| Records |
| Author |
Saleh, H.M.; Tawfik, M.M.; Abouellail, H. |
| Title |
Prospective, randomized study of long-term hemodialysis catheter removal versus guidewire exchange to treat catheter-related bloodstream infection |
Type |
Randomized Controlled Trial |
| Year |
2017 |
Publication |
Journal of Vascular Surgery |
Abbreviated Journal |
J Vasc Surg |
| Volume |
66 |
Issue |
5 |
Pages  |
1427-1431.e1 |
| Keywords |
Aged; Anti-Bacterial Agents/therapeutic use; Catheter-Related Infections/blood/diagnosis/microbiology/*therapy; Catheterization, Central Venous/*adverse effects/*instrumentation; Catheters, Indwelling/*adverse effects; Central Venous Catheters/*adverse effects; *Device Removal/adverse effects; Disease-Free Survival; Egypt; Equipment Design; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prospective Studies; Renal Dialysis; Risk Factors; Time Factors; Treatment Outcome |
| Abstract |
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter. The aim of this study was to compare the clinical outcome of CRBSI treated with two different strategies: GE vs CR with new catheter insertion 3 to 7 days later. METHODS: This prospective randomized study analyzed the outcomes of all cases of long-term hemodialysis CRBSI during a 5-year period. The catheter infection-free survival time was analyzed in the two groups of patients (GE group, 339 patients; CR group, 339 patients). Three weeks of systemic antibiotic therapy was used according to culture in both groups. The catheter infection-free survival was analyzed using Kaplan-Meier analysis. RESULTS: No statistically significant difference was found in catheter infection-free survival time for GE and CR groups (P = .69), which is not affected by age, sex, presence of diabetes mellitus, or type of causative organism. CONCLUSIONS: Our study did not demonstrate a difference in the clinical outcome of CRBSI treated with GE or CR with new catheter insertion 3 to 7 days later. However, guidewire catheter exchange saves veins for future access, reduces the cost and number of procedures, and avoids complications of new venipuncture. |
| Address |
Department of Nephrology, Ain Shams University, El Demerdash Hospital, Cairo, Egypt |
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English |
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| ISSN |
0741-5214 |
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| Notes |
PMID:28822660 |
Approved |
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| Call Number |
ref @ user @ |
Serial |
99317 |
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| Author |
Saleh, H.M.; Tawfik, M.M.; Abouellail, H. |
| Title |
Prospective, randomized study of long-term hemodialysis catheter removal versus guidewire exchange to treat catheter-related bloodstream infection |
Type |
Randomized Controlled Trial |
| Year |
2017 |
Publication |
Journal of Vascular Surgery |
Abbreviated Journal |
J Vasc Surg |
| Volume |
66 |
Issue |
5 |
Pages |
1427-1431.e1 |
| Keywords |
Aged; Anti-Bacterial Agents/therapeutic use; Catheter-Related Infections/blood/diagnosis/microbiology/*therapy; Catheterization, Central Venous/*adverse effects/*instrumentation; Catheters, Indwelling/*adverse effects; Central Venous Catheters/*adverse effects; *Device Removal/adverse effects; Disease-Free Survival; Egypt; Equipment Design; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prospective Studies; Renal Dialysis; Risk Factors; Time Factors; Treatment Outcome |
| Abstract |
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter. The aim of this study was to compare the clinical outcome of CRBSI treated with two different strategies: GE vs CR with new catheter insertion 3 to 7 days later. METHODS: This prospective randomized study analyzed the outcomes of all cases of long-term hemodialysis CRBSI during a 5-year period. The catheter infection-free survival time was analyzed in the two groups of patients (GE group, 339 patients; CR group, 339 patients). Three weeks of systemic antibiotic therapy was used according to culture in both groups. The catheter infection-free survival was analyzed using Kaplan-Meier analysis. RESULTS: No statistically significant difference was found in catheter infection-free survival time for GE and CR groups (P = .69), which is not affected by age, sex, presence of diabetes mellitus, or type of causative organism. CONCLUSIONS: Our study did not demonstrate a difference in the clinical outcome of CRBSI treated with GE or CR with new catheter insertion 3 to 7 days later. However, guidewire catheter exchange saves veins for future access, reduces the cost and number of procedures, and avoids complications of new venipuncture. |
| Address |
Department of Nephrology, Ain Shams University, El Demerdash Hospital, Cairo, Egypt |
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English |
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| ISSN |
0741-5214 |
ISBN |
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| Notes |
PMID:28822660 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
100347 |
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| Author |
Castillo, M.E.; Molina, J.R.; Rodriguez Y Silva, F.; Garcia-Chevesich, P.; Garfias, R. |
| Title |
A system to evaluate fire impacts from simulated fire behavior in Mediterranean areas of Central Chile |
Type |
Journal Article |
| Year |
2017 |
Publication |
The Science of the Total Environment |
Abbreviated Journal |
Sci Total Environ |
| Volume |
579 |
Issue |
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Pages |
1410-1418 |
| Keywords |
Wildfire behavior; Wildfire intensity; Wildfire simulation |
| Abstract |
Wildfires constitute the greatest economic disruption to Mediterranean ecosystems, from a socio-economic and ecological perspective (Molina et al., 2014). This study proposes to classify fire intensity levels based on potential fire behavior in different types of Mediterranean vegetation types, using two geographical scales. The study considered >4 thousand wildfires over a period of 25years, identifying fire behavior on each event, based on simulations using “KITRAL”, a model developed in Chile in 1993 and currently used in the entire country. Fire intensity values allowed results to be classified into six fire effects categories (levels), each of them with field indicators linking energy values with damage related to burned vegetation and wildland urban interface zone. These indicators also facilitated a preliminary assessment of wildfire impact on different Mediterranean land uses and, are therefore, a useful tool to prioritize future interventions. |
| Address |
International Hydrology Research Group, Faculty of Forest Sciences and Nature Conservancy, University of Chile |
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English |
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| ISSN |
0048-9697 |
ISBN |
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| Notes |
PMID:27923572 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
97511 |
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| Author |
Thomas, A.A.; Abrey, L.E.; Terziev, R.; Raizer, J.; Martinez, N.L.; Forsyth, P.; Paleologos, N.; Matasar, M.; Sauter, C.S.; Moskowitz, C.; Nimer, S.D.; DeAngelis, L.M.; Kaley, T.; Grimm, S.; Louis, D.N.; Cairncross, J.G.; Panageas, K.S.; Briggs, S.; Faivre, G.; Mohile, N.A.; Mehta, J.; Jonsson, P.; Chakravarty, D.; Gao, J.; Schultz, N.; Brennan, C.W.; Huse, J.T.; Omuro, A. |
| Title |
Multicenter phase II study of temozolomide and myeloablative chemotherapy with autologous stem cell transplant for newly diagnosed anaplastic oligodendroglioma |
Type |
Journal Article |
| Year |
2017 |
Publication |
Neuro-Oncology |
Abbreviated Journal |
Neuro Oncol |
| Volume |
19 |
Issue |
10 |
Pages |
1380-1390 |
| Keywords |
1p/19q codeletion; anaplastic oligodendroglioma; autologous stem cell transplant; temozolomide |
| Abstract |
Background: Anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA) are chemotherapy-sensitive tumors with prolonged survival after radiochemotherapy. We report a prospective trial using induction temozolomide (TMZ) followed by myeloablative high-dose chemotherapy (HDC) with autologous stem-cell transplant (ASCT) as a potential strategy to defer radiotherapy. Methods: Patients with AO/AOA received 6 cycles of TMZ (200 mg/m2 x 5/28 day). Responding patients were eligible for HDC (thiotepa 250 mg/m2/day x 3 days, then busulfan 3.2 mg/kg/day x 3 days), followed by ASCT. Genomic characterization was performed using next-generation sequencing. Results: Forty-one patients were enrolled; 85% had 1p/19q codeleted tumors. After induction, 26 patients were eligible for HDC-ASCT and 21 agreed to proceed. There were no unexpected adverse events or toxic deaths. After median follow-up of 66 months, 2-year progression-free survival (PFS) for transplanted patients was 86%, 5-year PFS 60%, and no patient has died. Among all 1p/19q codeleted patients (N = 33), 5-year PFS was 50% and 5-year overall survival (OS) 93%, with median time to radiotherapy not reached. Next-generation sequencing disclosed typical oligodendroglioma-related mutations, including IDH1, TERT, CIC, and FUBP1 mutations in 1p/19q codeleted patients, and glioblastoma-like signatures in 1p/19q intact patients. Aside from IDH1, potentially oncogenic/actionable mutations were variable, depicting wide molecular heterogeneity within oligodendroglial tumors. Conclusions: TMZ followed by HDC-ASCT can be safely administered to patients with newly diagnosed 1p/19q codeleted AO. This strategy was associated with promising PFS and OS, suggesting that a chemotherapy-based approach may delay the need for radiotherapy and radiation-related toxicities. Raw data for further genomic and meta-analyses are publicly available at http://cbioportal.org/study?id=odgmsk2017, accessed 6 January 2017. Clinicaltrials.gov registry: NCT00588523. |
| Address |
Memorial Sloan Kettering Cancer Center, New York, New York,USA; Northwestern Memorial Hospital, Chicago, Illinois, USA; NorthShore University, Evanston, Illinois,USA; University of Calgary, Calgary, Alberta, Canada; Massachusetts General Hospital, Boston, Massachusetts, USA; MD Anderson Cancer Center, Houston, Texas, USA |
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English |
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1522-8517 |
ISBN |
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| Notes |
PMID:28472509 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
96586 |
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| Author |
Loza-Correa, M.; Kou, Y.; Taha, M.; Kalab, M.; Ronholm, J.; Schlievert, P.M.; Cahill, M.P.; Skeate, R.; Cserti-Gazdewich, C.; Ramirez-Arcos, S. |
| Title |
Septic transfusion case caused by a platelet pool with visible clotting due to contamination with Staphylococcus aureus |
Type |
Journal Article |
| Year |
2017 |
Publication |
Transfusion |
Abbreviated Journal |
Transfusion |
| Volume |
57 |
Issue |
5 |
Pages |
1299-1303 |
| Keywords |
Aged; Anti-Bacterial Agents/therapeutic use; Central Venous Catheters/microbiology; Erythrocyte Transfusion/adverse effects; Female; Humans; Leukemia, Myeloid, Acute/therapy; Platelet Transfusion/*adverse effects; Sepsis/*etiology; Staphylococcal Infections/*transmission; *Staphylococcus aureus; Transfusion Reaction/*microbiology |
| Abstract |
BACKGROUND: Contamination of platelet concentrates (PCs) with Staphylococcus aureus is one of the most significant ongoing transfusion safety risks in developed countries. CASE REPORT: This report describes a transfusion reaction in an elderly patient diagnosed with acute myeloid leukemia, transfused with a 4-day-old buffy coat PC through a central venous catheter. The transfusion was interrupted when a large fibrous clot in the PC obstructed infusion pump flow. Shortly afterward, a red blood cell (RBC) unit transfusion started. After septic symptoms were developed, the RBC transfusion was also interrupted. While the RBC unit tested negative for bacterial contamination, the PC and the patient samples were found to be contaminated with a S. aureus strain that exhibited the same phenotypic and genome sequencing profiles. The isolated S. aureus forms biofilms and produces the superantigen enterotoxin-like U, which was detected in a sample of the transfused PCs. The patient received posttransfusion antibiotic treatment and had her original central line removed and replaced. DISCUSSION: As the implicated PC had been tested for bacterial contamination during routine screening yielding negative results, this is a false-negative transfusion sepsis case. Using a point-of-care test could have prevented the transfusion reaction. This report highlights the increasing incidence of S. aureus as a major PC contaminant with grave clinical implications. Importantly, S. aureus is able to interact with platelet components resulting in visible changes in PCs. CONCLUSION: Visual inspection of blood components before transfusion is an essential safety practice to interdict the transfusion of bacterially contaminated units. |
| Address |
Canadian Blood Services |
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English |
Summary Language |
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0041-1132 |
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| Notes |
PMID:28205241 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
99087 |
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