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1.
BMC Gastroenterol ; 22(1): 283, 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35659585

RESUMO

BACKGROUND: For infants who need long-term enteral feeding but are unable to maintain sufficient oral intake, feeding gastrostomy tube placement is required. The use of a Foley catheter as a replacement catheter in a Stamm gastrostomy is indicated in the absence of dedicated gastrostomy feeding tubes; however, this approach has been associated with many morbidities. In this report, an unusual case of an infant who underwent a major operation due to coiled spring jejunal intussusception caused by Foley catheter migration is described. CASE PRESENTATION: A 6-month-old neurologically impaired premature female patient was admitted to the emergency unit with respiratory distress, nonbilious vomiting and an ineffective gastrostomy feeding tube. Her history revealed that, at the age of 2 months, she had undergone Stamm gastrostomy for enteral feeding with a Pezzer catheter. However, at the age of 5 months, the Pezzer catheter became dislodged and was replaced with a Foley catheter. The patient subsequently underwent emergent exploratory laparotomy due to intestinal obstruction. During the operation, retrograde coiled spring jejunal intussusceptions with multiple areas of local necrosis and perforations were observed. Resection of the affected jejunal segment and end-to-end anastomosis were performed. The postoperative period was long and very demanding due to the presence of several comorbidities. To our knowledge, this is the first operative demonstration of coiled spring intussusception. CONCLUSION: This case report aims to increase clinical awareness of the possibility of coiled spring intussusception following the use of Foley catheter in a gastrostomy and the difficulties encountered in the surgical course of a premature infant.


Assuntos
Dispositivos Anticoncepcionais Femininos , Intussuscepção , Cateteres/efeitos adversos , Dispositivos Anticoncepcionais Femininos/efeitos adversos , Nutrição Enteral/efeitos adversos , Feminino , Gastrostomia/efeitos adversos , Humanos , Lactente , Intussuscepção/etiologia , Intussuscepção/cirurgia
2.
Rev Esc Enferm USP ; 56: e20210398, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35724261

RESUMO

OBJECTIVE: To identify risk factors for peripheral intravenous catheter-related phlebitis in adult patients. METHOD: This is a post hoc analysis of a randomized clinical trial, totaling 1,319 patients. Demographic and clinical variables related to therapy and phlebitis were investigated. For data analysis, frequencies, measures of central tendency and dispersion were calculated, and Pearson's chi-square test and Fisher's exact test were used, with logistic regression, ROC curve, and Odds Ratio calculation (95% confidence interval; 5% significance level) being implemented. RESULTS: Of the 1,319 participants, 80 (6.1%) developed phlebitis. The following were associated with the occurrence of phlebitis: reduced mobility (p = 0.015), family history of deep vein thrombosis (p = 0.05), catheterization of veins on the back of the hand (p = 0.012), pain (p < 0.01), Amoxicillin-Potassium Clavulanate (p = 0.015), and Omeprazole Sodium (p = 0.029). CONCLUSION: Risk factors for phlebitis involved intrinsic and extrinsic factors to the patient, indicating preventive nursing interventions such as promoting patient mobility, not catheterizing veins in the dorsal arch of the hand, cautious infusion of risk drugs, and valuing pain complaints.


Assuntos
Cateterismo Periférico , Flebite , Adulto , Cateterismo Periférico/efeitos adversos , Cateteres/efeitos adversos , Humanos , Dor/etiologia , Flebite/epidemiologia , Flebite/etiologia , Fatores de Risco
3.
BJS Open ; 6(3)2022 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-35543263

RESUMO

BACKGROUND: Rectus sheath catheter analgesia (RSCA) and thoracic epidural analgesia (TEA) are both used for analgesia following laparotomy. The aim was to compare the analgesic effectiveness of RSCA with TEA after laparotomy for elective colorectal and urological surgery. METHODS: Patients undergoing elective midline laparotomy were randomized in a non-blinded fashion to receive RSCA or TEA for postoperative analgesia at a single UK teaching hospital. The primary quantitative outcome measure was dynamic pain score at 24 h after surgery. A nested qualitative study (reported elsewhere) explored the dual primary outcome of patient experience and acceptability. Secondary outcome measures included rest and movement pain scores over 72 h, functional analgesia, analgesia satisfaction, opiate consumption, functional recovery, morbidity, safety, and cost-effectiveness. RESULTS: A total of 131 patients were randomized: 66 in the RSCA group and 65 in the TEA group. The median (interquartile range; i.q.r.) dynamic pain score at 24 h was significantly lower after TEA than RSCA (33 (11-60) versus 50.5 (24.50-77.25); P = 0.018). Resting pain score at 72 h was significantly lower after RSCA (4.5 (0.25-13.75) versus 12.5 (2-13); P = 0.019). Opiate consumption on postoperative day 3 (median (i.q.r.) morphine equivalent 17 (10-30) mg versus 40 (13.25-88.50) mg; P = 0.038), hypotension, or vasopressor dependency (29.7 versus 49.2 per cent; P = 0.023) and weight gain to day 3 (median (i.q.r.) 0 (-1-2) kg versus 1 (0-3) kg; P = 0.046) were all significantly greater after TEA, compared with RSCA. There were no significant differences between groups in other secondary outcomes, although more participants experienced serious adverse events after TEA compared with RSCA, which was also the more cost-effective. CONCLUSIONS: TEA provided superior initial postoperative analgesia but only for the first 24 h. By 72 hours RSCA provides superior analgesia, is associated with a lower incidence of unwanted effects, and may be more cost-effective.


Assuntos
Analgesia Epidural , Analgesia Epidural/efeitos adversos , Analgésicos Opioides/uso terapêutico , Cateteres/efeitos adversos , Humanos , Morfina , Manejo da Dor , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle
4.
Clin Neurol Neurosurg ; 217: 107268, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35490562

RESUMO

OBJECTIVE: Spontaneous intracranial hypotension (SIH) can be effectively treated by epidural blood patch (EBP) following the primary unsuccessful conservative therapy. Nevertheless, multi-site cerebrospinal fluid (CSF) leaks or those originating at the cervical or thoracic spine remain therapeutically challenging. Therefore, this study aimed to present our experience in the treatment of thoracic CSF leaks using epidural catheters for the EBP infusion. METHODS: Three patients presenting with typical orthostatic headaches were qualified for an EBP procedure. Preoperative MRI scans, myelography, and CT myelography were performed. Additionally, delayed CT myelography was repeated after 3 h to identify the CSF leakage site. Patients were followed-up clinically and radiologically for three months. RESULTS: The CT myelography identified CSF leak at the T2-3 (case 1), T5-12 (case 2), and T3-7 level (Case 3). A 0.06" diameter lumbar drainage catheter (Case 1 and 2) or Abbot's spinal cord stimulation (SCS) catheter (Case 3) was inserted epidurally through the lower thoracic/lumbar single-entry point and advanced into the identified thoracic leak site. The average volume of injected blood was 15.7 ml. No procedure-related complications were observed, and all patients improved clinically. CONCLUSIONS: Epidural catheters remain safe and effective in treating thoracic and multi-site CSF leaks. In addition, Abbot's SCS catheter was found superior to the lumbar drainage catheter due to higher rigidity and bigger diameter despite being shorter than the lumbar drainage catheter.


Assuntos
Placa de Sangue Epidural , Hipotensão Intracraniana , Placa de Sangue Epidural/efeitos adversos , Placa de Sangue Epidural/métodos , Cateteres/efeitos adversos , Vazamento de Líquido Cefalorraquidiano/etiologia , Humanos , Hipotensão Intracraniana/complicações , Hipotensão Intracraniana/diagnóstico por imagem , Hipotensão Intracraniana/terapia , Imageamento por Ressonância Magnética/efeitos adversos , Mielografia/efeitos adversos
6.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 34(3): 320-324, 2022 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-35574755

RESUMO

The central line-associated bloodstream infection (CLABSI) is a common and serious complication of central venous catheterization, which can lead to various short-term and long-term adverse outcomes. Neonatal CLABSI did not increase linearly with the prolongation of peripherally inserted central catheter (PICC). When the umbilical venous catheter (UVC) is retained for more than 1-2 weeks, the incidence of neonatal CLABSI may increase significantly; PICC replacement at 7-10 days after UVC indwelling may reduce the incidence of CLABSI, but it has not been supported by evidence-based medicine. This article reviews the related studies between neonatal CLABSI and catheter dwell time, in order to plan the indwelling time more reasonably and prevent CLABSI better.


Assuntos
Infecções Relacionadas a Cateter , Cateterismo Venoso Central , Cateteres Venosos Centrais , Sepse , Infecções Relacionadas a Cateter/etiologia , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Cateteres/efeitos adversos , Cateteres Venosos Centrais/efeitos adversos , Humanos , Recém-Nascido , Estudos Retrospectivos , Fatores de Risco , Sepse/complicações
8.
Int Urol Nephrol ; 54(7): 1461-1470, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35449382

RESUMO

BACKGROUND: Hydrophilic coated catheters are recommended to reduce the side effects of intermittent catheterization (IC) in patients with bladder dysfunction. However, there is lack of Level one evidence to support the use of this intervention. SEARCH METHODS: Several electronic databases were systematically searched to evaluate complication incidences for hydrophilic coated (HC) and non-hydrophilic catheters (NHC). RESULTS: Twelve studies were eligible for inclusion in the review. The meta-analyses exploring microscopic hematuria frequencies (RR = 0.69; 95% CI 0.52-0.90) and urethral stricture frequencies (RR = 0.28; 95% CI 0.13-0.60) showed a lower risk ratio associated with HC in comparison to NHC, whereas gross hematuria was no statistically significant difference in two groups. Subgroup analyses of gross hematuria which was grouped according to "catheterization frequency", "single/multiple catheterization" and "self/other catheterization" were performed and the values of combined RR were also no statistically significant difference. CONCLUSIONS: Compared with non-hydrophilic catheters, the hydrophilic coated catheters have positive significance in reducing the incidence of urethral microtrauma and the urethral stricture. However, more studies are warranted for evaluating effects of hydrophilic coated catheters on the incidence of gross hematuria.


Assuntos
Cateterismo Uretral Intermitente , Estreitamento Uretral , Infecções Urinárias , Cateterismo/efeitos adversos , Cateteres/efeitos adversos , Hematúria/epidemiologia , Hematúria/etiologia , Humanos , Cateterismo Uretral Intermitente/efeitos adversos , Estreitamento Uretral/complicações , Estreitamento Uretral/etiologia , Bexiga Urinária , Cateterismo Urinário/efeitos adversos , Infecções Urinárias/etiologia
9.
J Feline Med Surg ; 24(6): e28-e33, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35363097

RESUMO

OBJECTIVES: The aims of this study were to describe the indications for percutaneous pigtail catheter placement in cats requiring urine diversion, and to report the associated intra- and postoperative complications. METHODS: The medical records of cats that underwent percutaneous pigtail catheter placement for urine diversion between January 2011 and May 2021 were retrospectively reviewed. RESULTS: Twenty-five cats were included. Indications for pigtail catheter placement were medical management of obstructive urinary tract disease (n = 12), urinary tract damage after traumatic injury (n = 8) and neurological bladder dysfunction (n = 5). Catheters were in place for a median time of 8.28 days (range 3-27), and the duration of the catheter placement was not different between the medical, traumatic and neurological groups. Ten cats (40%) developed pigtail catheter complications including dislodgement, urine leakage, urinary tract infection and bladder rupture. The majority of complications were easily resolved and did not require surgical intervention. CONCLUSIONS AND RELEVANCE: The results suggest that percutaneous pigtail catheter placement can facilitate urine diversion in both the emergency setting and in the long-term management of urine retention without many complications.


Assuntos
Doenças do Gato , Doenças Urológicas , Animais , Doenças do Gato/cirurgia , Cateteres/efeitos adversos , Cateteres de Demora/efeitos adversos , Cateteres de Demora/veterinária , Gatos , Cistostomia/efeitos adversos , Cistostomia/métodos , Cistostomia/veterinária , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Doenças Urológicas/etiologia , Doenças Urológicas/cirurgia , Doenças Urológicas/veterinária
10.
Biomed Res Int ; 2022: 4846279, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372576

RESUMO

Aim: In this study, we aimed to investigate the efficacy of catheter directed thrombolysis (CDT) and peripheral intravenous thrombolysis (PIT) in the treatment of patients with acute pulmonary embolism (APE) and assess its effect on the prognosis of patients. Methods: We recruited 74 patients with APE, who were assigned to CDT and PIT groups, according to the treatments received by them. The arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (Pa CO2), pulmonary artery pressure (PAP), pulmonary artery obstruction index (PAOI), thrombus volume, pain score, and therapeutic benefits were compared between the two groups before and after treatment, and the factors affecting patient prognoses were also analyzed. Results: Using the clinical data before treatment as the baseline, it was found that changes in indicators of plasma, thrombus volume, and pain scores were significantly better in the CDT group than in the PIT group after treatment. The total effective rate of CDT was higher than that of PIT in the treatment of APE. The mean follow-up time for both the CDT and PIT groups was 41.08 ± 9.12 months, and the total mortality rate was 14.8% and 31%, respectively. The logistic regression analysis revealed the significant impacts of previous incidences of pulmonary embolism (PE), concurrent deep vein thrombosis (DVT), and pulmonary arterial hypertension (PAH) on the occurrence and progression of APE, and these factors were subsequently identified as risk factors for APE using Kaplan-Meier survival analysis. Observations from PAE onset to the end of follow-up revealed that there was a difference in survival rates between the CDT and PIT groups. Conclusions: Taken together, CDT is an effective treatment strategy for APE and can provide effective symptomatic relief. In addition, the previous incidences of PE, concurrent DVT, and PAH are important risk factors that affect the survival rates of patients with APE.


Assuntos
Embolia Pulmonar , Terapia Trombolítica , Doença Aguda , Cateteres/efeitos adversos , Fibrinolíticos/uso terapêutico , Hemodinâmica , Humanos , Dor/tratamento farmacológico , Prognóstico , Fatores de Tempo , Resultado do Tratamento
11.
Eur Rev Med Pharmacol Sci ; 26(6): 1846-1851, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35363332

RESUMO

OBJECTIVE: The aim of this study was to investigate the technical success and in-hospital outcomes of endovascular thrombectomy (ET) in acute ischemic stroke (AIS) patients performed by interventional cardiologists. PATIENTS AND METHODS: ET for AIS provides fast, effective and safe recanalization. Insufficient number of catheter laboratories for stroke interventions and experienced interventional neurologists are limiting the widespread application of such a promising treatment method. RESULTS: 123 patients with AIS and eligible for ET were evaluated retrospectively. 65 patients were female (52.8%) and the mean age of the patients was 71.5 ± 11.9 years. Most of the patients had a middle cerebral artery (MCA) occlusion (112 patients, 91%). Successful recanalization (thrombolysis in cerebral infarction grading 2b or higher) was achieved in 109 patients (88.6%). Access site complication was observed only in 3 patients (2.4%). Intracranial bleeding was observed in 17 patients (13.8%) and only 8 of them were symptomatic (6.5%). In-hospital death occurred in 19 patients (15.4%). The initial National Institutes of Health Stroke Scale (NIHSS) was 16.8±3.3 (median 18) which improved significantly to 10.4±7.2 (median 11) at 24 hours (p<0.001). Dramatic neurologic improvement was observed in 60 of 123 patients (48.8%). The modified rankin score of the patients was significantly lower at discharge compared to admission (4.2±0.7 vs. 2.9±2, p<0.001). CONCLUSIONS: ET in AIS can be performed safely with high success rates by trained interventional cardiologists within the stroke team. Until the number of stroke centers is sufficient, endovascular treatment of AIS can be supported by experienced interventional cardiologists.


Assuntos
Isquemia Encefálica , Cardiologistas , Procedimentos Endovasculares , AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/complicações , Isquemia Encefálica/terapia , Cateteres/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Feminino , Mortalidade Hospitalar , Humanos , Laboratórios , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents/efeitos adversos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/cirurgia , Trombectomia/efeitos adversos , Resultado do Tratamento
12.
Am J Cardiol ; 172: 90-97, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35387738

RESUMO

Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation ≥2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p <0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p <0.001) and septic shock (adjusted p <0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation ≥2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up.


Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Endocardite , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/complicações , Insuficiência da Valva Aórtica/epidemiologia , Insuficiência da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/cirurgia , Cateteres/efeitos adversos , Endocardite/epidemiologia , Endocardite/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Valva Mitral/cirurgia , Fatores de Risco , Substituição da Valva Aórtica Transcateter/efeitos adversos , Resultado do Tratamento
13.
Br J Nurs ; 31(8): S14-S23, 2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35439080

RESUMO

AIM: This study aimed to identify the types of complications of peripheral intravenous catheters (PIVCs) in hospitalised children and possible risk factors for the development of extravasation, infiltration and phlebitis. METHOD: The study was conducted in the largest children's hospital in a region of Turkey, with a bed capacity of 354 and 1400 employees, which provides care only to paediatric patients aged from newborn to 18 years old. In this 5-month prospective study, the complications of PIVCs in hospitalised children and risk factors leading to the development of extravasation, infiltration and phlebitis were recorded. During morning and afternoon daily visits, the researcher examined catheter sites for complications and indications for removal. RESULTS: The study covered 244 patients aged from 1 month to 17 years, 575 PIVCs and 1600 catheter days. The rates of infiltration and phlebitis observed in children with PIVCs were 8.7 % and 15.8% respectively. Logistic regression revealed that using 22- and 24-gauge catheters, hospitalisation in the surgery ward and continuous infusion were significant independent risk factors for the development of infiltration (P<0.001). Direct logistic regression revealed that age in months, hospitalisation in a surgery ward and placement of the catheter in the veins of the antecubital fossa were significant independent risk factors for the development of phlebitis (P<0.001). CONCLUSION: Catheter size, hospitalisation in the surgery ward and continuous infusion contributed to the development of infiltration. Age, hospitalisation in the surgery ward and catheter placement in the antecubital vein contributed to the development of phlebitis.


Assuntos
Cateterismo Periférico , Flebite , Cateterismo Periférico/efeitos adversos , Cateteres/efeitos adversos , Cateteres de Demora/efeitos adversos , Criança , Humanos , Recém-Nascido , Flebite/epidemiologia , Flebite/etiologia , Estudos Prospectivos , Fatores de Risco
14.
JSLS ; 26(1)2022.
Artigo em Inglês | MEDLINE | ID: mdl-35391779

RESUMO

Background and Objectives: Peritoneal dialysis is an excellent treatment for end-stage renal disease. Peritoneal dialysis is more advantageous if the catheter is positioned laparoscopically with omentopexy. General anesthesia is required for laparoscopic peritoneal dialysis catheter placement. General anesthesia is associated with increased postoperative morbidity and mortality in high-risk patients. In this retrospective study, the results of laparoscopic placement of peritoneal dialysis catheter under preperitoneal local anesthesia technique and sedation are presented for end-stage renal disease patients not fit for general anesthesia. Methods: We recruited 13 patients for laparoscopic placement of peritoneal dialysis catheter out of 99 end-stage renal disease patients who presented at a local tertiary hospital. The selection criteria were based on the American Society of Anesthesiologists classification III or above and patients unfit for general anesthesia. Results: Laparoscopic placement of peritoneal dialysis catheter was performed on 99 patients, and 13 patients were unfit for general anesthesia. Laparoscopic placement of peritoneal dialysis catheter and omentopexy were performed on these 13 patients together with capnoperitoneum, under preperitoneal local anesthesia technique and sedation. Three catheters were removed due to exit-site infection. One patient died after 2 years due to cardiac disease. The remaining patients continued with peritoneal dialysis. No omental entrapment, catheter migration, or other complications were encountered. Conclusion: Laparoscopic placement of peritoneal dialysis catheter under preperitoneal local anesthesia technique and sedation was successful for high-risk patients unfit for general anesthesia. This technique can be expanded for healthy patients to avoid general anesthesia complications, reduce costs, and speed recovery.


Assuntos
Falência Renal Crônica , Laparoscopia , Diálise Peritoneal , Anestesia Local , Cateteres/efeitos adversos , Cateteres de Demora , Humanos , Falência Renal Crônica/terapia , Laparoscopia/métodos , Estudos Retrospectivos
15.
J Stroke Cerebrovasc Dis ; 31(7): 106488, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35472654

RESUMO

OBJECTIVES: After subarachnoid hemorrhage (SAH), potential renal insults are numerous but the burden of early acute kidney injury (AKI) is unclear. We determined its incidence, rate of persistence, risk factors, and impact on patients' outcomes. MATERIALS AND METHODS: Patients with non-traumatic SAH were retrospectively included if they underwent catheter angiography within the 48 h after their admission to the intensive care unit. Early AKI was defined according to Kidney Disease Improving Global Outcome (KDIGO) criteria, analyzed from the time of catheter angiography. Early AKI was considered as persistent if the KDIGO stage did not decrease between the 48th and the 60th hour. RESULTS: Among 499 consecutive patients, early AKI (mostly oliguria) occurred in 132 (26%): stage 1, 2 and 3 in 72 (14%), 44 (9%), and 16 (3%) patients, respectively. It persisted in 36% of cases. Early AKI occurred more likely when SAH was severe or renal function was impaired at hospital admission: adjusted odds ratio of 2.76 [95% 1.77-4.30] and 3.32 [1.17-9.46], respectively. ICU and hospital lengths of stay were longer in patients who developed early AKI than in patients who did not: 16 [9-29] versus 12 [4-24] days (p = 0.0003) and 21 [14-43] versus 16 [11-32] days (p = 0.007), respectively. There was an independent link between early AKI and renal outcome (n = 274 in the model) but not with hospital mortality (n = 453). CONCLUSIONS: One quarter of our population developed early AKI, mostly oliguria. It persisted beyond the 48th hour in one third of cases. The associated risk factors we identified were non-modifiable.


Assuntos
Injúria Renal Aguda , Oligúria , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Angiografia/efeitos adversos , Cateteres/efeitos adversos , Humanos , Incidência , Unidades de Terapia Intensiva , Oligúria/complicações , Estudos Retrospectivos , Fatores de Risco
16.
Arch Ital Urol Androl ; 94(1): 91-96, 2022 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-35352533

RESUMO

OBJECTIVE: The aim of the present study was to examine the results of antegrade JJ stent placement in upper urinary tract obstruction in patients where retrograde placement was not possible. METHODS: In this retrospective study, patients who underwent antegrade JJ stent placement for malignant ureteral obstruction in the urology clinic of a university hospital between January 1, 2018 and December 31, 2020 were included in the study. JJ stent was placed under local or general anaesthesia guided by ultrasonography and fluoroscopy. Age, gender, kidney function values, pathologies causing obstruction, and complications of the patients were examined. RESULTS: In this study, 40 patients (16 men, 24 women) who underwent antegrade JJ stent placement were included. The mean ages of the women and men included were 51 (31-91) years and 62.5 (26-81) years, respectively. In all, antegrade JJ stenting was performed in 61 renal units of these patients. Of these, 21 were bilateral, 11 in the right collecting system and 8 in the left collecting systems. Clinical and technical success was achieved in 59 of the 61 procedures (96.6%). Arteriovenous fistula developed in only one patient, whereas no serious complications such as massive bleeding, resistant hematuria or pseudoaneurysm occurred in the remaining patients. The procedure was completed in a mean time of 15-30 minutes. CONCLUSIONS: Antegrade JJ stent placement is a procedure with a high success rate and low risk of complications that can be used in patients with severe ureteral obstruction owing to malignant or benign aetiologies. This method should be applied in centres experienced in malignant ureteral obstruction and on patients where retrograde placement was not possible. Furthermore, it should be considered as an alternative treatment option to open surgery as it can be performed under local anaesthesia in patients at a high risk of anaesthesia.


Assuntos
Obstrução Ureteral , Idoso , Idoso de 80 Anos ou mais , Cateteres/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents/efeitos adversos , Resultado do Tratamento , Obstrução Ureteral/etiologia , Obstrução Ureteral/cirurgia
18.
Appl Biochem Biotechnol ; 194(6): 2796-2830, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35247153

RESUMO

In every age group, urinary tract infection (UTI) is found as a major recurrence infectious disorder. Bio-films produced by bacteria perform a vital role in causing infection in the tract of the urinary system, leading to recurrences and relapses. The purpose of this review is to present the role and mechanism of bio-film producing MDR Gram-negative bacteria causing UTI, their significance, additionally the challenges for remedy and prevention of catheter-associated UTI. This work appreciates a new understanding of bio-film producers which are having multi-drug resistance capability and focuses on the effect and control of bio-film producing uropathogenic bacteria related to catheterization. We have tried to analyze approaches to target bio-film and reported phytochemicals with anti-bio-film activity also updated on anti-bio-film therapy.


Assuntos
Antibacterianos , Infecções Urinárias , Antibacterianos/farmacologia , Bactérias , Cateteres/efeitos adversos , Bactérias Gram-Negativas , Humanos , Testes de Sensibilidade Microbiana , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/prevenção & controle
19.
J Healthc Eng ; 2022: 6383777, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35313516

RESUMO

In order to provide reference for the prevention and treatment of CRBSI during clinical intravenous infusion therapy, this paper investigates the incidence of catheter-related bloodstream infection (CRBSI) in the treatment of midline catheters (MCs) and peripherally inserted central catheters (PICCs) by intravenous infusion. Web of Science, PubMed, Scopus, Embase, Cochrane Library, and ProQuest are searched to collect CRBSI-related studies on MC and PICC. The retrieval time is from the database construction to August 2020. Two researchers independently searched and screened literature quality evaluation and extracted data according to inclusion and exclusion criteria, and RevMan 5.3 software was used for analysis. Eleven studies are included, with a total of 33809 patients. The incidence of CRBSI in the MC group is 0.599% (43/7079), and that in the PICC group is 0.4993% (133/26630). Meta-analysis showed that the incidence of CRBSI in the MC group is higher than that in the PICC group (OR = 0.72, 95% CI = 0.43-1.08, P=0.11), and the difference is statistically significant when low-quality studies are excluded (OR = 0.60, 95% CI = 0.39-0.93, P=0.02). There is no significant difference in the incidence of CRBSI between MC group and PICC group (P > 0.05), American subgroup (OR = 0.52), and British subgroup (OR = 4.86), the results of the two groups are opposite, and the incidence of CRBSI between the MC group and PICC group is statistically significant. There is no significant difference in the incidence of CRBSI between the adult and other subgroups (all P > 0.05). There is no significant difference in the incidence of CRBSI between the MC group and the PICC group (P > 0.05). Overall, the inter-study stability is general, the quality is good and the medium is good, and there is no obvious publication bias. The risk of CRBSI in MC and PICC is systematically evaluated and meta-analyzed for the first time. The incidence of CRBSI in MC group is lower than that in PICC group during intravenous infusion therapy. Under the same conditions, MC patients can be given priority for intravenous infusion therapy. More high-quality and child-related studies are needed to further evaluate and explore the risk of CRBSI between MC and PICC.


Assuntos
Infecções Relacionadas a Cateter , Cateterismo Periférico , Sepse , Adulto , Infecções Relacionadas a Cateter/epidemiologia , Cateterismo Periférico/efeitos adversos , Cateteres/efeitos adversos , Humanos , Incidência
20.
PLoS One ; 17(3): e0265102, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35316286

RESUMO

BACKGROUND: Catheter-associated urinary tract infection is the leading cause of hospital-acquired infections. They remain the second most common healthcare-associated infection in critically sick patients. OBJECTIVE: To determine the prevalence of catheter-associated urinary tract infection, the spectrum of etiological agents, antibiotic sensitivity profile of bacterial pathogens among adult patients admitted to intensive care units. MATERIALS AND METHODS: Patients admitted to the intensive care unit of hospitals in Addis Ababa who were on urethral indwelling catheters for >48 hours from October 2020 to September 2021 were included in the study. Urine specimens were aseptically collected and processed as per standard protocols. Microorganisms were isolated, identified, and subjected to antibiotic susceptibility testing. RESULTS: In all 220 pateints included in the study development of significant bacteriuria/candiduria was not affected by sex, age, and prior antibiotic therapy. However, the length of stay in the intensive care unit was significantly associated with bacteriuria /candiduria (P-value < 0.001). The overall prevalence of bacteriuria/candiduria was 51.4% among which 21.0%, 19.1%, and 11.4% were bacteriuria, candiduria, and polymicrobial infections, respectively. About 138 organisms were recovered of which 79 (57.25%) were bacteria and 59 (42.75%) were yeast isolates. Acinetobacter species, Pseudomonas species, Klebsiella species E. coli, and Enterococcus species were the dominant bacterial isolates. Candida. albicans, Candida. krusei and Candida. tropicalis were the commonest yeasts. Many gram-negative bacterial isolates were resistant to ceftriaxone 36(94.7%), ampicillin 21(91.3%) followed by cefotaxime34(89.5%), amikacin (16.0%), nitrofurantoin (17.4%), meropenem (20.0%) and imipenem (20.0%). Out of 79 bacterial pathogens, 52(65.8%) were multiple antibiotic resistant of which 37(71.0%) were Gram-negative bacteria and 15(29%%) were Gram-positive bacteria. About 13(86.7%) isolates of Acinetobacter, all isolates of Klebsiella species (100%) and E. coli (100%) were multiple antibiotic-resistant. Out Of 18,10(55.56%), isolates of Enterococcus were multiple antibiotic-resistant. CONCLUSIONS: A very high prevalence of bacteriuria/ candiduria was demonstrated in this study. This warrants the establishment of multidimensional infection control approach on catheter associated urinary tract infection in ICU. In addition to high prevalence of candiduria, recovery of non-albicans candida species almost in equal proportion with candida albicans in the present study was an important finding as non-albicans candida species distinct to C. albicans are intrinsically resistant to the commonly used azole antifungal drugs in Ethiopia. The prevalence of rate MDR bacteria in our ICU particularly of E. coli, Klebsiella spp, Pseudomonas and Acetobacter spp was very high. In order to combat this problem, proper antibiotic policies should be formulated.


Assuntos
Bacteriúria , Candidíase , Infecção Hospitalar , Infecções Urinárias , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias , Bacteriúria/microbiologia , Candidíase/complicações , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Cateteres/efeitos adversos , Infecção Hospitalar/complicações , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Escherichia coli , Etiópia/epidemiologia , Feminino , Bactérias Gram-Negativas , Humanos , Unidades de Terapia Intensiva , Masculino , Testes de Sensibilidade Microbiana , Centros de Atenção Terciária , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia
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