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Sabur, Sarah, and Amine El-Harti. "The use of a Foley catheter in the excision of big nasal ala tumor." International Surgery Journal 7, no. 12 (2020): 4250. http://dx.doi.org/10.18203/2349-2902.isj20205396.
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The author reports the use of Foley catheter in the excision of big nasal ala tumor. The inflation of the Foley catheter balloon in the nasal antrum before the tumoral excision offer stabilization and immobilization of the nasal ala skin during the procedure.
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Shah, Amar, and Harish Chandran. "Use of Foley's catheter to gain access for retroperitoneoscopy." ANZ Journal of Surgery 74, no. 11 (2004): 1015. http://dx.doi.org/10.1111/j.1445-1433.2004.03222.x.
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Choy, A. T. K., D. G. John, C. A. van Hasselt, and M. Med. "Posterior epistaxis and the undeflatable Foley's urinary catheter balloon." Journal of Laryngology & Otology 107, no. 2 (1993): 142–43. http://dx.doi.org/10.1017/s0022215100122443.
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A rare complication relating to the use of a Foley catheter in the control of posterior epistaxis is described. The balloon failed to deflate after the catheter had been in place for 32 hours and per-oral removal was required.
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Kanada, Anjali R., and Mahima Jain. "A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 9 (2019): 3689. http://dx.doi.org/10.18203/2320-1770.ijrcog20193799.
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Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.
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Mohammed, Naglaa H., and Faiza A. A. Hakam. "Efficacy and safety of intravaginal misoprostol and intracervical foley's catheter ballooning in second trimester pregnancy termination." Scientific Journal of Al-Azhar Medical Faculty, Girls 5, no. 1 (2021): 23–27. http://dx.doi.org/10.4103/sjamf.sjamf_8_21.
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Background Termination of pregnancy in second trimester is one of the greatest challenges in modern obstetrics practice and is more risky than during first trimester. Now the main concern of the obstetrician is to provide the most effective, safest, and cost-effective regimen with least or no complications. Objective To compare the efficacy and safety of intravaginal misoprostol alone and in combination with intracervical Foley's catheter ballooning for termination of pregnancy at second trimester. Patients and methods This prospective randomized clinical study was conducted at Alzahra University Hospital and Alglaa Teaching Hospital from June 2019 till June 2020. A total of 100 pregnant women with second trimester who missed abortion were randomly divided into two groups: group I included 50 patients who received misoprostol 200-mg tab intravaginally per 6 h till maximum of four doses, in addition to intracervical Foley's catheter being placed till the catheter got expelled out spontaneously or after 24 h. Group II included 50 patients who received only misoprostol (200 μg) tab, same dose as group I. Results In this study, the success of abortion within 24 h was 42 (84%) cases in group I and 29 (58%) cases in group II. The failure of abortion after 48 h was 6% (three cases) in group I and in 18% (nine cases) in group II. The mean induction to abortion time was 14.26 h in group I and 17.243 in group II, with P value of 0.002. There was a significant decrease in the need for surgical evacuation [three (6%) cases − in group I compared with seven (14%) cases in group II]. There is no significant difference between both groups regarding complications (lower abdominal pain, postabortion bleeding, vomiting, headache, and fever); all these complications were mild. Conclusion Combined use of intravaginal misoprostol and intracervical Foley's catheter has a shorter induction to abortion time than misoprostol alone and less need for surgical evacuation, with no significant increase in adverse effects.
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bandil, Megha. "INTRA-VAGINAL MISOPROSTOL ALONE VS MISOPROSTOL IN COMBINATION WITH INTRA-CERVICAL FOLEY’S CATHETER FOR SECOND TRIMESTER ABORTION: A COMPARATIVE STUDY." Journal of Medical pharmaceutical and allied sciences 10, no. 4 (2021): 3241–43. http://dx.doi.org/10.22270/jmpas.v10i4.1405.
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Pregnancy termination in the second trimester is riskier than in the first. The primary objective is to create a more effective means of termination while also reducing induction time. To compare the efficacy, safety, and acceptability of intra-cervical foley's catheter with vaginal misoprostol versus vaginal misoprostol for second-trimester pregnancy termination. This clinical study involved 400 pregnant women who were scheduled to have their pregnancy terminated between 13 and 22 weeks of pregnancy for any reason. The enrolled women were divided into two categories: Category I (Misoprostol category): intra-cervical Foley’s catheter inserted with a standard regimen of moistened misoprostol tablets (400 g) 4 hourly inserted vaginally to a maximum of 5 doses; Category II (Combined category): intra-cervical Foley catheter inserted with a standard regimen of moistened misoprostol tablets (400 g) 4 hourly inserted vaginally to a maximum of 5 doses 4 hourly intra-vaginal injections were employed. Misoprostol was retained in the posterior fornix, and the dose was repeated every 4 hours until the catheter was removed, or until a maximum of five doses had been administered. The mean induction to abortion interval in the misoprostol category was 15.38 + 1.25 hours and 8.25 + 2.25 hours in the combination category, which was statistically significant (p= 0.001). The misoprostol category had a 94 percent success rate, while the combined category had a 97 percent success rate. The use of a combined intra-cervical foley's catheter and vaginal misoprostol to end a pregnancy in the second trimester is a novel, safe, effective, and acceptable procedure.
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Bowa, K., B. Bvulani, and L. Mukonge. "The use of Foley's catheter in the removal of a coin in the oesophagus." Tropical Doctor 39, no. 2 (2009): 97–98. http://dx.doi.org/10.1258/td.2008.070466.
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Priya, Karanam Ramya, and Katti Kala. "EFFICACY OF COMBINED USAGE OF FOLEYS WITH MISOPROSTOL FOR SECOND AND EARLY THIRD TRIMESTER TERMINATION IN PREGNANCY." International Journal of Scientific Development and Research 9, no. 5 (2024): 1321–25. https://doi.org/10.5281/zenodo.11516644.
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Background : Second trimester pregnancy losses constitute 10 to 15% of all pregnancy losses. Mid trimester pregnancy termination is a difficult procedure. Maternal mortality rate is 0.4/1 lakh, but in mid trimester 10.4/1 lakh, various methods including medical and mechanical have been used for induction. Misoprostol is safe, effective easily applicable non-invasive for mid trimester. In this trial the combination of intracervical foleys catheter and misoprostol was taken to reduce the dose of misoprostol and reduce the induction delivery interval. Objective: To know the effectiveness and safety of combined intracervical foleys catheter and misoprostol use for mid trimester and early third trimester termination. Method: We conducted a retrospective study from July 2022 - June 2023 of selective patients with gestational age between 14 weeks to 34 weeks. 14 F foleys catheter was inserted intra-cervically and instilled 30 cc sterile water. Simultaneously, misoprostol was given vaginally. Patients received misoprostol 200 μg in the second trimester and 100mcg in the early third trimester at the time of intracervical foley's placement and then 4th hourly till intracervical foley's expulsion. We primarily evaluated effectiveness and secondarily safety, complications and total dosage of misoprostol used. Result : Out of 30 cases analysed, mean age of the group was 24years, for one patient more than three doses of misoprostol was required. Mean time of intracervical foley’s expulsion to foetus expulsion is 1 hour, induction delivery interval on an average 12 hours, (minimum interval-4 hours, maximum interval -18 hours), hysterotomy was done in 1 patient, 2 patients required ICU admissions for medical conditions , 1 patient required blood transfusion, dilatation and evacuation was performed for 2 cases. Conclusion: Combination of intracervical foleys and vaginal misoprostol is a safe and effective method of termination of pregnancy in mid-trimester and early third trimester.
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Khanam, Dr Sifat Ara, Dr Farzana Ali, Dr Maliha Rashid Kathy, Dr Asma Hasan Sathi, and Dr Sabriya Shafi Beg. "Complications of Induction of Labour with Foley's Catheter in Patients with a Previous Cesarean Section." Scholars International Journal of Obstetrics and Gynecology 7, no. 11 (2024): 568–72. https://doi.org/10.36348/sijog.2024.v07i11.006.
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Background: Management of IUFD has immense significance in today’s obstetric practice. To summarize, dinoprostone gel, misoprostol and intra cervical catheter can be used for induction of labour in second and third trimester IUFD. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Objective: To observed the complications of induction of labor with Foley's catheter in patients with a previous cesarean section. Materials and Methods: The observational study was carried out in the Department of Obstetrics & Gynecology, Dhaka Medical College Hospital. Dhaka, Bangladesh. Total 52 patients with singleton pregnancy with IUFD, at ≥28 weeks of gestation was attending in the Department of Obstetrics & Gynae were included in this study. Details of history, general physical and systemic examination, ultrasonography, basic laboratory investigations like haemoglobin level, and DIC profile were recorded. Results: Forty three (82.7%) received augmentation with oxytocin, 3(5.8%) developed scar tenderness and 8(15.4%) had failed induction. Failed ICC was found 8 cases, among them 5(62.5%) had dinoprostone gel used followed by vaginal birth, 2(25.0%) had LUCS and 1(12.5%) had laparotomy. Induction delivery interval was found 16.3±5.5 hours. Regarding maternal outcome 49(94.2%) patients had normal vaginal delivery, 4(7.7%) had PPH, 3(5.8%) had fever, 2(3.8%) were ICU admission, 1(1.9%) had laparotomy and 1(1.9%) had rupture uterus. Conclusion: Common maternal complications were PPH, fever, ICU admission, laparotomy and rupture uterus. Induction can be done safely in carefully selected cases of previous LSCS with Foley’s Balloon.
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Vyas, Sheena, and Vyomesh Bhatt. "Self retaining retractor in endoscopic assisted approach to the forehead - another use for the Foley's catheter." British Journal of Oral and Maxillofacial Surgery 52, no. 8 (2014): e76. http://dx.doi.org/10.1016/j.bjoms.2014.07.105.
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Abd El Razek, Eman R., Sayed A. Taha, Mahmoud I. Al-Rashidi, and Mohmmad A. Mohmmad. "Outcome of use and non- use of indwelling Foley's catheter during cesarean section in Qena University Hospital : Randomized controlled trial." SVU-International Journal of Medical Sciences 2, no. 2 (2019): 23–30. http://dx.doi.org/10.21608/svuijm.2019.122258.
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McNeill, Elizabeth E., Nicole L. Hines, and Regina Phariss. "A Clinical Trial of a New All-in-One Peripheral Short Catheter." Journal of the Association for Vascular Access 14, no. 1 (2009): 46–51. http://dx.doi.org/10.2309/java.14-1-8.
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Abstract The objectives of this survey were to: 1) understand current peripheral IV stabilization practices within our hospital and 2) evaluate the use of a new closed IV catheter system with a built-in stabilization platform. All medical-surgical patients within an 851-bed acute care hospital with peripheral-short catheters were evaluated within a 3-day period for catheter securement, dwell time, and signs of complications. Additionally, catheter restart data were collected from a renal telemetry unit for 2 weeks. Catheter and dressing protocols were then standardized to a new catheter system with a built-in stabilization platform (Nexiva™ Closed Catheter System) and an absorbent transparent dressing (SorbaView® 2000). After a 2-week trial of the new protocol, catheters were again evaluated for securement and restart data were again collected from the renal telemetry unit. Staff nurse (N = 42) opinions on the new catheter system and dressing combination were sought, as well as a vote on willingness to change to the new catheter system and dressing. Results demonstrate improvement in catheter stabilization (out to 96 hours of dwell-time), decreased restarts, a high clinical preference for the new catheter/dressing system, and a high willingness to convert to the new system. Results indicate that the new closed IV catheter system with a built-in stabilization platform and the transparent absorbent dressing evaluated in this survey may help to improve catheter securement and increase dwell-time. Research studies utilizing more rigorous randomized, controlled comparisons are warranted.
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Ali, Mohammed Khairy, Ahmed M. Abbas, Ahmed Yehia Abdelbadee, Sherif A. Shazly, and Ahmed M. AbdelMajeed. "Use of Foley's catheter balloon tamponade to control placental site bleeding resulting from major placenta previa during cesarean section." Proceedings in Obstetrics and Gynecology 6, no. 3 (2016): 1–8. http://dx.doi.org/10.17077/2154-4751.1305.
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Pandey, Rajeev, Sanjeev Kumar, Jitender Kumar, Varun Arya, Rishabh Thakker, and Minerva Singh. "Use of Foley's catheter as a tourniquet for the management of vascular lesion of lip in Mowat-Wilson syndrome." Journal of Indian Society of Pedodontics and Preventive Dentistry 39, no. 3 (2021): 329. http://dx.doi.org/10.4103/jisppd.jisppd_414_20.
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Waterhouse, Jennifer, Varsha Bandisode, Debra Brandon, Meredith Olson, and Sharron L. Docherty. "Evaluation of the Use of a Stabilization Device to Improve the Quality of Care in Patients With Peripherally Inserted Central Catheters." AACN Advanced Critical Care 25, no. 3 (2014): 213–20. http://dx.doi.org/10.4037/nci.0000000000000026.
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Objectives This project evaluated the implementation of use of the StatLock stabilization device (Bard Access Systems, Inc, Salt Lake City, Utah) for peripherally inserted central catheters (PICCs) in pediatric cardiology patients. The aim was to implement the use of the Stat- Lock device and evaluate its effects on the following 4 outcomes: incidence of dislodgement, infection, catheter dwell time, and the number of catheter replacements. The primary goal was to determine whether the StatLock device offered advantages over tape and sutures. Methods A quality improvement design was used to evaluate whether the use of the StatLock stabilization device for PICC securement on 30 pediatric cardiology patients decreased the number of PICC complications compared with 30 historical comparison patients. Results The comparison group had a significantly higher number of catheter dislodgements (n = 16; 59.3%) than the StatLock group (n = 8; 30.8%; P =.035). The comparison group did not have a significantly higher number of catheter replacements (n = 16; 59.3%) than the StatLock group (n = 10; 34.5%; P =.10). No significant differences were found in the rate of infection or in the catheter dwell time between the 2 groups (StatLock group, mean ± SD = 33.13 ± 22.71 days; comparison group, mean ± SD = 28.10 ± 24.83 days; P &gt;.20). Conclusions Use of the StatLock device resulted in better outcomes when compared with the use of sutures, and it provided a more effective way to stabilize and secure PICCs.
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Waterhouse, Jennifer, Varsha Bandisode, Debra Brandon, Meredith Olson, and Sharron L. Docherty. "Evaluation of the Use of a Stabilization Device to Improve the Quality of Care in Patients With Peripherally Inserted Central Catheters." AACN Advanced Critical Care 25, no. 3 (2014): 213–20. http://dx.doi.org/10.4037/nci.0000000000000026.
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Objectives This project evaluated the implementation of use of the StatLock stabilization device (Bard Access Systems, Inc, Salt Lake City, Utah) for peripherally inserted central catheters (PICCs) in pediatric cardiology patients. The aim was to implement the use of the Stat- Lock device and evaluate its effects on the following 4 outcomes: incidence of dislodgement, infection, catheter dwell time, and the number of catheter replacements. The primary goal was to determine whether the StatLock device offered advantages over tape and sutures. Methods A quality improvement design was used to evaluate whether the use of the StatLock stabilization device for PICC securement on 30 pediatric cardiology patients decreased the number of PICC complications compared with 30 historical comparison patients. Results The comparison group had a significantly higher number of catheter dislodgements (n = 16; 59.3%) than the StatLock group (n = 8; 30.8%; P =.035). The comparison group did not have a significantly higher number of catheter replacements (n = 16; 59.3%) than the StatLock group (n = 10; 34.5%; P =.10). No significant differences were found in the rate of infection or in the catheter dwell time between the 2 groups (StatLock group, mean ± SD = 33.13 ± 22.71 days; comparison group, mean ± SD = 28.10 ± 24.83 days; P &gt;.20). Conclusions Use of the StatLock device resulted in better outcomes when compared with the use of sutures, and it provided a more effective way to stabilize and secure PICCs.
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Delp, Jose, and Lynn Hadaway. "New Product Decisions - The Process and Outcome for a Community Health System." Journal of the Association for Vascular Access 16, no. 2 (2011): 74–84. http://dx.doi.org/10.2309/java.16-2-4.
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Abstract Purpose: To compare patient outcomes and evaluate safety features and costs associated with a new catheter system and securement dressing. Background: The need to improve dwell times for short peripheral catheters and reduce complication rates, along with improvements in clinical practice in radiology and enhanced staff safety were driving factors leading to a change in peripheral catheters and securement systems. Review of Relevant Literature: Several reports of catheter stabilization devices have shown improved clinical outcomes with their use. Currently available studies on this new catheter system include one small evaluation and a randomized trial comparing a traditional round hub catheter coupled with a supplemental securement device and the new catheter system with an integrated stabilization platform combined with a securement dressing. Passive safety mechanisms on peripheral catheters may produce fewer needlestick injuries than mechanisms requiring the user to activate the device. Methods: After a learning period, the following seven months were designated the intervention period. Outcome data from the same seven-month period of the preceding year were used for comparison. The data were divided into scheduled and unscheduled restarts. Data from two hospitals are reported separately and in combination. Data from the two periods were analyzed for equivalence or noninferiority. Results: Clinical outcomes for both periods are virtually equivalent, demonstrating that one system is not inferior to the other regarding catheter complications. However the catheter system with the integrated stabilization platform was less costly and safer due to a passive safety mechanism. Problems with high pressure injection in the radiology department were also solved with the new catheter system. Conclusions: While any product change can be a challenging experience, we accomplished these changes in an orderly manner without negative impact on patient outcomes and reducing costs. Improvements in radiology were also attributed to these changes, along with enhanced staff safety. Implications for Practice: The catheter designed with an integrated stabilization platform, a pre-attached extension set, and a passive safety mechanism produced benefits for radiology staff without negatively affecting patient outcomes in other clinical areas. These product changes were implemented in an organized manner and involved all stakeholders in the process.
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Sakamoto, Shigeyuki, Toshinori Matsushige, Masaru Abiko, et al. "Navigation of a 6-French guiding sheath into the common carotid artery using a tri-axial catheter system in transbrachial carotid artery stenting." Interventional Neuroradiology 25, no. 1 (2018): 38–43. http://dx.doi.org/10.1177/1591019918795034.
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Background and purpose Placement of a large-bore guiding sheath or catheter into the common carotid artery (CCA) is crucial in transbrachial carotid artery stenting (CAS). Herein, we describe technical tips for the navigation of a 6-French guiding sheath into the CCA using a tri-axial catheter system in transbrachial CAS. Materials and methods A total of 27 patients underwent transbrachial CAS. For the right side, a 6-French straight guiding sheath was navigated directly into the CCA using a tri-axial catheter system, with a 4-French Simmons catheter placed through a 6-French straight guiding catheter. For the left side, a 6-French Simmons guiding sheath was navigated into the CCA using a tri-axial catheter system, with a 4-French Simmons catheter placed through a 6-French Simmons guiding catheter. After the placement of a 6-French guiding sheath into the CCA, CAS was performed under distal filter or balloon protection. Results Fifteen patients had a right carotid stenosis and 12 patients had a left carotid stenosis. The 6-French guiding sheath was safely placed with ease and provided adequate stabilization for CAS. All procedures were successfully performed without any complications. Conclusion The use of a tri-axial catheter system for the navigation of a 6-French guiding sheath into the CCA appears safe and efficient, allowing transbrachial CAS, with 6-French guiding sheath stabilization, to be performed without any complication.
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Raghuvanshi, Kshitij, KetanP Vartak, Abid Raval, and DevendraKumar Jain. "Stented Foley's catheter is a versatile, highly useful, easy-to-use way of double J stenting for a short time: A randomized study." Urological Science 31, no. 5 (2020): 233. http://dx.doi.org/10.4103/uros.uros_34_20.
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Babita, A. Pawan, B. Neelam, and G. Divya. "A Comparative Study of the Effectiveness of Intravaginal Misoprostol Alone and Combined Use of Intravaginal Misoprostol and Intracervical Foley's Catheter for Termination of Mid Trimester Pregnancy in Women with Previous Ceserean Section." Global Journal of Research in Medical Sciences 3, no. 1 (2023): 18–22. https://doi.org/10.5281/zenodo.7600383.
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Introduction: Termination of pregnancy in 2nd trimester is one of the greatest challenges in modern obstetrics practice and is more risky than during 1st trimester. In our study, we aimed at assessing the effectiveness and safety of intracervical foleys catheter with vaginal misoprostol and comparing it with vaginal misoprostol for mid trimester abortion in patients with previous cesarean. Methods: A hospital based comparative study was conducted on 100 women with period of gestation 13 to 20 weeks for termination of mid trimester pregnancy in women with previous cesarean section Results: The mean induction-abortion interval for group 1 was 17.9 ± 6.7 hours and for group 2 it was 13.4 ± 5.2 hours. The mean total amount of drug required in group 1 was 1560 ± 437.05 µg and for group 2 it was 1256 ± 404.14 µg. Complete abortion was achieved in 76% (38) and 88% (44) of the patient in group 1 and group 2 respectively. No significant difference as regard occurrence of adverse effects between the two groups. Conclusions: Intracervical foley’s catheter with misoprostol is safe and more efficacious than misoprostol alone for second trimester termination of pregnancy in women with previous cesarean section with no significant increase in side effects.
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Madhu, Priya, Kumari Jyoti, and Bibha Kumari. "To Evaluate the Effectiveness of Balloon Tamponade in Preventing Atonic Postpartum Hemorrhage in Comparison to Foley's Condom." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 791–96. https://doi.org/10.5281/zenodo.12737956.
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<strong>Background: </strong>One of the top five causes of maternal mortality in both developed and developing nations is primary postpartum hemorrhage (PPH). Various uterine taponade devices have been used successfully to treat PPH over the past 20 years. In order to reduce atonic postpartum hemorrhage, this study compares the effectiveness and safety of balloon tamponade and Foley’s condom balloon tamponade (FC). <strong>Methods: </strong>100 patients with atonic PPH were randomly divided into two groups for the prospective randomized control experiment. Group 1 (50 cases) received Foley’s condom balloon management, while Group 2 (50 cases) received JH balloon tamponade management. Time of UBT implantation and time of bleeding cessation were used as outcome indicators. It was also documented if there were any negative effects or balloon slippage. To ascertain the long-term outcomes in terms of menses, uterine cavities, and pregnancies, the patients were followed up with at 6 months. <strong>Results: </strong>In cases of JH balloon tamponade, the success rate was 92%, whereas in situations of FC balloon tamponade, it was 88% (p=0.74). B-Lynch sutures, uterine artery ligation, and sub-total hysterectomy were used in two of the six cases of failure in the FC group, while same procedures were used in all four cases of failure in the JH group (p=0.418). The mean time to make, insert, and inflate the catheter (3.01 vs. 3.12 mins; p=0.09) and the mean time to halt bleeding (7.08 vs. 6.91 mins; p=0.65) were comparable between the FC and JH groups. Only 1 patient in the JH group experienced JH balloon tamponade slippage compared to 10 patients out of 50 in the FC group (p=0.008). 38 patients in the FC group and 40 patients in the JH group reported no unfavorable long-term results during the 6-month follow-up. During that time, they experienced typical menstrual periods with no subsequent pain. <strong>Conclusion: </strong>The success rates of JH balloon tamponade and Foley’s condom balloon were both good and comparable (88% and 92%, respectively). Both balloon tamponades make the best use of the available resources and are simple to perform, even at peripheral health centers with limited resources and without wasting much time. Therefore, both types of balloons can be employed successfully in atonic PPH treatments instead of surgery.
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Binning, M. J., P. Yashar, D. Orion, et al. "Use of the Outreach Distal Access Catheter for Microcatheter Stabilization during Intracranial Arteriovenous Malformation Embolization." American Journal of Neuroradiology 33, no. 9 (2011): E117—E119. http://dx.doi.org/10.3174/ajnr.a2547.
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S Saleh, Hend, Hala E Sherif, and Eman M Mahfouz. "Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy." Obstetrics Gynecology and Reproductive Sciences 3, no. 1 (2019): 01–04. http://dx.doi.org/10.31579/2578-8965/028.
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Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.
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Saleh, Hend. "Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy." Obstetrics Gynecology and Reproductive Sciences 3, no. 3 (2019): 01–05. http://dx.doi.org/10.31579/2578-8965/028.
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Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.
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Zerla, Pietro Antonio, Antonio Canelli, Lidia Cerne, et al. "Evaluating safety, efficacy, and cost-effectiveness of PICC securement by subcutaneously anchored stabilization device." Journal of Vascular Access 18, no. 3 (2017): 238–42. http://dx.doi.org/10.5301/jva.5000655.
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Purpose In recent years, a large variety of medical devices has become available. Every device must be efficient, safe and cost effective, but it is not enough to use it properly without considering the environment in which it will be employed. We applied this kind of analysis to subcutaneously anchored sutureless devices (SAS). Methods This is a one-center prospective observational study on safety, effectiveness and cost effectiveness of an SAS device (SecurAcath, Interrad) for securement of peripherally inserted central catheter (PICC) in 30 adult cancer patients with treatment expected to be >60 days. Results During 4963 catheter days and after 709 dressing changes (documented by 373 pictures), the use of SAS was associated with no episode of PICC dislodgement and a lower incidence of complications if compared to traditional securement devices. Insertion, management and removal of SAS were not associated with an increased pain perception by the patients. Cost effectiveness was particularly evident for long dwelling PICCs. Conclusions Our study suggests that SAS is a highly effective and cost-effective method for securement of medium- to long-term PICCs with expected duration longer than 30 days. The introduction of SAS had a positive impact on our healthcare organization.
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S Saleh, Hend, Hala E Sherif, and Eman M Mahfouz. "Single dose of Methotrexate therapy followed by suction curettage for management of Cesarean Scar Pregnancy." MOJ Women's Health 9, no. 2 (2020): 45–48. http://dx.doi.org/10.15406/mojwh.2020.09.00268.
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Aim: To evaluate the efficacy and safety of single dose of of Systemic MTX 50 mg/m2 followed by D&S in cases of Cesarean scar pregnancy (CSP). Objective: Implantation of the pregnancy in a cesarean scar is a rare condition named; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management. It is a prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in the management of women with cesarean scar pregnancy (CSP). Methods: 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula (D&S) under guidance of ultrasound after 48 preceded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results: The mean gestational age at diagnosis was (8.5±1.6) and the mean gestational age of pregnancy was 8.5±1.6. The mean level of serum b-human chorionic gonadotrophin was (7424±2.560). 88.7% was the successive rate without complication or need of intervention, 2 (5.7%) patients needed intrauterine foley's catheter for 24 hours as a mechanical hemostasis. 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %) underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.
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Badheka, Aditya, Pradeep Bangalore Prakash, and Veerajalandhar Allareddy. "Successful use of extracorporeal membrane oxygenation in a child with obstructive shock due to massive bilateral pulmonary embolism." Perfusion 33, no. 4 (2017): 323–25. http://dx.doi.org/10.1177/0267659117736380.
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Background: Acute massive pulmonary embolism (PE) is a very rare condition in children. We report the successful use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a lifesaving modality in a child with acute massive PE. Case presentation: A nine-year-old female with spinal muscular atrophy type 1, chronic respiratory failure with tracheostomy and ventilator dependence presented with tachypnea and hypoxia. She had recent coiling of her pulmonary arterio-venous malformation. A chest computerized tomography scan showed massive bilateral PE. Urgent catheter-directed thrombolysis failed. She was placed on VA-ECMO with stabilization of hemodynamics. She underwent surgical thrombo-embolectomy followed by weaning of ECMO support. Discussion: The use of VA ECMO supported the cardio-respiratory status and perfusion to facilitate surgical embolectomy.
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Shraddha, Chandrakar, Markam Dipti, Narayan Sharma Sharad, and Prakash Singh Ravi. "Comparing the Effectiveness of JH Balloon Tamponade and Foley's Condom Balloon Tamponade in Preventing Atonic Postpartum Hemorrhage: A Study from NSCB Medical College, Jabalpur." International Journal of Pharmaceutical and Clinical Research 15, no. 5 (2023): 1681–87. https://doi.org/10.5281/zenodo.12603950.
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<strong>Background: </strong>Postpartum hemorrhage (PPH) is one of the major causes of massive obstetric hemorrhage in obstetric settings. World Health Organization (WHO) and the Federation of Gynecology and Obstetrics (FIGO) recommend using uterotonics followed by intrauterine balloon tamponade to manage PPH. <strong>Aim and Objectives:</strong> This study evaluates the efficacy and safety of two methods for controlling atonic postpartum hemorrhage: the JH balloon tamponade and the Foley’s condom balloon tamponade (FC). <strong>Materials and Methods:</strong> One hundred patients with atonic PPH were split into two groups for the prospective randomized control trial: Group 1 (n=50) was treated with Foley’s condom balloon management, and Group 2 (n=50) was treated with JH balloon tamponade. The outcome metrics were the time to inject the UBT and the time to halt bleeding. The balloon’s slipperiness and other unwanted consequences were also recorded. Long-term effects on menstruation, the uterine cavity, and pregnancy were assessed by following the patients for six months. <strong>Results:</strong> The success rate of JH balloon tamponade was 92% (p=0.74), while the success rate of FC balloon tamponade was 88% (p=0.74). Four of the four failures in the JH group were treated with B-Lynch sutures and uterine artery ligation (p=0.418), while two of the six failures in the FC group were treated with each of these procedures (p=0.418). Mean times to make, insert, and inflate the catheter (3.01 vs. 3.12 minutes; p=0.09) and to halt bleeding (7.08 vs. 6.91 minutes; p=0.65) were similar between the FC and JH groups. Slippage of balloon tamponade occurred in 1 patient in the JH group compared to 10 patients in the FC group (p=0.008). No long-term complications were reported by patients in either the FC or JH groups after six months of follow-up. During their regular menstrual periods, they experienced no discomfort. <strong>Conclusion:</strong> The success rates of the Foley’s condom balloon and the JH balloon tamponade were high and similar to 92%. Both balloon tamponade methods efficiently use available resources and may be made quickly and easily even at a health center with limited means located in a rural area. Therefore, both balloon types can be employed effectively in atonic PPH treatments as a non-invasive alternative to surgical interventions.
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Flippo, Polly L., and Jayne Lee. "Clinical Evaluation of the Sorbaview SHIELD Securement Device Used on Peripheral Intravenous Catheters in the Acute Care Setting." Journal of the Association for Vascular Access 16, no. 2 (2011): 95–102. http://dx.doi.org/10.2309/java.16-2-6.
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Abstract Peripheral intravenous therapy (PIV) is probably the most common acute care invasive procedure, estimated at 90 percent for all inpatients. Current standards of practice recommend the use of a manufactured catheter stabilization device to secure PIVs. At FirstHealth Moore Regional Hospital (MRH), the PIV policy requires the use of a stabilization device to achieve a 96 hour dwell time for the PIV. The hospital does not utilize an intravenous therapy team; all nurses can insert PIVs and apply the dressing. In 2009, as a cost reduction measure, MRH changed securement devices from a two piece dressing and securement device to the Sorbaview SHIELD (SHIELD). A clinical evaluation of the SHIELD was conducted in January 2010, with 109 medical-surgical patients with PIVs, to demonstrate the expected cost savings associated with the SHIELD by maintaining the PIV for 96 hours and meeting patient and staff expectations. In 91.5% of the patients, the PIV stayed in for their length of stay (if less than 96 hours) or for 96 hours, only eight patients had unscheduled restarts. Eighty-six percent of nurses surveyed rated the device as excellent to good. Ninety-one percent of patients reported no discomfort of their PIV site. Changing to this device in 2009 has resulted in an average annual cost savings of $120,000 over the two piece device and has improved compliance by nursing.
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Ponomarova, Kateryna. "POSSIBILITIES OF USING MINIINVASIVE CATHETER TECHNOLOGIES IN THE TREATMENT OF LUNG BLEEDING." EUREKA: Health Sciences 6 (November 30, 2019): 41–48. http://dx.doi.org/10.21303/2504-5679.2019.001087.
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Aim – improve the results of the treatment of patients with pulmonary bleeding through widespread use of endovascular surgery methods for hemostasis. Materials and methods. Method of endovascular embolization of bronchial arteries is widely used in our clinic SI «Zaycev V. T. Institute of General and Emergency surgery of NAMS of Ukraine» not only as independent surgery in patients with LB, but also as way of preparation of patients with lung bleeding for planned thorax surgery. The most of the often spread nosological forms complicated by bleeding in our research were polycystic lung disease, chronic obstructive pulmonary disease, bronchiectasis disease, community-acquired pneumonia. Indications to the сatheter embolization procedure of bronchial arteries are the following: conservative treatment failure, hemoptysis in patients with bilateral inflammatory processes who was not prescribed surgical treatment for a range of reasons, absence of gross structural changes, lung resection, mainly in patients with oncologic lung injury, at massive and life-threatening profuse bleedings as a mean of temporary or constant hemostasis. Discussed treatment method is applied only in bleeding or within a 6 – 12 hour after its treatment. Successful result in embolization can be obtained in 79–99 %. Results. As a result of complete physical examination of patients with LB, it has been established that lung hemorrhage was the result of obstructive bronchitis in 14 patients (42 %), there was chronic obstructive pulmonary disease in 7 (21 %) patients and bronchiectasis was diagnosed in 6 (18 %) patients. In 2 (6 %) patients pulmonary hemorrhage was caused by community-acquired pneumonia. Central lung cancer was detected in 4 (12 %) patients. Conclusion. Therefore bronchial artery angiography gives high efficiency in solving the problem of hemostasis in oncological and nonspecific lung diseases, for determination of localization and source of bleeding. Endovascular occlusion of bronchial arteries in pulmonary hemorrhage permits: – to elaborate diagnosis because of the presence of specific angiographic signs of malignant tumour; – to perform effective endovascular hemostasis; – to gain time for stabilization the patient with the aim of planned surgical treatment.
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Gumeniuk, K. V., Yu Yu Sivash, V. M. Rogovskyi, D. M. Beshley, and А. Т. Slobodianiuk. "First experience of endovascular balloon occlusion of the aorta in the wounded with hemorrhagic shock during the war in Ukraine." EMERGENCY MEDICINE 20, no. 6 (2024): 433–47. http://dx.doi.org/10.22141/2224-0586.20.6.2024.1754.
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Background. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used worldwide to stop bleeding in trauma and wounds in patients with hemorrhagic shock. REBOA allows for the hemodynamic stabilization, patient transportation and final bleeding control. The study aims to demonstrate the capabilities of REBOA as a method of bleeding control in the wounded with hemorrhagic shock in the context of war in Ukraine. Materials and methods. Five AFU servicemen who sustained mine-blast wounds in the Eastern Ukraine as a result of shelling by Russian troops were delivered with signs of internal bleeding and hemorrhagic shock to the primary and secondary levels of medical care (Role 1, 2). The REBOA balloon catheter was inserted and inflated by surgeons working in stabilization centers or advanced surgical teams. Upon admission, all patients underwent chest and abdominal ultrasound according to the FAST protocol. We used COBRA-OS 4 Fr and ER-REBOA 7 Fr balloon catheters. The positioning of the balloon in the aorta was performed according to external anatomical landmarks (3 cases) and ultrasound (2 cases). In all clinical cases, the balloon catheter was placed in zone I. In one case, the balloon was moved from zone I to zone III (control of the source of bleeding). The duration of aortic occlusion ranged from 15 to 50 minutes. Immediately after removal of the introducer, manual compression of the puncture site was used (3 cases) or suturing of the arteriotomy (2 cases). Results. The sources of bleeding in our clinical cases were injuries of the iliac vessels (2 cases), the renal artery (1 case), and injuries of the inferior vena cava and liver (2 cases). Four patients were evacuated to a higher level of medical care after the REBOA was installed. In one case, there were complications from vascular access (femoral artery thrombosis). We were unable to save one wounded soldier, most likely due to the delay in evacuation from the previous stage, the severity of injury, and massive blood loss. Conclusions. As our observations have shown, the use of REBOA in combat conditions allows not only to stabilize hemodynamics in the wounded with severe combined trauma and bleeding but also to conduct a successful evacuation to a higher level of medical care to stop bleeding ultimately. REBOA can be successfully used at the prehospital stage. This requires clearly defined indications for the technique’s use, training of medical personnel, and provision of balloon catheters to medical units of the Armed Forces of Ukraine.
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Kateryna, Ponomarova. "POSSIBILITIES OF USING MINIINVASIVE CATHETER TECHNOLOGIES IN THE TREATMENT OF LUNG BLEEDING." EUREKA: Health Sciences 6 (November 30, 2019): 41–48. https://doi.org/10.21303/2504-5679.2019.001087.
Full textAbstract:
<strong>Aim</strong> – improve the results of the treatment of patients with pulmonary bleeding through widespread use of endovascular surgery methods for hemostasis. <strong>Materials and methods.</strong> Method of endovascular embolization of bronchial arteries is widely used in our clinic SI «Zaycev V. T. Institute of General and Emergency surgery of NAMS of Ukraine» not only as independent surgery in patients with LB, but also as way of preparation of patients with lung bleeding for planned thorax surgery. The most of the often spread nosological forms complicated by bleeding in our research were polycystic lung disease, chronic obstructive pulmonary disease, bronchiectasis disease, community-acquired pneumonia. Indications to the сatheter embolization procedure of bronchial arteries are the following: conservative treatment failure, hemoptysis in patients with bilateral inflammatory processes who was not prescribed surgical treatment for a range of reasons, absence of gross structural changes, lung resection, mainly in patients with oncologic lung injury, at massive and life-threatening profuse bleedings as a mean of temporary or constant hemostasis. Discussed treatment method is applied only in bleeding or within a 6 – 12 hour after its treatment. Successful result in embolization can be obtained in 79–99 %. <strong>Results.</strong> As a result of complete physical examination of patients with LB, it has been established that lung hemorrhage was the result of obstructive bronchitis in 14 patients (42 %), there was chronic obstructive pulmonary disease in 7 (21 %) patients and bronchiectasis was diagnosed in 6 (18 %) patients. In 2 (6 %) patients pulmonary hemorrhage was caused by community-acquired pneumonia. Central lung cancer was detected in 4 (12 %) patients. <strong>Conclusion.</strong> Therefore bronchial artery angiography gives high efficiency in solving the problem of hemostasis in oncological and nonspecific lung diseases, for determination of localization and source of bleeding. Endovascular occlusion of bronchial arteries in pulmonary hemorrhage permits: – to elaborate diagnosis because of the presence of specific angiographic signs of malignant tumour; – to perform effective endovascular hemostasis; – to gain time for stabilization the patient with the aim of planned surgical treatment.
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Sato, Shuzo, Shigeo Toya, Takayuki Ohira, Tohru Mine, and Nigel H. Greig. "Echocardiographic detection and treatment of intraoperative air embolism." Journal of Neurosurgery 64, no. 3 (1986): 440–44. http://dx.doi.org/10.3171/jns.1986.64.3.0440.
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✓ A real-time two-dimensional echocardiogram was used to detect the presence of an air embolism in patients undergoing neurosurgical procedures in the sitting position. The technique could with good sensitivity detect the appearance of a single air bubble intraoperatively, thus allowing early intervention to prevent development of further air emboli. Two types of air embolism could be differentiated; the single-bubble type and the “stormy-bubble” type. The single-bubble type was observed during skin and muscle incisions, craniotomy, and brain lesion excision. Further embolism development was prevented by electrocoagulation and application of bone wax. The stormy-bubble type occurred during dura and muscle incisions and was prevented by electrocoagulation, reflection of the dura, or suturing the affected muscle. The routine use of a Swan-Ganz catheter for removal of air embolism by suction proved effective for the treatment of the stormy-bubble type of air embolism. Masking the operative field with saline-soaked cotton strips was of moderate benefit in the stabilization of the single-bubble type of air influx, but proved to be of little value in controlling the entrance of the stormy-bubble type.
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Mohamed, M. Megahed, N. Zakhary Tamer, A. AbdElHady Mohamed, and G. Zaki Haitham. "Validity of ultrasonography in detection of central venous catheter position and pneumothorax compared to portable chest X-ray." Biolife 4, no. 4 (2022): 687–92. https://doi.org/10.5281/zenodo.7350413.
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<strong>ABSTRACT</strong> Ultrasonographic guidance for insertion of central venous catheter is now almost a standard of care, leading to fewer failed attempts and complications. Nowadays, the ultrasound examination used to detect position of the central line and pneumothorax occurrence as an alternative to X-ray. The aim of this work is to assess validity of ultrasonography and portable chest X-ray in detection of central venous catheter position and post-central line insertion pneumothorax. The study was carried out on one hundred catheter insertions for patients who were admitted to Critical Care Medicine Department in Alexandria Main University Hospital. Confirmation of endovenous placement of the catheter was done by ultrasonography using “Bubble test” and examination of internal jugular veins and subclavian veins of both sides. Then, lung ultrasound was done to detect pneumothorax occurrence. After that, a portable chest X-ray film was done for all patients to detect the catheter tip position and presence of pneumothorax. Then, Computed tomography of the chest was done for all patients after their hemodynamics stabilization to confirm the previous data and compare accuracy of the ultrasound and X-ray to detect catheter tip position and post-insertion pneumothorax. The researcher found that there is statistically significant correlation between site of insertion and incidence of post-insertion pneumothorax occurrence (80% with subclavian approach versus 20% for internal jugular approach). In detection of the catheter position, the ultrasound showed sensitivity and specificity of 82.7%, 96.8% respectively versus 93.8%, 95.8% respectively for portable X-ray. Furthermore, in detection of post-insertion pneumothorax, the ultrasound showed sensitivity and specificity of 90%, 96.3% respectively versus 45%, 96.3% respectively for portable chest X-ray. We can use the ultrasound to detect position of catheter tip and pneumothorax after insertion of central line as a better alternative to routine portable chest X-ray with higher accuracy. <strong>Keywords</strong> : <em>Ultrasound, central venous catheter, portable chest X-ray, pneumothorax, catheter position, CT chest.</em> <strong><em>REFERENCES</em></strong> O'Grady NP, Alexander M and Dellinger EP. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 2002; 51:1-18. Irwin RS and Rippe's JM. <em>Procedures and Techniques: in Intensive Care Medicine</em>. 5<sup>th</sup> ed. Philadelphia, Lippincott Williams and Wilkins Company 2003:17-18. Ng PK, Ault MJ and Maldonado LS. Peripherally inserted central catheters in the intensive care unit. <em>J Intensive Care Med</em> 1996; 11:49-52. Linos DA, Mucha P and Van Heerden JA. Subclavian vein: a golden route. <em>Mayo Clin Proc</em> 1980; 55:315. Merrell SW, Peatross BG and Grossman MD. Peripherally inserted central venous catheters: low-risk alternatives for ongoing venous access. <em>West J Med</em> 1994; 160:259. Lam S, Scannell R and Roessler D. Peripherally inserted central catheters in an acute-care hospital. <em>Arch Intern Med</em> 1994; 154:1833-9. Kondro WA. Alberta retreats over sterilisation compensation. <em>Lancet</em> 1998; 351:892. Hall JB, Shmidt GA and Wood LD. <em>Intravascular Devices: in Principles Of critical Care</em>. 3rd ed. New York, McGraw-Hill Company 2005:131-138. De Lorenzo RA, Morris MJ, Williams JB, et al. Does a simple bedside sonographic measurement of the inferior vena cava correlate to central venous pressure?. <em>J Emerg Med</em> 2012; 42(4):429-36. Dubick MA. Small-volume fluid resuscitation for the far-forward combat environment: current concepts. <em>J Trauma</em> 2003; 54(5 Suppl): s43–5. Porika Raju and Estari Mamidala (2015). Anti-diabetic activity of compound isolated from Physalis angulata fruit extracts in alloxan induced diabetic rats. The Ame J Sci & Med Res, 2015,1(1); Pages 1 -6. doi:10.17812/ajsmr2015.11.1. Lichtenstein D and Mezière G. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: The BLUE Protocol. <em>Chest</em> 2008; 134:117-25. Magder S. How to use central venous pressure measurements. <em>Current Opinion in Critical Care</em> 2005; 11(3):264-70. Eisen LA, Narasimhan M, Berger JS, et al. Mechanical complications of central venous catheters. <em>J Intensive Care Med</em>. 2006 Jan-Feb; 21(1):40-6. Wolfram Schummer, Claudia Schummer, Norman Rose, et al. Mechanical complications and malpositions of central venous cannulations by experienced operators. <em>Intensive Care Medicine</em> 33(6):1055-9. Alonso-Quintela P, Oulego-Erroz, Rodriguez-Blanco S, et al. Location of the Central Venous Catheter Tip With Bedside Ultrasound in Young Children: Can We Eliminate the Need for Chest Radiography?. <em>Pediatr Crit Care Med</em>. 2015 Nov; 16(9):e340-5. Duran-Gehring PE, Guirgis FW, McKee KC, et al. The bubble study: ultrasound confirmation of central venous catheter placement. <em>Am J Emerg Med</em>. 2015 Mar; 33(3):315-9. Kamalipour, Hamid, Sedigheh Ahmadi, Karmella Kamali, et al. "Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?." <em>Anesthesiology and Pain Med </em>2016; 6(5):e38834. Uzma Mumtaz, Zainab Zahur, Muhammad Amjad Chaudhry, et al. Bedside ultrasongraphy: a useful tool for traumatic pneumothorax. <em>J Coll Physicians Surg Pak</em> 2016 Jun; 26(6):459-62. S Manimala Rao, et al. “Can we predict the Position of Central Venous Catheter Tip Following Cannulation of Internal Jugular Vein?. <em>EC Anaesthesia</em> 2015; 2(3):126-30.
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Ravikumar, T. S., G. Pizzorno, W. Bodden, et al. "Percutaneous hepatic vein isolation and high-dose hepatic arterial infusion chemotherapy for unresectable liver tumors." Journal of Clinical Oncology 12, no. 12 (1994): 2723–36. http://dx.doi.org/10.1200/jco.1994.12.12.2723.
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PURPOSE This prospective, nonrandomized trial evaluated a percutaneous isolated chemotherapy perfusion approach for treating advanced primary and metastatic liver tumors. Chemotherapy was administered via hepatic artery catheter and hepatic venous blood isolated by a novel percutaneous double-balloon inferior vena cava (IVC) catheter was passed through a detoxification/filtration cartridge in a venovenous bypass circuit. PATIENTS AND METHODS Among 23 patients enrolled onto the study, 58 procedures were performed on 21 patients. Twelve patients received dose escalations of fluorouracil (5-FU) (1,000 mg/m2 to 5,000 mg/m2), and nine received dose escalations of doxorubicin (50 mg/m2 to 120 mg/m2). Pharmacokinetic studies included drug accumulation in the liver, extraction by detoxification filters, systemic exposure, and alterations of half-life. Each patient received two treatments at 3-week intervals. Those showing stabilization or response received additional treatments. RESULTS There was a direct relationship between dose and peak concentration of drug entering the hepatic veins. The system functioned efficiently throughout the dose range, with extraction efficiencies ranging from 64% to 91% (P < .001). The hepatic vein drug levels showed a sixfold increase in 5-FU with dose escalation from 1,000 to 5,000 mg/m2, and a twofold increase in dox with dose escalation from 50 to 120 mg/m2 (P < .001, filter-mediated drug extraction). The treatments were accomplished with only an overnight hospital stay and no mortality. The common procedure-related toxicity was transient hypotension (grade I to II), due to catecholamine depletion by the filter. Dose-limiting toxicity (leukopenia) was observed in patients receiving 5-FU at a dose of 5,000 mg/m2 and doxorubicin at a dose of 120 mg/m2. Significant tumor response (> 95% reduction) was obtained in two patients receiving doxorubicin at 90 mg/m2 and 120 mg/m2. CONCLUSION The use of a double-balloon catheter to isolate and detoxify hepatic venous blood during intraarterial therapy is technically feasible, safe, and allows administration of large doses of intrahepatic chemotherapy at short intervals. This approach should allow new dose-intensification strategies to increase tumor responses in primary and metastatic liver tumors.
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Kowlgi, Gurukripa N., and Yong-Mei Cha. "Management of ventricular electrical storm: a contemporary appraisal." EP Europace 22, no. 12 (2020): 1768–80. http://dx.doi.org/10.1093/europace/euaa232.
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Abstract Ventricular electrical storm (VES) is a clinical scenario characterized by the clustering of multiple episodes of sustained ventricular arrhythmias (VA) over a short duration. Patients with VES are prone to psychological disorders, heart failure decompensation, and increased mortality. Studies have shown that 10–28% of the patients with secondary prevention ICDs can sustain VES. The triad of a susceptible electrophysiologic substrate, triggers, and autonomic dysregulation govern the pathogenesis of VES. The rate of VA, underlying ventricular function, and the presence of implantable cardioverter-defibrillator (ICD) determine the clinical presentation. A multi-faceted approach is often required for management consisting of acute hemodynamic stabilization, ICD reprogramming when appropriate, antiarrhythmic drug therapy, and sedation. Some patients may be eligible for catheter ablation, and autonomic modulation with thoracic epidural anesthesia, stellate ganglion block, or cardiac sympathetic denervation. Hemodynamically unstable patients may benefit from the use of left ventricular assist devices, and extracorporeal membrane oxygenation. Special scenarios such as idiopathic ventricular fibrillation, Brugada syndrome, Long and short QT syndrome, early repolarization syndrome, catecholaminergic polymorphic ventricular tachycardia, arrhythmogenic right ventricular cardiomyopathy, and cardiac sarcoidosis have been described as well. VES is a cardiac emergency that requires swift intervention. It is associated with poor short and long-term outcomes. A structured team-based management approach is paramount for the safe and effective treatment of this sick cohort.
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Moraes, Vinicius De Jesus, Karina Médici Madureira, Rodrigo Freitas Bittencourt, Carlos Hiroshi Duarte Iwassa, and Vivian Fernanda Barbosa. "Postoperative Pain Management in a Sheep Using Continuous Epidural Morphine." Acta Scientiae Veterinariae 46 (January 17, 2018): 6. http://dx.doi.org/10.22456/1679-9216.85150.
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Background: Although ruminants experience pain like other species, diagnosis and treatment may be imprecise and challenging, especially because of lack of recognition and restraint of therapeutic resources. In addition to the restrictions inherent in the species, organic dysfunctions may further restrict the analgesic arsenal, making it necessary to find viable and effective alternative for pain control. The continuous administration of opioids in the epidural space has been highlightedas an analgesic resource in several species. However, until this moment, there are few information on this practice in ruminants. Therefore, the aim of this study was to describe the use of continuous epidural infusion of morphine in a sheep undergoing to urethrostomy with a history of chronic pain and urolithiasis.Case: A 3-year-old Santa Ines sheep, weighting 110 kg, was presented to the Veterinary Hospital of Federal University of Bahia with history of recurrent urolithiasis, lameness, severe pain and continuous use of nonsteroidal anti-inflammatory drug (NSAID). The findings of the physical examination, imaging and laboratory tests revealed possible abomasum inflammation, chronic laminitis, left humerus-radioulnar osteoarthritis and urethral urolithiasis with uremia. A clinical stabilization of the animal was performed, including an interruption of the use of the NSAID and the administration of fluid, urinary acidifier (ammonium chloride), histamine H2 receptor antagonist (ranitidine), cytoprotectant (sucralfate), antibiotic (norfloxacin) and dipyrone. After 3 days, urethrostomy was performed followed by the implantation of an epidural catheter (19G) in the lumbosacral space (L7 - S1) by means of a Tuohy needle (18G), after the surgical procedure. Administration of morphine (0.1 mg kg-1) through the catheter at 24-h intervals, associated with dipyrone (25 mg kg-1) intravenously (IV), every 8 h, over a 5-day period, was the postoperative analgesic protocol chosen. The data of heart rate (HR), respiratory rate (f),rectal temperature (T °C), ruminal movements (RM) and possible behavior related to pain were registered at intervals of four-hours until the fifth day after surgery. After 24 h postoperative, stability of the variables (HR, f, T °C) with increased RM concomitant to the interest for food was verified. On the fifth postoperative day, the animal was hydrated, visibly comfortable and with normal levels of serum creatinine.Discussion: Considering the initial clinical status involving renal insufficiency and significant gastric abnormalities, the use of NSAIDs was immediately disregarded. However, the need to relieved musculoskeletal and postoperative pain, has raised interest in the use of morphine, whose literature refers duration of up to 24 h in other species, with reduced adverse effects compared to systemic administration, due to the considerably lower dose. Dipyrone was incorporated into the protocol forproviding visceral analgesia and minimal effects on the organic functions. During the 5-days of evaluation, the signs of well-being presented by the animal associated to the stability of vital parameters, feeding and satisfactory ruminal activity attested to the viability of the protocol tested. It was concluded that the use of morphine, through the continuous epiduralroute, contributed to the relief of postoperative pain, reestablishment of the organic functions and patient welfare, being suitable as an analgesic alternative to NSAID use in sheep.Keywords: ovine, analgesia, opioid, epidural.
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POLAT, Esra, Elif İlkay YÜCE, Engin DONDURMACI, and Mehmet Cihat DEMİR. "Pain management in ST-segment elevation myocardial infarction: an observational analysis." Anatolian Current Medical Journal 4, no. 4 (2022): 426–30. http://dx.doi.org/10.38053/acmj.1172867.
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Aim: ST-segment elevation myocardial infarction (STEMI) is one of the most severe forms of pain. However, the guidelines give quite a few places for pain control in STEMI and, do not offer strong recommendations on this issue. This study aimed to reveal which medications are given to STEMI patients for pain control until they arrive at the catheter laboratory, in which situations they are used, and the frequency of use. 
 Material and Method: A total of 272 consecutive STEMI patients were prospectively collected. Medications were administered to the patients until they arrived at the angiography laboratory; vital signs, comorbidities, referral status, infarction types, the time between the onset of pain and the admission to the emergency department, and the door-balloon time were also noted. The patients’ pain characteristics and intensity were evaluated.
 Results: It was observed that 96.3% of the patients presented with chest pain. The pain of diabetic patients was severe according to the visual analog scale (VAS) score (p=0.023). It was witnessed that 9.92% of the patients were administered drugs for analgesic purposes. The most commonly administered medication was paracetamol. It was noticed that morphine was used frequently after paracetamol. Medication administration for analgesia was more common in referred patients (p=0.040).
 Conclusion: Physicians behave timidly in their clinical practice in pain control of STEMI and move away from the guideline. In terms of comfort and hemodynamic stabilization of the patients, it will be beneficial for the applications in the field to give more place to the treatments for pain control in the guidelines.
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Kawamoto, Fernando Yoiti Kitamura, Lívia Perles, Levi Oliveira Dos Santos, et al. "Association of Rush Pin and Intramedular Pin Techniques for the Stabilization of Salter Harris Type I Fracture in Rabbit (Oryctolagus cuniculus)." Acta Scientiae Veterinariae 46 (June 19, 2018): 4. http://dx.doi.org/10.22456/1679-9216.86894.
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Background: In domestic rabbits, fractures are usually the result of household accidents. Fractures of the distal femoral physis are frequently observed in animals with immature skeletons and may cause future orthopedic problems. With this type of fracture, early reduction and stabilization are necessary to prevent additional damage to the physis and to preserve the growth potential of the bone. This report aims to describe the clinical and radiographic findings, as well as the surgical method used that combined Rush pins with an intramedullary pin, associated with a Salter Harris type I fracture of the right distal femur in a rabbit.Case: A 4-month male domestic rabbit (Oryctolagus cuniculus) weighing 1.2 kg, was referred to the Veterinary Hospital with a right pelvic limb lameness after an episode of trauma. Orthopedic examination revealed swelling, instability, crepitation, and increased pain sensitivity in the distal aspect of the right femur. Following physical and radiographic examination,a Salter Harris type I fracture of the right distal femur was diagnosed. The patient was premedicated with a combination of xylazine (2 mg/kg IM) and ketamine (10 mg/kg IM), which allowed placement of an IV catheter for the administration of fluids and intubation using an endotracheal tube with an internal diameter of 2 mm. Anesthesia was maintained with isoflurane, and an epidural was performed with a combination of lidocaine (2 mg/kg) and bupivacaine (0.75 mg/kg). Osteosynthesis was performed with two Rush pins and an intramedullary pin. Radiographic examination 110 and 330 days after the surgical procedure showed good alignment of the bone and adequate healing of the fracture. The combination of techniques used in this case report proved to be effective, resulting in functional recovery of the limb and rapid bone healing.Discussion: Preoperative planning for orthopedic surgery in rabbits is different from that of dogs and cats, due to the particularities of the species. Familiarity with the regional anatomy, patient preparation, and appropriate instrumentation are necessary when contemplating osteosynthesis in a rabbit. Salter Harris fractures affect young animals, where the physis is considered an area of fragility in the bone. Surgical planning should take into account the function of the growth plates.It is recommended that implants passing through the physis do so perpendicularly, since angulation greater than 45° may predispose the bone to premature closure of the growth plate. Another important consideration involves the choice of implants, since the use of trocar-tipped pins facilitates their precise placement in the bone. The use of threaded pins should be avoided due to their weakness at the thread-shaft interface, and the risk of impaired longitudinal bone growth and thedifficulty of removal if necessary. Steinman pins and Kirschner wires can be used to stabilize a variety of different fractures. In Salter-Harris type I and II fractures, the use of pins neutralizes bending forces but not rotational or compressive forces. In contrast, Rush pinning and cross-pinning techniques are effective in neutralizing the forces acting on the physis, and are frequently used for the fixation of fractures in this region. Complications, often associated with poor reduction and alignment, can result in varus or valgus deviation and are associated with a high risk of implant failure or migration, malunion, and patellar luxation. It was concluded that the combination of Rush pins and an intramedullary pin resulted in adequate stabilization of the Salter Harris type I fracture of the distal femur in this rabbit.Keywords: Orthopedic implants, osteosynthesis, trauma, bone repairing, lagomorph.
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Simmons, Colby G., Jason D. Williams, Azin Kheirandish, Alexander M. Kaizer, and Jason C. Brainard. "A Randomized, Noninferiority, Comparative Evaluation of Vascular Securement Devices: Cost and Clinical Analysis." Journal of the Association for Vascular Access 29, no. 3 (2024): 52–58. http://dx.doi.org/10.2309/java-d-23-00032.
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Highlights Abstract Background: Peripheral intravenous catheters (PIVCs) are a near universal element of modern medicine with nearly 2 billion PIVCs placed annually worldwide. Virtually all PIVC complications are related to stabilization. Recent innovations in dressings and securement have sought to minimize these complications; however, evidence is lacking in determining superiority of devices and selecting one product over another. In this quality assurance evaluation, we attempted to select a more cost-effective and optimal product for use in our large, tertiary-referral academic institution. Methods: A randomized, noninferiority, comparative evaluation was undertaken to compare an integrated securement device (ISD) new to our institution to our institution’s current standard adhesive securement device (ASD). Patients were selected for randomization based on likelihood of a &gt;5-day postoperative inpatient stay, allowing for prolonged daily follow up and survey of both patients and nurses. Results: Results showed that the ISD outperformed the ASD in terms of efficiency of application, adhesive quality, stability, overall satisfaction, and patient comfort. Additionally, the ISD demonstrated a lower rate of complications than the ASD. Cost analysis revealed that the ISD was 28% less expensive than the ASD, resulting in significant cost savings and fewer venipunctures. Conclusion: Intravenous catheter placement is the most common procedure performed annually in hospitalized patients. Given the large volume of PIVC insertions each year and associated costs, combined with the frequency of complications, it is imperative to identify a more adequate and cost-effective device. Our quality improvement project, at a high-volume, tertiary care referral center, provides the groundwork for similar studies at other institutions and supports a more cost-effective and potentially safe delivery.
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Schiller, Gary J., Leonard Goldstein, Richard Finn, and Ronald Busuttil. "Intravenous Hemin as Prophylaxis of Allograft Function Following Second Liver Transplant for Erythropoietic Protoporphyria." Blood 104, no. 11 (2004): 3677. http://dx.doi.org/10.1182/blood.v104.11.3677.3677.
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Abstract Erythropoietic protoporphyria (EPP) is a rare disorder of heme biosynthesis caused by an inherited deficiency of mitochondrial ferrochelatase. This deficiency results in accumulation of protoporphyrin, a heme precursor, in bone marrow, skin, nervous system, and liver. In some patients, toxic levels of protoporphyrins in the liver cause chronic liver disease, cirrhosis, and hepatic failure. Liver transplantation is the only treatment available; however, the risk of allograft dysfunction is high as a result of continued, excessive protoporphyrin production due to the underlying systemic enzyme deficiency. We present the case of a 40 year-old man with EPP, diagnosed at age 6, who underwent orthotopic liver transplantation (OLT) at age 25. By age 31, biopsy-proven recurrent EPP with liver dysfunction was identified in the allograft with subsequent hepatic failure seven years later at age 38. A second liver transplant was complicated by a biliary anastomotic leak requiring further surgery and prolonged hospitalization. Six months prior to a second liver transplant, the patient was started on 4 mg/kg hemin infusions every week; following second liver transplant, the frequency was increased to twice weekly to maintain graft function. Infusions have been well tolerated and administered at home through a central venous catheter and there has been no evidence of iron overload. Three months following second transplant, blood alkaline phosphatase, ALT, AST, and bilirubin were 1009, 53, 64, and 11.5, respectively. Fourteen months after the second allograft, these levels are 234, 65, 65, and 1.2, respectively. Prior to hemin therapy, erythrocyte protoporphyrin level was 6600 mg/dl and was 5573 mg/dl immediately before second allograft. With twice weekly hemin, erythrocyte protoporphyrin level fourteen months after transplantation is 1240 mg/dl - greatly reduced but still elevated above the normal range. A liver biopsy three months after the second allograft showed cholestasis and biliary obstruction consistent with recurrent porphyria, but no subsequent biopsy has been performed yet despite improvement in alkaline phosphatase, bilirubin, and transaminase levels. This case study confirms an earlier report of clinical graft stabilization with hemin infusions after orthotopic liver transplantation for erythropoietic protoporphyria (Dellon et al., Transplantation2002; 73:911–5) and to our knowledge is the first case of long-term hemin use to maintain the integrity of a second liver allograft. Further follow-up and biopsy will be needed to determine the impact of this strategy on preserving graft function.
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Low, Kin Huat, Shuxiang Guo, Xinyan Deng, et al. "Special Issue on Focused Areas and Future Trends of Bio-Inspired Robots “Analysis, Control, and Design for Bio-Inspired Robotics”." Journal of Robotics and Mechatronics 24, no. 4 (2012): 559–60. http://dx.doi.org/10.20965/jrm.2012.p0559.
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The science of biomimetics is about “the abstraction of good design from nature.” The goal of this scientific field is to identify specific desirable features in the biological systems and apply them to the design of new products or systems. Engineers, scientists, entrepreneurs, and business people are increasingly turning towards nature for design inspiration. The combination of biological principles, mechanical engineering, and robotics has opened entirely new areas and possibilities. On the other hand, we can see that nature can serve as an important source of inspiration to foster innovation. Industrial applications designers can exploit millions of years of tinkering and tweaking by borrowing from nature’s best designs and applying these to new problems and situations. Through biomimetics, we are able to learn and mimic the aforementioned abilities from biology to effectively promote the development of science and technology. In this special issue, you will find a total of eleven papers covering various biomimetics research with focus on analysis, control, design, and simulation. The articles in this issue are contributed by authors from several countries (USA, Japan, UK, China, Switzerland, Brunei, and Singapore) and are grouped into three categories: analysis, control, and design. In the first paper, Kim and Kurabayashi formulate the stability conditions for the artificial pheromone potential field. On the basis of the result of the stability analysis, they further presented a pheromone filter for making a smoothing kernel. The proposed filter was applied to the potential field with several peaks and used by the mobile agent. They are developing a fully automated pheromone robotic system, which aims at achieving a system closer to the natural biological world. In the second paper by Zhang and He, the influence of reciprocal effect between swimming models and morphologic on the fin propulsion performance is analyzed. From the simulation and experiments, they find that the compliance of the distribution mode of fin outline with amplitude envelope can generate better propulsion force. The results are useful for the optimal design of undulating robotic fins. For the third paper, Gouwanda and Senanayake introduce the use of wearable wireless gyroscopes for estimating gait stability. An experimental study was conducted to verify the validity of this approach. The result is expected to be employed in clinical research to assist clinicians and biomechanists in further study, which allows clinicians and biomechanists to devise appropriate strategies that improve human walking stability and reduce the risk of falls in the elderly. In another paper, Pang, Guo, and Song present an implementation of a continuous upper limb motion recognition method based on surface electromyography (sEMG) into control of an Upper Limb Exoskeleton Rehabilitation Device (ULERD). Experimental results showed that this method is effective for obtaining a control source through raw sEMG signals derived from the unaffected arm for motor control of a ULERD equipped on the affected arm during bilateral rehabilitation in real-time. There are three papers related to the control of bioinspired robots. In the paper by Sinnet and Ames, a sagittal walking is designed using Human-Inspired Control which produces human-like bipedal walking with good stability properties. The proposed control scheme, which is based on a fundamental understanding of human walking, is validated in both simulation and experiment. In the second paper, Cheng and Deng have presented a filtered-error based controller for attitude stabilization and tracking in flapping flight. By approximating nonlinear terms in the dynamic equation, the controller has successfully achieved stabilization and tracking tasks for two different insect models. Compared to a Linear Quadratic Gaussian (LQG) controller designed solely for stabilization purposes, the current controller achieves faster convergence and a broader stable region. In order to tackle such a discrepancy between biological and artificial systems, Maheshwari, Gunura and Iida present the concept and design of an adaptive clutch mechanism that discretely covers the full-range of dynamics. This novel actuation principle is then tested in a case study of position and trajectory control for a simple pendulum. The preliminary investigation of this actuation principle has shown a few potentially interesting research directions in the future. The four papers in this special issue cover the design and simulation. In the first paper, Chi and Low introduce the background of fin designs for robotic manta ray. After having analyzed and summarized the various designs, the structure of fin ray effect is investigated in depth. Their characteristics in motion are revealed through kinematic analysis, and the potential design for their RoMan IV with such structure is also presented. The work in the second paper by Boxerbaum et al. reports on the design and optimization of a biologically inspired amphibious robot for deployment and operation in an ocean beach environment. The authors present a new design fusing a range of insect-inspired passive mechanisms with active autonomous control architectures to seamlessly adapt to and traverse through a range of challenging substrates both in and out of the water. A bio-inspired adaptive perching mechanism is presented in the third paper by Chi et al. Based on the anatomy analysis of bird’s perching, some guiding principles for the perching mechanism design are obtained. By making use of motion capture system, reliability of the designed perching mechanism under static conditions is validated. Experiment results show that the perching mechanism is applicable to wide ranges of perching angles and target diameters. In the last paper, Guo et al. present virtual-reality simulators for training with force feedback in Minimally Invasive Surgery (MIS). This application allows generating realistic physical-based models of catheters and blood vessels, and enables surgeons to touch, feel and manipulate virtual catheter inside a vascular model through the same surgical operation mode as is used in actual MIS. The special issue of the Journal of Robotics and Mechatronics on Focused Areas and Future Trends of Bio-Inspired Robots at a particularly appropriate time when the area of biomimetics has attracted a growing interest in recent years in developing autonomous robots that can interact in an unknown environment. Research has also shown that biologically inspired robots will exhibit much greater adaptivity and robustness in performance in unstructured environments than today’s conventional robots. This new class of robots will be substantially more compliant and stable than current robots, and will take advantage of new developments in materials, fabrication technologies, sensors and actuators. Applications of bio-inspired robots will include autonomous or semi-autonomous tasks such as reconnaissance and de-mining for small, insect-like robots and human interaction tasks at a larger scale. We would like to thank the authors for contributing their research papers to this special issue, and the reviewers who, in spite of their busy schedules, took time to provide in-depth comments and constructive criticisms. Last but not least, we would like to thank Editor-in-Chief, Professor Tatsuo Arai, for his support and suggestions to our proposal, which makes the publication of this special issue possible. Our heartfelt thanks go to Mr. Kunihiko Uchida of Fuji Technology Press Ltd. for his professional assistance during the editing process of this special section.
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Haqverdiyev, B. D. "УЛУЧШЕНИЕ РЕЗУЛЬТАТОВ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ГРЫЖ ПЕРЕДНЕЙ БРЮШНОЙ СТЕНКИ У ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА". Azerbaijan Medical Journal, № 1 (28 березня 2024): 45–48. http://dx.doi.org/10.34921/amj.2024.1.007.
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Tədqiqatın məqsədi qarnın ön divarının yırtığı olan, yüksək zəriflik indeksli yaşlı xəstələrin cərrahi müalicəsinin yaxşılaşdırılması məqsədilə yeni müalicə taktikasının effektivliynin öyrənilməsi olmuşdur. Kontrol qrupunda olan (n=43) xəstə ənənəvi qaydada əməliyyatdan sonrakı müalicə almışdır. Əsas qrup xəstələrdə (n=49) müəllifin təklif etdiyi üsulla müalicə aparılmışdır: bütün xəstələrə nazoqastral zond qoyulmuş, mərkəzi vena kateterizasiya edilmiş, genişspektrli antibiotik infuziyası, mərkəzi venoz təzyiqi və arterial təzyiqi stabilləşdirmək şərtilə vena daxilinə kolloid və kristalloid məhlulların infuziyası aparılmış və xəstələr 6 saat ərzində əməliyyata götürülmüşdür. Əməliyyatdan sonrakı erkən dövrdə intensiv terapiya şöbəsində tənəffüs gimnastikası, erkən per os qidalanma, ağrının idarə edilməsi üçün epidural kateter vasitəsilə ağrıkəsicilərin istifadəsi, erkən hərəkətə başlama və beynin funksional aktivliyinin artırılması üçün kognitiv məşqlər icra edilmişdir. Əsas və kontrol qruplarında alınmış nəticələrin müqayisəsi göstərmişdir ki, Clavien-Dindo klassifikasiyasına görə II və III sinif ağırlaşmalara kontrol qrupunda daha çox rast gəlinmişdir. Xəstələrin əməliyyatdan sonrakı hospitaldaxili vəziyyətləri əsas qrupda daha yaxşı olması ilə seçilmişdir. Təklif etdiyimiz yeni metodun effektivliyi qanda iltihab əlamətlərinin daha mülayim olması ilə öz təsdiqini tapmışdır. Представлены результаты исследования, проведенного с целью изучения эффективности новой тактики лечения, предложенного автором для улучшения хирургического лечения больных пожилого возраста с грыжами передней брюшной стенки с высоким индексом хрупкости. Больные контрольной группы (n=43) получали традиционное послеоперационное лечение. Основная группа больных (n=49) получили лечение предлагаемым автором способом, в которое входили: установление всем пациентам назогастрального зонда, катетеризация центральной вены, инфузия антибиотиков широкого спектра действия, внутривенное введение коллоидных и кристаллоидных растворов при условии стабилизации центрального венозного давления и артериального давления, а также 6 часов, в течение которых больного доставляют на операцию. В раннем послеоперационном периоде в отделении интенсивной терапии проводили дыхательную гимнастику, раннее пероральное питание, применение обезболивающих средств через эпидуральный катетер для купирования боли, раннюю двигательную и когнитивную гимнастику для повышения функциональной активности головного мозга. Сравнение результатов, полученных в основной (n=49) и контрольной (n=43) группах, показало, что по классификации Clavien-Dindo в контрольной группе чаще встречались осложнения II и III классов. Течение послеоперационого периода было лучше в основной группе. Эффективность предложенного нового метода подтверждена более хорошими показателями воспаления в анализах крови. The aim was to study the effectiveness of new treatment tactics to improve the surgical treatment of elderly patients with hernias with a high frailty index. Patients in the control group (n=43) received traditional postoperative treatment. The main group of patients (n=49) received treatment using the method we proposed, which included: all patients had a nasogastric tube installed, central vein catheterization, infusion of broad-spectrum antibiotics, intravenous administration of colloid and crystalloid solutions, subject to stabilization of central venous pressure and blood pressure, as well as 6 hours, during which the patient is taken to surgery. In the early postoperative period in the intensive care unit, breathing exercises, early oral nutrition, the use of painkillers through an epidural catheter to relieve pain, and early motor and cognitive exercises to increase the functional activity of the brain were performed. A comparison of the results obtained in the main (n = 49) and control (n=43) groups, showed that according to the Clavien-Dindo classification, complications of classes II and III were more common in the control group. The course of the postoperative period was better in the main group. The effectiveness of our new method is confirmed by better indicators of inflammation in blood tests.
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Sedakov, Igor, Vladlena Dubinina, Oleksandr Bondar, Oleg Lukianchuk, and Oleksandr Zavoloka. "COMPARATIVE CHARACTERISTICS OF THE METHODS OF CHEMODRUGS ADMINISTRATION IN THE TREATMENT OF PATIENTS WITH LOCALLY-ADVANCED BREAST CANCER." EUREKA: Health Sciences 1 (January 29, 2016): 31–39. http://dx.doi.org/10.21303/2504-5679.2016.00038.
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The development of new methods of treating patients with breast cancer (BC) causes no doubts at anyone at present moment. The statistical data testify to steady growth of BC sickness rate during recent 20 years without tendency to stabilization The special attention is paid to the development of new methods of treating BC patients (regional forms of disease) with unfavorable factors for forecast of tumor growth. The presented methods of treatment of patients with locally-advanced breast cancer consist in giving complex treatment using two simultaneous ways of administration of chemodrugs - selective intra-arterial and endolymphatic in combination with a systemic one. The results obtained demonstrated greater efficacy of treatment with combinations of selective intra-arterial chemotherapy with a systemic one compared with endolymphatic chemotherapy in combination with the systemic one for the treatment of this disease. Materials and methods. The present study was based on the data of 285 patients with locally-advanced forms of breast cancer HER/2-neu positive and basal-like biological subtypes, with the stages T4N0-2M0, the treatment was given in Donetsk regional antitumor center and Odessa University Clinic in 2000-2014. During the research for an adequate analysis of the results of treatment by the technique under consideration there were formed two groups of patients. The first investigated group included 221 patients, in 168 patients were diagnosed HER/2-neu positive tumors in immunohistochemical conclusion and 53 patients had basal-like biological subtype of the tumor. The program of the comprehensive treatment of patients in this group included the internal thoracic artery catheterization through the upper epigastric artery, two or three cycles of SIAPCT in combination with intravenous one with an interval of 21 days, evaluation of the effect of radiation therapy (RT) on the breast and zone of the regional lymph outflow in the static mode SFD- 2-2.5 Gy, CFD- 40 Gy, the interval, estimation of the effect. Mastectomy in the patients of the investigated group was performed only when there was a complete or partial tumor response (136 surgeries in a radical scope). Courses of intraarterial PCT were given in continuous long-term infusion (4 hours) by the scheme CMF, CAF or CAMF. Taking into account the possibility of local complications against the background of administration of some chemotherapeutic agents (most often - doxorubicin), half of the drug dose was administered intravenously. The total course doses of chemodrugs were calculated according to BSA criteria. The control group included 64 patients, 45 were identified to have HER/2-neu positive and 19 basal-like subtypes of breast cancer. The program of comprehensive treatment of the patients of this group includes endolymphatic chemotherapy according to the method developed by Donetsk regional antitumor center. As the main method of administration of chemodrugs in the lymphatic system there was used infusion introduction with the help of the system for intravenous drip, infusion rate was 0.3-0.5 ml/min that allowed us to exclude the possibility of extravasation of the chemodrug solution. The course dose of the drug was administered endolymphatically within 5-7 days. At the interval of 21 days two or three courses of ELPHT were given combined with the intravenous administration of anthracyclines (at the end of each cycle the catheter was removed, the catheterization was performed repeatedly). Then the effectiveness of the treatment by the criteria of RECIST was evaluated. Radiation therapy (RT) to the breast and area of the regional lymph outflow was given in a static mode SFD- 2-2.5 Gy, CFD- 40 Gy followed by evaluation of the effect. Mastectomy in the patients of the control group was performed only at the complete or partial tumor response (36 operations in a radical scope). Courses of endolymphatic PCT were given by the continuous long-term infusion (up to 8 hours) scheme of CMF, CAF or CAMF. Taking into account the possibility of local complications against the background of introduction of some chemotherapeutic agents, intercalator doxorubicin was administered intravenously, and antimetabolites and alkylating agents (methotrexate, 5-fluorouracil and cyclophosphamide) in all schemes were introduced endolymphatically. Results. The average life expectancy of patients of the investigated group was 3.43 ± 0.18 years, while in the control group it was 2.82 ± 0.3 that significantly exceeded the statistical data of domestic and foreign authors. Indices of total 3-year survival rate of patients of the investigated group were 59.9 ±4.5% and 5-year- - 43.1 ±5.5 months. In the control group indices of cumulative 3- and 5-year survival rates were significantly lower - 37.8% ± 6.6 and 25.2 ± 7.0%months respectively. Conclusions. 1. The results of complex treatment of locally-advanced breast cancer with unfavorable prognostic factors of tumor growth by the developed technique by using a combination of selective intra-arterial injection and intravenous chemotherapy in a pool of the internal thoracic artery in combination with radiation and hormonal therapy exceed the results of standard treatment programs for the patients with locally-advanced breast cancer with performing mastectomy and systemic chemotherapy. 2. The method developed by the authors can be recommended for widespread use in these patients.
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Vrindha, Balakrishnan Nair, Narashiman Seethalakshmi, and Kothandaraman Srikamakshi. "'old foley's in a new bottle'- USE OF FOLEY'S CATHETER IN ANTERIOR MAXILLARY WALL FRACTURES." Otolaryngology online, March 6, 2013. https://doi.org/10.5281/zenodo.812090.
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Management of comminuted zygomaticomaxillary fractures are is an entity that has always tested the skill of surgeons. A variety of methods have been coined over the years for management of these fractures. Packing the antrum with a gauze or balloon can be used in much comminuted fractures especially with anterior antral wall communication. Internal immobilization with a Foley's balloon catheter is being used widely in Blow out fractures of orbit and rarely in tripod fractures. Despite a thorough search, not much literature could be found of its use in anterior maxillary wall fractures. The purpose of this article is to appraise this technique in anterior maxillary wall fractures. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.
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Dr, Mahnoor Fatima Dr Saif ullah Dr Aneela Ishaq. "INDUCTION OF LABOUR WITH FOLEY'S CATHETER AND PROSTAGLANDIN E 2 TABLET VERSUS PROSTAGLANDIN E 2 TABLET ALONE." October 1, 2020. https://doi.org/10.5281/zenodo.4062194.
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<strong><em>Introduction: </em></strong><em>Induction of labour (IOL) is one of the commonest obstetric interventions, occurring in approximately 25% of term pregnancies in developed countries. <strong>Aims and objectives: </strong>The basic aim of the study is to find the induction of labour with Foley’s catheter and prostaglandin E 2 versus Prostaglandin tablet E 2 tablet alone.<strong> Material and methods: </strong>This descriptive study was conducted in Shaheed Zulfiqar Ali Bhutto Medical University during June 2019 to January 2020. The data was collected from 100 pregnant women. The data was divided into two groups, one group received only Foley’s catheter and prostaglandin E 2 and second group contain only Prostaglandin tablet E 2 tablet alone. <strong>Results: </strong>The data was collected from 100 pregnant women. The commonest indication for IOL was post-date pregnancy (58.3% in Group A and 61.4% in group B). There were no significant differences in the mode of delivery between the two study groups (63% in Group A and 61% in Group B had normal vaginal delivery). <strong>Conclusion: </strong>It is concluded that Foley catheter balloon is an effective non pharmacological method for cervical ripening. There is a greater chance of vaginal delivery with the simultaneous use of Foleys catheter with PGE2 for induction of labour.</em>
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Berger, Simon, Nicolas Combaret, and Geraud Souteyrand. "What Do I Do if the Valve Don't Pass? Use a Snare Catheter!" Clinical Case Reports 12, no. 12 (2024). https://doi.org/10.1002/ccr3.9628.
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ABSTRACTWe report a case of a complex transcatheter aortic valve implantation (TAVI) complicated by severe calcifications, which prevented the delivery system from advancing through the aortic valve. To address this challenge, we employed an innovative solution using a Snare catheter. This approach enabled stabilization and guidance of the delivery system, facilitating the crossing of the calcified obstruction and the successful completion of the procedure. This case highlights the utility of the Snare catheter as a complementary technique to overcome anatomical challenges in complex TAVI procedures.
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Sahai, Swati, S. Vasanthi, and D. Agatha. "BACTERIOLOGICAL PROFILE OF CATHETER ASSOCIATED URINARY TRACT INFECTION IN MEDICAL INTENSIVE CARE UNIT." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, September 1, 2024, 3–6. http://dx.doi.org/10.36106/ijsr/3203274.
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Background: Urinary tract infection (UTI) is the most common nosocomial infection among which more than 80% are catheter-associated [1] [2,3] (CAUTI) . As compared to patients in non-critical area, those in intensive care unit have more risk of acquiring CAUTI . This study Objective: was conducted to determine the bacteriological prole of catheter associated urinary tract infection in medical intensive care unit (ICU) patients and perform antibiotic susceptibility pattern of the isolated organisms. The risk factors associated with CAUTI was also determined. Methods: A total of 100 patients admitted in medical ICU and put on Foley's catheter were included in the study. They were followed up for the development of symptomatic CAUTI as per CDC guidelines. Urine culture, isolation and identication of organism were done by per standard microbiological methods. Antibiotic susceptibility testing was done by disc diffusion and MIC method following CLSI guidelines. This study identied 26 Results: CAUTI cases with 40 isolated organisms. Most isolates were from Enterobacteriaceae (34.5%) and non-fermenters (32.5%). Pseudomonas aeruginosa was the most common (25%), followed by Klebsiella pneumoniae (17.5%), Enterococcus faecalis (15%), Escherichia coli (15%), and Candida spp. (15%). High resistance was noted among Enterobacteriaceae, with 66.67% ESBL, 22.22% Amp C, 11.11% MBL, and 11.11% carbapenemase production. One methicillin-resistant Staphylococcus aureus was also isolated. The dev Conclusion: elopment of CAUTI is frequently observed in critically ill patients, with most cases being attributed to Gram-negative organisms. The rise of antimicrobial resistance is a global concern, with a growing number of multidrug-resistant strains causing CAUTI. To reduce the incidence of drug resistance, the prophylactic use of antibiotics should be avoided.
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Santos, Luciano Marques dos, Taynara Bispo Conceição, Cleonara Sousa Gomes e. Silva, Sheilla Siedler Tavares, Patrícia Kuerten Rocha, and Ariane Ferreira Machado Avelar. "Care related to peripheral intravenous catheterism in pediatrics performed by nursing technicians." Revista Brasileira de Enfermagem 75, no. 2 (2022). http://dx.doi.org/10.1590/0034-7167-2020-0611.
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ABSTRACT Objectives: to evaluate the care practice adopted by nursing technicians before, during and after peripheral intravenous catheterization performed in hospitalized children. Methods: cross-sectional and descriptive research, carried out in a pediatric hospital in Bahia through non-participatory observation of peripheral intravenous catheterizations performed in children by nursing technicians. Data was collected through an instrument containing care related to the moments before, during and after insertion of the catheter, calculating absolute and relative frequencies, measures of central tendency and dispersion. Results: there were 31 nursing technicians, who performed care mainly before intravenous catheterization. Nonconformities were identified regarding hand hygiene, use of a disposable mask, selection of the catheter insertion site, antisepsis, stabilization and catheter coverage. Conclusions: most of the precautions observed regarding peripheral intravenous catheterization are not in accordance with the standards of practice recommended by the national and international literature.
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Templet, Tricia, Roger Rholdon, and Ansley Bienvenu. "Evaluating Effectiveness of the Use of an Extremity Stabilization Device for Vascular Access Procedures in Pediatrics." Journal of Pediatric Intensive Care, October 25, 2021. http://dx.doi.org/10.1055/s-0041-1736551.
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AbstractThe purpose of this study is to evaluate the effectiveness of SafeBoard, a Food and Drug Administration–approved extremity stabilization device, as an assistive method in performing peripherally inserted central catheter procedures on children 0 to 3 years of age. This is a retrospective chart review (n = 59) of vascular access procedures where SafeBoard was utilized (n = 32) in comparison to those procedures which utilized a traditional approach to placement (n = 27). Statistical analysis demonstrated significant effect on length of procedure time, number of personnel needed for procedure, and success of placement when SafeBoard was utilized. Obtaining vascular access in pediatrics can be a challenging endeavor. Most young pediatric patients require procedural sedation and/or assistive personnel as a “holder” for successful vascular access placement to occur. An alternative option for extremity stabilization may provide improved workflow and improved placement success, which in turn may positively affect workflow.