A Retrospective Analysis of Our 15-year Experience with Bedside ‘Blind’ Positioning of Long-term Tunneled Groshong® Catheters in the Pre-ultrasound Era

Abstract Long-term tunneled Groshong catheters have been widely used in our institution since 1987, both in adult and pediatric patients, for different purposes (chemotherapy, parenteral nutrition, etc.). In the period 1987–2003, most of these catheters were inserted adopting the ‘blind’ percutaneous venipuncture of the internal jugular vein, by the so called ‘low lateral’ approach (Jernigan's technique). Also, with the exception of selected pediatric cases, they have been inserted at the bedside, without intra-operative fluoroscopy. A retrospective analysis of 1848 tunneled Groshong catheters inserted at our institution over a 15 year period (1987–2003) showed that this protocol was particularly safe (low incidence of complications) and cost-effective (low costs: limited use of fluoroscopy and the operating room).

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748 INDICATIONS FOR AND OUTCOME OF PEDIATRIC PATIENTS ON LONG TERM HOME PARENTERAL NUTRITION (HTPN)

Pediatric Research ◽

10.1203/00006450-198504000-00778 ◽

1985 ◽

Vol 19 (4) ◽

pp. 235A-235A

Author(s):

Jorge Vargas ◽

William E Berquist ◽

Marvin E Ament

Keyword(s):

Parenteral Nutrition ◽

Pediatric Patients ◽

Home Parenteral Nutrition

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Occupational Voice Disorders in Slovakia Today and in the Past

Acta Medica Martiniana ◽

10.2478/acm-2019-0005 ◽

2019 ◽

Vol 19 (1) ◽

pp. 38-44

Author(s):

M Mikolajcikova ◽

V Ferencikova ◽

K Fiolkova ◽

V Sokolikova ◽

Z Matuskova ◽

...

Keyword(s):

Retrospective Analysis ◽

Medical Information ◽

Slovak Republic ◽

Voice Disorders ◽

University Hospital ◽

Voice Disorder ◽

Occupational Health Services ◽

Teaching Staff ◽

Low Incidence

Abstract Introduction: Voice disorders primarily affect workers in professions with increased voice demands, such as teaching personnel in educational system, singers, lecturers, actors or managers. Severe voice disorders often require a permanent change of work position. Methods: Retrospective analysis of a set of patients with occupational voice disorders who were hospitalized at the Clinic of Occupational Medicine and Toxicology, Martin University Hospital (COMaT, MUH) in the years of 2000–2017. Comparison of the data obtained with the National Centre of Medical Information (NCMI) data on the occurrence of occupational voice disorders throughout the Slovak Republic (SR). Comparison with the retrospective analysis of reported occupational voice disorders in the years of 1967-1996. Case report of a patient with an occupational voice disorder. Results: We point to a long-term low incidence of occupational voice disorders. In the years of 2000-2017, 24 cases of occupational voice disorders were reported in Slovakia, of which 20 cases were reported under item 42-1 and 4 cases under item 42-2 in the List of Occupational Diseases. Through the COMaT, MUH 11 cases of occupational voice disorders were reported during these years, of which 9 cases were listed under item 42-1 and 2 cases under item 42-2. From 1967 to 1996 there were 52 occupational voice disorders reported in Slovakia, of which 45 were under item 42-1 and 7 under item 42-2. Conclusions: As there is a tendency to underestimate the voice difficulties among teaching staff, it is necessary to provide better information about the possible consequences, prevention, and treatment of these diseases. All of this should be in the competency of occupational health services.

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A Retrospective Analysis of the Effect of Combination of Pure Fish Oil with Third Generation Lipid Emulsion on Liver Function in Children on Long-Term Parenteral Nutrition

Nutrients ◽

10.3390/nu11102495 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2495

Author(s):

Mikołaj Danko ◽

Aleksandra Żyła-Pawlak ◽

Janusz Książyk ◽

Katarzyna Olszewska-Durkacz ◽

Marta Sibilska ◽

...

Keyword(s):

Liver Disease ◽

Liver Function ◽

Parenteral Nutrition ◽

Fish Oil ◽

Retrospective Analysis ◽

Lipid Emulsion ◽

Intestinal Failure ◽

Third Generation ◽

Glutamyl Transferase

Background: Deterioration of liver function, or intestinal failure-associated liver disease, is often observed in long-term parenterally fed children. Fish oil-based intravenous lipids have been reported to play a role in the prevention and treatment of intestinal failure associated liver disease. Methods: This retrospective analysis included 40 pediatric patients, (20 male and 20 female), median age 38 months (range 1.5–200 months) on long-term (≥1 month) parenteral nutrition who received the parenteral mixtures containing a combination of a third-generation lipid emulsion and pure fish oil because of laboratory liver function abnormalities. The total dose of fish oil from both emulsions for each patient exceeded 0.5 g/kg/day. Data from visits in an outpatient clinic were retrospectively analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation test. Results: The median time of therapy was 149 days (range 28–418 days). There was a decrease of median total and direct (conjugated) bilirubin concentration from 22.23 µmol/L (range 3.42–243 µmol/L) to 10.26 µmol/L (range 3.42–180.58 µmol/L; p < 0.005) and 8.55 (range 1.71–212.04 µmol/L) to 6.84 µmol/L (range 1.71–150.48 µmol/L; p < 0.007) respectively. A significant decrease in median alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase was also observed. In 11 patients bilirubin concentrations increased or remained unchanged. When compared to the patients who responded to the combination therapy, the patients who did not respond received parenteral nutrition for a longer time prior to the start of the therapy (51 vs. 30 months; p < 0.05). Conclusions: The mixture of an intravenous lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil with the addition of pure fish oil emulsion may be helpful in the treatment of liver complications in children on long-term parenteral nutrition.

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