to obtain blood samples to make the diagnosis and to administer fluids or medicines as part of treatment. Although relatively new in the history of medicine, the placement and maintenance of the various venous access devices now occupies a significant portion of many vascular and interventional radiology practices. Thus, it is important to have a thorough understanding of these devices and their uses. The first long-term venous access devices were used in 1973. These were placed via a surgical cut-down on the subclavian vein. In 1982, the first subcutaneous implantable ports were described. These procedures were initially performed by surgeons, but over the last 5-10 years, both the insertion and management of these devices has shifted to interventional radiologists. Peripherally inserted central catheter (PICC) lines have almost completely supplanted the use of standard central lines (Fig. 1). A number of factors have facilitated this - namely, ready and less expensive room access, outpatient procedure and radiologists' accessibility and familiarity with image-guidance procedures and catheters and guide wires. (author)

  10. A systematically improved high quality genome and transcriptome of the human blood fluke Schistosoma mansoni.

    Directory of Open Access Journals (Sweden)

    Anna V Protasio

    2012-01-01

    Full Text Available Schistosomiasis is one of the most prevalent parasitic diseases, affecting millions of people in developing countries. Amongst the human-infective species, Schistosoma mansoni is also the most commonly used in the laboratory and here we present the systematic improvement of its draft genome. We used Sanger capillary and deep-coverage Illumina sequencing from clonal worms to upgrade the highly fragmented draft 380 Mb genome to one with only 885 scaffolds and more than 81% of the bases organised into chromosomes. We have also used transcriptome sequencing (RNA-seq from four time points in the parasite's life cycle to refine gene predictions and profile their expression. More than 45% of predicted genes have been extensively modified and the total number has been reduced from 11,807 to 10,852. Using the new version of the genome, we identified trans-splicing events occurring in at least 11% of genes and identified clear cases where it is used to resolve polycistronic transcripts. We have produced a high-resolution map of temporal changes in expression for 9,535 genes, covering an unprecedented dynamic range for this organism. All of these data have been consolidated into a searchable format within the GeneDB (www.genedb.org and SchistoDB (www.schistodb.net databases. With further transcriptional profiling and genome sequencing increasingly accessible, the upgraded genome will form a fundamental dataset to underpin further advances in schistosome research.

  11. Arterial Spin Labeling and Blood Oxygen Level-Dependent MRI Cerebrovascular Reactivity in Cerebrovascular Disease : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Smeeing, Diederik P J; Hendrikse, Jeroen; Petersen, Esben T; Donahue, Manus J; de Vis, Jill B

    2016-01-01

    BACKGROUND: The cerebrovascular reactivity (CVR) results of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI studies performed in patients with cerebrovascular disease (steno-occlusive vascular disease or stroke) were systematically reviewed. SUMMARY: Thirty-one articles were

  12. Chronic Venous Insufficiency

    Science.gov (United States)

    ... circulation of blood in the hypertension or high blood pressure in the vein. This leg veins is impaired. CVI may affect ... Prolonged standing • Heavy lifting Limited physical activity, high blood ... varicose veins in women. Diagnosis CVI is primarily diagnosed by ...

  13. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  14. Venous Thromboembolism in Adolescents

    Directory of Open Access Journals (Sweden)

    Aneta Samková

    2012-01-01

    Full Text Available The incidence of venous thromboembolism (VTE during childhood is low with two peaks – neonatal and adolescent age. This retrospective study is focused on clinical characteristics of VTE during adolescence. The main goals are to assess the most frequent inherited and acquired risk factors and to evaluate the benefit of D-dimers in diagnostics of venous thromboemblism. The data of 18 adolescents were analysed – 16 girls (88.9%, 2 boys (11.1%. In 9 patients (50% thrombosis of the lower limb deep veins was diagnosed, six patients (33.3% suffered from symptomatic pulmonary embolism (PE and 3 patients (16.7% from thrombosis at unusual sites. One patient had an idiopathic VTE, the mean number of the inherited and acquired risk factors was 2.6. The most frequent inherited risk factor was Leiden mutation of factor V (27.8%. The most frequent acquired risk factor was oral contraception (OC in 12 out of 16 girls (75%. All of our patients on oral contraception had one or more additional risk factors. 10 out of 18 (55.6% patients with VTE had elevated activity of factor VIII. The sensitivity of D-dimers was low (50% in patients with distal lower limb thrombosis, but very high (100% in patients with PE.

  15. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  16. Patterns of superficial venous arrangement in the cubital fossa of ...

    African Journals Online (AJOL)

    2012-02-26

    Feb 26, 2012 ... Background: The cubital fossa is a common site for the removal of venous blood for analysis, transfusion, and intravenous therapy. .... have subgroups consisting of minor variations based on the following criteria: Type A ... cubital fossa, consisting of minor M variation: Type A1 is the typical M shaped pattern ...

  17. Reduction in central venous pressure enhances erythropoietin synthesis

    DEFF Research Database (Denmark)

    Montero, D.; Rauber, S.; Gøtze, Jens Peter

    2016-01-01

    AIMS: Erythropoiesis is a tightly controlled biological event, but its regulation under non-hypoxic conditions, however, remains unresolved. We examined whether acute changes in central venous blood pressure (CVP) elicited by whole-body tilting affect erythropoietin (EPO) concentration according...

  18. Systematic review and meta-analysis of randomised controlled trials testing the effects of vitamin C supplementation on blood lipids.

    Science.gov (United States)

    Ashor, Ammar W; Siervo, Mario; van der Velde, Femke; Willis, Naomi D; Mathers, John C

    2016-06-01

    Randomised controlled trials (RCTs) in humans revealed contradictory results regarding the effect of vitamin C supplementation on blood lipids. We aimed to conduct a systematic review and meta-analysis of RCTs investigating the effect of vitamin C supplementation on total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triglycerides and to determine whether the effects are modified by the participants' or intervention characteristics. Four databases (PubMed, Embase, Scopus and Cochrane Library) were searched from inception until August 2014 for RCTs supplementing adult participants with vitamin C for ≥ 2 weeks and reporting changes in blood lipids. Overall, vitamin C supplementation did not change blood lipids concentration significantly. However, supplementation reduced total cholesterol in younger participants (≤52 years age) (-0.26 mmol/L, 95% CI: -0.45, -0.07) and LDL-C in healthy participants (-0.32 mmol/L, 95% CI: -0.57, -0.07). In diabetics, vitamin C supplementation reduced triglycerides significantly (-0.15 mmol/L, 95% CI: -0.30, -0.002) and increased HDL-C significantly (0.06 mmol/L, 95% CI: 0.02, 0.11). Meta-regression analyses showed the changes in total cholesterol (β: -0.24, CI: -0.36, -0.11) and in triglycerides (β: -0.17, CI: -0.30, -0.05) following vitamin C supplementation were greater in those with higher concentrations of these lipids at baseline. Greater increase in HDL-C was observed in participants with lower baseline plasma concentrations of vitamin C (β: -0.002, CI: -0.003, -0.0001). Overall, vitamin C supplementation had no significant effect on lipid profile. However, subgroup and sensitivity analyses showed significant reductions in blood lipids following supplementation in sub-populations with dyslipidaemia or low vitamin C status at baseline. PROSPERO Database registration: CRD42014013487, http://www.crd.york.ac.uk/prospero/. Copyright © 2015

  19. Estimated venous return surface and cardiac output curve precisely predicts new hemodynamics after volume change.

    Science.gov (United States)

    Sugimachi, Masaru; Sunagawa, Kenji; Uemura, Kazunori; Kamiya, Atsunori; Shimizu, Shuji; Inagaki, Masashi; Shishido, Toshiaki

    2010-01-01

    In our extended Guyton's model, the ability of heart to pump blood is characterized by a cardiac output curve and the ability of vasculature to pool blood by a venous return surface. These intersect in a three-dimensional coordinate system at the operating right atrial pressure, left atrial pressure, and cardiac output. The baseline cardiac output curve and venous return surface and their changes after volume change would predict new hemodynamics. The invasive methods needed to precisely characterize cardiac output curve and venous return surface led us to aim at estimating cardiac output curve and venous return surface from a single hemodynamic measurement. Using the average values for two logarithmic function parameters, and for two slopes of a surface, we were able to estimate cardiac output curve and venous return surface. The estimated curve and surface predicted new hemodynamics after volume change precisely.

  20. Sources of inaccuracy in the measurement of adult patients’ resting blood pressure in clinical settings: a systematic review

    Science.gov (United States)

    Kallioinen, Noa; Hill, Andrew; Horswill, Mark S.; Ward, Helen E.; Watson, Marcus O.

    2017-01-01

    Background: To interpret blood pressure (BP) data appropriately, healthcare providers need to be knowledgeable of the factors that can potentially impact the accuracy of BP measurement and contribute to variability between measurements. Methods: A systematic review of studies quantifying BP measurement inaccuracy. Medline and CINAHL databases were searched for empirical articles and systematic reviews published up to June 2015. Empirical articles were included if they reported a study that was relevant to the measurement of adult patients’ resting BP at the upper arm in a clinical setting (e.g. ward or office); identified a specific source of inaccuracy; and quantified its effect. Reference lists and reviews were searched for additional articles. Results: A total of 328 empirical studies were included. They investigated 29 potential sources of inaccuracy, categorized as relating to the patient, device, procedure or observer. Significant directional effects were found for 27; however, for some, the effects were inconsistent in direction. Compared with true resting BP, significant effects of individual sources ranged from −23.6 to +33 mmHg SBP and −14 to +23 mmHg DBP. Conclusion: A single BP value outside the expected range should be interpreted with caution and not taken as a definitive indicator of clinical deterioration. Where a measurement is abnormally high or low, further measurements should be taken and averaged. Wherever possible, BP values should be recorded graphically within ranges. This may reduce the impact of sources of inaccuracy and reduce the scope for misinterpretations based on small, likely erroneous or misleading, changes. PMID:27977471

  1. The effect of black tea on blood pressure: a systematic review with meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Arno Greyling

    Full Text Available Epidemiological evidence has linked consumption of black tea, produced from Camellia sinensis, with a reduced risk of cardiovascular diseases. However, intervention studies on the effects of tea consumption on blood pressure (BP have reported inconsistent results. Our objective was to conduct a systematic literature review with meta-analysis of controlled human intervention studies examining the effect of tea consumption on BP.We systematically searched Medline, Biosis, Chemical Abstracts and EMBASE databases through July 2013. For inclusion, studies had to meet the following pre-defined criteria: 1 placebo controlled design in human adults, 2 minimum of 1 week black tea consumption as the sole intervention, 3 reported effects on systolic BP (SBP or diastolic BP (DBP or both. A random effects model was used to calculate the pooled overall effect of black tea on BP.Eleven studies (12 intervention arms, 378 subjects, dose of 4-5 cups of tea met our inclusion criteria. The pooled mean effect of regular tea ingestion was -1.8 mmHg (95% CI: -2.8, -0.7; P = 0.0013 for SBP and -1.3 mmHg (95% CI: -1.8, -0.8; P<0.0001 for DBP. In covariate analyses, we found that the method of tea preparation (tea extract powders versus leaf tea, baseline SBP and DBP, and the quality score of the study affected the effect size of the tea intervention (all P<0.05. No evidence of publication bias could be detected.Our meta-analysis indicates that regular consumption of black tea can reduce BP. Although the effect is small, such effects could be important for cardiovascular health at population level.

  2. Routine testing for blood-borne viruses in prisons: a systematic review.

    Science.gov (United States)

    Rumble, Caroline; Pevalin, David J; O'Moore, Éamonn

    2015-12-01

    People in prison have a higher burden of blood-borne virus (BBV) infection than the general population, and prisons present an opportunity to test for BBVs in high-risk, underserved groups. Changes to the BBV testing policies in English prisons have recently been piloted. This review will enable existing evidence to inform policy revisions. We describe components of routine HIV, hepatitis B and C virus testing policies in prisons and quantify testing acceptance, coverage, result notification and diagnosis. We searched five databases for studies of both opt-in (testing offered to all and the individual chooses to have the test or not) and opt-out (the individual is informed the test will be performed unless they actively refuse) prison BBV testing policies. Forty-four studies published between 1989 and 2013 met the inclusion criteria. Of these, 82% were conducted in the USA, 91% included HIV testing and most tested at the time of incarceration. HIV testing acceptance rates ranged from 22 to 98% and testing coverage from 3 to 90%. Mixed results were found for equity in uptake. Six studies reported reasons for declining a test including recent testing and fear. While the quality of evidence is mixed, this review suggests that reasonable rates of uptake can be achieved with opt-in and, even better, with opt-out HIV testing policies. Little evidence was found relating to hepatitis testing. Policies need to specify exclusion criteria and consider consent processes, type of test and timing of the testing offer to balance acceptability, competence and availability of individuals. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

  3. Effect of childhood obesity prevention programs on blood pressure: a systematic review and meta-analysis.

    Science.gov (United States)

    Cai, Li; Wu, Yang; Wilson, Renee F; Segal, Jodi B; Kim, Miyong T; Wang, Youfa

    2014-05-06

    Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. We searched databases up to April 22, 2013, for relevant randomized, controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet or physical activity intervention(s) and were followed for ≥ 1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic BP and diastolic BP with the use of weighted random-effects models. Of the 23 included intervention studies (involving 18 925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on systolic BP and 18 on diastolic BP. The pooled intervention effect was -1.64 mm Hg (95% confidence interval, -2.56 to -0.71; P=0.001) for systolic BP and -1.44 mm Hg (95% confidence interval, -2.28 to -0.60; P=0.001) for diastolic BP. The combined diet and physical activity interventions led to a significantly greater reduction in both systolic BP and diastolic BP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP, whereas 11 interventions (39%) showed a significant desirable effect on BP but not on adiposity-related outcomes. Obesity prevention programs have a moderate effect on reducing BP, and those targeting both diet and physical activity seem to be more effective.

  4. Effect of cheese consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    de Goede, Janette; Geleijnse, Johanna M; Ding, Eric L; Soedamah-Muthu, Sabita S

    2015-05-01

    Cheese may affect lipids and lipoproteins differently than other high-fat dairy foods.  The present systematic review and meta-analysis was performed to evaluate randomized controlled trials that examined the effect of cheese consumption compared with another food product on blood lipids and lipoproteins.  A systematic literature search of the MEDLINE, Embase, Scopus, CAB Abstracts, the Cochrane Controlled Trials Register, and the clinicaltrials.gov website was performed.  A total of 12 randomized controlled trials (RCTs) were identified that examined the effect of cheese consumption on blood lipids and lipoproteins in healthy adults.  A meta-analysis of 5 RCTs that compared the effects of hard cheese and butter, both of which had a similar ratio of polyunsaturated fatty acids to saturated fatty acids (P/S ratio), was performed.  Compared with butter intake, cheese intake (weighted mean difference: 145.0 g/d) reduced low-density lipoprotein cholesterol (LDL-C) by 6.5% (-0.22 mmol/l; 95%CI: -0.29 to -0.14) and high-density lipoprotein cholesterol (HDL-C) by 3.9% (-0.05 mmol/l; 95%CI: -0.09 to -0.02) but had no effect on triglycerides. Compared with intake of tofu or fat-modified cheese, cheese intake increased total cholesterol or LDL-C, as was expected on the basis of the P/S ratio of the diets. There was insufficient data to compare intake of cheese with intake of other foods.  Despite the similar P/S ratios of hard cheese and butter, consumption of hard cheese lowers LDL-C and HDL-C when compared with consumption of butter. Whether these findings can be attributed to calcium, specific types of saturated fatty acids, or the food matrix of cheese warrants further research. . © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. Perioperative Blood Transfusion Promotes Worse Outcomes of Bladder Cancer after Radical Cystectomy: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    You-Lin Wang

    Full Text Available Multiple studies have investigated the effect of perioperative blood transfusion (PBT for patients with radical cystectomy (RC, but the results have been inconsistent. We conducted a systematic review and meta-analysis to investigate the relationship between PBT and the clinical outcomes of RC patients.We searched MEDLINE, EMBASE, the Cochrane library and BIOSIS previews to identify relevant literature for studies that focused on the relationship of PBT and outcomes of patients undergoing RC. A fixed or random effects model was used in this meta-analysis to calculate the pooled hazard ratio (HR with 95% confidence intervals (CIs.A total of 7080 patients in 6 studies matched the selection criteria. Aggregation of the data suggested that PBT in patients who underwent RC correlated with increased all-cause mortality, cancer-specific mortality and cancer recurrence. The combined HRs were 1.19 (n = 6 studies, 95% CI: 1.11-1.27, Z = 4.71, P<0.00001, 1.17 (n = 4 studies, 95% CI: 1.06-1.30, Z = 3.06, P = 0.002, 1.14 (n = 3 studies, 95% CI: 1.03-1.27, Z = 2.50, P = 0.01, respectively. The all-cause mortality associated with PBT did not vary by the characteristics of the study, including number of study participants, follow-up period and the median blood transfusion ratio of the study.Our data showed that PBT significantly increased the risks of all-cause mortality, cancer-specific mortality and cancer recurrence in patients undergoing RC for bladder cancer.

  6. Venous thromboembolism in women

    DEFF Research Database (Denmark)

    Group, ESHRE Capri Workshop; Skouby, Sven Olaf

    2013-01-01

    BACKGROUND Venous thromboembolism (VTE) is a specific reproductive health risk for women. METHODS Searches were performed in Medline and other databases. The selection criteria were high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed...... is associated with an inherited thrombophilia in men and women. Changes in the coagulation system and in the risk of clinical VTE in women also occur during pregnancy, with the use of reproductive hormones and as a consequence of ovarian stimulation when hyperstimulation syndrome and conception occur together...... therapy (HRT) increases the VTE risk 2- to 4-fold. There is a synergistic effect between thrombophilia and the various reproductive risks. Prevention of VTE during pregnancy should be offered to women with specific risk factors. In women who are at high risk, CHC and HRT should be avoided. CONCLUSIONS...

  7. Prevalence of High Blood Pressure in 122,053 Adolescents: A Systematic Review and Meta-Regression

    Science.gov (United States)

    de Moraes, Augusto César Ferreira; Lacerda, Maria Beatriz; Moreno, Luis A.; Horta, Bernardo L.; Carvalho, Heráclito Barbosa

    2014-01-01

    Abstract Several studies have reported high prevalence of risk factors for cardiovascular disease in adolescents. To perform: i) systematically review the literature on the prevalence of high blood pressure (HBP) in adolescents; ii) analyze the possible methodological factors associated with HBP; and iii) compare the prevalence between developed and developing countries. We revised 10 electronic databases up to August 11, 2013. Only original articles using international diagnosis of HBP were considered. The pooled prevalence's of HBP were estimated by random effects. Meta-regression analysis was used to identify the sources of heterogeneity across studies. Fifty-five studies met the inclusion criteria and total of 122,053 adolescents included. The pooled-prevalence of HBP was 11.2%, 13% for boys, and 9.6% for girls (P < 0.01). Method of measurement of BP and year in which the survey was conducted were associated with heterogeneity in the estimates of HBP among boys. The data indicate that HBP is higher among boys than girls, and that the method of measurement plays an important role in the overall heterogeneity of HBP value distributions, particularly in boys. PMID:25501086

  8. Epidemiology of recurrent venous thrombosis

    Science.gov (United States)

    Ribeiro, D.D.; Lijfering, W.M.; Barreto, S.M.; Rosendaal, F.R.; Rezende, S.M.

    2011-01-01

    Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed. PMID:22183247

  9. Massive superior mesenteric venous aneurysm with portal venous thrombosis.

    Science.gov (United States)

    Starikov, Anna; Bartolotta, Roger J

    2015-01-01

    Portal venous aneurysm is a rare and sometimes dangerous vascular pathology, which can result in thrombosis or rupture. We present the computed tomography, magnetic resonance, and sonographic imaging of a 27-year-old man with superior mesenteric venous aneurysm and subsequent thrombosis following acute pancreatitis. This multimodality imaging approach can prove useful in the evaluation of these rare aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Effect of perioperative blood transfusion on the long-term survival of patients undergoing esophagectomy for esophageal cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Boshier, P R; Ziff, C; Adam, M E; Fehervari, M; Markar, S R; Hanna, G B

    2017-12-18

    Perioperative blood transfusion has been linked to poorer long-term survival in patients undergoing esophagectomy, presumably due to its potential immunomodulatory effects. This review aims to summarize existing evidence relating to the influence of blood transfusion on long-term survival following esophagectomy for esophageal cancer. A systematic literature search (up to February 2017) was conducted for studies reporting the effects of perioperative blood transfusion on survival following esophagectomy for esophageal cancer. Meta-analysis was used to summate survival outcomes. Twenty observational studies met the criteria for inclusion. Eighteen of these studies compared the outcomes of patients who received allogenic blood transfusion to patients who did not receive this intervention. Meta-analysis of outcomes revealed that allogenic blood transfusion significantly reduced long-term survival (HR = 1.49; 95% CI 1.26 to 1.76; P blood having lower long-term survival compared to patient who received between 0 and 2 units (HR = 1.59; 95% CI 1.31 to 1.93; P blood transfusion showed superior survival in the latter group. Factors associated with the requirement for perioperative blood transfusion included: intraoperative blood loss; preoperative hemoglobin; operative approach; operative time, and; presences of advanced disease. These findings indicate that perioperative blood transfusion is associated with significantly worse long-term survival in patients undergoing esophagectomy for esophageal cancer. Autologous donation of blood, meticulous intraoperative hemostasis, and avoidance of unnecessary transfusions may prevent additional deaths attributed to this intervention. © The Author(s) 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Hematocrit and risk of venous thromboembolism in a general population. The Tromsø study

    Science.gov (United States)

    Brækkan, Sigrid K.; Mathiesen, Ellisiv B.; Njølstad, Inger; Wilsgaard, Tom; Hansen, John-Bjarne

    2010-01-01

    Background Hematocrit above the normal range for the population, such as in primary or secondary erythrocytosis, predisposes to both arterial and venous thrombosis. However, little is known about the association between hematocrit and risk of venous thromboembolism in a general population. Design and Methods Hematocrit and related hematologic variables such as hemoglobin, red blood cell count, mean corpuscular volume, and baseline characteristics were measured in 26,108 subjects, who participated in the Tromsø Study in 1994–1995. Incident venous thromboembolic events during follow-up were registered up to September 1st, 2007. Results There were 447 venous thromboembolic events during a median of 12.5 years of follow-up. Multivariable hazard ratios per 5% increment of hematocrit for the total population, adjusted for age, body mass index and smoking, were 1.25 (95% CI: 1.08–1.44) for total venous thromboembolism and 1.37 (95% CI: 1.10–1.71) for unprovoked venous thromboembolism. In category-based analyses, men with a hematocrit in the upper 20th percentile (≥46% in men) had a 1.5-fold increased risk of total venous thromboembolism (95% CI: 1.08–2.21) and a 2.4-fold increased risk of unprovoked venous thromboembolism (95% CI: 1.36–4.15) compared to men whose hematocrit was in the lower 40th percentile. The risk estimates were higher for men than for women both in continuous and category-based analyses. The findings for hemoglobin and red blood cell count were similar to those for hematocrit, whereas mean corpuscular volume was not associated with venous thromboembolism. Conclusions Our findings suggest that hematocrit and related hematologic variables such as hemoglobin and red blood cell count are risk factors for venous thromboembolism in a general population. PMID:19833630

  12. Hepatic venous oxygen content in alcoholic cirrhosis and non-cirrhotic alcoholic liver disease

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Widding, A

    1987-01-01

    Blood gas analyses and hepatic blood flow were determined during hepatic vein catheterization in order to establish a possible hypoxic component in alcoholic liver disease. Fifty-six patients (9 non-cirrhotic liver disease, 14 cirrhosis Child-Turcotte class A, 23 class B, 10 class C) and 10 control...... venous difference of base excess was small and of the same size in all groups, indicating no enhanced production of lactic acid in the liver. Our results do not support the concept that hepatic venous oxygen content is low in alcoholic liver disease and thereby contributes to hypoxic liver damage....... subjects were studied. Mean hepatic venous oxygen saturation and tension were almost the same in all groups, and hepatic blood flow was inversely correlated to the arteriohepatic venous oxygen difference (r = -0.53, P less than 0.01). Splanchnic oxygen uptake was similar in all groups studied. The arterio-hepatic...

  13. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials.

    Science.gov (United States)

    Saneei, P; Salehi-Abargouei, A; Esmaillzadeh, A; Azadbakht, L

    2014-12-01

    Findings were not consistent on the therapeutic effect of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure. We aimed to review systematically and perform a meta-analysis to assess the magnitude of the effect of the DASH diet on blood pressure in randomized controlled trials (RCTs) among adults. We conducted a systematic review and random effects meta-analysis of all RCTs which evaluated the effect of the DASH diet on blood pressure including published papers until June 2013, using PubMed, ISI Web of Science, Scopus and Google scholar database. Subgroup analysis and meta-regression were used to find out possible sources of between-study heterogeneity. Seventeen RCTs contributing 20 comparisons with 2561 participants were included. Meta-analysis showed that the DASH diet significantly reduced systolic blood pressure by 6.74 mmHg (95%CI: -8.25, -5.23, I(2) = 78.1%) and diastolic blood pressure by 3.54 mmHg (95%CI: -4.29, -2.79, I(2) = 56.7%). RCTs with the energy restriction and those with hypertensive subjects showed a significantly greater decrease in blood pressure. Meta-regression showed that mean baseline of SBP and DBP was explained 24% and 49% of the variance between studies for SBP and DBP, respectively. The results revealed the profitable reducing effect of the DASH-like diet on both systolic and diastolic blood pressure in adults; although there was a variation in the extent of the fall in blood pressure in different subgroups. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Total anomalous pulmonary venous return

    Science.gov (United States)

    ... pulmonary venous return, x-ray References Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... 62. Review Date 10/17/2017 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, ...

  15. Hydrocephalus in cerebral venous thrombosis

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; van den Berg, René; Troost, Dirk; Majoie, Charles B.; Stam, Jan; Coutinho, Jonathan M.

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and

  16. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jicheng Lv

    Full Text Available BACKGROUND: Guidelines recommend intensive blood pressure (BP lowering in patients at high risk. While placebo-controlled trials have demonstrated 22% reductions in coronary heart disease (CHD and stroke associated with a 10-mmHg difference in systolic BP, it is unclear if more intensive BP lowering strategies are associated with greater reductions in risk of CHD and stroke. We did a systematic review to assess the effects of intensive BP lowering on vascular, eye, and renal outcomes. METHODS AND FINDINGS: We systematically searched Medline, Embase, and the Cochrane Library for trials published between 1950 and July 2011. We included trials that randomly assigned individuals to different target BP levels. We identified 15 trials including a total of 37,348 participants. On average there was a 7.5/4.5-mmHg BP difference. Intensive BP lowering achieved relative risk (RR reductions of 11% for major cardiovascular events (95% CI 1%-21%, 13% for myocardial infarction (0%-25%, 24% for stroke (8%-37%, and 11% for end stage kidney disease (3%-18%. Intensive BP lowering regimens also produced a 10% reduction in the risk of albuminuria (4%-16%, and a trend towards benefit for retinopathy (19%, 0%-34%, p = 0.051 in patients with diabetes. There was no clear effect on cardiovascular or noncardiovascular death. Intensive BP lowering was well tolerated; with serious adverse events uncommon and not significantly increased, except for hypotension (RR 4.16, 95% CI 2.25 to 7.70, which occurred infrequently (0.4% per 100 person-years. CONCLUSIONS: Intensive BP lowering regimens provided greater vascular protection than standard regimens that was proportional to the achieved difference in systolic BP, but did not have any clear impact on the risk of death or serious adverse events. Further trials are required to more clearly define the risks and benefits of BP targets below those currently recommended, given the benefits suggested by the currently available data.

  17. Venous and arterial thrombosis: Two aspects of the same disease?

    Directory of Open Access Journals (Sweden)

    Paolo Prandoni

    2009-01-01

    Full Text Available Paolo PrandoniDepartment of Cardiothoracic and Vascular Sciences, Thromboembolism Unit, University Hospital of Padua Padua, ItalyAbstract: An increasing body of evidence suggests the likelihood of a link between venous and arterial thrombosis. The two vascular complications share several risk factors, such as age, obesity, diabetes mellitus, blood hypertension, hypertriglyceridemia, and metabolic syndrome. Moreover, there are many examples of conditions accounting for both venous and arterial thrombosis, such as the antiphospholipid antibody syndrome, hyperhomocysteinemia, malignancies, infections, and the use of hormonal treatment. Finally, several recent studies have consistently shown that patients with venous thromboembolism are at a higher risk of arterial thrombotic complications than matched control individuals. We, therefore, speculate the two vascular complications are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice.Keywords: venous thromboembolism, deep vein thrombosis, pulmonary embolism, myocardial infarction, ischemic stroke, atherosclerosis

  18. Central venous oxygen saturation does not correlate with the venous oxygen saturation at the surgical site during abdominal surgery.

    Science.gov (United States)

    Weinrich, Malte; Scheingraber, Stefan; Stephan, Bernhard; Weiss, Christel; Kayser, Anna; Kopp, Berit; Schilling, Martin K

    2008-01-01

    Measurement of central venous oxygen saturation has become a surrogate parameter for fluid administration, blood transfusions and treatment with catecholamines in (early) goal directed therapy in the treatment of acute septic patients. These strategies are not easily transferred to the postoperative management of abdominal surgery due to the different conditions in surgical patients. A study population of 15 patients (8 females/7 males) underwent elective major abdominal surgery: 6 gastrectomies, 5 major liver resections and 4 lower anterior rectum resections. Surgery was performed for primary or secondary malignancy. The patients' age was 65.4+/-12.7 (mean+/-standard deviation, range 44-84, median 62) years. Blood samples were taken intraoperatively from indwelling central venous lines as well as from draining veins at the surgical site. Blood gas analyses to determine the oxygen saturations were performed immediately. All patients were operated in standardized general anesthesia including epidural analgesia and in a balanced volume status. Central venous oxygen saturations and oxygen saturations in blood from the draining veins of the surgical site showed a wide range with high intra- and interindividual differences intraoperatively. Overall, at most time points no correlation between the two oxygen saturations could be detected in three operation types. A significant correlation was only observed at one time point during liver resections. Our results show a lack of correlation between central venous oxygen saturations and oxygen saturations in the draining veins of the surgical site during major abdominal surgery. Measurement of central venous oxygen saturations does not seem to be a good surrogate for the local oxygen supply in the field of interest in major abdominal surgery even under standardized conditions.

  19. A sonographic quantitative cutoff value of cerebral venous outflow in neurologic diseases: a blinded study of 115 subjects.

    Science.gov (United States)

    Monti, L; Menci, E; Piu, P; Leonini, S; Arrigucci, U; Bellini, M; Zandonella, A; Galluzzi, P; Casasco, A

    2014-07-01

    The autonomic nervous system maintains constant cerebral venous blood outflow in changing positions. Alterations in cerebral autoregulation can be revealed by postural changes at quantitative color Doppler sonography. The aim of this study was to reach an optimal cutoff value of the difference between the cerebral venous blood outflow in the supine and seated positions that can discriminate healthy controls from patients with multiple sclerosis and those with other neurologic diseases and to evaluate its specificity, sensitivity, and diagnostic accuracy. One hundred fifteen subjects (54 with MS, 31 healthy controls, 30 with other neurologic diseases) underwent a blinded quantitative color Doppler sonography evaluation of cerebral venous blood outflow in the supine and sitting positions. An optimal difference value between the supine and sitting positions of the cerebral venous blood outflow cutoff value was sought. The difference value between supine and sitting positions of the cerebral venous blood outflow was ≤ 503.24 in 38/54 (70.37%) patients with MS, 9/31 (29.03%) healthy controls, and 13/30 (43.33%) subjects with other neurological diseases. A difference value between supine and sitting positions of the cerebral venous blood outflow at a 503.24 cutoff reached a sensitivity at 70.37%, a 70.96% specificity, a 80.85% positive predictive value, and a 57.89% negative predictive value; the quantitative color Doppler sonography parameters yielded significant differences. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 assessed the significant difference between MS versus other neurological diseases. Alteration of cerebral venous blood outflow discriminated MS versus other neurologic diseases and MS versus healthy controls. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 was statistically associated with MS. © 2014 by American Journal of Neuroradiology.

  20. TEMPO DE VIABILIDADE DE AMOSTRAS DE SANGUE VENOSO BOVINO DESTINADAS AO EXAME HEMOGASOMÉTRICO, QUANDO MANTIDAS SOB CONSERVAÇÃO EM ÁGUA GELADA VIABILITY TIME OF BLOOD GAS ANALYSIS IN BOVINE VENOUS BLOOD SAMPLES STORED IN ICE WATER BATH

    Directory of Open Access Journals (Sweden)

    Júlio Augusto Naylor Lisbôa

    2001-04-01

    adequadamente conservadas em banho de água gelada, mantendo, assim, o seu valor diagnóstico.In order to verify the viability of blood gas analysis in bovine venous blood stored on ice water bath, two samples (10ml each were taken from the jugular vein of 14 healthy animals (7 males and 7 females, 1- to 5-year-old, using plastic syringes and attached needles filled with sodium heparin (1,000IU. The blood samples were obtained anaerobically, the air bubbles observed were immediately removed, and the needle was maintened capped with a rubber stopper. Each syringe of the pair was distinctally stored at room temperature (23-30ºC or in ice water bath (0-4ºC during the experimental period. Values of pH, carbon dioxide (PvCO2 and oxigen (PvO2 tensions, bicarbonate (HCO3-, total carbon dioxide (TCO2, base excess (BE, standard bicarbonate (StB, oxigen saturation (SatO2, and oxigen content (O2 were determined soon after sampling and after 1, 2, 3, 4, 5, 6, 8, 10, 12 and 24 hours. According to the type of storage temperature, the results were analysed through repeated measurements ANOVA, considering the contrast between the mean value of each time and the initial one. On the storage at room temperature, the in vitro changes were characterized from continuous decreases in pH, PvO2, BE, StB, SatO2, and O2 values, and gradual increase in PvCO2, starting at 2- or 3-hour after the collection. In the samples stored at 0-4ºC, on the other hand, the changes in pH occurred only at the 4th hour, and the stability of the PvCO2, BE, and StB values were maintened for up to the 6th hour. These results indicated that the diagnostic utility of blood gas analysis is conserved in bovine venous blood samples adequately stored up to 6 hours in ice water bath, at 0-4ºC.

  1. Effect of probiotics and synbiotics on blood glucose: a systematic review and meta-analysis of controlled trials.

    Science.gov (United States)

    Nikbakht, Elham; Khalesi, Saman; Singh, Indu; Williams, Lauren Therese; West, Nicholas P; Colson, Natalie

    2018-02-01

    High fasting blood glucose (FBG) can lead to chronic diseases such as diabetes mellitus, cardiovascular and kidney diseases. Consuming probiotics or synbiotics may improve FBG. A systematic review and meta-analysis of controlled trials was conducted to clarify the effect of probiotic and synbiotic consumption on FBG levels. PubMed, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched for relevant studies based on eligibility criteria. Randomized or non-randomized controlled trials which investigated the efficacy of probiotics or synbiotics on the FBG of adults were included. Studies were excluded if they were review articles and study protocols, or if the supplement dosage was not clearly mentioned. A total of fourteen studies (eighteen trials) were included in the analysis. Random-effects meta-analyses were conducted for the mean difference in FBG. Overall reduction in FBG observed from consumption of probiotics and synbiotics was borderline statistically significant (-0.18 mmol/L 95 % CI -0.37, 0.00; p = 0.05). Neither probiotic nor synbiotic subgroup analysis revealed a significant reduction in FBG. The result of subgroup analysis for baseline FBG level ≥7 mmol/L showed a reduction in FBG of 0.68 mmol/L (-1.07, -0.29; ρ probiotics showed a more pronounced reduction of 0.31 mmol/L (-0.58, -0.03; ρ = 0.03) compared to single species trials. This meta-analysis suggests that probiotic and synbiotic supplementation may be beneficial in lowering FBG in adults with high baseline FBG (≥7 mmol/L) and that multispecies probiotics may have more impact on FBG than single species.

  2. Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Sahebkar, Amirhossein; Ferri, Claudio; Giorgini, Paolo; Bo, Simona; Nachtigal, Petr; Grassi, Davide

    2017-01-01

    Punica granatum L. (Pomegranate) has been claimed to provide several health benefits. Pomegranate juice is a polyphenol-rich fruit juice with high antioxidant capacity. Several studies suggested that pomegranate juice can exert antiatherogenic, antioxidant, antihypertensive, and anti-inflammatory effects. Nevertheless, the potential cardioprotective benefits of pomegranate juice deserve further clinical investigation. To systematically review and meta-analyze available evidence from randomized placebo-controlled trials (RCTs) investigating the effects of pomegranate juice consumption and blood pressure (BP). A comprehensive literature search in Medline and Scopus was carried out to identify eligible RCTs. A meta-analysis of eligible studies was performed using a random-effects model. Quality assessment, sensitivity analysisand publication bias evaluations were conducted using standard methods. Quantitative data synthesis from 8 RCTs showed significant reductions in both systolic [weighed mean difference (WMD): -4.96mmHg, 95% CI: -7.67 to -2.25, ppomegranate juice consumption. Effects on SBP remained stable to sensitivity analyses. Pomegranate juice reduced SBP regardless of the duration (>12 wks: WMD=-4.36mmHg, 95% CI: -7.89 to -0.82, p=0.016) and 240cc: WMD=-3.62mmHg, 95% CI: -6.62 to -0.63, p=0.018) and pomegranate juice per day) whereas doses >240cc provided a borderline significant effect in reducing DBP. The present meta-analysis suggests consistent benefits of pomegranate juice consumption on BP. This evidence suggests it may be prudent to include this fruit juice in a heart-healthy diet. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Effects of Hazelnut Consumption on Blood Lipids and Body Weight: A Systematic Review and Bayesian Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Simone Perna

    2016-11-01

    Full Text Available Hazelnuts are rich in monounsaturated fatty acids and antioxidant bioactive substances: their consumption has been associated with a decreased risk of cardiovascular disease events. A systematic review and a meta-analysis was performed to combine the results from several trials and to estimate the pooled (overall effect of hazelnuts on blood lipids and body weight outcomes. Specifically, a Bayesian random effect meta-analysis of mean differences of Δ-changes from baseline across treatment (MDΔ (i.e., hazelnut-enriched diet vs. control diet has been conducted. Nine studies representing 425 participants were included in the analysis. The intervention diet lasted 28–84 days with a dosage of hazelnuts ranging from 29 to 69 g/day. Out of nine studies, three randomized studies have been meta-analyzed showing a significant reduction in low-density lipoprotein (LDL cholesterol (pooled MDΔ = −0.150 mmol/L; 95% highest posterior density interval (95%HPD = −0.308; −0.003 in favor of a hazelnut-enriched diet. Total cholesterol showed a marked trend toward a decrease (pooled MDΔ = −0.127 mmol/L; 95%HPD = −0.284; 0.014 and high-density lipoprotein (HDL cholesterol remained substantially stable (pooled MDΔ = 0.002 mmol/L; 95%HPD = −0.140; 0.147. No effects on triglycerides (pooled MDΔ = 0.045 mmol/L; 95%HPD = −0.195; 0.269 and body mass index (BMI (pooled MDΔ = 0.062 kg/m2; 95%HPD = −0.293; 0.469 were found. Hazelnut-enriched diet is associated with a decrease of LDL and total cholesterol, while HDL cholesterol, triglycerides and BMI remain substantially unchanged.

  4. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis.

    Science.gov (United States)

    Arirachakaran, Alisara; Sukthuayat, Amnat; Sisayanarane, Thaworn; Laoratanavoraphong, Sorawut; Kanchanatawan, Wichan; Kongtharvonskul, Jatupon

    2016-06-01

    Clinical outcomes between the use of platelet-rich plasma (PRP), autologous blood (AB) and corticosteroid (CS) injection in lateral epicondylitis are still controversial. A systematic review and network meta-analysis of randomized controlled trials was conducted with the aim of comparing relevant clinical outcomes between the use of PRP, AB and CS injection. Medline and Scopus databases were searched from inception to January 2015. A network meta-analysis was performed by applying weight regression for continuous outcomes and a mixed-effect Poisson regression for dichotomous outcomes. Ten of 374 identified studies were eligible. When compared to CS, AB injection showed significantly improved effects with unstandardized mean differences (UMD) in pain visual analog scale (VAS), Disabilities of Arm Shoulder and Hand (DASH), Patient-Related Tennis Elbow Evaluation (PRTEE) score and pressure pain threshold (PPT) of -2.5 (95 % confidence interval, -3.5, -1.5), -25.5 (-33.8, -17.2), -5.3 (-9.1, -1.6) and 9.9 (5.6, 14.2), respectively. PRP injections also showed significantly improved VAS and DASH scores when compared with CS. PRP showed significantly better VAS with UMD when compared to AB injection. AB injection has a higher risk of adverse effects, with a relative risk of 1.78 (1.00, 3.17), when compared to CS. The network meta-analysis suggested no statistically significant difference in multiple active treatment comparisons of VAS, DASH and PRTEE when comparing PRP and AB injections. However, AB injection had improved DASH score and PPT when compared with PRP injection. In terms of adverse effects, AB injection had a higher risk than PRP injection. This network meta-analysis provided additional information that PRP injection can improve pain and lower the risk of complications, whereas AB injection can improve pain, disabilities scores and pressure pain threshold but has a higher risk of complications. Level I evidence.

  5. Combined oral contraceptives: venous thrombosis.

    Science.gov (United States)

    de Bastos, Marcos; Stegeman, Bernardine H; Rosendaal, Frits R; Van Hylckama Vlieg, Astrid; Helmerhorst, Frans M; Stijnen, Theo; Dekkers, Olaf M

    2014-03-03

    Combined oral contraceptive (COC) use has been associated with venous thrombosis (VT) (i.e., deep venous thrombosis and pulmonary embolism). The VT risk has been evaluated for many estrogen doses and progestagen types contained in COC but no comprehensive comparison involving commonly used COC is available. To provide a comprehensive overview of the risk of venous thrombosis in women using different combined oral contraceptives. Electronic databases (Pubmed, Embase, Web of Science, Cochrane, CINAHL, Academic Search Premier and ScienceDirect) were searched in 22 April 2013 for eligible studies, without language restrictions. We selected studies including healthy women taking COC with VT as outcome. The primary outcome of interest was a fatal or non-fatal first event of venous thrombosis with the main focus on deep venous thrombosis or pulmonary embolism. Publications with at least 10 events in total were eligible. The network meta-analysis was performed using an extension of frequentist random effects models for mixed multiple treatment comparisons. Unadjusted relative risks with 95% confidence intervals were reported.Two independent reviewers extracted data from selected studies. 3110 publications were retrieved through a search strategy; 25 publications reporting on 26 studies were included. Incidence of venous thrombosis in non-users from two included cohorts was 0.19 and 0.37 per 1 000 person years, in line with previously reported incidences of 0,16 per 1 000 person years. Use of combined oral contraceptives increased the risk of venous thrombosis compared with non-use (relative risk 3.5, 95% confidence interval 2.9 to 4.3). The relative risk of venous thrombosis for combined oral contraceptives with 30-35 μg ethinylestradiol and gestodene, desogestrel, cyproterone acetate, or drospirenone were similar and about 50-80% higher than for combined oral contraceptives with levonorgestrel. A dose related effect of ethinylestradiol was observed for gestodene

  6. [Duplexsonography investigation in patients with venous ulcer].

    Science.gov (United States)

    Jeanneret-Gris, Christina

    2011-03-01

    Venous hypertension due to venous insufficiency causes venous ulcers. Duplexsonography is a widely accepted non invasive method to assess venous insufficiency with venous reflux measurements. Retrograde venous flow is defined as venous reflux. The testing of venous reflux is reliable if transvalvular pressure is sufficiently high and transvalvular flow velocity exceeds 30 cm/s. Reflux testing in the proximal leg veins (V. femoralis communis, V. femoralis, V. saphena magna) is done using a standardised Valsalva Manoeuvre (exspiration into a tube up to a pressure of 30 mmHg, pressure established within 0.5 seconds, pressure hold for 3 seconds). Distal leg vein testing (V. poplitea, V. tibialis posterior, V. saphena parva) is recommended with a two handed - compression distally to the tested veins. The most important parameter is venous reflux time, a cut off of > 2 seconds is recommended.

  7. Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis.

    Science.gov (United States)

    Tucker, Katherine L; Sheppard, James P; Stevens, Richard; Bosworth, Hayden B; Bove, Alfred; Bray, Emma P; Earle, Kenneth; George, Johnson; Godwin, Marshall; Green, Beverly B; Hebert, Paul; Hobbs, F D Richard; Kantola, Ilkka; Kerry, Sally M; Leiva, Alfonso; Magid, David J; Mant, Jonathan; Margolis, Karen L; McKinstry, Brian; McLaughlin, Mary Ann; Omboni, Stefano; Ogedegbe, Olugbenga; Parati, Gianfranco; Qamar, Nashat; Tabaei, Bahman P; Varis, Juha; Verberk, Willem J; Wakefield, Bonnie J; McManus, Richard J

    2017-09-01

    Self-monitoring of blood pressure (BP) appears to reduce BP in hypertension but important questions remain regarding effective implementation and which groups may benefit most. This individual patient data (IPD) meta-analysis was performed to better understand the effectiveness of BP self-monitoring to lower BP and control hypertension. Medline, Embase, and the Cochrane Library were searched for randomised trials comparing self-monitoring to no self-monitoring in hypertensive patients (June 2016). Two reviewers independently assessed articles for eligibility and the authors of eligible trials were approached requesting IPD. Of 2,846 articles in the initial search, 36 were eligible. IPD were provided from 25 trials, including 1 unpublished study. Data for the primary outcomes-change in mean clinic or ambulatory BP and proportion controlled below target at 12 months-were available from 15/19 possible studies (7,138/8,292 [86%] of randomised participants). Overall, self-monitoring was associated with reduced clinic systolic blood pressure (sBP) compared to usual care at 12 months (-3.2 mmHg, [95% CI -4.9, -1.6 mmHg]). However, this effect was strongly influenced by the intensity of co-intervention ranging from no effect with self-monitoring alone (-1.0 mmHg [-3.3, 1.2]), to a 6.1 mmHg (-9.0, -3.2) reduction when monitoring was combined with intensive support. Self-monitoring was most effective in those with fewer antihypertensive medications and higher baseline sBP up to 170 mmHg. No differences in efficacy were seen by sex or by most comorbidities. Ambulatory BP data at 12 months were available from 4 trials (1,478 patients), which assessed self-monitoring with little or no co-intervention. There was no association between self-monitoring and either lower clinic or ambulatory sBP in this group (clinic -0.2 mmHg [-2.2, 1.8]; ambulatory 1.1 mmHg [-0.3, 2.5]). Results for diastolic blood pressure (dBP) were similar. The main limitation of this work was that significant

  8. Contemporary diagnosis of venous malformation

    Directory of Open Access Journals (Sweden)

    Lee BB

    2013-11-01

    Full Text Available BB Lee,1 I Baumgartner21Department of Surgery, George Washington University, Washington, DC, USA; 2Swiss Cardiovascular Center, University Hospital Bern, Bern, SwitzerlandAbstract: Venous malformation is a congenital vascular malformation resulting from defective development during various stages of embryogenesis and selectively affecting the venous system. Depending on the embryologic stage when the developmental arrest occurred, the clinical presentation of venous malformation is extremely variable in location, extent, severity, natural progression, and hemodynamic impact. Extratruncular lesions occur in the earlier stages of embryonic life, and retain characteristics unique to mesenchymal cells (angioblasts, growing and proliferating when stimulated internally (eg, by menarche, pregnancy, and hormones or externally (eg, by trauma or surgery. These lesions also have a significant hemodynamic impact on the venous system involved, in addition to the risk of localized intravascular coagulopathy. However, truncal lesions, as defective developments along the late stage, no longer carry the risk of proliferation and recurrence due to lack of mesenchymal characteristics. Although, they often have serious hemodynamic consequences due to direct involvement of the main vein trunk. Therefore, a thorough clinical history and careful physical examination should be followed by an appropriate combination of noninvasive and less invasive tests (eg, Doppler ultrasonography, magnetic resonance imaging, computed tomography to confirm the clinical impression as well as to define the extent and severity of the venous malformation. Invasive tests, eg, phlebography or angiography, are seldom needed for the diagnosis per se. Additional evaluation for coagulation abnormalities, eg, D-dimer and fibrinogen levels, is generally recommended, especially for the treatment of surgery and endovascular candidates with extensive lesions to assess the localized intravascular

  9. Venous chest anatomy: clinical implications

    International Nuclear Information System (INIS)

    Chasen, M.H.; Charnsangavej, C.

    1998-01-01

    This article provides a practical approach to the clinical implications and importance of understanding the collateral venous anatomy of the thorax. Routine radiography, conventional venography, computed tomography (CT), and magnetic resonance (MR) imaging studies provide correlative anatomic models for the demonstration of how interconnecting collateral vascular networks within the thorax maintain venous stability at all times. Five major systems comprise the collateral venous network of the thorax ( Fig. 1 ). These include the paravertebral, azygos-hemiazygos, internal mammary, lateral thoracic, and anterior jugular venous systems (AJVS). The five systems are presented in the following sequence: (a) a brief introduction to the importance of catheter position and malposition in understanding access to the thoracic venous system, (b) the anatomy of the azygos-hemiazygos systems and their relationship with the paravertebral plexus, (c) the importance of the AJVS, (d) 'loop' concepts interconnecting the internal mammary and azygos-hemiazygos systems by means of the lateral thoracic and intercostal veins, and (e) the interconnecting venous networks on the thoracic side of the thoracoabdominal junction. Certain aspects of the venous anatomy of the thorax will not be discussed in this chapter and include (a) the intra-abdominal anastomoses between the superior and inferior vena cavae (IVC) via the internal mammary, lateral thoracic, and azygos-hemiazygos systems (beyond the scope of this article), (b) potential collateral vessels involving vertebral, parascapular, thyroidal, thymic, and other smaller veins that might anastomose with the major systems, and (c) anatomic variants and pitfalls that may mimic pathologic conditions (space limitations). (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  10. Types of Blood Pressure Medications

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Types of Blood Pressure Medications Updated:Nov 6,2017 Prescription blood ... will find an overview of the classes of blood pressure medication. To expand the information on a type of medication, simply click on the subject tab. ...

  11. The efficacy of the Cook-Swartz implantable Doppler in the detection of free-flap compromise: a systematic review protocol

    OpenAIRE

    Agha, R. A.; Gundogan, B.; Fowler, A. J.; Bragg, T. W. H.; Orgill, Dennis Paul

    2014-01-01

    Introduction The Cook-Swartz implantable Doppler monitors venous or arterial blood flow from free flaps and can detect free-flap compromise. Previous studies have shown that the use of this Doppler can improve detection and salvage rates as it provides an earlier warning than the current method of clinical assessment. Such studies assert that the implantable Doppler is of great value in monitoring free flaps in current microsurgical units. This systematic review aims to compare the efficacy o...

  12. Infection of totally implantable venous access devices: A review of the literature.

    Science.gov (United States)

    Pinelli, Fulvio; Cecero, Elena; Degl'Innocenti, Dario; Selmi, Valentina; Giua, Rosa; Villa, Gianluca; Chelazzi, Cosimo; Romagnoli, Stefano; Pittiruti, Mauro

    2018-03-01

    Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient's quality of life. Nonetheless, totally implantable venous access devices are not free from complications. Among those, infection is the most relevant, affecting patients' morbidity and mortality-both in the hospital or outpatient setting-and increasing healthcare costs. Knowledge of pathogenesis and risk factors of totally implantable venous access device-related infections is crucial to prevent this condition by adopting proper insertion bundles and maintenance bundles based on the best available evidence. Early diagnosis and prompt treatment of infection are of paramount importance. As a totally implantable venous access device-related infection occurs, device removal or a conservative approach should be chosen in treating this complication. For both prevention and therapy, antimicrobial lock is a major matter of controversy and a promising field for future clinical studies. This article reviews current evidences in terms of epidemiology, pathogenesis and risk factors, diagnosis, prevention, and treatment of totally implantable venous access device-related infections.

  13. Effect of resveratrol on blood pressure: A systematic review and meta-analysis of randomized, controlled, clinical trials.

    Science.gov (United States)

    Fogacci, Federica; Tocci, Giuliano; Presta, Vivianne; Fratter, Andrea; Borghi, Claudio; Cicero, Arrigo F G

    2018-01-23

    Results of previous clinical trials evaluating the effect of resveratrol supplementation on blood pressure (BP) are controversial. We aimed to assess the impact of resveratrol on BP through systematic review of literature and meta-analysis of available randomized, controlled clinical trials (RCTs). Literature search included SCOPUS, PubMed-Medline, ISI Web of Science and Google Scholar databases up to 17th October 2017 to identify RCTs investigating the impact of resveratrol on BP. Two review authors independently extracted data on study characteristics, methods and outcomes. Overall, the impact of resveratrol on BP was reported in 17 trials. Administration of resveratrol did not significantly affect neither systolic BP [weighted mean difference (WMD): -2.5 95% CI:(-5.5, 0.6) mmHg; p=0.116; I 2 =62.1%], nor diastolic BP [WMD: -0.5 95% CI:(-2.2, 1.3) mmHg; p=0.613; I 2 =50.8], nor mean BP [MAP; WMD: -1.3 95% CI:(-2.8, 0.1) mmHg; p=0.070; I 2 =39.5%] nor pulse pressure [PP; WMD: -0.9 95% CI:(-3.1, 1.4) mmHg; p=0.449; I 2 =19.2%]. However, significant WMDs were detected in subsets of studies categorized according to high resveratrol daily dosage (≥300 mg/day) and presence of diabetes. Meta-regression analysis revealed a positive association between systolic BP-lowering resveratrol activity (slope: 1.99; 95% CI: 0.05, 3.93; two-tailed p= 0.04) and Body Mass Index (BMI) at baseline, while no association was detected neither between baseline BMI and MAP-lowering resveratrol activity (slope: 1.35; 95% CI: -0.22, 2.91; two-tailed p= 0.09) nor between baseline BMI and PP-lowering resveratrol activity (slope: 1.03; 95% CI: -1.33, 3.39; two-tailed p= 0.39). Resveratrol was fairly well-tolerated and no serious adverse events occurred among most of the eligible trials. The favourable effect of resveratrol emerging from the current meta-analysis suggests the possible use of this nutraceutical as active compound in order to promote cardiovascular health, mostly when used in

  14. Intrahepatic portosystemic venous shunts: diagnosis by Doppler ultrasound; Cortocircuitos venosos portosistemicos intrahepaticos: diagnostico mediante ecografia Doppler

    Energy Technology Data Exchange (ETDEWEB)

    Garofano, M. P.; Medina, A.; Lopez, G.; Garrido, C. [Hospital Universitario Virgen de las Nieves. Granada (Spain)

    2001-07-01

    Intrahepatic portosystemic venous shunts are venous vascular lesions that allow intrahepatic portal vessels to communicate with hepatic veins. They may present in patients with portal hypertension or b discovered incidentally; it is considered that the latter may be congenital or acquired. A noninvasive methods. Doppler ultrasound aids in the diagnosis of these anomalous communications by providing images of the vessels and the direction, velocity and volume of the blood flow through the shunt. We present four cases of intrahepatic portosystemic venous shunt. (Author) 8 refs.

  15. Dutch Venous Ulcer guideline update.

    Science.gov (United States)

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-01

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Venous leg ulcer in the context of chronic venous disease.

    Science.gov (United States)

    Lozano Sánchez, F S; Marinel lo Roura, J; Carrasco Carrasco, E; González-Porras, J R; Escudero Rodríguez, J R; Sánchez Nevarez, I; Díaz Sánchez, S

    2014-05-01

    Chronic venous disease (CVD) is a frequent disorder with a high socioeconomic impact. Little is known about the possible differences between healed ulcer (C5 group) and active ulcer (C6 group) in terms of disease severity and quality of life (QoL). Our aim was to determine the possible differences in severity disease and QoL between the C5-C6 and C1 (control) group. Data from a national, multicentre, observational and cross-sectional study (n = 1598) were used to compare three groups of CVD: C1 (n = 243), C5 (n = 136) and C6 (n = 70). CVD severity was assessed with the Venous Clinical Severity Score (VCSS) and QoL with the Short Form 12 Health Survey (SF-12) and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). Patients with active ulcers had a higher mean total VCSS than patients with healed ulcers (P ulcers than in those with C1 (P ulcers (C6) had lower QoL scores, but the differences were not statistically significant. Patients with venous leg ulcers (C5-C6) are associated with high severity and poor QoL. However, the healing of a leg ulcer did not contribute to improvement of QoL.

  17. DISTAL SPLENORENAL VENOUS ANASTOMOSIS IN TREATMENT OF DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    T. I. Shraer

    2010-01-01

    Full Text Available We studied the outcomes of the operations for distal splenorenal venous anastomosis of 134 patients with type 1 diabetes mellitus. We have noticed the significant improvement of patient’s general condition due to spasmolytic effect of glucagon, bypassed to blood circulation without coming through liver and also a stabilization of glyce- mia because of a restoration of insulin-glucagon ratio in systemic circulation. The effect of a surgery depends on a stage of microangiopathy and nephrosclerosis. 

  18. Central Venous Catheter (CVC) related infections: a local retrospective study

    OpenAIRE

    Manuela Fresu; Agostina Ronca; Carla Pruzzo; Simona Roveta

    2008-01-01

    Background. Central venous catheter (CVC) related infection is associated with significant increases in morbidity, mortality, and health care cost.This local surveillance study was carry out to monitor the frequency of occurrence of CVC-related blood stream infections. Materials and methods. During the period January – December 2005, 226 CVC specimens were analyzed (quantitative method) and microrganism identification from positive samples was performed by Vitek II. In 53 patients it was poss...

  19. The Genome-Wide DNA Methylation Profile of Peripheral Blood Is Not Systematically Changed by Short-Time Storage at Room Temperature

    Directory of Open Access Journals (Sweden)

    Nicklas Heine Staunstrup

    2017-12-01

    Full Text Available Background: Epigenetic epidemiology has proven an important research discipline in the delineation of diseases of complex etiology. The approach, in such studies, is often to use bio-banked clinical material, however, many such samples were collected for purposes other than epigenetic studies and, thus, potentially not processed and stored appropriately. The Danish National Birth Cohort (DNBC includes more than 100,000 peripheral and umbilical cord blood samples shipped from maternity wards by ordinary mail in EDTA tubes. While this and other similar cohorts hold great promises for DNA methylation studies the potential systematic changes prompted by storage at ambient temperatures have never been assessed on a genome-wide level. Methods and Results: In this study, matched EDTA whole blood samples were stored up to three days at room temperature prior to DNA extraction and methylated DNA immunoprecipitation coupled with deep sequencing (MeDIP-seq. We established that the quality of the MeDIP-seq libraries was high and comparable across samples; and that the methylation profiles did not change systematically during the short-time storage at room temperature. Conclusion: The global DNA methylation profile is stable in whole blood samples stored for up to three days at room temperature in EDTA tubes making genome-wide methylation studies on such material feasible.

  20. Arterial and venous oxygen partial pressure and utilization factor η, resp., and 133Xe muscle clearance after UV irradiation of skin or blood of healthy persons and patients with occlusive arterial disease and psoriasis, resp

    International Nuclear Information System (INIS)

    Scherf, H.P.; Strangfeld, D.; Meffert, H.; Glatzel, E.; Siewert, H.; Soennichsen, N.; Correns, H.J.

    1988-01-01

    In three teams of test persons series of UV irradiations of the skin (λ max 365 nm) and of the blood (λ max 254 nm) were performed, and moreover pseudoirradiations of the blood as placebo and infrared irradiations of the skin were carried out. UV irradiations of the blood increased the factor η (O 2 utilization) in all test persons. In healthy persons and patients with psoriasis UV irradiations of the skin involved a homogeneous, but less distinct effect, this was, however, not the case in patients with vascular diseases. According to the results of the 133 Xe muscle clearance the improved utilization of oxygen does not result from increased peripheral blood supply. (author)

  1. Familial Clustering of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Sindet-Pedersen, Caroline; Oestergaard, Louise Bruun; Gundlund, Anna

    2016-01-01

    BACKGROUND: Identification of risk factors for venous thromboembolism (VTE) is of utmost importance to improve current prophylactic regimes and treatment guidelines. The extent to which a family history contributes to the risk of VTE needs further exploration. OBJECTIVES: To examine the relative ...

  2. History of venous leg ulcers.

    Science.gov (United States)

    Gianfaldoni, S; Wollina, U; Lotti, J; Gianfaldoni, R; Lotti, T; Fioranelli, M; Roccia, M G

    To retrieve the history of venous ulcers and of skin lesions in general, we must go back to the appearance of human beings on earth. It is interesting to note that cutaneous injuries evolved parallel to human society. An essential first step in the pathogenesis of ulcers was represented by the transition of the quadruped man to Homo Erectus. This condition was characterized by a greater gravitational pressure on the lower limbs, with consequences on the peripheral venous system. Furthermore, human evolution was characterized by an increased risk of traumatic injuries, secondary to his natural need to create fire and hunt (e.g. stones, iron, fire, animal fighting). Humans then began to fight one another until they came to real wars, with increased frequency of wounds and infectious complications. The situation degraded with the introduction of horse riding, introduced by the Scites, who first tamed animals in the 7th century BC. This condition exhibited iliac veins at compression phenomena, favouring the venous stasis. With time, man continued to evolve until the modern age, which is characterized by increased risk factors for venous wounds such as poor physical activity and dietary errors (1, 2).

  3. Prostacyclin Increases Portal Venous Flow.

    Science.gov (United States)

    1984-07-01

    decline in CO. If PCI 2 were administered for an unrelated disease when cirrhosis, portal hypertension, and esophageal varices were present, flow into...the portal system would increase and possibly initiate variceal hemorrhage. The portal venous effects of PGI should be 2realized when considering this

  4. Lower-limb venous thrombosis

    African Journals Online (AJOL)

    muscle strains, tears, or twisting injuries to the leg. • other causes of lower-limb swelling such as cardiac, hepatic and renal pathologies. • lymphoedema. • chronic venous hypertension and its complications. • popliteal (Baker's) cysts. • cellulitis. • other knee pathologies. The objective methods of making a diagnosis of DVT ...

  5. Determination of carcinoembryonic antigen levels in peripheral and draining venous blood in patients with colorectal carcinoma Determinação dos níveis do antígeno carcinoembriônico no sangue periférico e no efluente venoso em doentes com carcinoma colorretal

    Directory of Open Access Journals (Sweden)

    Jaques Waisberg

    2004-06-01

    Full Text Available BACKGROUND: The problem of the relationship between blood carcinoembryonic antigen (CEA levels and tissue CEA content in colorectal carcinoma, and the mechanisms for CEA release from tumor cells in tissue adjacent to the neoplasm is important to understanding the biology of colorectal carcinoma. It has not been adequately explained whether CEA in the peripheral blood is drained mainly by portal system blood or by the lymphatic system, or indeed by both systems. AIM: To study the behavior of CEA levels in peripheral blood (CEA-p and venous effluent blood (CEA-d among patients with colorectal tumors, who underwent curative operation. METHOD: A total of 28 patients were studied (12 male [42.9%] and 16 female [57.1%], mean age 66.1 years [range: 43 - 84]. Immediately after laparotomy, peripheral venous blood was extracted by antecubital venous puncture and venous effluent blood was collected from the main drainage vein of the lesions. Values of CEA-p, CEA-d and the gradient between CEA-d and CEA-p that were less than 5.0 ng/mL were considered normal. RESULTS: Eight (28.6% patients were stage A in Duke's classification, nine (32.1% stage B and 11 (39.3% stage C. The neoplasm was located in the rectum of 14 patients (50.0%, in the transverse colon in five (17.9%, in the sigmoid in four (14.3%, in the cecum and/or ascending colon in three (10.7%, and in the descending colon in two (7.1%. The histopathological examination revealed well-differentiated adenocarcinoma in all the patients. Only one patient (3.6%, Duke's classification stage C, presented neoplasm with venous invasion. The gradient between the CEA-p and CEA-d levels were normal in 25 patients (88.3% and high in three (10.7%. The mean value for CEA-p was 3.8 ± 4.1 ng/mL (0.1-21.1 ng/mL and for the drained CEA (CEA-d it was 4.5 ± 4.3 ng/mL (0.3-20.2 ng/mL, without significant difference between these values. There was a significant difference between the mean value for CEA-p and CEA-d levels

  6. Chinese Herbal Medicine Combined with Conventional Therapy for Blood Pressure Variability in Hypertension Patients: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Zhuo Chen

    2015-01-01

    Full Text Available Objective. The aim of this systematic review is to evaluate effect of Chinese medicine combined with conventional therapy on blood pressure variability (BPV in hypertension patients. Methods. All randomized clinical trials (RCTs comparing Chinese medicine with no intervention or placebo on the basis of conventional therapy were included. Data extraction, analyses, and quality assessment were performed according to the Cochrane standards. Results. We included 13 RCTs and assessed risk of bias for all the trials. Chinese medicine has a significant effect in lowering blood pressure (BP, reducing BPV in the form of standard deviation (SD or coefficient of variability (CV, improving nighttime BP decreased rate, and reversing abnormal rhythm of BP. Conclusions. Chinese medicine was safe and showed beneficial effects on BPV in hypertension patients. However, more rigorous trials with high quality are warranted to give high level of evidence before recommending Chinese medicine as an alternative or complementary medicine to improve BPV in hypertension patients.

  7. Therapeutic ultrasound to promote healing of lower extremity venous ulcers: CAT

    Directory of Open Access Journals (Sweden)

    Raúl Alberto Aguilera Eguía

    2013-10-01

    Full Text Available Purpose. The aim of this CAT (Critically Appraised Topic was to check the validity of the results and applicability regarding the effectiveness of therapeutic ultrasound in increasing healing of lower extremity ulcers and to answer the question: In subjects that have lower extremity venous ulcers, does high-frequency therapeutic ultrasound improve healing rate compared to placebo? Method. We conducted an analysis of the article "Therapeutic Ultrasound for lower extremity venous ulcers, Cochrane Systematic Review" of Cullum, et al (2010. Results. The application of high-frequency therapeutic ultrasound could increase healing in patients with lower extremity venous ulcers, RR = 1.40 (95% CI 1.00 to 1.96. Conclusion. The use of therapeutic ultrasound to promote healing in lower extremity venous ulcers is neither endorsed nor discouraged.

  8. Blood transfusion after percutaneous coronary intervention and risk of subsequent adverse outcomes: a systematic review and meta-analysis.

    Science.gov (United States)

    Kwok, Chun Shing; Sherwood, Matthew W; Watson, Sarah M; Nasir, Samina B; Sperrin, Matt; Nolan, Jim; Kinnaird, Tim; Kiatchoosakun, Songsak; Ludman, Peter F; de Belder, Mark A; Rao, Sunil V; Mamas, Mamas A

    2015-03-01

    This study sought to define the prevalence and prognostic impact of blood transfusions in contemporary percutaneous coronary intervention (PCI) practice. Although the presence of anemia is associated with adverse outcomes in patients undergoing PCI, the optimal use of blood products in patients undergoing PCI remains controversial. A search of EMBASE and MEDLINE was conducted to identify PCI studies that evaluated blood transfusions and their association with major adverse cardiac events (MACE) and mortality. Two independent reviewers screened the studies for inclusion, and data were extracted from relevant studies. Random effects meta-analysis was used to estimate the risk of adverse outcomes with blood transfusions. Statistical heterogeneity was assessed by considering the I(2) statistic. Nineteen studies that included 2,258,711 patients with more than 54,000 transfusion events were identified (prevalence of blood transfusion 2.3%). Crude mortality rate was 6,435 of 50,979 (12.6%, 8 studies) in patients who received a blood transfusion and 27,061 of 2,266,111 (1.2%, 8 studies) in the remaining patients. Crude MACE rates were 17.4% (8,439 of 48,518) in patients who had a blood transfusion and 3.1% (68,062 of 2,212,730) in the remaining cohort. Meta-analysis demonstrated that blood transfusion was independently associated with an increase in mortality (odds ratio: 3.02, 95% confidence interval: 2.16 to 4.21, I(2) = 91%) and MACE (odds ratio: 3.15, 95% confidence interval: 2.59 to 3.82, I(2) = 81%). Similar observations were recorded in studies that adjusted for baseline hematocrit, anemia, and bleeding. Blood transfusion is independently associated with increased risk of mortality and MACE events. Clinicians should minimize the risk for periprocedural transfusion by using available bleeding-avoidance strategies and avoiding liberal transfusion practices. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. Assessing the Association between Natural Food Folate Intake and Blood Folate Concentrations: A Systematic Review and Bayesian Meta-Analysis of Trials and Observational Studies

    Directory of Open Access Journals (Sweden)

    Claire M. Marchetta

    2015-04-01

    Full Text Available Folate is found naturally in foods or as synthetic folic acid in dietary supplements and fortified foods. Adequate periconceptional folic acid intake can prevent neural tube defects. Folate intake impacts blood folate concentration; however, the dose-response between natural food folate and blood folate concentrations has not been well described. We estimated this association among healthy females. A systematic literature review identified studies (1 1992–3 2014 with both natural food folate intake alone and blood folate concentration among females aged 12–49 years. Bayesian methods were used to estimate regression model parameters describing the association between natural food folate intake and subsequent blood folate concentration. Seven controlled trials and 29 observational studies met the inclusion criteria. For the six studies using microbiologic assay (MA included in the meta-analysis, we estimate that a 6% (95% Credible Interval (CrI: 4%, 9% increase in red blood cell (RBC folate concentration and a 7% (95% CrI: 1%, 12% increase in serum/plasma folate concentration can occur for every 10% increase in natural food folate intake. Using modeled results, we estimate that a natural food folate intake of ≥450 μg dietary folate equivalents (DFE/day could achieve the lower bound of an RBC folate concentration (~1050 nmol/L associated with the lowest risk of a neural tube defect. Natural food folate intake affects blood folate concentration and adequate intakes could help women achieve a RBC folate concentration associated with a risk of 6 neural tube defects/10,000 live births.

  10. Evidence of increased blood pressure and hypertension risk among people living with HIV on antiretroviral therapy: a systematic review with meta-analysis.

    Science.gov (United States)

    Nduka, C U; Stranges, S; Sarki, A M; Kimani, P K; Uthman, O A

    2016-06-01

    Owing to antiretroviral drug-induced endothelial dysfunction, HIV-infected patients on antiretroviral therapy (ART) may have elevated blood pressure. We conducted a systematic review and meta-analysis to estimate the effects of ART on blood pressure levels and hypertension risk among HIV-infected populations worldwide. We sought articles that compared the mean blood pressure measurements and hypertension prevalence between HIV-infected adults naive and exposed to ART. Thirty-nine studies comprising 44 903 participants met the inclusion criteria. Overall, systolic (mean difference (MD) 4.52 mm Hg, 95% confidence interval (CI) 2.65-6.39, I(2)=68.1%, 19 studies) and diastolic blood pressure levels (MD 3.17 mm Hg, 95% CI 1.71-4.64, I(2)=72.5%, 16 studies) were significantly higher among ART-exposed patients compared with treatment-naive patients. Similarly, the risk of hypertension was significantly higher among ART-exposed patients, such that among 28 908 ART-exposed patients, 4195 (14.5%) had hypertension compared with 950 of 9086 (10.5%) in those who were treatment-naive (odds ratio 1.68, 95% CI 1.35-2.10, I(2)=81.5%, 32 studies). In summary, exposure to ART is significantly associated with increased systolic and diastolic blood pressure levels, and increased risk of hypertension, regardless of study-level sociodemographic differences. This meta-analysis supports the need for population-based strategies to reduce the risk of high blood pressure among people living with HIV on ART.

  11. High blood pressure in school children and adolescents in Argentina over the past 25 years: A systematic review of observational studies.

    Science.gov (United States)

    Díaz, Alejandro; Calandra, Luciana

    2017-02-01

    Over the past years, hypertension has been recognized as an important health problem in the pediatric population. A systematic review of observational studies published between 1988 and 2014 was conducted to estimate the prevalence of high blood pressure and cardiovascular risk factors among children and adolescents in Argentina. A bibliographic search was done in MEDLINE, SciELO, and LILACS to look for studies on high blood pressure prevalence in school children and adolescents in Argentina. Studies and surveys that had included the measurement of blood pressure in children and adolescents (aged 5-20 years) according to the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents by the American Academy of Pediatrics were included in this study. Fourteen publications were identified. The pooled prevalence in 11 706 subjects (random effects model) was 6.61% (95% confidence interval [CI]: 4.30-9.37). The crude prevalence was 7.35% (95% CI: 6.88-7.83). High blood pressure was more prevalent among adolescents than children ≤ 10 years old (7.4% versus 4.3%, P = 0.001), and among boys than girls (11.2% versus 6.8%, P = 0.001). The most common risk factors included a sedentary lifestyle (50%), overweight (15.4%), abdominal obesity (13.7%), obesity (11.5%), and smoking (6.5%). Our data show that the prevalence of high blood pressure and cardiovascular risk factors in school children and adolescents is high, and this accounts for a very important public health problem in Argentina. Sociedad Argentina de Pediatría

  12. No evidence for thrombophilia in patients with retinal venous occlusion

    DEFF Research Database (Denmark)

    Kirkegaard, Kirstine; Heegaard, Steffen; Hvas, Anne-Mette

    2016-01-01

    was to evaluate the evidence for thrombophilia investigation in patients presenting with retinal venous occlusion. Eligible studies were identified by a MESH-based search in PubMed 11–13 of March 2015. The level of evidence was stated according to the guidelines published by the GRADE working group using three...... levels for quality of evidence: high, moderate and low. A total of 118 studies relating to the study question were identified. After excluding case stories, commentaries, cross-sectional studies and reviews/expert opinions, 28 original papers and two meta-analyses were included in the final qualitative...... synthesis. The majority of studies were small case–control studies, and only one large cohort study was identified. No randomized controlled trials were retrieved. All the studies were categorized as low quality of evidence. Systematic thrombophilia screening in patients presenting with retinal venous...

  13. Agreement and correlation of pH, bicarbonate, base excess and lactate measurements in venous and arterial blood of premature and term infants Concordância e correlação das medidas de pH, bicarbonato, excesso de base e lactato no sangue venoso e arterial de recém-nascidos de termo e prematuros

    Directory of Open Access Journals (Sweden)

    Orlei R. Araujo

    2007-09-01

    Full Text Available BACKGROUND AND OBJECTIVES: Determine the extent of agreement and correlation between arterial samples and venous (obtained from a venous umbilical catheter, with respect to measurements of pH, bicarbonate, base excess and lactate, in critically ill term and premature newborns. METHODS: Arterial blood samples (0.5-1 mL were obtained for gas analysis by radial artery puncture, and, within the limit of 5 minutes, samples were obtained from venous umbilical catheters. Bland-Altman plots were used to depict agreement between arterial and venous measurements. Limits of agreement were defined as the mean difference ± 2SD (Standard Deviation. Correlation was assessed by Pearson's method. RESULTS: A hundred and six samples (53 pairs were taken from 53 patients for analysis of bicarbonate, pH and base excess. Lactate was analyzed in 49 pairs of samples. Differences were within the limits of agreement in 94.3% of pairs of samples for pH, and the same percentage was observed for bicarbonate. There was agreement in 96.2% of pairs for base excess, and in 91.8% for lactate. Mean differences were 0.03 units for pH, -1.2 mmol/L for bicarbonate, -0.24 mmol/L for base excess and 0.33 mmol/L for lactate. Pearson's correlation coefficients (r were 0.87 for pH, 0.76 for bicarbonate, 0.86 for base excess and 0.95 for lactate. CONCLUSIONS: Although single venous values cannot be used as equivalent to arterial for assessing acid base status in newborns, venous blood samples can be used serially for monitoring trends over time.JUSTIFICATIVA E OBJETIVOS: Determinar o grau de concordância e correlação entre amostras arteriais e as obtidas através de um cateter venoso umbilical, com relação ao pH, bicarbonato, excesso de base (BE e lactato, em recém-nascidos prematuros e de termo, criticamente doentes. MÉTODO: Foram obtidas amostras para gasometria (0,5 - 1 mL, por punção de artéria radial, e, dentro do limite de 5 minutos, do cateter venoso umbilical. O m

  14. The ovine cerebral venous system: comparative anatomy, visualization, and implications for translational research.

    Science.gov (United States)

    Hoffmann, Anke; Stoffel, Michael H; Nitzsche, Björn; Lobsien, Donald; Seeger, Johannes; Schneider, Holm; Boltze, Johannes

    2014-01-01

    Cerebrovascular diseases are significant causes of death and disability in humans. Improvements in diagnostic and therapeutic approaches strongly rely on adequate gyrencephalic, large animal models being demanded for translational research. Ovine stroke models may represent a promising approach but are currently limited by insufficient knowledge regarding the venous system of the cerebral angioarchitecture. The present study was intended to provide a comprehensive anatomical analysis of the intracranial venous system in sheep as a reliable basis for the interpretation of experimental results in such ovine models. We used corrosion casts as well as contrast-enhanced magnetic resonance venography to scrutinize blood drainage from the brain. This combined approach yielded detailed and, to some extent, novel findings. In particular, we provide evidence for chordae Willisii and lateral venous lacunae, and report on connections between the dorsal and ventral sinuses in this species. For the first time, we also describe venous confluences in the deep cerebral venous system and an 'anterior condylar confluent' as seen in humans. This report provides a detailed reference for the interpretation of venous diagnostic imaging findings in sheep, including an assessment of structure detectability by in vivo (imaging) versus ex vivo (corrosion cast) visualization methods. Moreover, it features a comprehensive interspecies-comparison of the venous cerebral angioarchitecture in man, rodents, canines and sheep as a relevant large animal model species, and describes possible implications for translational cerebrovascular research.

  15. The Ovine Cerebral Venous System: Comparative Anatomy, Visualization, and Implications for Translational Research

    Science.gov (United States)

    Nitzsche, Björn; Lobsien, Donald; Seeger, Johannes; Schneider, Holm; Boltze, Johannes

    2014-01-01

    Cerebrovascular diseases are significant causes of death and disability in humans. Improvements in diagnostic and therapeutic approaches strongly rely on adequate gyrencephalic, large animal models being demanded for translational research. Ovine stroke models may represent a promising approach but are currently limited by insufficient knowledge regarding the venous system of the cerebral angioarchitecture. The present study was intended to provide a comprehensive anatomical analysis of the intracranial venous system in sheep as a reliable basis for the interpretation of experimental results in such ovine models. We used corrosion casts as well as contrast-enhanced magnetic resonance venography to scrutinize blood drainage from the brain. This combined approach yielded detailed and, to some extent, novel findings. In particular, we provide evidence for chordae Willisii and lateral venous lacunae, and report on connections between the dorsal and ventral sinuses in this species. For the first time, we also describe venous confluences in the deep cerebral venous system and an ‘anterior condylar confluent’ as seen in humans. This report provides a detailed reference for the interpretation of venous diagnostic imaging findings in sheep, including an assessment of structure detectability by in vivo (imaging) versus ex vivo (corrosion cast) visualization methods. Moreover, it features a comprehensive interspecies-comparison of the venous cerebral angioarchitecture in man, rodents, canines and sheep as a relevant large animal model species, and describes possible implications for translational cerebrovascular research. PMID:24736654

  16. Radiologically-placed venous ports in children under venous anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2015-02-15

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  17. Venous sinus stenting for pseudotumour cerebri with venous sinus stenosis

    International Nuclear Information System (INIS)

    Chen Huairui; Bai Rulin; Wu Xiaojun; Qi Xiangqian; Mei Qiyong; Lu Yicheng

    2011-01-01

    Objective: To explore the relation between venous sinus stenosis and pseduotumour cerebri and to discuss the efficacy and strategy of venous sinus stenting for its treatment. Methods: Venous sinus stenting was performed in a total of 9 patients with pseudotumour cerebri accompanied by dural sinus stenosis. The clinical data, including the clinical presentations, intracranial pressure, angiographic findings, pressure of dural sinus,methods of treatment and the therapeutic results, were retrospectively analyzed. Results: Bilateral disc edema was seen in all patients. The pressure gradient in the lateral sinuses was obviously high before stenting (22.67±7.25)mmHg in all patients and a reduction in intra-sinus pressure and pressure gradient was also found (5.78±3.77)mmHg. The symptoms associated with intracranial hypertension were gradually improved or disappeared in two weeks after the placement of the stent in all cases, and the intracranial pressure dropped evidently (12.78±5.97)cm H 2 O. Vision was improved in 7 cases at three months, whereas it remained poor in 2 cases despite normalized intracranial pressure. There was no other permanent procedure-related morbidity. The patients were followed up for 3 months to 5 years, and no recurrence developed. Conclusion: Lateral sinus stenting is an effective method for the treatment of pseudotumour cerebri with dural sinus stenosis. (authors)

  18. Blood as a Substitute for Tumor Tissue in Detecting EGFR Mutations for Guiding EGFR TKIs Treatment of Nonsmall Cell Lung Cancer: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Mao, Chen; Yuan, Jin-Qiu; Yang, Zu-Yao; Fu, Xiao-Hong; Wu, Xin-Yin; Tang, Jin-Ling

    2015-05-01

    Tumor tissues are often absent or insufficient for testing epidermal growth factor receptor (EGFR) mutations to guide EGFR tyrosine kinase inhibitors (TKIs) treatment of patients with nonsmall cell lung cancer (NSCLC). We conducted this systematic review and meta-analysis to assess whether blood can be used as a substitute for tumor tissue in detecting EGFR mutations. MEDLINE, EMBASE, and the Cochrane Library were searched for studies that provided data to estimate the accuracy of blood testing against tissue testing in NSCLC patients and/or those directly compared the efficacy of EGFR TKIs in EGFR mutant and wild-type patients according to sources of specimens. Sensitivity, specificity, and concordance rate were used as measures of the accuracy. Risk ratio (RR) for objective response and hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) were used as measures for treatment efficacy. We combined the effects by using the fixed-effects model unless there was evidence of heterogeneity, in which case a random-effects mode was used. This systematic review included 25 studies with 2605 patients. The pooled overall sensitivity, specificity, and concordance rate were 0.61, 0.90, and 0.79, respectively. Serum showed lower sensitivity (0.56 vs 0.65) but higher specificity (0.95 vs 0.85) and higher concordance (0.86 vs 0.74) than plasma. EGFR mutations (exon 19 or 21) in blood were significantly associated with objective response (RR: 4.08; 95% confidence interval [CI] 2.48-6.70), PFS (HR: 0.72; 95% CI 0.64-0.80), and OS (HR: 0.71; 95% CI 0.50-0.99). Importantly, the association of the mutations with the 3 clinical outcomes for serum was similar to that for tumor tissue and higher than that for plasma. Blood, in particular serum, is a good substitute when tumor tissue is absent or insufficient for testing EGFR mutations to guide EGFR TKIs treatment in patients with NSCLC. EGFR mutation positivity in blood could be used to recommend EGFR TKIs

  19. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  20. Venous responses during exercise in rainbow trout, Oncorhynchus mykiss : [alpha]-adrenergic control and the antihypotensive function of the renin-angiotensin system

    DEFF Research Database (Denmark)

    Sandblom, E.; Axelsson, M.; McKenzie, David

    2006-01-01

    The role of the [alpha]-adrenergic system in the control of cardiac preload (central venous blood pressure; Pven) and venous capacitance during exercise was investigated in rainbow trout (Oncorhynchus mykiss). In addition, the antihypotensive effect of the renin-angiotesin system (RAS...... trout. It is also the first study to suggest that the RAS may be an important modulator of venous pressure and capacitance in fish....

  1. Fingertip Reconstruction Using Free Toe Tissue Transfer Without Venous Anastomosis

    Directory of Open Access Journals (Sweden)

    Won Young Yoon

    2012-09-01

    Full Text Available BackgroundThis study was designed to introduce the feasibility of toe tissue transfer without venous outflow for fingertip reconstruction.MethodsFive cases of fingertip defects were treated successfully with this method. Four cases were traumatic fingertip defects, and one case was a hook-nail deformity. The lateral pulp of a great toe or medioinferior portion of a second toe was used as the donor site. An arterial pedicle was dissected only within the digit and anastomosis was performed within 2 cm around the defect margin. The digital nerve was repaired simultaneously. No additional dissection of the dorsal or volar pulp vein was performed in either the donor or recipient sites. Other surgical procedures were performed following conventional techniques. Postoperative venous congestion was monitored with pulp temperature, color, and degree of tissue oxygen saturation. Venous congestion was decompressed with a needle-puncture method intermittently, but did not require continuous external bleeding for salvage.ResultsVenous congestion was observed in all the flaps, but improved within 3 or 4 days postoperatively. The flap size was from 1.5×1.5 cm2 to 2.0×3.0 cm2. The mean surgical time was 2 hours and 20 minutes. A needle puncture was carried out every 2 hours during the first postoperative day, and then every 4 hours thereafter. The amount of blood loss during each puncture procedure was less than 0.2 mL. In the long-term follow-up, no flap atrophy was observed.ConclusionsWhen used properly, the free toe tissue transfer without venous anastomosis method can be a treatment option for small defects on the fingertip area.

  2. Managing High Blood Pressure Medications

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Managing High Blood Pressure Medications Updated:Jan 10,2018 When your doctor ... checkup. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  3. Common High Blood Pressure Myths

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Common High Blood Pressure Myths Updated:May 4,2018 Knowing the facts ... health. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  4. What Is High Blood Pressure?

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More What is High Blood Pressure? Updated:Feb 27,2018 First, let’s define high ... resources . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  5. High Blood Pressure and Women

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure and Women Updated:Jan 29,2018 Pregnancy and ... Women . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  6. MRI in venous thromboembolic disease

    International Nuclear Information System (INIS)

    Sostman, H.D.; Debatin, J.F.; Spritzer, C.E.; Coleman, R.E.; Grist, T.M.; MacFall, J.R.

    1993-01-01

    We evaluated the ability of magnetic resonance (MR) imaging to detect deep venous thrombosis (DVT) and pulmonary embolism (PE). MR venography was performed on 217 patients suspected of having DVT. Cine-MR imaging of the pulmonary arteries was performed in 14 other patients who were thought to have PE based on other imaging studies. In a third group of 5 patients, MR pulmonary angiograms were performed in the sagittal and coronal planes with a multislice fast gradient recalled echo technique. All but one of the 217 MR venograms were technically adequate. In 72 patients with correlative imaging studies (venography and ultrasound) MR venography was 99% sensitive and 95% specific. On the basis of follow-up (mean 8.3 months), no false-negative MR venograms were detected in an additional 64 patients. In 11 other patients MR revealed a diagnosis other than DVT. Cine-MR showed PE in all 14 patients evaluated. MR pulmonary arteriography demonstrated filling defects consistent with acute PE in 2 of 3 patients with acute PE; in the third patient only a questionable filling defect was seen. Coarctations or webs were found in the pulmonary arteries of both patients with chronic PE. These preliminary data suggest that MR imaging may be able to evaluate both the peripheral venous and the pulmonary arterial component of venous thromboembolic disease. Further technical refinement and more extensive clinical experience will be required to establish the role of this method in diagnosing pulmonary embolism, but MR venography is now used routinely in our hospital for the diagnosis of deep venous thrombosis. (orig.)

  7. Blood donation barriers and facilitators of Sub-Saharan African migrants and minorities in Western high-income countries: a systematic review of the literature.

    Science.gov (United States)

    Klinkenberg, E F; Huis In 't Veld, E M J; de Wit, P D; van Dongen, A; Daams, J G; de Kort, W L A M; Fransen, M P

    2018-03-01

    The present study aimed to gain more insight into, and summarise, blood donation determinants among migrants or minorities of Sub-Saharan heritage by systematically reviewing the current literature. Sub-Saharan Africans are under-represented in the blood donor population in Western high-income countries. This causes a lack of specific blood types for transfusions and prevention of alloimmunisation among Sub-Saharan African patients. Medline, EMBASE, PsycINFO and BIOSIS were searched for relevant empirical studies that focused on barriers and facilitators of blood donation among Sub-Saharan Africans in Western countries until 22 June 2017. Of the 679 articles screened by title and abstract, 152 were subsequently screened by full text. Paired reviewers independently assessed the studies based on predefined eligibility and quality criteria. Of the 31 included studies, 24 used quantitative and 7 used qualitative research methods. Target cohorts varied from Black African Americans and refugees from Sub-Sahara Africa to specific Sub-Saharan migrant groups such as Comorians or Ethiopians. Main recurring barriers for Sub-Saharan Africans were haemoglobin deferral, fear of needles and pain, social exclusion, lack of awareness, negative attitudes and accessibility problems. Important recurring facilitators for Sub-Saharan Africans were altruism, free health checks and specific recruitment and awareness-raising campaigns. The findings of this review can be used as a starting point to develop recruitment and retention strategies for Sub-Saharan African persons. Further research is needed to gain more insight in the role of these determinants in specific contexts as socioeconomic features, personal histories and host country regulations may differ per country. © 2018 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.

  8. Significance of venous anastomosis in fingertip replantation.

    Science.gov (United States)

    Hattori, Yasunori; Doi, Kazuteru; Ikeda, Keisuke; Abe, Yukio; Dhawan, Vikas

    2003-03-01

    Adequate venous outflow is the most important factor for successful fingertip replantation. The authors have attempted venous anastomosis in all cases of fingertip replantation to overcome postoperative congestion. In this article, the significance of venous repair for fingertip replantation is described from the authors' results of 64 complete fingertip amputations in 55 consecutive patients, which were replanted from January of 1996 to June of 2001. The overall survival rate was 86 percent. Of the 44 replantations in zone I, 37 survived, and the success rate was 84 percent. Of the 20 replantations in zone II, 18 survived, and the success rate was 90 percent. Venous anastomosis was attempted in all cases, but it was possible in 39 zone I and in all zone II replantations. For arterial repair, vein grafts were necessary in 17 of the 44 zone I and in one of the 20 zone II replantations; for venous repair, they were necessary in six zone I replantations and one zone II replantation. Postoperative vascular complications occurred in 15 replantations. There were five cases of arterial thrombosis and 10 cases of venous congestion. Venous congestion occurred in nine zone I and one zone II replantations. In five of these 10 replantations, venous anastomosis was not possible. In another five replantations, venous outflow was established at the time of surgery, but occlusion occurred subsequently. Except for the five failures resulting from arterial thrombosis, successful venous repair was possible in 49 of 59 replantations (83 percent). Despite the demand for skillful microsurgical technique and longer operation time, the authors' results using venous anastomosis in successful fingertip replantations are encouraging. By performing venous anastomosis, external bleeding can be avoided and a higher survival rate can be achieved. Venous anastomosis for fingertip replantation is a reliable and worthwhile procedure.

  9. Cerebral sino-venous thrombosis

    International Nuclear Information System (INIS)

    Sayama, Ichiro; Kobayashi, Tsunesaburo; Nakajima, Kenji

    1982-01-01

    Three cases of cerebral sino-venous thrombosis were reported. Repeated CT findings were studied and discussed on account of the treatments for those pathologic conditions. Those of studied cases are; a 22-year-old postpartum woman, a 42-year-old woman with irregular vaginal bleeding, and a 26-year-old man with severe reactive emesis after drinking alcohol. They were treated conservatively. Case 1 died in its acute stage. In the remaining ones, each had an uneventful recovery. CT scan findings of them manifested their exact clinical conditions. These findings were devided into two categories, one was direct signs expressed sino-venous occlusion, the other was indirect signs which appeared as a result of these occlusion. Direct signs cannot always get in every cases with sino-venous occlusion, but as for indirect signs, we can get various changes corresponding to the time taken CT photoes, and they are useful to decide appropriate treatments at that time. Considering suitable treatments for this disease, it is necessary to select most suitable ones according to their pathologic conditions, which may be precisely drawn with CT scans. (J.P.N.)

  10. Comparison of utility of blood cultures from intravascular catheters and peripheral veins: a systematic review and decision analysis.

    Science.gov (United States)

    Falagas, Matthew E; Kazantzi, Maria S; Bliziotis, Ioannis A

    2008-01-01

    Blood cultures are sometimes obtained from intravascular catheters for convenience. However, there is controversy regarding this practice. The authors compared the diagnostic test characteristics of blood cultures obtained from intravascular catheters and peripheral veins. Relevant studies for inclusion in this review were identified through PubMed (January 1970-October 2005) and the Cochrane Central Register of Controlled Trials. Studies that reported clear definitions of true bacteraemia were included in the analysis. Two reviewers independently extracted the data. Six studies were included in the analysis, providing data for 2677 pairs of blood cultures obtained from an intravascular catheter and a peripheral venipuncture. A culture obtained from an intravascular catheter was found to be a diagnostic test for bacteraemia with better sensitivity (OR 1.85, 95 % CI 1.14-2.99, fixed effects model) and better negative predictive value (almost with statistical significance) (OR 1.55, 95 % CI 0.999-2.39, fixed effects model) but with less specificity (OR 0.33, 95 % CI 0.18-0.59, random effects model) and lower positive predictive value (OR 0.41, 95 % CI 0.23-0.76, random effects model) compared to a culture taken by peripheral venipuncture. In a group of 1000 patients, eight additional patients with true bacteraemia would be identified and 59 falsely diagnosed as having bacteraemia by a blood culture obtained from an intravascular catheter compared to results of the peripheral blood culture. Given the consequences of undertreating patients with bacteraemia, the authors believe that, based on the available evidence, at least one blood culture should be obtained from the intravascular catheter.

  11. Sudden Bilateral Sensorineural Hearing Loss Secondary to Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Muhammad-Nu’aim Ishak

    2018-03-01

    Full Text Available Introduction: Sudden sensorineural hearing loss (SSNHL is an important otological emergency. Up to 90% of the cases are idiopathic. Cerebral venous thrombosis (CVT is an extremely rare identifiable cause as it only represents 0.5% of all strokes.   Case Report: In this paper, an unusual case of bilateral SSNHL secondary to bilateral CVT with rapid and complete recovery is reported. The patient presented with sudden bilateral hearing loss associated with some neurological symptoms. Initial computed tomography (CT venography revealed a CVT of bilateral transverse sinuses. The patient was started on an anticoagulant and imaging was repeated after five days, revealing the absence of the thrombosis. Serial pure tone audiometry (PTA showed complete recovery of bilateral hearing within 10 days.   Conclusion: Early detection and intervention may fasten hearing recovery and improve the quality of life. The immediate restoration of venous blood flow and intracranial pressure may lead to the complete recovery of bilateral hearing loss.

  12. Determination of ammonia in ear-lobe capillary blood is an alternative to arterial blood ammonia

    NARCIS (Netherlands)

    Huizenga, J. R.; Gips, C. H.; Conn, H. O.; Jansen, P. L.

    1995-01-01

    Blood ammonia determination is a laboratory test to diagnose hepatic encephalopathy. Arterial blood is superior to peripheral venous blood ammonia because of ammonia metabolism in muscle. We have compared capillary with arterial whole blood ammonia as capillary sampling is an attractive alternative.

  13. DETERMINATION OF AMMONIA IN EAR-LOBE CAPILLARY BLOOD IS AN ALTERNATIVE TO ARTERIAL BLOOD AMMONIA

    NARCIS (Netherlands)

    HUIZENGA, [No Value; GIPS, CH; CONN, HO; JANSEN, PLM

    1995-01-01

    Blood ammonia determination is a laboratory test to diagnose hepatic encephalopathy. Arterial blood is superior to peripheral venous blood ammonia because of ammonia metabolism in muscle. We have compared capillary with arterial whole blood ammonia as capillary sampling is an attractive alternative.

  14. A systematic review on the influence of trial quality on the effect of garlic on blood pressure.

    NARCIS (Netherlands)

    Simons, S.O.; Wollersheim, H.C.H.; Thien, Th.

    2009-01-01

    BACKGROUND: Garlic is a widely used herbal product for hypertension. Previous meta-analyses on the effect of garlic on blood pressure (BP) have been contradictory however. We hypothesised that methodological deficiencies may have contributed to this disagreement. We therefore evaluated whether

  15. In vitro susceptibilities in lymphocytes from mothers and cord blood to the monofunctional alkylating agent EMS

    DEFF Research Database (Denmark)

    Wyatt, N P; Falque-Gonzalez, C; Farrar, D

    2007-01-01

    at the Bradford Royal Infirmary collected venous blood samples from mothers at the time of birth and venous cord blood post-delivery. Lymphocytes were isolated from both blood types and examined in the alkaline comet assay using the monofunctional alkylating agent ethyl methanesulphonate (EMS). There were...

  16. Chronic fructose substitution for glucose or sucrose in food or beverages has little effect on fasting blood glucose, insulin, or triglycerides: a systematic review and meta-analysis.

    Science.gov (United States)

    Evans, Rebecca A; Frese, Michael; Romero, Julio; Cunningham, Judy H; Mills, Kerry E

    2017-08-01

    Background: Conflicting evidence exists on the role of long-term fructose consumption on health. No systematic review has addressed the effect of isoenergetic fructose replacement of other sugars and its effect on glycated hemoglobin (HbA1c), fasting blood glucose, insulin, and triglycerides. Objective: The objective of this study was to review the evidence for a reduction in fasting glycemic and insulinemic markers after chronic, isoenergetic replacement of glucose or sucrose in foods or beverages by fructose. The target populations were persons without diabetes, those with impaired glucose tolerance, and those with type 2 diabetes. Design: We searched the Cochrane Library, MEDLINE, EMBASE, the WHO International Clinical Trials Registry Platform Search Portal, and clinicaltrials.gov The date of the last search was 26 April 2016. We included randomized controlled trials of isoenergetic replacement of glucose, sucrose, or both by fructose in adults or children with or without diabetes of ≥2 wk duration that measured fasting blood glucose. The main outcomes analyzed were fasting blood glucose and insulin as well as fasting triglycerides, blood lipoproteins, HbA1c, and body weight. Results: We included 14 comparison arms from 11 trials, including 277 patients. The studies varied in length from 2 to 10 wk (mean: 28 d) and included doses of fructose between 40 and 150 g/d (mean: 68 g/d). Fructose substitution in some subgroups resulted in significantly but only slightly lowered fasting blood glucose (-0.14 mmol/L; 95% CI: -0.24, -0.036 mmol/L), HbA1c [-10 g/L (95% CI: -12.90, -7.10 g/L; impaired glucose tolerance) and -6 g/L (95% CI: -8.47, -3.53 g/L; normoglycemia)], triglycerides (-0.08 mmol/L; 95% CI: -0.14, -0.02 mmol/L), and body weight (-1.40 kg; 95% CI: -2.07, -0.74 kg). There was no effect on fasting blood insulin or blood lipids. Conclusions: The evidence suggests that the substitution of fructose for glucose or sucrose in food or beverages may be of benefit

  17. The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient.

    Science.gov (United States)

    Streit, L; Dvořák, Z; Novák, O; Stiborová, S; Veselý, J

    2014-01-01

    Replantation of amputated fingertip is a technical challenge to the microsurgeons. The success rate depends directly on the availability and the size of preserved vessels and on the degree of their damage. In distal digital amputations, veins are usually not easily recovered or even absent, and thus high number of replantation procedures fails because of the venous congestion. The use of medicinal leeches is a treatment option for venous congestion of replanted fingers. A case report of a 4-year-old patient after fingertip replantation without venous anastomosis when temporary venous drainage was provided by an application of medicinal leeches is reported together with literature review. We observed an unusually short duration of venous congestion (48 hours) and there was no need of blood transfusion.

  18. Femoral venous oxygen saturation is no surrogate for central venous oxygen saturation

    NARCIS (Netherlands)

    van Beest, Paul A.; van der Schors, Alice; Liefers, Henriëtte; Coenen, Ludo G. J.; Braam, Richard L.; Habib, Najib; Braber, Annemarije; Scheeren, Thomas W. L.; Kuiper, Michaël A.; Spronk, Peter E.

    2012-01-01

    Objective: The purpose of our study was to determine if central venous oxygen saturation and femoral venous oxygen saturation can be used interchangeably during surgery and in critically ill patients. Design: Prospective observational controlled study. Setting: Nonacademic university-affiliated

  19. Venous responses during exercise in rainbow trout, Oncorhynchus mykiss : [alpha]-adrenergic control and the antihypotensive function of the renin-angiotensin system

    DEFF Research Database (Denmark)

    Sandblom, E.; Axelsson, M.; McKenzie, David

    2006-01-01

    The role of the [alpha]-adrenergic system in the control of cardiac preload (central venous blood pressure; Pven) and venous capacitance during exercise was investigated in rainbow trout (Oncorhynchus mykiss). In addition, the antihypotensive effect of the renin-angiotesin system (RAS) was invest...

  20. Monitoring arterio-venous differences of glucose and lactate in the anesthetized rat with or without brain damage with ultrafiltration and biosensor technology

    NARCIS (Netherlands)

    Leegsma-Vogt, G; Venema, K; Postema, F; Korf, J

    2001-01-01

    Continuous monitoring of arterio-venous glucose and lactate differences may serve as a diagnostic tool to assess normal brain function and brain pathology. We describe a method and some results obtained with arterio-venous measurements of glucose and lactate in the blood of the

  1. Clinicoroentgenological diagnosis of chronic venous ovarian insufficiency

    International Nuclear Information System (INIS)

    Grakova, L.S.; Galkin, E.V.; Naumova, E.B.

    1989-01-01

    The paper is devoted to clinicoroentgenological correlations of venous renogonadal hemodynamics in 168 women of reproductive age (151 women with infertility, habitual abortion, disordered menstrual function and 17 patients without disorders of the reproductive tract). Clinicolaboratory investigation was followed by visceral and parietal flebography for the detection of a pathological venous reflux into the ovarian pampiniform plexus. Clinicoroentgenological semiotics of chronic venous ovarian insufficiency was analyzed. Infertility was shown to be the main clinical manifestation of ovarian varicocele

  2. Pdgfrb-Cre targets lymphatic endothelial cells of both venous and non-venous origins.

    Science.gov (United States)

    Ulvmar, Maria H; Martinez-Corral, Ines; Stanczuk, Lukas; Mäkinen, Taija

    2016-06-01

    The Pdgfrb-Cre line has been used as a tool to specifically target pericytes and vascular smooth muscle cells. Recent studies showed additional targeting of cardiac and mesenteric lymphatic endothelial cells (LECs) by the Pdgfrb-Cre transgene. In the heart, this was suggested to provide evidence for a previously unknown nonvenous source of LECs originating from yolk sac (YS) hemogenic endothelium (HemEC). Here we show that Pdgfrb-Cre does not, however, target YS HemEC or YS-derived erythro-myeloid progenitors (EMPs). Instead, a high proportion of ECs in embryonic blood vessels of multiple organs, as well as venous-derived LECs were targeted. Assessment of temporal Cre activity using the R26-mTmG double reporter suggested recent occurrence of Pdgfrb-Cre recombination in both blood and lymphatic ECs. It thus cannot be excluded that Pdgfrb-Cre mediated targeting of LECs is due to de novo expression of the Pdgfrb-Cre transgene or their previously established venous endothelial origin. Importantly, Pdgfrb-Cre targeting of LECs does not provide evidence for YS HemEC origin of the lymphatic vasculature. Our results highlight the need for careful interpretation of lineage tracing using constitutive Cre lines that cannot discriminate active from historical expression. The early vascular targeting by the Pdgfrb-Cre also warrants consideration for its use in studies of mural cells. genesis 54:350-358, 2016. © 2016 The Authors. Genesis Published by Wiley Periodicals, Inc. © 2016 The Authors. Genesis Published by Wiley Periodicals, Inc.

  3. Sonographic detection of portal venous gas

    International Nuclear Information System (INIS)

    Lee, Wang Yul; Lee, S. K.; Cho, O. K.

    1989-01-01

    Portal venous gas suggests underlying bowel disease such as strangulating intestinal obstruction and its demonstration carries with it an important implications with respect to patient management. Radiography has been the gold standard for the detection of portal venous gas. We have experienced two cases of portal venous gas diagnosed by ultrasound. Sonographic findings were floating echoes in the main portal vein and highly echogenic linear or patchy echoes within the hepatic parenchyma. Simple abdominal films of those cases failed to demonstrate gas in the portal venous system

  4. Systematic review of topic treatment for venous ulcers Revisión sistemática del tratamiento tópico de la úlcera venosa Revisão sistemática do tratamento tópico da úlcera venosa

    Directory of Open Access Journals (Sweden)

    Eline Lima Borges

    2007-12-01

    Full Text Available Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3% and topical treatment (45.7%. It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.Pacientes con úlcera venosa pueden convivir con esta situación durante varios años, sin obtener la cicatrización de la herida caso el tratamiento no sea adecuado. La práctica profesional basada en evidencias produce resultados efectivos para el paciente y para los servicios. La finalidad del estudio fue realizar una revisión sistemática para evaluar el método más eficaz para mejorar el retorno venoso y el mejor tratamiento tópico de la úlcera. Se buscaron estudios indexados en ocho bases de datos, mediante los descriptores úlcera de pierna, úlcera venosa y similares. La muestra incluyó 33 estudios primarios y 2 estudios de metanálisis. Se identificó una diversidad de tratamientos que fueron agrupados en terapia compresiva (54,3% y tratamiento tópico (45,7%. Fue evidenciado que la terapia compresiva aumenta la tasa de cicatrización de la úlcera y que debe ser usado en pacientes sin comprometimiento arterial. No queda claro cual es la mejor terapia tópica. Sin embargo, las diferentes opciones deben ser asociadas a la

  5. Effects of shorter versus longer storage time of transfused red blood cells in adult ICU patients: a systematic review with meta-analysis and Trial Sequential Analysis.

    Science.gov (United States)

    Rygård, Sofie L; Jonsson, Andreas B; Madsen, Martin B; Perner, Anders; Holst, Lars B; Johansson, Pär I; Wetterslev, Jørn

    2018-02-01

    Patients in the intensive care unit (ICU) are often transfused with red blood cells (RBC). During storage, the RBCs and storage medium undergo changes, which may have clinical consequences. Several trials now have assessed these consequences, and we reviewed the present evidence on the effects of shorter versus longer storage time of transfused RBCs on outcomes in ICU patients. We conducted a systematic review with meta-analyses and trial sequential analyses (TSA) of randomised clinical trials including adult ICU patients transfused with fresher versus older or standard issue blood. We included seven trials with a total of 18,283 randomised ICU patients; two trials of 7504 patients were judged to have low risk of bias. We observed no effects of fresher versus older blood on death (relative risk 1.04, 95% confidence interval (CI) 0.97-1.11; 7349 patients; TSA-adjusted CI 0.93-1.15), adverse events (1.26, 0.76-2.09; 7332 patients; TSA-adjusted CI 0.16-9.87) or post-transfusion infections (1.07, 0.96-1.20; 7332 patients; TSA-adjusted CI 0.90-1.27). The results were unchanged by including trials with high risk of bias. TSA confirmed the results and the required information size was reached for mortality for a relative risk change of 20%. We may be able to reject a clinically meaningful effect of RBC storage time on mortality in transfused adult ICU patients as our trial sequential analyses reject a 10% relative risk change in death when comparing fresher versus older blood for transfusion.

  6. A systematic assessment of the association of polysomnographic indices with blood pressure: the Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Dean, Dennis A; Wang, Rui; Jacobs, David R; Duprez, Daniel; Punjabi, Naresh M; Zee, Phyllis C; Shea, Steven; Watson, Karol; Redline, Susan

    2015-04-01

    Blood pressure (BP) may be adversely affected by a variety of sleep disturbances, including sleep fragmentation, hypoxemia, respiratory disturbances, and periodic limb movements. We aim to identify which polysomnography indices are most strongly and consistently associated with systolic and diastolic blood pressure (SBP, DBP) levels in a population-based sample. Cross-sectional analysis of data from 2,040 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent polysomnography at MESA Exam 5 in 2011-2013. Multisite cohort study. Participants were mean age 68 y (54% females; 28% African American, 24% Hispanic, 11% Chinese). Thirty-two candidate polysomnography predictors were identified representing the domains of breathing disturbance frequency, hypoxemia, sleep architecture, and periodic limb movements. Cluster analysis was used for variable reduction. Statistical models, adjusted for potential confounders, were derived using stepwise regression. Final models were selected using cross-validation techniques. The apnea-hypopnea index (AHI) defined using a 4% desaturation hypopnea criterion (AHI4P) was most consistently associated with SBP level. The AHI and periodic limb movement index (associated with arousals; PLMIA) were significantly associated with DBP. Estimated adjusted differences in SBP and DBP levels between an individual with no sleep apnea (AHI4P = 0) and one with moderately severe sleep apnea (AHI4P = 30) were 2.2 mm Hg and 1.1 mm Hg, respectively. Each 10-unit increase in the PLMIA was associated with an increase in DBP of 1.2 mm Hg. Our results support the use of a currently recommended apnea-hypopnea index definition as a marker of blood pressure risk and indicate that measurement of limb movements with arousals is also independently associated with diastolic blood pressure. © 2015 Associated Professional Sleep Societies, LLC.

  7. Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis.

    Science.gov (United States)

    Holst, Lars B; Petersen, Marie W; Haase, Nicolai; Perner, Anders; Wetterslev, Jørn

    2015-03-24

    To compare the benefit and harm of restrictive versus liberal transfusion strategies to guide red blood cell transfusions. Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. Cochrane central register of controlled trials, SilverPlatter Medline (1950 to date), SilverPlatter Embase (1980 to date), and Science Citation Index Expanded (1900 to present). Reference lists of identified trials and other systematic reviews were assessed, and authors and experts in transfusion were contacted to identify additional trials. Published and unpublished randomised clinical trials that evaluated a restrictive compared with a liberal transfusion strategy in adults or children, irrespective of language, blinding procedure, publication status, or sample size. Two authors independently screened titles and abstracts of trials identified, and relevant trials were evaluated in full text for eligibility. Two reviewers then independently extracted data on methods, interventions, outcomes, and risk of bias from included trials. random effects models were used to estimate risk ratios and mean differences with 95% confidence intervals. 31 trials totalling 9813 randomised patients were included. The proportion of patients receiving red blood cells (relative risk 0.54, 95% confidence interval 0.47 to 0.63, 8923 patients, 24 trials) and the number of red blood cell units transfused (mean difference -1.43, 95% confidence interval -2.01 to -0.86) were lower with the restrictive compared with liberal transfusion strategies. Restrictive compared with liberal transfusion strategies were not associated with risk of death (0.86, 0.74 to 1.01, 5707 patients, nine lower risk of bias trials), overall morbidity (0.98, 0.85 to 1.12, 4517 patients, six lower risk of bias trials), or fatal or non-fatal myocardial infarction (1.28, 0.66 to 2.49, 4730 patients, seven lower risk of bias trials). Results were not affected by the inclusion of trials with unclear or

  8. LINE-1 hypomethylation in blood and tissue samples as an epigenetic marker for cancer risk: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Martina Barchitta

    Full Text Available A systematic review and a meta-analysis were carried out in order to summarize the current published studies and to evaluate LINE-1 hypomethylation in blood and other tissues as an epigenetic marker for cancer risk.A systematic literature search in the Medline database, using PubMed, was conducted for epidemiological studies, published before March 2014. The random-effects model was used to estimate weighted mean differences (MDs with 95% Confidence Intervals (CIs. Furthermore, subgroup analyses were conducted by sample type (tissue or blood samples, cancer types, and by assays used to measure global DNA methylation levels. The Cochrane software package Review Manager 5.2 was used.A total of 19 unique articles on 6107 samples (2554 from cancer patients and 3553 control samples were included in the meta-analysis. LINE-1 methylation levels were significantly lower in cancer patients than in controls (MD: -6.40, 95% CI: -7.71, -5.09; p<0.001. The significant difference in methylation levels was confirmed in tissue samples (MD -7.55; 95% CI: -9.14, -65.95; p<0.001, but not in blood samples (MD: -0.26, 95% CI: -0.69, 0.17; p = 0.23. LINE-1 methylation levels were significantly lower in colorectal and gastric cancer patients than in controls (MD: -8.33; 95% CI: -10.56, -6.10; p<0.001 and MD: -5.75; 95% CI: -7.75, -3.74; p<0.001 whereas, no significant difference was observed for hepatocellular cancer.The present meta-analysis adds new evidence to the growing literature on the role of LINE-1 hypomethylation in human cancer and demonstrates that LINE-1 methylation levels were significantly lower in cancer patients than in control samples, especially in certain cancer types. This result was confirmed in tissue samples, both fresh/frozen or FFPE specimens, but not in blood. Further studies are needed to better clarify the role of LINE-1 methylation in specific subgroups, considering both cancer and sample type, and the methods of measurement.

  9. Studies on venous chronic obstructions with perfused krypton-81m

    Energy Technology Data Exchange (ETDEWEB)

    Zicot, M.; Guillaume, M. (Universite de Liege, Centre de Recherches du Cyclotron (Belgium))

    1982-01-01

    A perfusion system is used to study the venous return of the lower limbs through an injection of a superficial vein of the foot. Multiple sequential perfusions are possible because there is no building up of the radioactivity (short-life of the Kr-81m and lung elimination). We are therefore able to study the system under different mechanical conditions (tourniquet at different sites and pressures, hyperaemia). The main veins (from popliteal vein to vena cava) are therefore normally vizualised by a peripheral injection. The region below the knee is difficult to study by venoscintigraphy. The transit times from the foot to the groin, and between regions of interest are also studied. We analyse the results obtained with a consecutive series of 31 patients suffering from possible chronic venous problems and sequelae of deep venous thrombosis (lasting for 2 weeks to more than 20 years): 58 limbs are actually examined. Most of these limbs are also assessed by non invasive heamodynamic techniques: Doppler ultrasound and calf plethysmography: 35 limbs are normal, 23 show obliterative sequelae of deep vein thrombosis. The venoscintigraphy displays the level and the degree of obstructions and the pattern of collateral pathways with an accuracy comparable to RX-phlebography. We demonstrate that the Doppler is able to recognize most of the residual obstructions. The resistances to venous outflow measured by plethysmography are also generally increased. We are not able to demonstrate systematic and significant variations of the transit times in the different haemodynamic conditions. These parameters do not seem therefore adequate for functional assessment.

  10. Studies on venous chronic obstructions with perfused krypton-81m

    International Nuclear Information System (INIS)

    Zicot, M.; Guillaume, M.

    1982-01-01

    A perfusion system is used to study the venous return of the lower limbs through an injection of a superficial vein of the foot. Multiple sequential perfusions are possible because there is no building up of the radioactivity (short-life of the Kr-81m and lung elimination). We are therefore able to study the system under different mechanical conditions (tourniquet at different sites and pressures, hyperaemia). The main veins (from popliteal vein to vena cava) are therefore normally vizualised by a peripheral injection. The region below the knee is difficult to study by venoscintigraphy. The transit times from the foot to the groin, and between regions of interest are also studied. We analyse the results obtained with a consecutive serie of 31 patients suffering from possible chronic venous problems and sequelae of deep venous thrombosis (lasting for 2 weeks to more than 20 years): 58 limbs are actually examined. Most of these limbs are also assessed by non invasive heamodynamic techniques: Doppler ultrasound and calf plethysmography: 35 limbs are normal, 23 show obliterative sequelae of deep vein thrombosis. The venoscintigraphy displays the level and the degree of obstructions and the pattern of collateral pathways with an accuracy comparable to RX-phlebography. We demonstrate that the Doppler is able to recognize most of the residual obstructions. The resistances to venous outflow measured by plethysmography are also generally increased. We are not able to demonstrate systematic and significant variations of the transit times in the different haemodynamic conditions. These parameters do not seem therefore adequate for functional assessment [fr

  11. Measurement of organ blood flow using tritiated water. II. Uterine blood flow in conscious pregnant ewes

    International Nuclear Information System (INIS)

    Brown, B.W.; Oddy, V.H.; Jones, A.W.

    1982-01-01

    Total uterine blood flow was measured with a tritiated water (TOH) diffusion method and with radioactive microspheres in six, conscious, pregnant ewes. With continuous infusion of TOH, equilibrium between the TOH concentration in utero-ovarian venous blood and arterial blood was attained within 50 min of the start of the infusion. The concentration of TOH in uterine and foetal tissue and in foetal blood water was the same as that in uterine venous water by 40 min; at this time, the concentration of TOH in the water of amniotic and allantoic fluids was 96% of that in uterine venous blood water. Estimates of total uterine blood flow obtained using TOH were highly correlated with those obtained with microspheres and the corresponding mean flow values obtained with the two techniques did not significantly differ. The percentage of the total uterine blood flow passing through arteriovenous anastomoses ranged from 1.4 to 3.3%

  12. Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Liu, F; Prabhakar, M; Ju, J; Long, H; Zhou, H-W

    2017-01-01

    This systematic review and meta-analysis was performed to assess the effects of inulin-type fructans (ITF) on human blood lipids and glucose homeostasis associated with metabolic abnormalities, including dyslipidemia, overweight or obesity, and type-2 diabetes mellitus (T2DM). The MEDLINE, EMBASE and Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) before January 2016. Human trials that investigated the effects of ITF supplementation on the lipid profile, fasting glucose and insulin were included using Review Manager 5.3. Twenty RCTs with 607 adult participants were included in this systematic review and meta-analysis. In the overall analysis, the supplementation of ITF reduced only the low density lipoprotein-cholesterol (LDL-c) (mean difference (MD): -0.15; 95% confidence interval (CI): -0.29, -0.02; P=0.03) without affecting the other endpoints. Within the T2DM subgroup analysis, ITF supplementation was positively associated with a decreased fasting insulin concentration (MD: -4.01; 95% CI: -5.92, -2.09; P<0.0001) and increased high density lipoprotein-cholesterol (HDL-c) (MD: 0.07; 95% CI: 0, 0.14; P=0.05). Moreover, a reduced fasting glucose tendency was identified only in the T2DM subgroup (MD: -0.42; 95% CI: -0.90, 0.06; P=0.09). There was a potential publication bias, and few trials were available for the T2DM subgroup analysis. In summary, the use of ITF may have benefits for LDL-c reduction across all study populations, whereas HDL-c improvement and glucose control were demonstrated only in the T2DM subgroup. Thus, additional, well-powered, long-term, randomized clinical trials are required for a definitive conclusion. Overall, ITF supplementation may provide a novel direction for improving the lipid profile and glucose metabolism.

  13. Effects of blueberry supplementation on blood pressure: a systematic review and meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Zhu, Y; Sun, J; Lu, W; Wang, X; Wang, X; Han, Z; Qiu, C

    2017-03-01

    Blueberries belong to the genus Vaccinium of the family Ericaceae. A series of epidemiological studies have demonstrated that blueberry polyphenols, particularly blueberry anthocyanins provide significant beneficial effects for humans. However, the findings of clinical studies have been equivocal. Therefore, we sought to assess the potential anti-hypertensive effects of blueberry supplementation through a meta-analysis of available randomized controlled trials (RCTs). A comprehensive literature search of PubMed, The Cochrane Library, AMED (Allied and Complementary Medicine Database), Embase, Web of Science, Wanfang Database, and China National Knowledge Infrastructure were performed to identify potential studies published before June 2015. The standardized mean difference and 95% confidence interval (CI) were used as summary statistics. Net changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the blueberry and placebo groups were calculated by subtracting the values at the end of follow-up from those at baseline. Meta-regression was used to identify potential moderators of effect size. Six RCT studies with 204 participants were included in our meta-analysis. There was no significant effect of blueberry supplementation on changes in blood pressure (BP) relative to baseline, and there was a mean difference of -0.28 (95% CI: -1.11 to 0.56, I 2 =87%) and -0.5 (95% CI: -1.24 to 0.24, I 2 =84%) mmHg for SBP and DBP, respectively. In summary, the results from this meta-analysis do not favor any clinical efficacy of blueberry supplementation in improving BP. Further well-designed larger RCTs are required to verify the association between blueberry supplementation and BP.

  14. [Factor V Leiden and prothrombin G20210A among Chilean patients with venous and arterial thrombosis].

    Science.gov (United States)

    Palomo, Iván; Pereira, Jaime; Alarcón, Marcelo; Pinochet, Carmen; Vélez, María T; Hidalgo, Patricia; Skagerberg, Karin; Poblete, Fernando

    2005-12-01

    Factor V Leiden and G20210A mutation of prothrombin gene are two important genetic polymorphisms associated with an increased risk for thrombosis. To establish the prevalence of factor V Leiden and prothrombin G20210A mutation in the Chilean population and their association to venous and arterial thromboembolism. A case-control study was conducted where 149 patients with thrombosis (87 with arterial and 62 with venous thrombosis) confirmed by CAT-scan, electrocardiogram and cardiac enzymes or Doppler depending on the case, and 160 healthy blood donors were genetically analyzed for the presence of both polymorphisms. Factor V Leiden mutation was found in 5.4% of patients and in 1.3% of healthy controls (p=0.04). Heterozygosity for G20210A prothrombin mutation was found in 5.4% of patients and in 2.5% of the control group (p=NS). When arterial and venous thrombosis were considered as separate entities, 4.6% of patients with arterial thrombosis and 6.5% with venous thrombosis presented factor V Leiden (p=NS). Likewise, 8.1% of patients with venous thrombosis and 3.5% of patients with arterial thrombosis had G20210A prothrombin mutation (p=NS). In non selected consecutive Chilean patients with arterial and venous thrombosis the frequency of factor V Leiden and prothrombin G20210A is less than we could expect from their prevalence in the general population.

  15. 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.

  16. The Need of Slanted Side Holes for Venous Cannulae

    Directory of Open Access Journals (Sweden)

    Joong Yull Park

    2012-01-01

    Full Text Available Well-designed cannulae must allow good flow rate and minimize nonphysiologic load. Venous cannulae generally have side holes to prevent the rupture of blood vessel during perfusion. Optimizing side hole angle will yield more efficient and safe venous cannulae. A numerical modeling was used to study the effect of the angle (0°–45° and number (0–12 of side holes on the performance of cannulae. By only slanting the side holes, it increases the flow rate up to 6% (in our models. In addition, it was found that increasing the number of side holes reduces the shear rate up to 12% (in our models. A new parameter called “penetration depth” was introduced to describe the interfering effect of stream jets from side holes, and the result showed that the 45°-slanted side holes caused minimum interfering for the flow in cannula. Our quantitative hemodynamic analysis study provides important guidelines for venous cannulae design.

  17. Central venous catheter-related bloodstream infections in cancer patients

    International Nuclear Information System (INIS)

    Butt, T.; Afzal, R.K.; Ahmad, R.N.; Hussain, I.; Anwar, M.

    2004-01-01

    Objective: To determine the frequency of central venous catheter-related bloodstream infections (CR-BSI) in cancer patients and the antimicrobial susceptibility pattern of the isolates. Subjects and Methods: Cancer patients requiring short or long-term central venous catheterization at the time of admission or thereafter were included. Catheter tips on removal were cultured quantitatively; specimens of blood and pus were cultured qualitatively. Isolates were identified and antimicrobial susceptibility testing was performed by standard techniques. Results: Eighty-nine patients were included in the study. The frequency of CR-BSI was 17%. Out of the 19 organisms isolated, 10 (53%) were Gram-positive cocci, 8 (42%) were Gram-negative rods and 1 (5%) was a fungus. Coagulase negative staphylococci (27%) were the predominant pathogens. Among the staphylococci, 46% of the isolates were methicillin-resistant. All Gram-positive isolates were susceptive to glycopeptides. Gram-negative rods were resistant to most of the commonly used antimicrobial groups. Conclusion: Central venous catheter is an important source of bloodstream infections in cancer patients. Most of the infections are caused by Gram-positive cocci. Rigorous infection control measures and continuous surveillance is required to curb the frequency of these infections. (author)

  18. Iliac Vein Interrogation Augments Venous Ulcer Healing in Patients Who Have Failed Standard Compression Therapy along with Pathological Venous Closure.

    Science.gov (United States)

    Mousa, Albeir Y; Broce, Mike; Yacoub, Michael; AbuRahma, Ali F

    2016-07-01

    Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. We conducted a systematic retrospective analysis of a consecutive series of patients who presented with CEAP (clinical, etiological, anatomical, and pathophysiological) 6 venous disease. All patients had great saphenous vein ablation, compressive treatment, wound care (including Unna boot compression), and perforator closure using ablation therapy. Iliac vein stenosis was defined as ≥50% stenosis in cross-sectional surface area on intravascular ultrasound. Primary outcomes include time of venous ulcer healing and/or measurable change in the Venous Clinical Severity Score. Twenty-two patients with CEAP 6 venous disease met the inclusion criteria (active ulcers >1.5 cm in diameter). The average age and body mass index were 62.2 ± 9.2 years and 41.7 ± 16.7, respectively. The majority were female (72.7%) with common comorbidities, such as hyperlipidemia (54.5%), hypertension (36.4%), and diabetes mellitus (27.3%). Twenty-nine ulcers with an average diameter of 3.4 ± 1.9 cm and a depth of 2.2 ± 0.5 mm were treated. The majority of the ulcers occurred on the left limb (n = 17, 58.6%). Average perforator venous reflux was 3.6 ± 0.8 sec, while common femoral reflux was 1.8 ± 1.6. The majority (n = 19, 64.5%) of the perforator veins were located at the base of the ulcer, while the remainder (n = 10, 34.5%) were within 2 cm from the base. Of the 13 patients who underwent IVI, 8 patients (61.5%) had stenosis >50% that was corrected with iliac vein angioplasty and stenting (IVAS). There was a strong trend toward shorter healing time in the IVI group (7.9 ± 9.5 weeks) than for patients in the no iliac vein interrogation (NIVI) group (20.2 ± 15

  19. ABO Blood Group and Risk of Thromboembolic and Arterial Disease

    DEFF Research Database (Denmark)

    Vasan, Senthil K; Rostgaard, Klaus; Majeed, Ammar

    2016-01-01

    BACKGROUND: ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies. METHODS AND RESULTS: We used the SCANDAT2...... (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987......-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis...

  20. Cortisol, heart rate, and blood pressure as early markers of PTSD risk: A systematic review and meta-analysis.

    Science.gov (United States)

    Morris, Matthew C; Hellman, Natalie; Abelson, James L; Rao, Uma

    2016-11-01

    Individuals with posttraumatic stress disorder (PTSD) typically exhibit altered hypothalamic-pituitary-adrenal (HPA) function and sympathetic nervous system (SNS) activity. The goals of this study were to determine whether HPA and SNS alterations in the immediate aftermath of trauma predict subsequent PTSD symptom development and whether inconsistencies observed between studies can be explained by key demographic and methodological factors. This work informs secondary prevention of PTSD by identifying subgroups of trauma survivors at risk for PTSD. This meta-analysis (26 studies, N=5186 individuals) revealed that higher heart rate measured soon after trauma exposure was associated with higher PTSD symptoms subsequently (r=0.13). Neither cortisol (r=-0.07) nor blood pressure (diastolic: r=-0.01; systolic: r=0.02) were associated with PTSD symptoms which may be influenced by methodological limitations. Associations between risk markers (heart rate, cortisol, systolic blood pressure) and PTSD symptoms were in the positive direction for younger samples and negative direction for older samples. These findings extend developmental traumatology models of PTSD by revealing an age-related shift in the presentation of early risk markers. More work will be needed to identify risk markers and pathways to PTSD while addressing methodological limitations in order to shape and target preventive interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Bone Marrow Versus Peripheral Blood Stem Cell Transplant in Lymphoma: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Jiang, Yanxia; Zhen, Yue; Xu, Qian; He, Dong; Chen, Guoan; Chen, Yan

    2017-12-18

    The choice of whether to use bone marrow or peripheral blood in autologous transplantation remains controversial. Posttransplant relapse and long-term survival are critical issues. Studies that compared bone marrow transplant versus peripheral blood stem cell transplant in lymphoma patients were searched. Our search resulted in 15 studies. Pooled data showed contradictory results with no conclusive differences in overall survival (for randomized controlled trials vs nonrandomized controlled trials: hazard ratio = 0.69 vs 1.17; 95% confidence interval, 0.44-1.10 vs 0.90-1.51; and P = .12 vs P = .25), progression-free survival (for randomized controlled trials vs nonrandomized controlled trials: hazard ratio = 0.89 vs 1.14; 95% confidence interval, 0.57-1.38 vs 0.82-1.58; and P = .60 vs P = .43), and relapse rates. However, we observed an overall trend toward lower relapse rate after bone marrow transplant. Lower relapse rate was likely associated with better progression-free survival (P = .052), and lower transplant-related mortality was associated with better overall survival (P = .043). Autologous bone marrow transplant with mobilization should be reconsidered for lymphoma patients to reduce recurrence and improve quality of life. More powered randomized controlled trials are warranted to update our findings.

  2. Prevalence of high blood pressure in Brazilian adolescents and quality of the employed methodological procedures: systematic review

    Directory of Open Access Journals (Sweden)

    Marina Gabriella Pereira de Andrada Magalhães

    2013-12-01

    Full Text Available OBJECTIVE: To review the literature on studies that estimated the prevalence of high blood pressure (HBP or systemic arterial hypertension (SAH in Brazilian adolescents, considering the employed methodological procedures. METHODS: Bibliographical research of prevalence studies of HBP/SAH in adolescents from 1995 to 2010. The search was conducted in the electronic databases PubMed/Medline, Lilacs, SciELO, and Isi Adolec. The descriptors "hypertension", "BP", "teen", "students", "cross-sectional", "prevalence" and "Brazil" were used in Portuguese and English. Furthermore, a score ranging from 0 to 18 based on Recommendations for Blood Pressure Measurement in Humans and Experimental Animals and the VI Brazil