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Local Cutaneous Effects Associated with Chlorhexidine-Impregnated Gel Dressing in Hematopoietic Stem Cell Transplantation Patients

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Open Journal of Nursing 2018年第2期8卷 115-129页

作者： Bruna Nogueira dos Santos Maria Carolina de Oliveira Fernanda T. M. M. Braga Amanda Salles Margatho Laís C. C. Esparrachiari Renata C. de C. P. Silveira Department of General and Specialized Nursing Ribeir&#227 o Preto College of Nursing University of S&#227 o Paulo Ribeir&#227 o Preto Brazil Division of Clinical Immunology Ribeir&#227 o Preto Medical School University of S&#227 o Paulo Ribeir&#227 o Preto Brazil Department of Nursing State University of Londrina Londrina Brazil

Introduction: Hematopoietic stem cell transplantation (HSCT) often requires a central venous catheter (CVC) for quick and safe vascular access. Currently, new technologies are available to protect the catheter insertion site, such as chlorhexidine-impregnated gel dressings (CIGD). Objectives: To evaluate local cutaneous effects associated with CIGD in patients undergoing HSCT. Methods: In this cross-sectional, prospective study, we evaluated 25 HSCT patients who had a CVC inserted. Patients were visited daily to monitor the CIGD changing procedures and evaluate abnormalities of the underlying skin after dressing removal. Findings: Local erythema was the most frequently detected abnormality, although usually transient and considered secondary to the mechanical trauma of dressing removal. The most severe lesions, consisting of areas of skin loss, erythematous plaques and/or vesicles were classified as skin irritation and presented in 11 (44%) of the 25 patients. An association test showed that skin irritation was more frequent in patients who underwent allogeneic HSCT (p = 0.03). Skin irritation was most frequently observed in areas of contact with the non-woven polyester adhesive tape (n = 22;88%), which made up the adhesive margins of the dressing. The CIGD was discontinued in 6 (54%) of the 11 patients who presented severe skin injuries. Conclusion: In this study, we detected that skin irritation was more frequent in patients who underwent allogeneic HSCT. The most common skin manifestation was skin loss.

关键词： Bandages Catheterization Central Venous catheters Hematopoietic Stem Cell Transplantation Skin Abnormalities

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The Potential Sources of Transmitting of Hospital Acquired Infection by Routine Devices in Adult ICU in Alrass General Hospital

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Journal of Biosciences and Medicines 2020年第4期8卷 69-80页

作者： Reem Dbas Alharbi Amal Hussain Mohammed Ali Ahmad Almatroudi Shaimaa Mohamed Department of Medical Laboratories College of Applied Medical Sciences Qassim University Qassim KSA Alrass General Hospital Qassim Health Cluster Saudi Ministry of Health Qassim KSA

Hospital-acquired infections (HAI) reflect as a major global safety concern for both patients and health-care professionals. These infections could be in the form of cross-infection, endogenous infection and environmental Infection. Over 80% of these infections are related to devices’ utilization needed for patients’ life support. Methods show this is an observational and cross-sectional study, to identify the microorganism and determine the potential source of transmitting of hospital acquired infection by routine devices in adult ICU. The samples were collected using Amies transport media;three swabs were taken from the surfaces of indwelling urinary catheter, mechanical ventilation device and central venous catheter used from every twelve patients. The samples were cultured and analyzed by using microbiologic technique. Finally, all samples analyzed by MicroScan WalkAway 96 pulse. Results showing the most bacteria isolated are “Klebsiella pneumonia” (18.37%), “Acinetobacter baumannii” (11.48%), “Staphylococcus epidermidis” (4.59%), “Staphylococcus haemolyticus” (4.59%), “E. coli” (4.59%), “Serratia marcescens” (2.3%), “Pseudomonas luteola” (2.3%), “Kocurio kristinae” (2.3%) and “Photorhabdus luminscens” (2.3%). This study detects a high contamination of routine devices and resistant organisms. In the end it is recommended that effective infection control practices and effective strategies to control antibiotic-resistant bacteria should be applied.

关键词： Health-Acquired Infection ICU Devices catheters Mechanical Ventilator Device

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Umbilical Catheter Complications in Newborns during Prone Position: A Pilot Study

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Open Journal of Nursing 2014年第12期4卷 859-867页

作者： Inge Arnts Ninke Schrijvers Coranne Meester Joannes Groenewoud Kian Djien Liem Department of Neonatology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands Department of Pain and Palliative Care Nijmegen The Netherlands Department of Health Evidence Radboud University Nijmegen Medical Centre Nijmegen The Netherlands

Introduction: It is not known whether prone position of newborns with umbilical catheters increases the complication risk. Purpose: Analysing complications of umbilical catheters in newborns during prone positioning a... 详细信息

关键词： Umbilical Venous catheters Umbilical Arterial catheters Complications Nursing Care Prone Position Newborns

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Effect of Human Insulin on the Formation of Catheter-Associated <i>E. coli</i>Biofilms

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Open Journal of Urology 2014年第5期4卷 49-56页

作者： Balbina J. Plotkin Zijian Wu Kathleen Ward Shaven Nadella Jacalyn M. Green Benny Rumnani Department of Biochemistry Midwestern University Downers Grove USA Department of Microbiology and Immunology Midwestern University Downers Grove USA

Biofilm formation is essential for the survival and growth of Escherichia coli?in catheter-associated infections. Individuals with type 2 diabetes mellitus can excrete insulin and/or glucose in their urine. This population also has an increased incidence of urinary tract infections. The focus of this study was to determine if the composition of Foley catheter material affects biofilm formation by E. coli in a model system for type 2 diabetes mellitus. Rubber (lubricious-coated), silicon-coated, silver-coated and nitrofurazone-coated catheter segments (5 mm;n = 6) were tested. Catheter segments were added to E. coli ATCC25922 (104 CFU/ml, final concentration) in artificial urine alone, or with insulin (40 μU/ml) and/or glucose (0.1%). After incubation (18 h, 37?C, in air and anaerobically) the level of catheter-associated biofilm was determined by crystal violet staining (Abs550nm). Statistical analysis was done by ANOVA with post-hoc analysis (Tukey). Neither nitrofurazone-coated nor silver-coated catheters supported the formation of E. coli biofilm, regardless of growth condition tested. In contrast, under aerobic biofilm formation on silicon catheters was significantly higher (p E. coli controls. Biofilm formation was also significantly increased

关键词： Escherichia coli Insulin catheters Diabetes Mellitus Biofilm Electronegativity

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Study of the Effectiveness of Papaver Sp. Alkaloids as Future Therapeutic Alternatives against Enterococcus Sp. Causing Hospital-Acquired Septicemic Infections

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Journal of Biosciences and Medicines 2024年第8期12卷 107-127页

作者： Lama Mohammed Ayoub Shbibe Georgette Antranik Babojian Department of Plant Biology Faculty of Science Damascus University Damascus Syria

Background and Objective: In recent years, control of Enterococcus sp. It has been proven in the local medical environment to be a cause of acquired septicemia in various age groups, and medical instruments are considered an effective means of transmitting enterococcal septicemia, and catheters are at the forefront in terms of danger. Based on this risk, this study aimed to monitor the spread of Enterococcus sp., which causes blood poisoning acquired from catheters, and to compare its response to antibiotics with that of those isolated from clinical samples in children, as a first study locally. The effectiveness of alkaloids of different types of Papaver sp. In Syrian plants, they were tested against infection with this bacteria. Materials and Methods: The study dealt with two parts: The first part included collecting clinical samples from the University Children’s Hospital in Damascus/bacterial diagnostic laboratories/then isolating and diagnosing the bacteria by following a set of tests to identify the most prevalent genera and species and comparing their prevalence rate with Enterococcus. The second part;It included collecting plant samples, confirming the species taxonomically, then extracting alkaloids from plant parts (fruit, stem, Flowers), then comparing the extent of resistance of bacterial strains to antibiotics compared to the Enterococcus sp., and then confirming the antibacterial activity of the Papaver sp. alkaloids against Enterococcus sp. Result:In its first part, the study confirmed the significant contribution of the Enterococcus sp. to infections acquired from various sources, largely in catheter tip infections (9.09%) and to a lesser extent in other sources (3.7%), The second part was to confirm the effective-ness of the alkaloid extract of the Papaver sp., especially the two species Papaver syriacum, and Papaver dubium, against Enterococcus sp. with areole diameters that ranged between (15 - 26 mm) for the fruit extract and at a minimum inhibit

关键词： catheters Skin Ulcers Acquired Infection Multi-Resistant Enterococcus Sp. Papaver Sp. Alkaloids Minimum Inhibitory and Lethal Concentration

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Infective Endocarditis in Hemodialysis: Descriptive Study

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Open Journal of Nephrology 2022年第1期12卷 133-141页

作者： Nisrine Hikki Kaoutar Benraiss Mina Agrou Naima Ouzeddoun Rabia Bayahia Loubna Benamar Department of Nephrology-Dialysis-Renal Transplantation CHU Ibn-Sina Rabat Morocco Mohammed V University Rabat Morocco

Introduction: Infective endocarditis (IE) is a complication associated with high mortality in chronic hemodialysis patients. The aim of our study is to describe the clinical, radiological, microbiological characteristics, and risk factors of mortality in hemodialysis patients with infective endocarditis. Methods: A retrospective study from November 2019 to November 2021 including hemodialysis patients with IE hospitalized in Ibn Sina hospital center in Rabat. Results: Eighteen hemodialysis patients were included. Mean age was 49.5 ± 18 years, sex ratio was 0.8. catheters were the access sites most commonly used (72.3%). Median duration of hemodialysis was 12 [6;24] months. Staphylococcus species is major causative bacteria in 60%. The mitral valve was the most commonly affected (44%). Frequent complications including valve insufficiency (50%), septic embolism (66.7%). Four patients underwent surgery and eight died during hospitalization (44.5%). Mitral localization of vegetation was the only factor significantly associated with mortality in our study (P Conclusion: The catheter was the most commonly used access site compared to the arteriovenous fistula. This confirms that it’s the vascular access of choice for his low rate of infectious complication compared to the catheter.

关键词： catheters Endocarditis Hemodialysis Mortality Septic Emboli

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Biomechanical aspects of catheter-related thrombophlebitis

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Journal of Biomedical Science and Engineering 2013年第12期6卷 6-13页

作者： Oren Moshe Rotman Dalit Shav Sagi Raz Uri Zaretsky Shmuel Einav Department of Biomedical Engineering Tel Aviv University Tel Aviv Israel

Short peripheral catheters (SPCs) are the most common intravenous devices used in medical practice. Short peripheral catheter thrombophlebitis (SPCT) is the most frequent complication associated with SPCs, causing discomfort and usually leading to removal of the catheter and insertion of a new one at a different site. The aim of this research was to explore whether biomechanical factors, in addition to biochemical factors, also play a role in the formation of thrombophlebitis. Hence, two of the biomechanical aspects of SPCT were investigated: the physical pressure load exerted by the SPC on the endothelial monolayer, and disturbances in the flow patterns due to the SPC. Endothelial activation was studied by subjecting human umbilical vein endothelial cells (HUVEC) to a weight load of SPC pieces and measuring the release profile of von-Willebrand Factor (vWF) over time, using ELISA. vWF release was chosen as the measure for endothelial activation since it was the major component of the Weibel-Palade Bodies (WPBs), which underwent exocytosis by endothelial cells during activation. Flow patterns were analyzed on a 3D computational fluid dynamics (CFD) model of a brachiocephalic vein with SPC. vWF release profiles were significantly higher in the HUVECs subjected to the load, indicating HUVEC activation. CFD simulations demonstrated a decrease in flow velocities along the catheter body, between the catheter and the vein, due to an enlarged boundary layer. Results indicate that the contact region between the SPC body and the vein wall can be partially responsible for SPCT development, and inflammatory and coagulatory processes initiated by stimulated endothelial cells may be amplified due to disturbed blood flow.

关键词： Endothelial Activation vWF Thrombophlebitis Phlebitis Short Peripheral catheters Infusion Intravenous Access CFD

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Diagnosis and Treatment Options for Pulmonary Embolism (PE) in the Acute Care Setting

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World Journal of Cardiovascular Diseases 2018年第2期8卷 152-161页

作者： Simona Campa Raymund Gantioque California State University Los Angeles CA USA

Thromboembolic diseases continue to be one of the most prevalent medical problems today and can lead to life-threatening conditions, such as pulmonary embolism (PE). Currently, PE diagnosis and treatment are a challenge because of acute onset right ventricular strain with right-sided heart failure, sudden death, pulmonary infarction, and cardiogenic shock, which limit the time for therapeutic success.?The aim of this study was to evaluate our perception, knowledge, and concerns regarding PE, discuss the importance of promptly diagnosing PE to provide appropriate treatment options for this life-threatening condition, list the most common clinical manifestations present when PE is suspected, and review the clinical approach to patients with suspected PE in an inpatient setting.?In addition, this study reviews the risk stratification of patients with PE and treatment options beyond anticoagulation, compares new treatment options for patients presenting with acute symptomatic PE, and compares aspiration catheters (10 F Pronto .035” and 14 F XL extraction catheter (Vascular Solutions, Minneapolis, MN)) and ultrasound-assisted catheter-directed thrombolysis (USAT) versus systemic *** literature review was limited by the quality and number of studies available regarding new treatment options for patients presenting with acute symptomatic PE. Thus, more studies are needed to prove the validity of newer treatment options being trialed, such as aspiration catheters (10 F Pronto .035” and 14 F XL extraction catheter) and USAT, with the hope that further studies will guide patient management and increase our understanding of next generation aspiration catheters, which may provide novel insights on treating acute symptomatic PE.

关键词： Pulmonary Embolism (PE) Aspiration catheters (The 10 F Pronto .035” and 14 F XL Extraction Catheter (Vascular Solutions Minneapolis MN)) The Ultrasound-Assisted Catheter-Directed Thrombolysis (USAT) Systemic Thrombolysis

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A Novel, Safe Way of Removing Non-Deflatable Bladder Catheter

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Open Journal of Urology 2012年第4期2卷 243-245页

作者： Ziauddin Khan Umair Tahir Khan Imran Khan Tahir Naeem Khan Consultant in Urology Imam Abdulrahman bin Faisal Hospital Dammam Kingdom of Saudi Arabia Department of Pathology Northampton General Hospital Northampton UK Department of Radiology Kings College Hospital London London UK University of Leicester Leicester UK

Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the catheter, though these can be associated with complications. We illustrate a simple and a safe method to overcome this problem using a flexible cystoscope under local anaesthesia.

关键词： Balloon Dilation Urinary Catheterization Urinary Bladder catheters Equipment Failure

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Confirming longline position in neonates-Survey of practice in England and Wales

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World Journal of Clinical Pediatrics 2017年第3期6卷 149-153页

作者： Arunoday Arunoday Christos Zipitis Department of Paediatrics Royal Albert Edward Infirmary the University of Manchester Manchester Academic Health Science Centre Wrightington Wigan and Leigh NHS Foundation Trust Royal Albert Edward Infirmary

AIM To establish how neonatal units in England and Wales currently confirm longline tip position, immediately after insertion of a *** We conducted a telephone survey of 170 neonatal units(37 special care baby units, 81 local neonatal units and 52 neonatal intensive care units) across England and Wales over the period from January to May 2016. Data was collected on specifically designed proformas. We gathered information on the following: Unit Level designation; whether the unit used longlines and specific type used? Modality used to confirm longline tip position? Whether guide wires were routinely removed and contrast injected to determine longline position? The responders were primarily senior *** We had 100% response rate. Out of the total neonatal units surveyed(170) in England and Wales, 141 units(83%) used longlines. Fifty-five out of 81 local neonatal units(68%) using longlines, used ones that came with guide wires; a similar percentage of neonatal intensive care units, i.e., 31 out of 52 units(60%) did the same. All of those units used radiography, plain X-rays, to establish longline tip position. Out of 55 local neonatal units usinglonglines with guide wires, 42(76%) were not removing wire to use contrast while this figure was 58%(18 out of 31 units) for neonatal intensive care units. Overall, only 49 out of 141 units(35%) of the units using longlines were using contrast. However it was interesting to note that use of contrast increased as one moved from special care baby units(25%, 2 out of 8 units) to local neonatal units(28%, 23 out of 81 units) and neonatal intensive care units level(46%, 24 out of 52 units) designation. CONCLUSION Neonatal units in England and Wales are overwhelmingly relying on plain radiographs to assess longline tip position immediately after insertion. Despite evidence of its usefulness, and in the absence of perhaps more accurate methods of assessing longline tip position in a reliable and consistent way, i

关键词： Central venous catheters Newborn Contrast media Line placement Premature infants

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