Reasons of unsuccessful implantation of short-term hemodialysis catheters in jugular veins using real-time ultrasound

Purpose: Real-time ultrasound is indicated for hemodialysis catheters’ insertion in internal jugular veins. We evaluated unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound between patients with and without previous short-term catheters. Methods: Observational open-label study of unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound from July 2013 to August 2014. Results: A total of 185 procedures were compared in 122 individuals; 120 (64.86%) had previously used short-term catheters. There were 5 (8%) unsuccessful implantation among 62 catheterizations without previous short-term catheter and 41 (33.6%) among 122 with previous short-term catheter (p = 0.001 Pearson’s chi-squared, odds ratio = 5.77, 95% confidence interval = 2.15–15.50, p = 0.001). Non-progressing guidewire occurred in 2 (3.2%) of 62 patients without previous short-term catheter and in 18 (14.8%) of 122 with previous short-term catheter (p = 0.018 Pearson’s chi-squared, odds ratio = 5.19, 95% confidence interval = 1.16–23.15, p = 0.031). No difference was observed between size of the veins with or without non-progressing guidewire. All 11 cases of venous thrombosis occurred in patients who had previous short-term catheter removed due to infection. Conclusion: Previous use of short-term catheter is pivotal in the occurrence of unsuccessful implantation of short-term catheter in internal jugular veins using real-time ultrasound.

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Fluvoxamine in the Treatment of Trichotillomania: An 8-Week, Open-Label Study

CNS Spectrums ◽

10.1017/s1092852900006520 ◽

1998 ◽

Vol 3 (9) ◽

pp. 64-71 ◽

Cited By ~ 4

Author(s):

Gary A. Christenson ◽

Scott J. Crow ◽

James E. Mitchell ◽

Thomas B. Mackenzie ◽

Ross D. Crosby ◽

...

Keyword(s):

Treatment Response ◽

Term Treatment ◽

Hair Pulling ◽

Short Term ◽

Open Label ◽

Short Term Treatment ◽

Open Label Study ◽

Label Study ◽

Long Term Treatment

AbstractThis short-term, open-label study investigates short- and long-term effects of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine for the treatment of trichotillomania (TTM). Additionally, this study aimed to test the hypothesis that the presence of hair pulling compulsiveness is predictive of SSRI response. Nineteen subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised, (DSM-III-R) criteria for TTM were treated with fluvoxamine at doses up to 300 mg/day. Random regression analysis of change across time for patients who completed the study (n=14) and those who dropped out (n=5) revealed statistically significant improvements in Physician Rating Scale, hair-pulling episodes, Trichotillomania Impairment Scale, and Trichotillomania Symptom Severity Scale, but not in estimated amount of hair pulled. In addition, the percentage of patients' focused or compulsive hair-pulling symptoms was predictive of treatment response. Unfortunately, all three subjects who entered long-term treatment displayed substantial movement back toward baseline by the end of 6 months. We concluded that fluvoxamine produces moderate reductions in symptoms during the short-term treatment of TTM and that the presence of focused or compulsive hair pulling may be predictive of treatment response. However, responses may be short lived when treatment is extended.

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