Thrombosis after umbilical venous catheterisation: prospective study with serial ultrasound

2019 ◽  
Vol 105 (3) ◽  
pp. 299-303 ◽  
Author(s):  
Gerdina H Dubbink-Verheij ◽  
Remco Visser ◽  
Arno A Roest ◽  
Cornelia Heleen van Ommen ◽  
Arjan B te Pas ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Thrombus Formation ◽  
Expectant Management ◽  
Ductus Venosus ◽  
Control Group ◽  
Umbilical Catheters ◽  
The Right ◽  
Lost To Follow Up ◽  
Umbilical Catheterisation

BackgroundUmbilical venous catheters (UVCs) are associated with thrombus formation. Most studies on thrombosis in infants with UVCs focus on only one part of the route, and none assessed a control group of infants without UVCs.ObjectiveTo determine the incidence and location of thrombi in infants after umbilical catheterisation and compare this with a control group of infants without umbilical catheters.DesignProspective observational study with serial ultrasonography of the UVC route from the umbilico-portal confluence to the heart. Ultrasonography was performed until day 14 after catheterisation in cases and day 14 after birth in controls.ResultsThrombi in the UVC route were detected in 75% (30/40) of infants with UVCs in the study group, whereas no thrombi were detected in the control group of infants without UVCs (0/20) (p<0.001). Six thrombi (20%) were located in the right atrium. Most of these were also partly present in the ductus venosus. Six thrombi (20%) were located in the ductus venosus only, and in 12 infants (40%), the thrombus was at least partly located in the umbilico-portal confluence. Thrombi persisted after UVC removal in 25/30 cases. Two infants with thrombotic events were treated with low-molecular-weight heparin and resolution was found. In the other 23 infants managed expectantly, 2 died due to necrotising enterocolitis, 1 was lost to follow-up and in 20 spontaneous regression was seen.ConclusionsThrombotic events occur frequently in infants after umbilical catheterisation. Most thrombi were asymptomatic and regressed spontaneously with expectant management. Routine screening for thrombi in UVCs is therefore not advised.

scholarly journals A New Coated Nitinol Occluder for Transcatheter Closure of Ventricular Septal Defects in a Canine Model

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Yong Zhou ◽  
Feng Chen ◽  
Xinmiao Huang ◽  
Xianxian Zhao ◽  
Hong Wu ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Thrombus Formation ◽  
Canine Model ◽  
Control Group ◽  
New Type ◽  
Good Biocompatibility ◽  
The Right ◽  
Microscopy Examination

Aims. This study evaluated feasibility and safety of implanting the polyester-coated nitinol ventricular septal defect occluder (pcVSDO) in the canine model.Methods and Results. VSD models were successfully established by transseptal ventricular septal puncture via the right jugular vein in 15 out of 18 canines. Two types of VSDOs were implanted, either with pcVSDOs (n=8) as the new type occluder group or with the commercial ventricular septal defect occluders (VSDOs,n=7, Shanghai Sharp Memory Alloy Co. Ltd.) as the control group. Sheath size was 10 French (10 Fr) in two groups. Then the general state of the canines was observed after implantation. ECG and TTE were performed, respectively, at 7, 30, 90 days of follow-up. The canines were sacrificed at these time points for pathological and scanning electron microscopy examination. The devices were successfully implanted in all 15 canines and were retrievable and repositionable. There was no thrombus formation on the device or occurrence of complete heart block. The pcVSDO surface implanted at day 7 was already covered with neotissue by gross examination, and it completed endothelialization at day 30, while the commercial VSDO was covered with the neotissue in 30th day and the complete endothelialization in 90th day.Conclusion. The study shows that pcVSDO is feasible and safe to close canine VSD model and has good biocompatibility and shorter time of endothelialization.

Intrathecal treatment trial of rituximab in progressive MS

Neurology ◽  
2018 ◽  
Vol 91 (20) ◽  
pp. e1893-e1901 ◽  
Author(s):  
Joakim Bergman ◽  
Joachim Burman ◽  
Jonathan D. Gilthorpe ◽  
Henrik Zetterberg ◽  
Elena Jiltsova ◽  
...  
Keyword(s):  
Progressive Multiple Sclerosis ◽  
Intrathecal Administration ◽  
Control Group ◽  
Csf Biomarkers ◽  
Ventricular Catheter ◽  
Frontal Horn ◽  
Severe Infections ◽  
Phase 1B ◽  
The Right

ObjectivesTo perform a phase 1b assessment of the safety and feasibility of intrathecally delivered rituximab as a treatment for progressive multiple sclerosis (PMS) and to evaluate the effect of treatment on disability and CSF biomarkers during a 1-year follow-up period.MethodsThree doses of rituximab (25 mg with a 1-week interval) were administered in 23 patients with PMS via a ventricular catheter inserted into the right frontal horn and connected to a subcutaneous Ommaya reservoir. Follow-ups were performed at 1, 3, 6, 9, and 12 months.ResultsMild to moderate vertigo and nausea were common but temporary adverse events associated with intrathecal rituximab infusion, which was otherwise well tolerated. The only severe adverse event was a case of low-virulent bacterial meningitis that was treated effectively. Of 7 clinical assessments, only 1 showed statistically significant improvement 1 year after treatment. No treatment effect was observed during the follow-up period among 6 CSF biomarkers.ConclusionsIntrathecal administration of rituximab was well tolerated. However, it may involve a risk for injection-related infections. The lack of a control group precludes conclusions being drawn regarding treatment efficacy.ClinicalTrials.gov identifierNCT01719159.Classification of evidenceThis study provides Class IV evidence that intrathecal rituximab treatment is well tolerated and feasible in PMS but involves a risk of severe infections.

Sight-threatening progressive corneo-scleral involvement in porphyria cutanea tarda

2021 ◽  
Vol 14 (10) ◽  
pp. e245160
Author(s):  
Sonali Prasad ◽  
Vidhata Vidhata ◽  
Subhash Prasad
Keyword(s):  
Porphyria Cutanea Tarda ◽  
Clinical Manifestations ◽  
Ocular Involvement ◽  
Slit Lamp ◽  
Uroporphyrinogen Decarboxylase ◽  
Progressive Loss ◽  
The Right ◽  
Lost To Follow Up ◽  
Test Serum

Porphyria cutanea tarda is the most common type of porphyria. It is associated with a deficiency of uroporphyrinogen decarboxylase enzyme responsible for heme synthesis. Clinical manifestations are predominantly dermatological and very rarely present with ocular involvement. Although scleral thinning in the interpalpebral area is a well-documented entity, sight-threatening corneal involvement is rarely described. We, herein report a case of a 58-year-old man who presented with ocular surface dryness, photophobia and mild redness. Slit-lamp biomicroscopy revealed corneo-scleral thinning in both eyes. The diagnosis was confirmed with a urine porphyrin test, serum iron and serum ferritin levels. We started him on conservative management after which he was lost to follow-up. He presented again after 6 years with total corneal opacification and progressive loss of vision in the right eye.

Manganese and Lipoflavonoid Plus® to Treat Tinnitus: A Randomized Controlled Trial

2016 ◽  
Vol 27 (08) ◽  
pp. 661-668 ◽  
Author(s):  
Eveling Rojas-Roncancio ◽  
Richard Tyler ◽  
Hyung-Jin Jun ◽  
Tang-Chuan Wang ◽  
Haihong Ji ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Data Collection And Analysis ◽  
Loudness Match ◽  
Minimal Masking Level ◽  
Lost To Follow Up ◽  
To Receive

Background: Several tinnitus sufferers suggest that manganese has been helpful with their tinnitus. Purpose: We tested this in a controlled experiment where participants were committed to taking manganese and Lipoflavonoid Plus® to treat their tinnitus. Research Design: Randomized controlled trial. Study Sample: 40 participants were randomized to receive both manganese and Lipoflavonoid Plus® for 6 months, or Lipoflavonoid Plus® only (as the control). Data Collection and Analysis: Pre- and postmeasures were obtained with the Tinnitus Handicap Questionnaire, Tinnitus Primary Functions Questionnaire, and tinnitus loudness and annoyance ratings. An audiologist performed the audiogram, the tinnitus loudness match, and minimal masking level. Results: Twelve participants were dropped out of the study because of the side effects or were lost to follow-up. In the manganese group, 1 participant (out of 12) showed a decrease in the questionnaires, and another showed a decrease in the loudness and annoyance ratings. No participants from the control group (total 16) showed a decrease in the questionnaires ratings. Two participants in the control group reported a loudness decrement and one reported an annoyance decrement. Conclusions: We were not able to conclude that either manganese or Lipoflavonoid Plus® is an effective treatment for tinnitus.

Dedicated Tracking of Patients with Retrievable Inferior Vena Cava Filters Improves Retrieval Rates

2012 ◽  
Vol 78 (8) ◽  
pp. 870-874 ◽  
Author(s):  
Donald J. Lucas ◽  
James R. Dunne ◽  
Carlos J. Rodriguez ◽  
Kathleen M. Curry ◽  
Eric Elster ◽  
...  
Keyword(s):  
Vena Cava ◽  
Control Group ◽  
Trauma Patients ◽  
Loss To Follow Up ◽  
Filter Retrieval ◽  
Ivc Filters ◽  
Vena Cava Filters ◽  
Baseline Characteristics ◽  
Lost To Follow Up

Retrievable IVC filters (R-IVCF) are associated with multiple complications, including filter migration and deep venous thrombosis. Unfortunately, most series of R-IVCF show low retrieval rates, often due to loss to follow-up. This study demonstrates that actively tracking R-IVCF improves retrieval. Trauma patients at one institution with R-IVCF placed between January 2007 and January 2011 were tracked in a registry with a goal of retrieval. These were compared to a control group who had R-IVCF placed previously (December 2005 to December 2006). Outcome measures include filter retrieval, retrieval attempts, loss to follow-up, and time to filter retrieval. We compared 93 tracked patients with R-IVCF with 20 controls. The baseline characteristics of the groups were similar. Tracked patients had significantly higher rates of filter retrieval (60% vs 30%, P = 0.02) and filter retrieval attempts (70% vs 30%, P = 0.002) and were significantly less likely to be lost to follow-up (5% vs 65%, P < 0.0001). Time to retrieval attempt was 84 days in the registry versus 210 days in the control group, which trended towards significance ( P = 0.23). Tracking patients with R-IVCF leads to improved retrieval rates, more retrieval attempts, and decreased loss to follow up. Institutions should consider tracking R-IVCF to maximize retrieval rates.

scholarly journals Medication Event Monitoring System for Infectious Tuberculosis Treatment in Morocco: A Retrospective Cohort Study

2019 ◽  
Vol 16 (3) ◽  
pp. 412 ◽  
Author(s):  
Seup Park ◽  
Ilham Sentissi ◽  
Seung Gil ◽  
Won-Seok Park ◽  
ByungKwon Oh ◽  
...  
Keyword(s):  
Success Rate ◽  
Monitoring System ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Control Group ◽  
Event Monitoring ◽  
Tb Treatment ◽  
The Mean ◽  
Lost To Follow Up

Non-adherence to tuberculosis (TB) treatment is a barrier to effective TB control. We investigated the effectiveness of a Medication Event Monitoring System (MEMS) as a tailored adherence-promoting intervention in Morocco. We compared patients who received a MEMS (n = 206) with patients who received standard TB care (n = 141) among new active TB patients with sputum smear-positive. The mean total medication days were 141.87 ± 29.5 in the control group and 140.85 ± 17.9 in the MEMS group (p = 0.7147), and the mean age and sex were not different between the two groups (p > 0.05). The treatment success rate was significantly higher in the MEMS group than in the control group (odds ratio (OR): 4.33, 95% confidence interval (CI): 2.13–8.81, p < 0.001), and the lost to follow-up rate was significantly lower in the MEMS group than in the control group (OR: 0.03, 95% CI: 0.05–0.24, p < 0.001) after adjusting for sex, age, and health centers. The mean drug adherence rate in the first month was significantly higher in the MEMS group than in the control group (p = 0.023). MEMS increased TB treatment success rate and decreased the lost to follow-up rate overall for infectious TB patients in a Moroccan rural area.

scholarly journals TRATAMENTO CIRÚRGICO SPLITTING NAS TENDINITES AGUDAS EXPERIMENTAIS EM EQÜINOS

2002 ◽  
Vol 7 (2) ◽  
Author(s):  
A. L. G. ALVES ◽  
J. L. M. NICOLETTI ◽  
A. THOMASSIAN ◽  
C. A. HUSSNI ◽  
M. J. WATANABE
Keyword(s):  
Research Work ◽  
Control Group ◽  
Histopathological Analysis ◽  
Mean Values ◽  
Repair Tissue ◽  
Superficial Digital Flexor Tendon ◽  
Tendon Lesion ◽  
Group 2 ◽  
The Right

O objetivo deste trabalho foi avaliar a eficácia do tratamento cirúrgico “splitting” em lesões tendíneas agudas induzidas experimentalmente. Para tanto, foram utilizados 8 eqüinos sadios, submetidos à aplicação de colagenase (2ml–2,5mg/ml) nos tendões flexores digitais superficiais (TFDS) dos membros torácicos e após 7 dias da aplicação, foram realizadas incisões percutâneas - splitting - no local da lesão dos membros direitos (grupo tratado), permanecendo os membros esquerdos como grupo controle. Os 8 animais foram divididos em 2 grupos de mesmo número, segundo o período da realização das biópsias (grupo 1 - 30o dia e o grupo 2 - 60o dia após indução da tendinite). A monitoração dos animais foi realizada através de exames clínicos, ultra-sonográficos, análises macroscópica e histopatológica. Ao exame clínico não foi observada diferença significativa entre o grupo tratado e o controle. Com o exame ultra-sonográfico foi constatado que no grupo tratado houve uma significativa redução da área média da lesão naqueles membros em que foram observadas lesões iniciais maiores que 30% da área tendínea. Foram observadas menor celularidade do tecido de reparação e maior fibroplastia nos tecidos tratados, indicando melhor maturação tecidual neste grupo. Através dos resultados obtidos conclui-se que o splitting utilizado em lesões com áreas maiores que 30% da área transversal tendínea reduz o tempo de cicatrização da lesão e melhora a remodelação tecidual. Tendon splitting surgical treatment on experimental equine acute tendinitis Abstract The main aim of the present research work was to study the effects of the splitting on equine experimental tendinitis. Eight horses without soundness problems were used in this experiment. The tendinitis was induced by administration of collagenase (2 ml, 2.5 mg/ml) in the superficial digital flexor tendon (SDFT) of all animals. After 7 days of the induction of tendinitis, an intralesional splitting was carried out with a tendon knife in the right forelimbs, the left forelimbs kept as control. The 8 animals were divided in two groups of 4 according to the period that the biopsies took place: group 1, at the 30th day and group 2 at the 60th day after the splitting had been performed. The splitting and healing processes were monitored by clinical and sonographic examinations during all the experiment, Gross and histopathological analysis of the forelimbs were performed in both groups of animals, at the 30th and the 60th day after the splitting, respectively. Follow-up sonographic examinations displayed the fact that lesions bigger than 30% of the tendon area showed significant decrease in the mean values of the lesion area in the split tendons, when compared with the control group at the days 15, 30 and 60 after the splitting. Split members showed marked improvement in the severity rates and percentile of residual tendon lesion at the 60 day. The cellularity of the repair tissue was significantly lower. besides the fact that there were more mature repair tissue in the split tendons at 30 and 60 days after the splitting. These results allowed to conclude that the split technique used in acute large core lesions reduce the time of wound healing and improve the scar remodeling.

scholarly journals Adult Coats Disease Presenting as Subfoveal Nodule

2018 ◽  
Vol 9 (1) ◽  
pp. 232-237 ◽  
Author(s):  
Salim Z. Asaad ◽  
Nazimul Hussain
Keyword(s):  
Retinal Vessel ◽  
Fundus Fluorescein Angiography ◽  
The Third ◽  
Macular Lesion ◽  
Corrected Visual Acuity ◽  
Coats Disease ◽  
The Right ◽  
Lost To Follow Up ◽  
Best Corrected Visual Acuity

A 21-year-old female presented with decreased vision in the right eye. Best corrected visual acuity was 6/60 in the right eye and 6/6 in the left eye. Funduscopy of the right eye revealed a subfoveal nodule with surrounding exudates and temporal peripheral retinal vessel telangiectasia with exudation. The patient underwent retinal laser in the areas of telangiectatic vessels and capillary non-perfusion as seen on fundus fluorescein angiography. It was combined with an intravitreal injection of bevacizumab which was repeated twice at monthly intervals. The macular lesion and peripheral vessels along with subretinal exudates showed resolution during the course of treatment. However, the patient was lost to follow-up and returned 5 months later when examination revealed increased macular fibrosis. In the literature, the reported presentation of subfoveal nodule in Coats disease is during the first decade. It progresses to macular fibrosis within a few months. This case illustrates that subfoveal nodule before macular fibrosis in Coats disease may present later, even up to the third decade.

Phaeohyphomycotic osteomyelitis in the femur of a cat

2009 ◽  
Vol 11 (10) ◽  
pp. 878-880 ◽  
Author(s):  
Michal O. Hess
Keyword(s):  
Physical Examination ◽  
Distal Femur ◽  
Lytic Lesion ◽  
High Dose ◽  
Dimorphic Fungus ◽  
Cytological Examination ◽  
The Right ◽  
Lost To Follow Up ◽  
Deep Fungal Infection

A 4-month-old castrated male domestic shorthair cat was presented for a right hind leg lameness of 1-week duration. Physical examination revealed a painful swelling over the right distal femur. A radiograph of the right stifle revealed an extensive lytic lesion involving the distal metaphysis of the right femur. Cytological examination of a needle aspirate was consistent with a deep fungal infection. A pigmented dimorphic fungus was isolated in pure culture from a representative needle aspirate from the lesion. The patient improved substantially after 5 weeks of high-dose itraconazole therapy, although it was subsequently lost to follow-up.

scholarly journals Result of the arc of movement of lower cervical spine after seven years of arthroplasty

2014 ◽  
Vol 13 (3) ◽  
pp. 185-187
Author(s):  
Luis Claudio de Velleca e Lima ◽  
Fernando Gritsch Sanchis
Keyword(s):  
Cervical Spine ◽  
Cervical Disc ◽  
Lower Cervical Spine ◽  
Lateral Bending ◽  
Disc Disease ◽  
Cervical Disc Replacement ◽  
The Right ◽  
Lost To Follow Up ◽  
Surgery Center

OBJECTIVE: To quantify the mobility of the lower cervical spine after seven years of total cervical disc replacement at two levels. METHOD: This clinical study was designed randomly and prospectively at the spine surgery center at the Hospital Nossa Senhora das Graças, in Canoas, RS-Brazil and at the Hospital Don João Becker, in Gravataí, RS-Brazil. Seventeen patients were included in the study that was designed to compare the data obtained from annual and sequential manner until the end of seven years. A comparison was made with the prior range of motion (ROM) of each patient. All patients were diagnosed with not tractable symptomatic cervical degenerative disc disease with two adjacent levels between C-3 and C-7. RESULTS: A total of patients underwent TDR in two levels and at the end of seven years, only one patient was lost to follow-up. The pre and postoperative ROM was the same in the first three years however after the fourth year there was a gradual decline with a loss of 12% of preoperative ROM in flexion, 21% in extension and 23% in the right and left lateral bending at the end of seven years. CONCLUSIONS: The clinical outcome of this study is evidence level IV in evaluating the ROM for Moby-C(r) for TDR in two adjacent levels at the lower cervical spine. These results show that the ROM is maintained during the first three years, gradually declining after that.

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