Oral ganciclovir: a new option for patients with CMV retinitis

Cytomegalovirus retinitis is a major cause of morbidity in patients with AIDS. The conventional treatment approach has involved insertion of a central venous catheter and intravenous administration of ganciclovir and/or foscarnet. This has been associated with systemic toxicity, line-related sepsis, and implications for patient quality-of-life. An oral formulation of ganciclovir has now been licensed for use as maintenance therapy in CMV retinitis. Multicentred trials comparing oral and intravenous ganciclovir have suggested that although the efficacy may be marginally reduced with the oral formulation, the associated toxicity is significantly lower. With careful and informed decision-making by both clinician and patient, the opportunity exists to enhance the quality of life in this patient group.

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Central venous catheter based closed thoracic drainage in the treatment of tuberculous pleuritis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.4.63 ◽

2019 ◽

Vol 35 (4) ◽

Author(s):

Ling Song ◽

Yueling Zhang ◽

Qiong Jia

Keyword(s):

Quality Of Life ◽

Treatment Group ◽

Central Venous Catheter ◽

Venous Catheter ◽

Control Group ◽

Central Venous ◽

Thoracic Drainage ◽

Significant Difference ◽

Tuberculous Pleurisy

Objective: To explore the clinical effect of central venous catheter closed thoracic drainage in the treatment of tuberculous pleurisy. Methods: One hundred and four patients with tuberculous pleurisy who were admitted to Binzhou People’s Hospital from August 2016 to August 2017 were divided into a control group and a treatment group according to random number table method, 52 each. The control group was treated with conventional pleural puncture and drainage, while the treatment group was treated with closed central venous catheter based thoracic drainage. The clinical efficacy, improvement time of clinical symptoms, total volume of drainage, pleural thickness, and improvement of quality of life and occurrence of adverse reactions were compared between the two groups. Results: Pleural effusion, fever and chest tightness of the treatment group disappeared earlier (P<0.05); the hospitalization time in the treatment group was less than that in the control group (P<0.05); the total amount of drainage in the treatment group was lower than that in the control group (P<0.05); the pleural thickness of the treatment group was higher than that in the control group (P<0.05); the quality of life score in the treatment group was significantly higher than that in the control group (P<0.05). The total effective rates of the treatment group and the control group were 93.5% and 85%, respectively, with a significant difference (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group, with a significant difference (P<0.05). Conclusion: Central venous catheter based closed thoracic drainage is more effective than conventional thoracic puncture and drainage in the treatment of tuberculous pleurisy. It can accelerate the improvement of clinical symptoms, improve the quality of life of patients, and reduce the incidence of complications. It is worth popularizing and applying. doi: https://doi.org/10.12669/pjms.35.4.63 How to cite this:Song L, Zhang Y, Jia Q. Central venous catheter based closed thoracic drainage in the treatment of tuberculous pleuritis. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.63 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Advantages of Totally Implanted Port over Impromptu Short-Term Central Venous Catheter in Oncological Pain Therapy

The Journal of Vascular Access ◽

10.1177/112972980300400204 ◽

2003 ◽

Vol 4 (2) ◽

pp. 50-55 ◽

Cited By ~ 2

Author(s):

C. Reale ◽

E. Vernaglione ◽

C.A. Reale ◽

A. Mancini ◽

M. Prologo ◽

...

Keyword(s):

Quality Of Life ◽

Central Venous Catheter ◽

Pain Therapy ◽

Venous Catheter ◽

Brief Pain Inventory ◽

Venous Access ◽

Central Venous ◽

Short Term ◽

Randomised Study

The aim of this paper is to determine if patient controlled analgesia (PCA) by means of programmable pumps improves patients' autonomy and to verify if the short-term central venous catheter - implanted when pain is first evident - makes the quality of life worse in comparison with an early implanted port. Forty non-terminally ill patients affected by urinary malignant pathologies with visceral and bone metastases were enrolled in a prospective and randomised study at the Urology Department of “La Sapienza” University in Rome, Italy. Intensity of pain and tolerability of venous access were assessed for the first 7 days, and weekly for 3 months. Such data were used to adjust drug therapy. In this study we hypothesized that a delayed central venous catheter implant, when the pain is at first considerably evident, can interfere negatively with drug treatment. The visual analogue scale (VAS) and the brief pain inventory (BPI) were administered to the patients, and these showed good levels of analgesia in both groups and a greater comfort to the patients with the previously implanted port in comparison with a short-term central venous catheter. In conclusion, PCA achieves a constant level of drugs and enables the patient to voluntary control the pain by means of supplemental boluses. Both central devices seem to provide similar technical benefits, but the port is much more easily tolerated and the quality of life is increased if it is already available when pain is first evident.

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Home Intermittent Amrinone Infusions in Terminal Congestive Heart Failure

DICP ◽

10.1177/106002808902300114 ◽

1989 ◽

Vol 23 (1) ◽

pp. 59-62 ◽

Cited By ~ 1

Author(s):

Richard J. Baptista ◽

Francis P. Mitrano ◽

Joanne Perri-Lafrancesca

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Congestive Heart Failure ◽

Central Venous Catheter ◽

Infusion Pump ◽

Venous Catheter ◽

Pilot Program ◽

Central Venous ◽

At Home

The prevalence of congestive heart failure (CHF) and its progressive degenerative course continue to generate pressure for alternative, more effective means of treatment. A confluence of factors, including the number of Americans with CHF, the spiraling costs of hospital care, and increasing interest in cost-effective home care, contribute to the current efforts to develop an effective, nontoxic therapy that effectively increases myocardial contractility and output and can be administered within the confines of the home. Given that preliminary clinical trials in the hospital setting with amrinone have produced positive results, the transition of this therapy to the home, when administered intermittently via central venous catheter and infusion pump, was undertaken. In order to prolong and increase quality of life in terminal CHF patients, intermittent amrinone infusions were provided at home to four patients as part of our pilot program. All four patients met the criteria for New York Heart Association (NYHA) functional class IV heart failure, and none had responded to conventional therapy suitable for outpatient maintenance. The patients also shared strong family support and an intense desire to improve the quality of remaining life. All four patients and designated family members were trained in the specifics of aseptic technique, medication dose preparation, central venous catheter care, and operation of an infusion pump. An ambulatory pump was used in three of the four patients. Subsequent to the initiation of intermittent home amrinone infusions, all four patients had greater tolerance to limited exercise and/or ambulation secondary to increased cardiac output and diuresis. Patients survived 8, 10, 47, and 56 weeks. This pilot program suggests that intravenous amrinone, administered intermittently at home, appears reasonably safe and might promote an improved quality of life. More research is necessary prior to substantiating any firm conclusions.

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Parental Narratives of Quality of Life in Children with Leukemia as Associated with the Placement of a Central Venous Catheter

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2005.05.021 ◽

2005 ◽

Vol 30 (6) ◽

pp. 544-552 ◽

Cited By ~ 6

Author(s):

Marta Tremolada ◽

Vanna Axia ◽

Marta Pillon ◽

Sara Scrimin ◽

Fabia Capello ◽

...

Keyword(s):

Quality Of Life ◽

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous

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Performance, pain, and quality of life on use of central venous catheter for management of pericardial effusions in patients undergoing coronary artery bypass graft surgery

Journal of Pain Research ◽

10.2147/jpr.s116483 ◽

2016 ◽

Vol Volume 9 ◽

pp. 887-892

Author(s):

Kamran Ghods ◽

Mohammadreza Razavi ◽

Mohammad Forozeshfard

Keyword(s):

Quality Of Life ◽

Coronary Artery ◽

Central Venous Catheter ◽

Coronary Artery Bypass Graft ◽

Artery Bypass ◽

Bypass Graft ◽

Venous Catheter ◽

Artery Bypass Graft ◽

Central Venous

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Poststroke Pain

Seminars in Neurology ◽

10.1055/s-0040-1722641 ◽

2021 ◽

Vol 41 (01) ◽

pp. 067-074

Author(s):

Seoyon Yang ◽

Min Cheol Chang

Keyword(s):

Quality Of Life ◽

Complex Regional Pain Syndrome ◽

Shoulder Pain ◽

Conventional Treatment ◽

Pain Syndrome ◽

Psychological State

AbstractPain is common but often underrecognized after stroke. Poststroke pain (PSP) hinders recovery, impairs quality of life, and is associated with the psychological state of patients with stroke. The most common subtypes of PSP include central PSP, complex regional pain syndrome, shoulder pain, spasticity-related pain, and headache. The pathophysiologies of these PSP subtypes are not yet clearly understood, and PSP is refractory to conventional treatment in many patients. However, recent studies have proposed potential pathophysiologies of PSP subtypes, which may help prioritize therapies that target specific mechanisms.

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Infrastructure Requirements for an Urgent-Start Peritoneal Dialysis Program

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00017 ◽

2013 ◽

Vol 33 (6) ◽

pp. 611-617 ◽

Cited By ~ 35

Author(s):

Arshia Ghaffari ◽

Vijay Kumar ◽

Steven Guest

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Treatment Approach ◽

Clinical Pathways ◽

Venous Catheter ◽

Central Venous ◽

Advanced Chronic Kidney Disease ◽

Flow Disturbances ◽

Late Referral ◽

Subsequent Replacement

Patients with advanced chronic kidney disease nearing dialysis but without pre-established access almost uniformly initiate dialysis with a temporary central venous catheter. These catheters are associated with high rates of infection and flow disturbances, requiring removal and subsequent replacement. Many of these patients might be candidates for peritoneal dialysis (PD), but because of the absence of prior catheter placement, the default initial modality is hemodialysis. Recent reports, however, have demonstrated the feasibility of initiating PD urgently despite the late referral for access placement. Urgent-start PD clinical pathways require a unique infrastructure and treatment approach. This article reviews the salient features required to establish an urgent-start PD program.

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High rate of native arteriovenous fistulas: How to reach this goal?

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1504226j ◽

2015 ◽

Vol 143 (3-4) ◽

pp. 226-229

Author(s):

Tamara Jemcov ◽

Marija Milinkovic ◽

Igor Koncar ◽

Ilija Kuzmanovic ◽

Nenad Jakovljevic ◽

...

Keyword(s):

Vascular Access ◽

Continuous Process ◽

Venous Catheter ◽

Medical Personnel ◽

High Rate ◽

Central Venous ◽

Vascular Surgeon ◽

Arteriovenous Fistulas ◽

Clinical Center

The types of vascular accesses for hemodialysis (HD) include the native arteriovenous fistula (AVF), arteriovenous graft (AVG) and central venous catheter (CVC). Adequately matured native AVF is the best choice for HD patients and a high percentage of its presence is the goal of every nephrologist and vascular surgeon. This paper analyses the number and type of vascular accesses for HD performed over a 10-year period at the Clinical Center of Serbia, and presents the factors of importance for the creation of such a high number of successful native AVF (over 80%). Such a result is, inter alia, the consequence of the appointment of the Vascular Access Coordinator, whose task was to improve the quality of care of blood vessels in the predialysis period as well as of functional vascular accesses, and to promote the cooperation among different specialists within the field. Vascular access is the ?lifeline? for HD patients. Thus, its successful planning, creation and monitoring of vascular access is a continuous process that requires the collaboration and cooperation of the patient, nephrologist, vascular surgeon, radiologist and medical personnel.

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Echocardiography with Elevated Central Venous Pressure Diagnosing Constrictive Pericarditis More Accurately Than Chest CT Scan: A Retrospective Study in 36 Cases

The Heart Surgery Forum ◽

10.1532/hsf.1906 ◽

2018 ◽

Vol 21 (3) ◽

pp. 190

Author(s):

Liwen Bao ◽

Jiechun Huang ◽

Fangrui Wang ◽

Liewen Pang ◽

Yiqing Wang ◽

...

Keyword(s):

Quality Of Life ◽

Cardiac Function ◽

Central Venous Pressure ◽

Constrictive Pericarditis ◽

Venous Pressure ◽

Definitive Diagnosis ◽

Central Venous ◽

Imaging Results ◽

Time To Diagnosis

Background: Constrictive pericarditis (CP) is defined as impaired diastolic cardiac function caused by a calcified and thickened pericardium. We assessed the clinical characteristics and time to diagnosis, as well as patient prognosis after pericardiectomy. Methods: We analyzed the records of 36 CP patients who underwent pericardiectomy at Huashan Hospital, China, between 2012 and 2015. Clinical manifestations, length of time to diagnosis, laboratory parameters, and diagnostic imaging results were examined. All patients underwent pericardiectomy, and were assessed post-operatively for quality of life and improvement of cardiac function using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results: All patients displayed shortness of breath and polyserous effusion, as well as elevated pro B-type natriuretic peptide and thickened pericardium. Mean time between onset of symptoms and a definitive diagnosis of CP was 9.5 ± 2.1 months. Pericardiectomy was performed within one week of diagnosis. Mean central venous pressure decreased from a pre-operative 19.92 ± 6.6 mmHg to a post-operative 8.5 ± 2.7 mmHg. Within 1.5 ± 0.7 years of surgery, all patients maintained good quality of life and cardiac function, which resulted in a mean score of 0.9 ± 0.6 on the MLHFQ. Conclusion: A definitive diagnosis of CP is usually made long after the onset of symptoms. Early detection and diagnosis by echocardiography with elevated central venous pressure and early treatment by surgery are key to an improved prognosis and resumption of good cardiac function.

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