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Shuichi Ito - One of the best experts on this subject based on the ideXlab platform.

  • Central Venous Catheter infection-related glomerulonephritis under long-term parenteral nutrition: a report of two cases
    BMC research notes, 2016
    Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi Ito
    Abstract:

    Advances in long-term parenteral nutrition via indwelling Central Venous Catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to Central Venous Catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomerulonephritis associated with Central Venous Catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial shunt is known to cause glomerulonephritis, a condition termed shunt nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomerulonephritis associated with Central Venous Catheter infection. Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via Central Venous Catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the Central Venous Catheter. Their renal biopsy revealed membranoproliferative glomerulonephritis with positive C3 deposition. One of them recovered completely following the removal of Catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. As Central Venous Catheter infection-related glomerulonephritis has a similar etiology to shunt nephritis, removal of the Catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical shunt nephritis is decreasing since the ventricular-peritoneal shunt has become became the major procedure for hydrocephalus, Central Venous Catheter infection-related glomerulonephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of Central Venous Catheter infection-related glomerulonephritis.

  • Central Venous Catheter infection-related glomerulonephritis under long-term parenteral nutrition: a report of two cases
    BMC Research Notes, 2016
    Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi Ito
    Abstract:

    Background Advances in long-term parenteral nutrition via indwelling Central Venous Catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to Central Venous Catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomerulonephritis associated with Central Venous Catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial shunt is known to cause glomerulonephritis, a condition termed shunt nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomerulonephritis associated with Central Venous Catheter infection. Case presentation Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via Central Venous Catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the Central Venous Catheter. Their renal biopsy revealed membranoproliferative glomerulonephritis with positive C3 deposition. One of them recovered completely following the removal of Catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. Conclusion As Central Venous Catheter infection-related glomerulonephritis has a similar etiology to shunt nephritis, removal of the Catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical shunt nephritis is decreasing since the ventricular-peritoneal shunt has become became the major procedure for hydrocephalus, Central Venous Catheter infection-related glomerulonephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of Central Venous Catheter infection-related glomerulonephritis.

Ronald S Chamberlain - One of the best experts on this subject based on the ideXlab platform.

G B Goodman - One of the best experts on this subject based on the ideXlab platform.

  • cardiac tamponade caused by Central Venous Catheter perforation of the heart a preventable complication
    Journal of The American College of Surgeons, 1995
    Co-Authors: P E Collier, G B Goodman
    Abstract:

    BACKGROUND: Pericardial tamponade caused by Central Venous Catheter perforation of the heart is a catastrophic complication that can be prevented by attention to proper positioning of the Catheter tip proximal to the cardiac silhouette. This study was performed to determine awareness of this potential complication among physicians and to suggest measures to minimize the incidence of this problem. STUDY DESIGN: Clinical and radiologic features of 11 cases were evaluated. House officers and attending staff who frequently pass Central Venous Catheters and train junior physicians to place these Catheters were questioned specifically to test their awareness of this complication and their knowledge of optimal Catheter tip positioning. Attending radiology staff physicians were questioned similarly. The written protocols of local community hospitals with respect to Central Venous Catheter placement were reviewed to determine their criteria for optimal Catheter placement. RESULTS: Ten of the 11 cases reviewed resulted in death; the 11th case resulted in severe anoxic brain insult with a persistent vegetative state. In the ten cases that had radiologic studies available for review, the Central Venous Catheter tip was seen to lie malpositioned within the cardiac silhouette. Questioning of house officers and attending staff as well as attending radiology staff revealed a lack of awareness of this problem generally and a lack of knowledge of optimal Catheter tip positioning specifically. The protocols of area hospitals revealed similar findings with respect to this potential complication. CONCLUSIONS: Pericardial tamponade resulting from Central Venous Catheter perforation of the heart can be avoided by adherence to proper technique in the placement of these Catheters, ensuring that the Catheter tip lies proximal to the cardiac silhouette, optimally in the superior vena cava, 2 cm proximal to the pericardial reflection. Physicians who place these Catheters and train others to do so must be aware of this issue and they must educate their trainees as well. Radiologists responsible for interpreting the roentgenographs of the chest obtained after Catheter placement should be alert to Catheter malposition and communicate this information promptly. Hospital protocols should deal with this issue explicitly and insist on repositioning of Catheters if Catheter tips are seen to lodge in suboptimal positions.

  • cardiac tamponade caused by Central Venous Catheter perforation of the heart a preventable complication
    Journal of The American College of Surgeons, 1995
    Co-Authors: P E Collier, G B Goodman
    Abstract:

    BACKGROUND: Pericardial tamponade caused by Central Venous Catheter perforation of the heart is a catastrophic complication that can be prevented by attention to proper positioning of the Catheter tip proximal to the cardiac silhouette. This study was performed to determine awareness of this potential complication among physicians and to suggest measures to minimize the incidence of this problem. STUDY DESIGN: Clinical and radiologic features of 11 cases were evaluated. House officers and attending staff who frequently pass Central Venous Catheters and train junior physicians to place these Catheters were questioned specifically to test their awareness of this complication and their knowledge of optimal Catheter tip positioning. Attending radiology staff physicians were questioned similarly. The written protocols of local community hospitals with respect to Central Venous Catheter placement were reviewed to determine their criteria for optimal Catheter placement. RESULTS: Ten of the 11 cases reviewed resulted in death; the 11th case resulted in severe anoxic brain insult with a persistent vegetative state. In the ten cases that had radiologic studies available for review, the Central Venous Catheter tip was seen to lie malpositioned within the cardiac silhouette. Questioning of house officers and attending staff as well as attending radiology staff revealed a lack of awareness of this problem generally and a lack of knowledge of optimal Catheter tip positioning specifically. The protocols of area hospitals revealed similar findings with respect to this potential complication. CONCLUSIONS: Pericardial tamponade resulting from Central Venous Catheter perforation of the heart can be avoided by adherence to proper technique in the placement of these Catheters, ensuring that the Catheter tip lies proximal to the cardiac silhouette, optimally in the superior vena cava, 2 cm proximal to the pericardial reflection. Physicians who place these Catheters and train others to do so must be aware of this issue and they must educate their trainees as well. Radiologists responsible for interpreting the roentgenographs of the chest obtained after Catheter placement should be alert to Catheter malposition and communicate this information promptly. Hospital protocols should deal with this issue explicitly and insist on repositioning of Catheters if Catheter tips are seen to lodge in suboptimal positions.

Mari Okada - One of the best experts on this subject based on the ideXlab platform.

  • Central Venous Catheter infection-related glomerulonephritis under long-term parenteral nutrition: a report of two cases
    BMC research notes, 2016
    Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi Ito
    Abstract:

    Advances in long-term parenteral nutrition via indwelling Central Venous Catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to Central Venous Catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomerulonephritis associated with Central Venous Catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial shunt is known to cause glomerulonephritis, a condition termed shunt nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomerulonephritis associated with Central Venous Catheter infection. Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via Central Venous Catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the Central Venous Catheter. Their renal biopsy revealed membranoproliferative glomerulonephritis with positive C3 deposition. One of them recovered completely following the removal of Catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. As Central Venous Catheter infection-related glomerulonephritis has a similar etiology to shunt nephritis, removal of the Catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical shunt nephritis is decreasing since the ventricular-peritoneal shunt has become became the major procedure for hydrocephalus, Central Venous Catheter infection-related glomerulonephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of Central Venous Catheter infection-related glomerulonephritis.

  • Central Venous Catheter infection-related glomerulonephritis under long-term parenteral nutrition: a report of two cases
    BMC Research Notes, 2016
    Co-Authors: Mari Okada, Mai Sato, Masao Ogura, Koichi Kamei, Kentaro Matsuoka, Shuichi Ito
    Abstract:

    Background Advances in long-term parenteral nutrition via indwelling Central Venous Catheter have improved the quality of life and mortality in patients with life-threatening gastrointestinal diseases complicated with severely impaired absorption. However, infection to Central Venous Catheter is still a common and critical complication for such patients. We encountered two patients under long-term parenteral nutrition who developed glomerulonephritis associated with Central Venous Catheter infection. Persistent bacterial infection in indwelling medical devices placed in the blood-stream such as a ventricular-atrial shunt is known to cause glomerulonephritis, a condition termed shunt nephritis. We reported the clinical manifestations, treatment and their pathological findings in the two patients with glomerulonephritis associated with Central Venous Catheter infection. Case presentation Both patients suffered from megacystis microcolon intestinal hypoperistalsis syndrome, a form of pseudo-Hirschsprung’s disease. They had been receiving home parenteral nutrition via Central Venous Catheter because of severe malabsorption. They presented proteinuria, hematuria, hypocomplementemia and positive PR3-antineutrophilic cytoplasmic antibody accompanied by Staphylococcus epidermidis infection in the Central Venous Catheter. Their renal biopsy revealed membranoproliferative glomerulonephritis with positive C3 deposition. One of them recovered completely following the removal of Catheter and administration of antibiotics, while another did not respond to the treatments. We then treated her with methylprednisolone pulse therapy followed by prednisolone. She responded well, and achieved complete remission. Conclusion As Central Venous Catheter infection-related glomerulonephritis has a similar etiology to shunt nephritis, removal of the Catheter and administration of antibiotics is fundamental to the treatment. If a patient is resistant to such conventional therapy, additional steroid and/or immunosuppressive agent could be considered. Although the number of patients with classical shunt nephritis is decreasing since the ventricular-peritoneal shunt has become became the major procedure for hydrocephalus, Central Venous Catheter infection-related glomerulonephritis may increase in the future due to a marked increase in the number of patients receiving long-term parenteral nutrition. Routine urinalysis should be considered in such patients for early detection of Central Venous Catheter infection-related glomerulonephritis.

Gail Donofrio - One of the best experts on this subject based on the ideXlab platform.