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1.
BMJ Case Rep ; 12(4)2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992283

RESUMO

Portal pyaemia or pylephlebitis is a form of septic (often suppurative) thrombophlebitis of the portal venous system. It may develop as a complication of intra-abdominal sepsis, such as diverticulitis or appendicitis. Patients typically present with a high fever that is sometimes accompanied by jaundice. We report a case of portal pyaemia associated with multiple liver abscesses and discuss the medical and surgical management of this condition.


Assuntos
Doenças do Colo/complicações , Perfuração Intestinal/complicações , Abscesso Hepático/etiologia , Flebite/etiologia , Sepse/etiologia , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Doenças do Colo/diagnóstico por imagem , Doenças do Colo/cirurgia , Humanos , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/cirurgia , Masculino , Veias Mesentéricas/diagnóstico por imagem , Pessoa de Meia-Idade , Flebite/tratamento farmacológico , Sepse/tratamento farmacológico , Tomografia Computadorizada por Raios X
2.
Complement Ther Clin Pract ; 35: 78-85, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31003690

RESUMO

BACKGROUND AND PURPOSE: Chemotherapy-induced phlebitis (CIP) is one of the most important and common complications in patients with cancer. Currently, the use of complementary methods to prevent or alleviate phlebitis symptoms has attracted great attention. In this study, we aimed to assess the effects of topical sesame oil in reducing the pain severity of CIP. MATERIALS AND METHODS: This randomized clinical trial was conducted on 60 patients with colorectal cancer afflicted with CIP. Patients received, twice a day for seven consecutive days, a 5-min massage solely (as the control group) or with 10 drops of sesame oil (as the experimental group) within the 10 cm radius of the affected site. The pain severity was evaluated by the visual analog scale on the first, third, fifth, and seventh days of the intervention. RESULTS: Mean changes of the pain severity compared to the baseline were significant on the third (P = 0.009), fifth (P < 0.001), and seventh (P < 0.001) days of the intervention in favor of the experimental group. Also, a significant reduction in the pain severity both in the experimental and control groups was observed during the seven days (F = 720.66, Ptime < 0.001); however, the decrease was more significant in the experimental group (F = 21.46, Pgroup < 0.001). CONCLUSION: Application of massage with sesame oil as a complementary method is effective in reducing the pain severity of patients with CIP.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias Colorretais/tratamento farmacológico , Massagem/métodos , Dor/tratamento farmacológico , Flebite/tratamento farmacológico , Óleo de Gergelim/uso terapêutico , Sesamum/química , Administração Tópica , Adulto , Idoso , Antineoplásicos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Flebite/etiologia , Extratos Vegetais/uso terapêutico , Óleo de Gergelim/farmacologia , Índice de Gravidade de Doença
3.
Ann Vasc Surg ; 55: 239-245, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30217712

RESUMO

BACKGROUND: Cyanoacrylate closure for the treatment of incompetent saphenous veins does not cause thermal damage and demonstrates satisfactory outcomes with rapid recovery. However, the characteristics of phlebitis-like abnormal reaction (PLAR), the most common adverse event after cyanoacrylate closure, have not been clarified. Moreover, it differs from typical phlebitis after thermal ablation. The objective of our study is to investigate the clinical features of PLAR after cyanoacrylate closure and to report its management. METHODS: A total of 160 patients with 271 incompetent saphenous veins (great saphenous veins, 201; small saphenous veins, 70) underwent cyanoacrylate closure with the VenaSeal™ system. We defined PLAR as any unusual skin condition that develops suddenly, such as erythema, itching, swelling, and pain/tenderness, over the treated veins several days after cyanoacrylate closure. Oral antihistamines and intravenous dexamethasone were administered to manage PLAR. RESULTS: Of the 271 treated veins, 69 experienced PLAR (25.4%). The mean time of occurrence was 13.6 ± 4.6 days after treatment. The rate of occurrence of erythema, itching, swelling, and pain/tenderness were 92.2%, 91.2%, 66.2%, and 48.5%, respectively. The occurrence of PLAR was significantly higher for great saphenous veins than for small saphenous veins (P < 0.001). Occurrences were more frequent in cases with a suprafascial great saphenous vein of length >10 cm than in cases with a subfascial great saphenous vein (P = 0.001). The proportion of patients who reported swelling decreased by more than half after the administration of oral antihistamine. The pain score on the 10th day also decreased significantly after the administration of antihistamine (P = 0.006). CONCLUSIONS: PLAR must be distinguished from classic phlebitis. We believe that PLAR is a type IV hypersensitivity reaction due to a foreign body, and in our experience, antihistamines or steroids are effective for the prevention and management of PLAR.


Assuntos
Cianoacrilatos/efeitos adversos , Reação a Corpo Estranho/induzido quimicamente , Hipersensibilidade Tardia/induzido quimicamente , Flebite/induzido quimicamente , Veia Safena , Adesivos Teciduais/efeitos adversos , Insuficiência Venosa/terapia , Administração Intravenosa , Administração Oral , Adulto , Idoso , Dexametasona/administração & dosagem , Feminino , Reação a Corpo Estranho/diagnóstico por imagem , Reação a Corpo Estranho/tratamento farmacológico , Reação a Corpo Estranho/fisiopatologia , Glucocorticoides/administração & dosagem , Antagonistas dos Receptores Histamínicos/administração & dosagem , Humanos , Hipersensibilidade Tardia/diagnóstico por imagem , Hipersensibilidade Tardia/tratamento farmacológico , Hipersensibilidade Tardia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Flebite/diagnóstico por imagem , Flebite/tratamento farmacológico , Flebite/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/fisiopatologia , Adulto Jovem
4.
Arch. Soc. Esp. Oftalmol ; 93(7): 354-356, jul. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-174914

RESUMO

Caso clínico: Varón de 27 años con pérdida visual brusca del OD. Como antecedentes personales había sido gran fumador y presentaba una isquemia crónica del miembro inferior izquierdo desde hacía un año. Por ello estaba diagnosticado de enfermedad de Buerger, que es un trastorno trombótico inflamatorio que afecta a los vasos de pequeño y mediano calibre. La agudeza visual (AV) del OD era de 0,9 y en la funduscopia se observaba una papila muy congestiva, tortuosidad venosa, hemorragias retinianas dispersas, pero sin edema macular. La evolución espontánea fue favorable con la completa recuperación de la AV. Discusión: La papiloflebitis puede ser una complicación ocular de la enfermedad de Buerger


Clinical case: A 27-year-old male with sudden visual loss of OD. He had a past history of heavy smoking, as well as a chronic ischaemia of his left lower limb of one-year onset. This led to a diagnosis of Buerger's disease, which is an inflammatory thrombotic disorder that affects small and medium vessels. The visual acuity (VA) of OD was 0.9, and in the funduscopy a very congestive papilla was observed, along with venous tortuosity, scattered retinal haemorrhages, but without macular oedema. He progressed favourably, with a complete recovery of VA. Discussion: Papillophlebitis may be an ocular complication of Buerger's disease


Assuntos
Humanos , Masculino , Adulto , Flebite/diagnóstico , Vasculite Retiniana , Trombose Venosa/diagnóstico , Veia Retiniana , Tromboangiite Obliterante/diagnóstico por imagem , Oclusão da Veia Retiniana/diagnóstico por imagem , Tromboangiite Obliterante , Acuidade Visual , Flebite/tratamento farmacológico , Tromboangiite Obliterante/complicações , Hemorragia Retiniana/complicações , Hemorragia Retiniana/diagnóstico por imagem , Olho/diagnóstico por imagem , Olho/patologia , Poluição por Fumaça de Tabaco/efeitos adversos , Tabagismo/complicações
5.
Mult Scler Relat Disord ; 17: 217-219, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29055460

RESUMO

Visual symptoms are a common clinical manifestation of multiple sclerosis (MS) and are frequently due to acute optic neuritis (ON). However, the entire visual pathway can be involved throughout the disease course. We describe the case of a young MS patient who experienced visual symptoms that were eventually found to be caused by retinal periphlebitis, an inflammatory process of the anterior visual pathway, which is common during MS, but rarely symptomatic. This case reinforces the concept that in all MS patients complaining visual symptoms, a complete work-up should be performed in order to rule out possible ON mimicries.


Assuntos
Esclerose Múltipla Recidivante-Remitente/fisiopatologia , Flebite/fisiopatologia , Transtornos da Visão/fisiopatologia , Adulto , Olho/diagnóstico por imagem , Olho/efeitos dos fármacos , Feminino , Humanos , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Flebite/diagnóstico , Flebite/tratamento farmacológico , Transtornos da Visão/diagnóstico , Transtornos da Visão/tratamento farmacológico , Vias Visuais/efeitos dos fármacos , Vias Visuais/fisiopatologia
7.
Rev Gaucha Enferm ; 38(2): e58793, 2017 Jun 29.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28678899

RESUMO

Objective: to determine the incidence of phlebitis during and after the use of peripheral intravenous catheter (PIC), and analyse the association of this complication with risk factors. Methods: cohort study with 165 adult patients admitted to a university hospital in Porto Alegre, totalling 447 accesses, from December 2014 to February 2015. Data were collected on a daily basis and analysed by means of descriptive and analytical statistics. Results: The incidence of phlebitis during PIC was 7.15% and the incidence of post-infusion phlebitis was 22.9%. Phlebitis during catheter use was associated with the use of Amoxicillin + Clavulanic Acid. The grade of post-infusion phlebitis was associated with age and use of Amoxicillin + Clavulanic Acid, Tramadol Hydrochloride, and Amphotericin. Conclusion: The incidence of post-infusion phlebitis proved to be an important indicator to analyse the quality of the healthcare setting.


Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Infecção Hospitalar/epidemiologia , Pacientes Internados/estatística & dados numéricos , Flebite/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Anfotericina B/uso terapêutico , Antibacterianos/uso terapêutico , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecções Relacionadas a Cateter/etiologia , Cateterismo Periférico/efeitos adversos , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/etiologia , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Incidência , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Flebite/tratamento farmacológico , Flebite/etiologia , Tramadol/uso terapêutico , Adulto Jovem
8.
Toxicol Appl Pharmacol ; 318: 23-32, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28126410

RESUMO

Chemotherapy is one of the major strategies for cancer treatment. Several antineoplastic drugs including vinorelbine (VRB) are commonly intravenously infused and liable to cause serious phlebitis. The therapeutic drugs for preventing this complication are limited. In this study, the mechanism of baicalein (BCN) was investigated on VRB-induced phlebitis in vivo and vascular endothelial cell injury in vitro. Treatment with BCN obviously attenuated vascular endothelial cell loss, edema, inflammatory cell infiltration and blood clots, and reduced the serum levels of TNF-α, IL-1ß, IL-6 and ICAM-1 in the rabbit model of phlebitis induced by intravenous injection of VRB compared with vehicle. Further tests in vitro demonstrated that BCN lessened VRB-induced endothelial cell apoptosis, decreased intracellular ROS levels, suppressed phosphorylation of p38 and eventually inhibited activation of NF-κB signaling pathway. And these effects could be reversed by p38 agonist P79350. These results suggested that BCN exerted the protective effects against VRB-induced endothelial disruption in the rabbit model of phlebitis via inhibition of intracellular ROS generation and inactivation of p38/NF-κB pathway, leading to the decreased production of pro-inflammatory cytokines. Thus, BCN could be used as a potential agent for the treatment of phlebitis.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Antioxidantes/uso terapêutico , Células Endoteliais/efeitos dos fármacos , Flavanonas/uso terapêutico , Flebite/tratamento farmacológico , Vimblastina/análogos & derivados , Animais , Antioxidantes/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , Relação Dose-Resposta a Droga , Células Endoteliais/metabolismo , Flavanonas/farmacologia , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Mediadores da Inflamação/antagonistas & inibidores , Mediadores da Inflamação/metabolismo , Masculino , Flebite/metabolismo , Coelhos , Distribuição Aleatória , Espécies Reativas de Oxigênio/antagonistas & inibidores , Espécies Reativas de Oxigênio/metabolismo , Vimblastina/toxicidade , Vinorelbina
9.
Arch Soc Esp Oftalmol ; 92(6): 291-294, 2017 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27773491

RESUMO

CLINICAL CASE: An 8 year-old boy with no known diseases, with sudden loss of visual acuity (VA) in the left eye (LE). EXAMINATION: VA 1 in right eye, and 0.1 in LE, discrete left relative afferent pupil defect (RAPD). Normal biomicroscopy. Funduscopy: congestive papilla, venous tortuosity, peripapillary haemorrhages with macular oedema in LE. The systemic study only revealed A C46Tpolymorphism in the F12 coagulation gene. He had a VA of 1 and normal funduscopy 8 months later. DISCUSSION: Papillophlebitis is an inflammatory and non-ischaemic central retinal vein occlusion, ophthalmoscopically similar to central retinal vein thrombosis. The systemic study is essential to rule out underlying diseases.


Assuntos
Fator XII/genética , Mutação de Sentido Incorreto , Disco Óptico/irrigação sanguínea , Flebite/diagnóstico , Mutação Puntual , Vasculite Retiniana/genética , Veia Retiniana , Trombose Venosa/diagnóstico , Anticoagulantes/uso terapêutico , Cegueira/etiologia , Criança , Diagnóstico Diferencial , Deficiência do Fator XII , Heterozigoto , Humanos , Masculino , Flebite/tratamento farmacológico , Flebite/genética , Vasculite Retiniana/tratamento farmacológico
10.
J Med Case Rep ; 10(1): 362, 2016 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-27998301

RESUMO

BACKGROUND: Meningococcal infection is a multifaceted disease including acute polyarthritis. This presentation should be known by clinicians in order to prevent delay in treatment. We report what we believe to be the first case of an association of parvovirus B19 and meningococcal polyarthritis in a young adult. CASE PRESENTATION: A 19-year-old Caucasian woman presented to our hospital with fever, intense leg pain, and a transient rash. A physical examination showed asymmetric polyarthritis and no neurological abnormalities. A parvovirus B19 polymerase chain reaction performed using a blood sample and knee fluid aspirate came back positive, but serology was negative for immunoglobulin M and positive for immunoglobulin G. A blood culture was positive for serotype C meningococcus; a polymerase chain reaction performed for Neisseria meningitidis was positive in joint fluid but negative in blood samples (performed after antibiotic treatment had begun). Our patient was treated with ceftriaxone for 15 days, associated with analgesic therapy. Hydroxychloroquine treatment was introduced 5 months after the onset of polyarthritis because of persisting inflammatory arthralgia. CONCLUSIONS: To the best of our knowledge, this is the first case report of polyarthritis caused by concomitant meningococcal and parvovirus B19 infections. This unusual presentation of meningococcal disease may have resulted from the persistent parvovirus B19 infection. Our experience with this case illustrates the need for a systematic approach to the diagnosis of febrile acute polyarthritis. Only long-term follow-up will reveal if this infectious polyarthritis will evolve towards an autoimmune rheumatism.


Assuntos
Artrite/etiologia , Infecções Meningocócicas/complicações , Infecções por Parvoviridae/complicações , Analgesia/métodos , Antibacterianos/uso terapêutico , Anticorpos Antivirais , Artrite/tratamento farmacológico , Artrite/imunologia , Artrite/fisiopatologia , Ceftriaxona/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Infecções Meningocócicas/tratamento farmacológico , Infecções Meningocócicas/imunologia , Infecções Meningocócicas/fisiopatologia , Dor , Medição da Dor , Infecções por Parvoviridae/tratamento farmacológico , Infecções por Parvoviridae/imunologia , Infecções por Parvoviridae/fisiopatologia , Parvovirus B19 Humano/isolamento & purificação , Flebite/diagnóstico , Flebite/tratamento farmacológico , Flebite/imunologia , Reação em Cadeia da Polimerase , Resultado do Tratamento , Adulto Jovem
11.
Acta Cir Bras ; 31(8): 549-56, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27579883

RESUMO

PURPOSE: To develop a chemotherapeutics induced phlebitis and explore the effects of Xianchen on the phlebitis treatment. METHODS: Forty-eight rabbits were divided into two series. Phlebitis model induced by vincristine was established at each series. The first series had 24 rabbits, which were divided into four groups (6 hours, 12 hours, 18 hours, 24 hours) after vincristine infusion. The grades of phlebitis through visual observation and histopathological examination were observed. The second series had also 24 rabbits. Interventions were performed 12 hours after vincristine infusion. These rabbits were randomly divided into four groups, according to treatment: Hirudoid (bid), Xianchen (daily), Xianchen (tid), Xianchen (five times a day). Four days after intervention, the venous injury through visual observation and histopathological examination were evaluated. RESULTS: Series 1: Phlebitis appeared 12 hours after infusion of vincristine through visual observation. There was a significant difference (p<0.05) between 6 hours and 24 hours, 6 hours and 18 hours through visual observation. However, the inflammation happened 6 hours after infusion, the loss of venous endothelial cells demonstrated differences among four groups through histopathological evaluation (p<0.05). There were significant differences (p<0.05) after 4 days among the intervention groups through visual observation, the effects of Xianchen group (five times a day) were better than Xianchen group (tid) (p<0.01). The treatment of edema demonstrated differences among groups through histopathological evaluation (p<0.05), Xianchen (five times a day) better relieved the degree of edema (p<0.05). CONCLUSIONS: The study showed that inflammatory reaction of phlebitis appeared early. Xianchen can treat vincristine induced phlebitis, as well as Hirudoid. It is particularly effective in the treatment of edema, and there is a remarkable dose-response relationship.


Assuntos
Anti-Inflamatórios/administração & dosagem , Medicamentos de Ervas Chinesas/administração & dosagem , Edema/tratamento farmacológico , Flebite/tratamento farmacológico , Fitoterapia/métodos , Extratos Vegetais/administração & dosagem , Animais , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Infusões Intravenosas , Medicina Tradicional Chinesa/métodos , Flebite/induzido quimicamente , Flebite/prevenção & controle , Coelhos , Vincristina
12.
Acta cir. bras ; 31(8): 549-556, Aug. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-792409

RESUMO

ABSTRACT PURPOSE: To develop a chemotherapeutics induced phlebitis and explore the effects of Xianchen on the phlebitis treatment. METHODS: Forty-eight rabbits were divided into two series. Phlebitis model induced by vincristine was established at each series. The first series had 24 rabbits, which were divided into four groups (6 hours, 12 hours, 18 hours, 24 hours) after vincristine infusion. The grades of phlebitis through visual observation and histopathological examination were observed. The second series had also 24 rabbits. Interventions were performed 12 hours after vincristine infusion. These rabbits were randomly divided into four groups, according to treatment: Hirudoid (bid), Xianchen (daily), Xianchen (tid), Xianchen (five times a day). Four days after intervention, the venous injury through visual observation and histopathological examination were evaluated. RESULTS: Series 1: Phlebitis appeared 12 hours after infusion of vincristine through visual observation. There was a significant difference (p<0.05) between 6 hours and 24 hours, 6 hours and 18 hours through visual observation. However, the inflammation happened 6 hours after infusion, the loss of venous endothelial cells demonstrated differences among four groups through histopathological evaluation (p<0.05). There were significant differences (p<0.05) after 4 days among the intervention groups through visual observation, the effects of Xianchen group (five times a day) were better than Xianchen group (tid) (p<0.01). The treatment of edema demonstrated differences among groups through histopathological evaluation (p<0.05), Xianchen (five times a day) better relieved the degree of edema (p<0.05). CONCLUSIONS: The study showed that inflammatory reaction of phlebitis appeared early. Xianchen can treat vincristine induced phlebitis, as well as Hirudoid. It is particularly effective in the treatment of edema, and there is a remarkable dose-response relationship.


Assuntos
Animais , Coelhos , Flebite/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Extratos Vegetais/administração & dosagem , Edema/tratamento farmacológico , Fitoterapia/métodos , Anti-Inflamatórios/administração & dosagem , Flebite/induzido quimicamente , Flebite/prevenção & controle , Vincristina , Infusões Intravenosas , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Medicina Tradicional Chinesa/métodos
13.
Medwave ; 15(8): e6258, 2015 Sep 08.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26485344

RESUMO

We present the case of a 50-year-old man who comes to the emergency department of Dos de Mayo Hospital, Lima, Peru, with fever, abdominal pain, diarrhea and jaundice. An intestinal infection arises as initial diagnosis. He is referred to the area of Internal Medicine where various laboratory tests and imaging studies were conducted, including an abdominal computerized tomography scan. The scan confirmed the diagnosis of pylephlebitis; treatment with antibiotics and anticoagulant therapy was immediately established. Response and evolution were favorable.


Assuntos
Dor Abdominal/etiologia , Febre/etiologia , Flebite/diagnóstico , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Flebite/tratamento farmacológico , Flebite/patologia , Veia Porta/patologia , Tomografia Computadorizada por Raios X
15.
Ned Tijdschr Geneeskd ; 158: A7763, 2014.
Artigo em Holandês | MEDLINE | ID: mdl-25248733

RESUMO

BACKGROUND: Pylephlebitis is a septic thrombophlebitis of the portal vein due to an intra-abdominal infection in the drainage area of this vein. CASE DESCRIPTION: We describe the case of a 77-year-old woman who presented at the emergency department with fever, cold chills and a two-month history of right upper quadrant abdominal pain. She was diagnosed with pylephlebitis without a clear infection site. Treatment consisted of antibiotics and anticoagulation. Two months after discharge she was again referred to the emergency department, this time with rectal blood loss. On endoscopy a cocktail stick was seen to be stuck in a diverticulum, 14 cm from the anus. The cocktail stick was endoscopically removed. In hindsight, the cocktail stick had been visible in the proximal colon on a previous abdominal CT scan. The pylephlebitis was probably due to a covered perforation of the caecum caused by the ingested cocktail stick which had then migrated to the distal colon. CONCLUSION: This case illustrates the importance of discovering the aetiology of pylephlebitis to avoid possible complications.


Assuntos
Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Flebite/etiologia , Veia Porta , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Idoso , Antibacterianos/uso terapêutico , Feminino , Humanos , Flebite/diagnóstico , Flebite/tratamento farmacológico
16.
Cancer Chemother Pharmacol ; 74(2): 239-47, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24879290

RESUMO

PURPOSE: We investigated E-selectin expression in mice and rabbits with vinorelbine-induced phlebitis and the effect of cimetidine. To find the relationship between E-selectin expression and vinorelbine-induced phlebitis. METHODS: Mouse and rabbit model of vinorelbine-induced phlebitis was established by intravenous infusion of vinorelbine. Pathological observation, molecular-biological determination of E-selectin and protein function of it was evaluated. RESULTS: Grossly, we observed swelling, edema and cord-like vessel changes in mice receiving vinorelbine but only mild edema in mice pretreated with cimetidine. Pathological scoring yielded a total score of 37 for vinorelbine-treated mice and 17 for mice pretreated with cimetidine (P < 0.05). ELISA revealed that rabbits treated with vinorelbine had markedly higher serum contents of E-selectin than normal saline (NS) controls (vinorelbine 1.534 ± 0.449 vs. NS 0.746 ± 0.170 ng/mL, P < 0.05), which was markedly attenuated by cimetidine (cimetidine 0.717 ± 0.468 vs. vinorelbine 1.534 ± 0.449 ng/mL, P < 0.05). Rose Bengal staining assays showed that vinorelbine markedly increased the adhesion rate of neutrophils for endothelial cells (vinorelbine 38.70 ± 8.34% vs. controls 8.93 ± 4.85%, P < 0.01), which, however, was significantly suppressed by cimetidine (9.93 ± 5.91%, P < 0.01 vs. vinorelbine). In E-selectin knockout mice, we found no apparent difference in tail swelling in mice receiving vinorelbine or cimetidine and vinorelbine. CONCLUSIONS: In conclusion, cimetidine attenuates vinorelbine-induced phlebitis in mice probably by suppressing increased expression of E-selectin.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Cimetidina/uso terapêutico , Selectina E/fisiologia , Antagonistas dos Receptores Histamínicos H2/uso terapêutico , Flebite/tratamento farmacológico , Vimblastina/análogos & derivados , Animais , Western Blotting , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Citometria de Fluxo , Humanos , Infusões Intravenosas , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Flebite/induzido quimicamente , Flebite/metabolismo , RNA Mensageiro/genética , Coelhos , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Vimblastina/toxicidade , Vinorelbina
17.
Cochrane Database Syst Rev ; (6): CD009162, 2014 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-24895299

RESUMO

BACKGROUND: Up to 80% of hospitalised patients receive intravenous therapy at some point during their admission. About 20% to 70% of patients receiving intravenous therapy develop phlebitis. Infusion phlebitis has become one of the most common complications in patients with intravenous therapy. However, the effects of routine treatments such as external application of 75% alcohol or 50% to 75% magnesium sulphate (MgSO4) are unsatisfactory. Therefore, there is an urgent need to develop new methods to prevent and alleviate infusion phlebitis. OBJECTIVES: To systematically assess the effects of external application of Aloe vera for the prevention and treatment of infusion phlebitis associated with the presence of an intravenous access device. SEARCH METHODS: The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched February 2014) and CENTRAL (2014, Issue 1). In addition the TSC searched MEDLINE to week 5 January 2014, EMBASE to Week 6 2014 and AMED to February 2014. The authors searched the following Chinese databases until 28 February 2014: Chinese BioMedical Database; Traditional Chinese Medical Database System; China National Knowledge Infrastructure; Chinese VIP information; Chinese Medical Current Contents; Chinese Academic Conference Papers Database and Chinese Dissertation Database; and China Medical Academic Conference. Bibliographies of retrieved and relevant publications were searched. There were no restrictions on the basis of date or language of publication. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-randomised controlled trials (qRCTs) were included if they involved participants receiving topical Aloe vera or Aloe vera-derived products at the site of punctured skin, with or without routine treatment at the same site. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data on the study characteristics, description of methodology and outcomes of the eligible trials, and assessed study quality. Data were analysed using RevMan 5.1. For dichotomous outcomes, the effects were estimated by using risk ratio (RR) with its 95% confidence interval (CI). For continuous outcomes, mean differences (MD) with 95% CIs were used to estimate their effects. MAIN RESULTS: A total of 43 trials (35 RCTs and eight qRCTs) with 7465 participants were identified. Twenty-two trials with 5546 participants were involved in prevention of Aloe vera for phlebitis, and a further 21 trials with 1919 participants were involved in the treatment of phlebitis. The included studies compared external application of Aloe vera alone or plus non-Aloe vera interventions with no treatment or the same non-Aloe vera interventions. The duration of the intervention lasted from one day to 15 days. Most of the included studies were of low methodological quality with concerns for selection bias, attrition bias, reporting bias and publication bias.The effects of external application of fresh Aloe vera on preventing total incidence of phlebitis varied across the studies and we did not combine the data. Aloe vera reduced the occurrence of third degree phlebitis (RR 0.06, 95% CI 0.03 to 0.11, P < 0.00001) and second degree phlebitis (RR 0.18, 95% CI 0.10 to 0.31, P < 0.00001) compared with no treatment. Compared with external application of 75% alcohol, or 33% MgSO4 alone, Aloe vera reduced the total incidence of phlebitis (RR 0.02, 95% CI 0.00 to 0.28, P = 0.004 and RR 0.43, 95% CI 0.24 to 0.78, P = 0.005 respectively) but there was no clear evidence of an effect when compared with 50% or 75% MgSO4 (total incidence of phlebitis RR 0.41, 95% CI 0.16 to 1.07, P = 0.07 and RR 1.10 95% CI 0.54 to 2.25, P = 0.79 respectively; third degree phlebitis (RR 0.28, 95% CI 0.07 to 1.02, P = 0.051 and RR 1.19, 95% CI 0.08 to 18.73, P = 0.9 respectively; second degree phlebitis RR 0.68, 95% CI 0.21 to 2.23, P = 0.53 compared to 75% MgSO4) except for a reduction in second degree phlebitis when Aloe vera was compared with 50% MgSO4 (RR 0.26, 95% CI 0.14 to 0.50, P < 0.0001).For the treatment of phlebitis, Aloe vera was more effective than 33% or 50% MgSO4 in terms of both any improvement (RR 1.16, 95% CI 1.09 to 1.24, P < 0.0001 and RR 1.22, 95% CI 1.16 to 1.28, P < 0.0001 respectively) and marked improvement of phlebitis (RR 1.97, 95% CI 1.44 to 2.70, P < 0.001 and RR 1.56, 95% CI 1.29 to 1.87, P = 0.0002 respectively). Compared with 50% MgSO4, Aloe vera also improved recovery rates from phlebitis (RR 1.42, 95% CI 1.24 to 1.61, P < 0.0001). Compared with routine treatments such as external application of hirudoid, sulphonic acid mucopolysaccharide and dexamethasone used alone, addition of Aloe vera improved recovery from phlebitis (RR 1.75, 95% CI 1.24 to 2.46, P = 0.001) and had a positive effect on overall improvement (marked improvement RR 1.26, 95% CI 1.09 to 1.47, P = 0.0003; any improvement RR 1.23, 95% CI 1.13 to 1.35, P < 0.0001). Aloe vera, either alone or in combination with routine treatment, was more effective than routine treatment alone for improving the symptoms of phlebitis including shortening the time of elimination of red swelling symptoms, time of pain relief at the location of the infusion vein and time of resolution of phlebitis. Other secondary outcomes including health-related quality of life and adverse effects were not reported in the included studies. AUTHORS' CONCLUSIONS: There is no strong evidence for preventing or treating infusion phlebitis with external application of Aloe vera. The current available evidence is limited by the poor methodological quality and risk of selective outcome reporting of the included studies, and by variation in the size of effect across the studies. The positive effects observed with external application of Aloe vera in preventing or treating infusion phlebitis compared with no intervention or external application of 33% or 50% MgSO4 should therefore be viewed with caution.


Assuntos
Aloe , Flebite/tratamento farmacológico , Flebite/prevenção & controle , Fitoterapia/métodos , Administração Tópica , Cateteres Venosos Centrais/efeitos adversos , Humanos , Infusões Intravenosas/efeitos adversos , Flebite/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Eur Rev Med Pharmacol Sci ; 18(9): 1419-21, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24867523

RESUMO

BACKGROUND: A small amount of data is already presented in the relevant literature related to the medical facts of scorpionism caused by Yellow scorpion (Mesobuthus gibbosus: M. gibbosus). Undoubtedly, it is considered as dangerous to human health. This paper presents an unusual case of scorpionism after the sting in vein. CASE REPORT: A 25 year old male was bitten by M. gibbosus. He experienced extremely severe intermittent pain in the right feet, followed by pulsating and glowing sensations, cold sweat and paleness. 15 minutes after the sting, the pain started to spread through the medial side of the leg, up to the inguinal region. Patient became excited, and experienced occasional spasms of leg muscles. A month after, the bitten vein of dorsal arch of the foot and v. sephena magna became non-uniformly tortuously spread through the entire length. On physical examination four years after the sting, the enlargement of the veins still exists, periodical tingling, and occasional muscle twitches during the night. CONCLUSIONS: M. gibbosus is endemic in Mediterranean area and represents a real hazard for local inhabitants and tourists. The medical treatment of this type of scorpionism is exclusively symptomatic.


Assuntos
Pé/irrigação sanguínea , Flebite/etiologia , Picadas de Escorpião/complicações , Escorpiões , Adulto , Animais , Doença Crônica , Humanos , Masculino , Dor/etiologia , Flebite/diagnóstico , Flebite/tratamento farmacológico , Picadas de Escorpião/diagnóstico , Picadas de Escorpião/tratamento farmacológico , Espasmo/etiologia , Sudorese , Fatores de Tempo , Veias/patologia
19.
JPEN J Parenter Enteral Nutr ; 38(5): 595-601, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23715775

RESUMO

BACKGROUND: Peripherally inserted central catheters (PICCs) are routinely used in women with hyperemesis gravidarum. However, little is known about the consequences of PICC insertion in these patients. Our aim was to analyze PICC-related complication rates among pregnant women. MATERIALS AND METHODS: Pregnant women with PICC insertion between January 2000 and June 2006 were studied retrospectively. Infusate type, comorbid conditions, and PICC duration were characterized. Major complications, defined as need for surgical intervention, bacteremia requiring intravenous antibiotics, or thromboembolic events, were identified. Minor complications, including phlebitis, PICC malfunction, early PICC removal, infection requiring oral antibiotics, or hospitalization for PICC evaluation, were also studied. RESULTS: Eighty-four catheters in 66 women were eligible for study, totaling 2544 PICC days. Catheters remained in place for 1-177 days; median duration was 21.0 days. PICCs were used for intravenous fluid (IVF, 59.4%), parenteral nutrition (PN, 34.5%), and antibiotics (6%). The overall complication rate was 18.5 per 1000 PICC days (55.9% of PICCs); 22.6% were major, with bacteremia being most frequent (20.2%). A diagnosis of diabetes was the only factor that significantly predicted complications (hazard ratio, 2.71; 95% confidence interval, 1.13-6.13). PICC duration and type of infusate (PN vs IVF alone) were not associated with complications. CONCLUSIONS: PICC insertion in pregnant women is associated with a high complication rate, which appears to be independent of the type of infusate and occurs in the majority of women. PICCs should be used judiciously and only when clearly necessary during pregnancy. Further studies are needed to determine how to reduce PICC-related complications in this population.


Assuntos
Infecções Relacionadas a Cateter/epidemiologia , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Complicações na Gravidez/terapia , Tromboembolia Venosa/epidemiologia , Adulto , Antibacterianos/uso terapêutico , Infecções Relacionadas a Cateter/diagnóstico , Infecções Relacionadas a Cateter/etiologia , Feminino , Humanos , Incidência , Nutrição Parenteral Total/efeitos adversos , Flebite/tratamento farmacológico , Flebite/epidemiologia , Flebite/etiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Tromboembolia Venosa/etiologia
20.
Anal Quant Cytopathol Histpathol ; 35(4): 189-96, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24341121

RESUMO

IgG4-related sclerosing disease, a multiorgan system disease that has been identified in the last 10 years, is a fibroinflammatory condition with a marked propensity to manifest itself as mass forming lesions characterized by three main histological features (sclerosis, obliterative phlebitis and lymphoplasmacytic infiltrate) and by the presence of abundant IgG4+ plasma cells, frequent elevation of serum IgG4 and a dramatic initial response to steroid therapy. The aim of this mini-review is to increase the capacity to identify the characteristic features of IgG4-related sclerosing disease in specific organs and in two newly proposed entities (urethral caruncle and paratesticular fibrous pseudotumor) using biopsy specimens and methods of counting IgG4. In addition we examine the relationship between IgG4-related sclerosing disease and malignancy. In fact, an increased ability to recognize the characteristic features of IgG4-related sclerosing disease would play an extremely important role in avoiding unnecessary surgery in favor of initiating corticosteroid therapy.


Assuntos
Glucocorticoides/uso terapêutico , Granuloma de Células Plasmáticas , Imunoglobulina G/imunologia , Neoplasias , Flebite , Diagnóstico Diferencial , Erros de Diagnóstico , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/tratamento farmacológico , Granuloma de Células Plasmáticas/imunologia , Humanos , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Flebite/diagnóstico , Flebite/tratamento farmacológico , Flebite/imunologia , Esclerose/diagnóstico , Esclerose/tratamento farmacológico , Esclerose/imunologia
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