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Background: Catheter-associated urinary tract infections (CAUTIs) are common health care–associated infections linked to indwelling urinary catheters. Nurse-driven protocols (NDPs) empower nurses to direct care without physician orders, potentially enhancing patient outcomes and reducing infection rates. Purpose: This systematic review and meta-analysis aimed to evaluate the effectiveness of NDPs for preventing CAUTIs and reducing catheter utilization rates. Methods: Databases searched included Cochrane Library, PubMed, Embase, and others. Ten studies involving 27, 965 NDP-treated patients and 30, 230 controls were reviewed, examining catheter utilization rates and CAUTI incidence. Results: Use of NDPs significantly lowered catheter utilization rates (34.84% vs 49.40%) and CAUTI incidence (2.867% vs 6.503%). Risk ratio analysis revealed a 29.48% decrease in catheter utilization and a 55.91% reduced CAUTI risk with NDP implementation. Conclusions: Using NDPs demonstrate superior efficacy in reducing catheter use and CAUTI occurrence compared to traditional methods. Further research is warranted to solidify evidence-based nursing practices in this area. [ABSTRACT FROM AUTHOR]

A central venous catheter is often used when managing patients who need hemodialysis. Venous thrombus formation is often a complication of catheter placement. Most patients with catheter-related thrombus (CRT) are asymptomatic. Gray scale and duplex sonography have a high sensitivity and specificity rate for detecting CRT. This case study presents a patient with a CRT and reviews the structures a sonographer should assess when a patient presents for evaluation of the lower extremity venous system, with an iliofemoral catheter in place. [ABSTRACT FROM AUTHOR]

Blood collection, one of the most frequently performed procedures in healthcare settings. The study aimed to develop a scale for phlebotomy procedures based on national phlebotomy guidelines and to assess the tendencies of phlebotomy personnel in certain blood collection practices.The survey included a 5-point likert scale, which consisted of 20 items and multiple-choice questions. The survey was disseminated to the attendees via an online platform (Google Forms®, Mountain View, California, USA), and they were requested to complete it, and a total of 1,439 participants were included in the study.The data showed that the scale complied with the guidelines and was highly valid and reliable. A significant finding from the study indicates that 47.9 % of the participants (689 individuals) chose the syringe response during the blood collection procedure. The variable of prior phlebotomy training exhibited no statistically significant effect on these responses (χ²=1.893, p=0.093). A statistically significant difference was observed in the frequency of tendencies for using intravenous cannulas/catheters in inpatient settings (p<0.05).The standardization of blood collection practices may be enhanced through the implementation of these procedures by specialized medical professionals. It is necessary to audit the quality of current practices and identify the most vulnerable steps in phlebotomy. The implementation of phlebotomy guidelines in healthcare settings should be encouraged. Furthermore, greater commitment is required from relevant authorities to develop educational programs and establish continuous education courses for healthcare phlebotomy personnel. [ABSTRACT FROM AUTHOR]

The fabrication of force sensors is reported using ZnO/ZnMgO coaxial nanorod arrays grown on a titanium (Ti) wire and their application for force monitoring inside a blood vessel during catheterization procedures. The core‐shell nanorod arrays are grown using catalyst‐free metal–organic chemical vapor deposition (MOCVD), enabling precise control over the growth and morphology of the nanorod arrays. The ZnO/ZnMgO heterostructures grown on Ti‐wires are characterized using various techniques and confirmed for suitability for force sensing applications. The force sensor is fabricated by creating Schottky metal contacts at the nanorod tips, while an insulating polyimide layer fills the gaps between the nanorod arrays, electrically separating the top metal contact from the bottom Ti‐wire. The sensor's performance is evaluated under various force conditions using a voice coil motor with a soft polydimethylsiloxane (PDMS)  pressure stamp to mimic the contact force between the sensor and the blood vessel. The sensor demonstrated high sensitivity, stable, and fast force responses under periodic applied forces. Furthermore, the force sensor is integrated with catheter for contact force monitoring inside an artificial blood vessel. The fabrication of force sensor on a Ti‐wire substrate creates a flexible, biocompatible sensing element suitable for implantation and real‐time force monitoring in vascular environment. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs), including congenital heart diseases (CHD), present significant global health challenges, emphasizing the need for safe and effective treatment modalities. Fluoroscopy‐guided endovascular interventions are widely utilized but raise concerns about ionizing radiation, especially in pediatric cases. Magnetic resonance imaging (MRI) offers a radiation‐free alternative with superior soft tissue visualization and functional insights. However, the lack of compatible instruments remains a major obstacle. An adapted thermal drawing platform that enables low‐cost and rapid prototyping of instruments for MR‐guided endovascular interventions is introduced. This platform is demonstrated through the development of two exemplary catheter systems: a tendon‐driven steerable catheter with helical lumina and an active tracking Tiger‐shaped catheter with an embedded coaxial wire. These catheters exhibit mechanical properties comparable to commercial counterparts and show promising outcomes in both in vitro and in vivo feasibility testing. This scalable thermal drawing platform addresses the limitations of existing manufacturing approaches and facilitates the exploration of diverse designs, potentially accelerating advancements in catheter technologies for MR‐guided cardiovascular interventions. [ABSTRACT FROM AUTHOR]

Currently, there is no consensus on the optimal timing for the initiation of peritoneal dialysis (PD) after catheter placement. Systematic review and meta-analysis. From inception till July 31, 2023. To assess the outcomes and safety of unplanned PD initiation (<14/7 days after catheter insertion) in cohort studies. Fifteen studies involving 3054 participants were included. (1) The risk of unplanned initiation of leakage and Obstruction was no difference in both the break-in period (BI) <14 and BI < 7 groups. (2) Catheter displacement was more likely to occur in the emergency initiation group with BI < 7. (3) No significant differences were observed between the two groups regarding infectious complications. (4) There was no difference in transition to HD between patients with BI < 7 and BI < 14 d. Infectious complications of unplanned initiation of peritoneal dialysis did not differ from planned initiation. Emergency initiation in the BI < 7 group had higher catheter displacement, but heterogeneity was higher. There were no differences in leakage or obstruction in either group. Catheter survival was the same for emergency initiation of peritoneal dialysis compared with planned initiation of peritoneal dialysis and did not increase the risk of conversion to hemodialysis. This meta-analysis was registered on PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, number: CRD42023431369) [ABSTRACT FROM AUTHOR]

Successful closure of patent ductus arteriosus (PDA) can be obtained with surgical ligation or with occlusion via minimally invasive per-catheter techniques. This study was performed to assess feasibility and effectiveness of transjugular PDA occlusion in dogs weighing < 3 kg with a device called Nit-Occlud® PDA. Thirteen client-owned dogs. This was a retrospective study. Clinical records of dogs that underwent PDA occlusion with a Nit-Occlud® PDA were reviewed. Data collection included patients' signalment, clinical findings, pre- and post-procedure echocardiographic measurements, device size, procedure time and clinical outcome. The median age of these patients was six months (2.5-38.0 months), with a mean body weight of 2.44 ± 0.43 kg. The mean minimal ductal diameter (MDD) was 1.82 ± 0.43 mm, while the mean ampulla diameter (AD) was 5.51 ± 1.89 mm. Duct closure was successful in 12 cases. Minimal or no residual shunt was observed on echocardiography prior to device release. In one dog, the device was not released owing to unsatisfactory occlusion, prompting an alternative occlusion method. Follow-up echocardiographic examinations showed complete ductal closure and reversed cardiac remodelling in all cases where the device was successfully released. The Nit-Occlud® is deployed through a delivery system with an outer diameter of 4 Fr or 5 Fr, which makes this solution particularly attractive in patients where vascular access is challenging or unfeasible due to the small size of their vessels. The Nit-Occlud® PDA appears a feasible and effective occlusion system in small patients weighing <3 kg. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe a straightforward, efficient, and reliable technique to simplify cannulation maneuvers during aortic branched endograft repair. Technique: The suggested approach utilizes the Penumbra Neuron Select catheter, which combines diagnostic, sizing, and support capabilities in one. This has the potential to reduce procedural time and minimize the need for serial catheter and guidewire exchanges. Conclusions: The proposed technique offers a simple yet effective tool to mitigate the risk of vessel loss and injury, and to streamline complex aortic repair procedures. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) using photosensitizer (PS)‐embedded silicone membrane‐covered self‐expandable metallic stents (SEMSs) can function in palliative therapeutic option for malignant gastrointestinal tract obstruction. However, stent‐related complications should be considered, and accurate delivery of light sources is technically difficult. Here, a Chlorin e6 (Ce6)‐an embedded stent‐based catheter is developed to improve its therapeutic efficacy and safety. PDT using Ce6‐embedded stent successfully induced cell death of colorectal cancer cell line. PDT‐treated liver tissues showed an increase in ablation depth in proportion to irradiation energy, and 600 J/cm2 demonstrates an even and sufficient ablation depth. Endoluminal PDT using the Ce6‐embedded stent‐based catheter was technically successful in a rat colon model without procedure‐related complications such as colonic perforation or stricture formation. The results in colonoscopy, colonography, and histological examination, along with statistical analysis, suggest that a novel PDT modality using a Ce6‐embedded stent‐based catheter was safely conducted and demonstrated apoptotic cell death at 12 h after PDT, and it gradually recovered from 2 to 4 weeks. Thus, the PDT using the Ce6‐embedded stent‐based catheter may represent a promising new approach for the treatment of malignant colorectal obstruction. [ABSTRACT FROM AUTHOR]

Purpose: To describe the surgical technique using a 10/14 French silicone urinary catheter as a novel tissue expander for repair of defects after removal of eyelid tumors. This device recruits additional tissue by tissue expansion for repair of large eyelid defects. Methods: A prospective noncomparative, interventional case study was conducted over a period of 3 years in which 30 patients were enrolled. All the 30 patients were selected for upper or lower lid Tenzel rotational flap after removal of large malignant tumor, using the tissue expander. Results: A 10/14-French silicone urinary catheter was placed in the periocular region and expanded by graded inflation with normal saline to a total volume of 10 or 14 ml, respectively, over a period of 3 days. On the fourth day before the planned surgery, the catheter balloon was deflated and a modified Tenzel rotational flap was performed to close the defect. Postoperative blink reflex was preserved. There were no cases of wound dehiscence. There was a significant reduction of incision length in upper and lower lid reconstruction with modified Tenzel flap reconstruction. Conclusion: This approach allows for temporary tissue expansion, permitting the closure of large eyelid defects, typically not possible with a conventional Tenzel flap. This also provides excellent functional outcomes without closing patients' eyelids (which limits vision for weeks to months) as is typical of other reconstructive modalities (e.g. Cutler Beard procedure). The device is cost-effective and readily available. The authors believe it is an excellent alternative in the developing world where access to more expensive options is limited. [ABSTRACT FROM AUTHOR]

Purpose: The direct aspiration first pass technique (ADAPT) is an effective and safe endovascular treatment for distal medium vessel occlusions (DMVOs). We evaluated technical features and initial results of a novel reperfusion catheter (REDTM 62) used for frontline aspiration thrombectomy of M2 occlusions in acute ischemic stroke patients. Appropriate aspiration catheters are crucial for a successful ADAPT maneuver; however, the selection of catheters suitable for smaller-sized vessels is scarce compared to the ones for large vessel occlusions. Materials and Methods: All patients treated with ADAPT using REDTM 62 as the frontline treatment approach for acute M2 occlusions between December 2022 and February 2024 were retrospectively enrolled. Demographic data, procedural timings and safety, recanalization rates, and outcome data were recorded. Results: Twenty patients with a median admission National Institutes of Health Stroke Scale (NIHSS) score of 8 were identified. Successful revascularization (DMVO-thrombolysis in cerebral infarction [TICI]≥2b) with REDTM 62 aspiration thrombectomy was obtained in 65.0% (13/20) of cases. The first pass effect was 45.0% (9/20). In 2 cases, the REDTM 62 did not reach the clot due to marked distal vessel tortuosity. Stent retrievers were additionally used in 9 cases and led to an overall DMVO-TICI 2c/3 of 90.0% (18/20). Mean procedural time was 48 minutes. No complications directly related to ADAPT occurred. In-hospital mortality rate was 20.0% (4/20). The median discharge NIHSS score was 2.5. A good functional outcome at discharge (modified Rankin scale 0-2) was achieved in 55.0% (11/20) of cases. Conclusion: Our initial experiences with the novel REDTM 62 reperfusion catheter for treatment of M2 occlusions is in line with published data. ADAPT using this catheter may be considered as a safe and effective first-line treatment option. Further studies are warranted to validate the initial results. [ABSTRACT FROM AUTHOR]

Introduction: Peritoneal catheters are a fundamental form of dialysis access. An appreciation of the principles of catheter design is important for practitioners involved in the insertion and maintenance of peritoneal dialysis access. Although silicone dual-cuffed catheters are standard, the optimal catheter design remains uncertain. Areas covered: This narrative review outlines common peritoneal dialysis catheter characteristics and summarizes their practical relevance. Catheter material, cuffs, tips, and tunneled segment shape are discussed. Expert opinion: Peritoneal dialysis catheter selection is informed by theoretic design principles and limited clinical evidence, but operator experience and patient and center factors are probably stronger predictors of outcomes. [ABSTRACT FROM AUTHOR]

Cardiac mapping is a crucial procedure for diagnosing and treating cardiac arrhythmias. Still, current clinical techniques face limitations including insufficient electrode coverage, poor conformability to complex heart chamber geometries, and high costs. This study explores the design, testing, and validation of a 64-electrode soft robotic catheter that addresses these challenges in cardiac mapping. A dual-layer flexible printed circuit board (PCB) was designed and integrated with sensors into a soft robotic sensor array (SRSA) assembly. Design considerations included flex PCB layout, routing, integration, conformity to heart chambers, sensor placement, and catheter durability. Rigorous SRSA in vitro testing evaluated the burst/leakage pressure, block force for electrode contact, mechanical integrity, and environmental resilience. For in vivo validation, a porcine model was used to demonstrate the successful deployment, conformability, and acquisition of electrograms in both the ventricles and atria. This catheter-deployable SRSA represents a meaningful step towards translating the integration of soft robotic actuators and stretchable electronics for clinical use, showcasing the unique mechanical and electrical performance that these designs enable. The high-density electrode array enabled rapid 2 s data acquisition with detailed spatial and temporal resolution, as illustrated by the clear and consistent cardiac signals recorded across all electrodes. The future of this work will lie in enabling high-density, anatomically conformable devices for detailed cardiac mapping to guide ablation therapy and other interventions. [ABSTRACT FROM AUTHOR]

Aims: The incidence of limb fractures in patients living with HIV (PLWH) is increasing. However, due to their immunodeficiency status, the operation and rehabilitation of these patients present unique challenges. Currently, it is urgent to establish a standardized perioperative rehabilitation plan based on the concept of enhanced recovery after surgery (ERAS). This study aimed to validate the effectiveness of ERAS in the perioperative period of PLWH with limb fractures. Methods: A total of 120 PLWH with limb fractures, between January 2015 and December 2023, were included in this study. We established a multidisciplinary team to design and implement a standardized ERAS protocol. The demographic, surgical, clinical, and follow-up information of the patients were collected and analyzed retrospectively. Results: Compared with the control group, the ERAS group had a shorter operating time, hospital stay, preoperative waiting time, postoperative discharge time, less intraoperative blood loss, and higher albumin and haemoglobin on the first postoperative day. The time to removal of the urinary catheter/drainage tube was shortened, and the drainage volume was also significantly reduced in the ERAS group. There was no significant difference in the visual analogue scale (VAS) scores on postoperative return to the ward, but the ERAS group had lower scores on the first, second, and third postoperative days. There were no significant differences in the incidence of complications, other than 10% more nausea and vomiting in the control group. The limb function scores at one-year follow-up were similar between the two groups, but time to radiological fracture union and time to return to physical work and sports were significantly reduced in the ERAS group. Conclusion: The implementation of a series of perioperative nursing measures based on the concept of ERAS in PLWH with limb fracture can significantly reduce the operating time and intraoperative blood loss, reduce the occurrence of postoperative pain and complications, and accelerate the improvement of the functional status of the affected limb in the early stage, which is worthy of applying in more medical institutions. Cite this article: Bone Joint Res 2024;13(11):647–658.

In cardiac ablation procedures, the accuracy of catheter positioning determines the authenticity of the cardiac model and the accuracy of the ablation target. This article reviews the literature on catheter positioning in electrophysiology and summarizes the key technologies for catheter positioning, such as magnetic-electric fusion and interference suppression. Addressing the limitations of electric and magnetic positioning individually, the paper elaborates on the rationale for catheter positioning technology based on magnetic-electric fusion. It also outlines the framework of a complex catheter positioning system. Specifically, the magnetoelectric conversion matrix is established first, followed by the optimization of the catheter shape. The interference factors such as magnetic field interference, body movement, respiration, and heartbeat in catheter positioning and their suppression methods are analyzed and discussed in detail. Finally, the development trend of three-dimensional electrophysiology catheter positioning technology is prospected, offering feasible insights for the research on catheter positioning technology based on magnetic-electric fusion.

Purpose: To describe the surgical technique using a 10/14 French silicone urinary catheter as a novel tissue expander for repair of defects after removal of eyelid tumors. This device recruits additional tissue by tissue expansion for repair of large eyelid defects. Methods: A prospective noncomparative, interventional case study was conducted over a period of 3 years in which 30 patients were enrolled. All the 30 patients were selected for upper or lower lid Tenzel rotational flap after removal of large malignant tumor, using the tissue expander. Results: A 10/14-French silicone urinary catheter was placed in the periocular region and expanded by graded inflation with normal saline to a total volume of 10 or 14 ml, respectively, over a period of 3 days. On the fourth day before the planned surgery, the catheter balloon was deflated and a modified Tenzel rotational flap was performed to close the defect. Postoperative blink reflex was preserved. There were no cases of wound dehiscence. There was a significant reduction of incision length in upper and lower lid reconstruction with modified Tenzel flap reconstruction. Conclusion: This approach allows for temporary tissue expansion, permitting the closure of large eyelid defects, typically not possible with a conventional Tenzel flap. This also provides excellent functional outcomes without closing patients’ eyelids (which limits vision for weeks to months) as is typical of other reconstructive modalities (e.g. Cutler Beard procedure). The device is cost-effective and readily available. The authors believe it is an excellent alternative in the developing world where access to more expensive options is limited.

Purpose The direct aspiration first pass technique (ADAPT) is an effective and safe endovascular treatment for distal medium vessel occlusions (DMVOs). We evaluated technical features and initial results of a novel reperfusion catheter (REDTM 62) used for frontline aspiration thrombectomy of M2 occlusions in acute ischemic stroke patients. Appropriate aspiration catheters are crucial for a successful ADAPT maneuver; however, the selection of catheters suitable for smaller-sized vessels is scarce compared to the ones for large vessel occlusions. Materials and Methods All patients treated with ADAPT using REDTM 62 as the frontline treatment approach for acute M2 occlusions between December 2022 and February 2024 were retrospectively enrolled. Demographic data, procedural timings and safety, recanalization rates, and outcome data were recorded. Results Twenty patients with a median admission National Institutes of Health Stroke Scale (NIHSS) score of 8 were identified. Successful revascularization (DMVO-thrombolysis in cerebral infarction [TICI]≥2b) with REDTM 62 aspiration thrombectomy was obtained in 65.0% (13/20) of cases. The first pass effect was 45.0% (9/20). In 2 cases, the REDTM 62 did not reach the clot due to marked distal vessel tortuosity. Stent retrievers were additionally used in 9 cases and led to an overall DMVO-TICI 2c/3 of 90.0% (18/20). Mean procedural time was 48 minutes. No complications directly related to ADAPT occurred. In-hospital mortality rate was 20.0% (4/20). The median discharge NIHSS score was 2.5. A good functional outcome at discharge (modified Rankin scale 0-2) was achieved in 55.0% (11/20) of cases. Conclusion Our initial experiences with the novel REDTM 62 reperfusion catheter for treatment of M2 occlusions is in line with published data. ADAPT using this catheter may be considered as a safe and effective first-line treatment option. Further studies are warranted to validate the initial results.

Background and objective: Catheter-associated urinary tract infections (CAUTIs) represent a significant burden in health care and its management is challenging. This study aims to assess and compare central European CAUTIs regarding diagnostics, treatment, and prophylaxis. Methods: An anonymized online questionnaire was distributed among urologists in Austria, France, Germany, and Switzerland between January and October 2023, consisting of demographic questions on catheter management and diagnostics, treatment, and prophylaxis of CAUTIs. An analysis was performed per country. Comparisons were done with the Fisher’s exact test (statistical significance with p

Patients with long-term indwelling urinary catheters suffer from complications like infection and encrustation, which are dealt with by catheter replacement or antibiotic therapy inevitably resulting in the emergence of drug-resistant bacteria. Development of antibiofilm catheter coatings with biocompatible materials is considered a practical way to address these issues. Therefore, in the present work, a polyzwitterion coating based on Poly(2,2-dimethylaminoethyl methacrylate)-block-Polyacrylic acid) (PDMAEMA-block-PAAc) was designed on the catheter surface. Herein, following the activation of the catheter silicone surface by UV/Ozone, it was functionalized with α-bromoisobutyryl bromide (BIBB), then 2,2-dimethylaminoethyl methacrylate and acrylic acid monomer were polymerized in situ on the surface. Coated catheters were evaluated by attenuated total reflection-fourier transform infrared (ATR-FTIR), scanning electron microscope (SEM), thermal gravimetric analysis (TGA), and atomic force microscopy (AFM). The hydrophilic PDMAEMA-block-PAAc-coated catheter was developed with high antibacterial and antibiofilm properties against Escherichia coli and Pseudomonas aeruginosa during 24 and 48 hours and also long-term biocompatibility with L929 fibroblast cells. In this study, a polyzwitterion polymer based on PDMAEMA-block-PAAc was coated on catheters to endow anti-fouling and antibacterial activity, in order to tailor the catheter surface to meet the specific requirements that support further clinical investigations. Created by [ABSTRACT FROM AUTHOR]

Abstract Objective Knowing factors that impact catheter stay duration is important since removing drainage catheters too early or late can have significant consequences. We present a single center retrospective study that analyzes multiple variables, including abscess size, white blood cell count, and patient age, to see if a correlation between them and duration of catheter stay exists. The inclusion criteria were patients that had abdominal abscesses treated with percutaneous abscess drainage using a pigtail catheter, ≥ 18 years of age, and had available medical images and records. 44 patients were included. Results Among white blood cell count, patient age, and abscess volume, the only significant relationship with duration of catheter stay was abscess size (R = 0.42, p-value = 0.0049).

Abstract Atrial fibrillation (A-fib) is the most common type of heart arrhythmia, typically treated with radiofrequency catheter ablation to isolate the heart from abnormal electrical signals. Monitoring the formation of ablation-induced lesions is crucial for preventing recurrences and complications arising from excessive or insufficient ablation. Existing imaging modalities lack real-time feedback, and their intraoperative usage is in its early stages. A critical need exists for an imaging-based lesion indexing (LSI) method that directly reflects tissue necrosis formation. Previous studies have indicated that spectroscopic photoacoustic (sPA) imaging can differentiate ablated tissues from their non-ablated counterparts based on PA spectrum variation. In this paper, we introduce a method for detecting ablation lesion boundaries using sPA imaging. This approach utilizes ablation LSI, which quantifies the ratio between the signal from ablated tissue and the total tissue signal. We enhance boundary detection accuracy by adapting a regression model-based compensation. Additionally, the method was cross-validated with clinically used intraoperative monitoring parameters. The proposed method was validated with ex vivo porcine cardiac tissues with necrotic lesions created by different ablation durations. The PA-measured lesion size was compared with gross pathology. Statistical analysis demonstrates a strong correlation (R > 0.90) between the PA-detected lesion size and gross pathology. The PA-detected lesion size also exhibits a moderate to strong correlation (R > 0.75) with local impedance changes recorded during procedures. These results suggest that the introduced PA imaging-based LSI has great potential to be incorporated into the clinical workflow, guiding ablation procedures intraoperatively.

Introduction: The sheathless transradial (TR) technique is a novel approach that may offer potential benefits over the conventional TR approach. We aim to comprehensively investigate the safety and efficacy of sheathless versus conventional TR percutaneous coronary interventions (PCIs). Methods: We conducted comprehensive searches across PubMed, CENTRAL, Web of Science (WOS), Scopus, and EMBASE until July 2023. Pooled data were reported using risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, along with a 95% confidence interval (CI). PROSPERO ID: CRD42023443834. Results: We included 11 studies with 15,392 patients. The radial artery spasm (RAS) (RR: 0.26, 95% CI: [0.09, 0.77], p = 0.02) and cross‐over to the femoral site (RR: 0.28, 95% CI: [0.10, 0.81], p = 0.02) were significantly lower in the sheathless group. However, radial artery occlusion (RAO) (RR: 2.84, 95% CI: [1.78, 4.54], p < 0.0001) and success rate (RR: 1.011, 95% CI: [1.004, 1.019], p = 0.002) were significantly higher in the sheathless group. Also, we did not find a significant difference between both groups in all‐cause mortality (RR: 0.41, 95% CI: [0.16, 1.04], p = 0.06). Conclusion: The sheathless TR approach showed lower rates of RAS and femoral conversion. Sheathless has a higher success rate; however, it also increased RAO. Thus, more trials are needed to confirm this technique's long‐term outcomes and complications. [ABSTRACT FROM AUTHOR]

Background Aims Methods Results Conclusion Healthcare‐associated infections are still a worrying health problem that complicates patient care and increases morbidity and mortality. The incidence of infections in hemodialysis patients is still high and they constitute the second cause of hospitalization and death in this category.The study's objective was to evaluate nursing and medical staff's involvement in hospital hygiene.This is an observational study that took place within the hemodialysis unit of a Moroccan university hospital from March 2021 to June 2021. A surface swabbing technique for bacteriological examination was also carried out.The study revealed some shortcomings regarding hand hygiene which was respected by the nurses in only 17.5% of sessions and in 42.2% by the doctors. Other shortcomings in asepsis measures, were also noted such as the non‐change of gloves after skin preparation (1.03%) and before manual compression. The serological status of patients concerning HBV, HVC, and HIV was also not always known (31.1%). The bacteriological samples from the surfaces also showed colonization of the medical devices and the ultrasound scanner used for the ultrasound‐guided introduction of the central catheters. The results of the study showed some deviations concerning the recommendations; however, they are comparable to other studies conducted internationally, especially in terms of hand hygiene.Our study results highlight some shortcomings adherence to hygiene measures like inconsistent disinfection of medical devices and dialysis stations, as well as insufficient hand hygiene practices among some staff members. However, we observed an improvement in practices following the implementation of awareness‐raising sessions. To maintain improved hygiene practices and prevent infections, it is crucial to provide ongoing training for staff, ensure adequate resources, and regularly monitor compliance with hygiene standards. [ABSTRACT FROM AUTHOR]

Objective: Knowing factors that impact catheter stay duration is important since removing drainage catheters too early or late can have significant consequences. We present a single center retrospective study that analyzes multiple variables, including abscess size, white blood cell count, and patient age, to see if a correlation between them and duration of catheter stay exists. The inclusion criteria were patients that had abdominal abscesses treated with percutaneous abscess drainage using a pigtail catheter, ≥ 18 years of age, and had available medical images and records. 44 patients were included. Results: Among white blood cell count, patient age, and abscess volume, the only significant relationship with duration of catheter stay was abscess size (R = 0.42, p-value = 0.0049). [ABSTRACT FROM AUTHOR]

Interventional procedures for the recanalization of blood vessels to treat deep vein thrombosis carry a high risk of vessel wall injuries or hemorrhaging. Focused ultrasound (FUS) has been used to non-invasively break down blood clots that occlude the vessels in both in vitro and in vivo studies. Previous studies have either used thrombolytic drugs or ultrasound contrast agents (e.g., microbubbles) in combination with FUS. Several studies have applied very high peak-negativepressures (PNP) during FUS treatment to achieve successful thrombolysis without the use of contrast agents. In the current study, we demonstrated that cavitation activity could be significantly enhanced by placing a nitinol wire, whose surface was roughed by laser etching, in the focal region of a FUS field. We demonstrated in vitro in a mock thrombosis that the thrombolysis efficacy of a 500 kHz FUS transducer was significantly enhanced using a surface-etched nitinol wire as compared to an unetched nitinol wire, whereas FUS-alone at the same pressure level did not result in any thrombolysis. These results suggest that a surface modified nitinol catheter exposed to FUS can result in intense cavitation activities leading to enhanced thrombolysis without the use of additional pharmacological or contrast agents. [ABSTRACT FROM AUTHOR]

Introduction: A minimally invasive alternative to surgery for treating pneumothorax has been developed, aiming to reduce risks while maintaining efficacy. This study conducted basic experiments using ex vivo and in vivo pig lung employing a super-thin catheter for treatment. This new device injects fibrin glue directly into the responsible lesion to close the air leak, which has two features: thin design and double-lumen. Methods: The experimental setup involved utilizing trachea and both lung specimens from pigs under positive pressure ventilation. To simulate pneumothorax, artificial fistulas were created on the lung surfaces. The super-thin catheter, guided through a bronchoscope near the fistula, was used to embolize the peripheral bronchus by injecting a fibrin preparation. Then, an air leak test was conducted afterward to assess the efficacy of the treatment. Additionally, a similar pneumothorax model was induced in alive pig under general anesthesia to evaluate its curability. Results: In the extracted pig lungs, embolization was performed in 21 cases, resulting in the cessation of air leaks in 19 cases, corresponding to a 90.5% cure rate. Notably, no major adverse events occurred with the treatment devices. Similarly, in living pigs, pneumothorax was successfully treated, with no recurrence observed up to the seventh postoperative day. Conclusion: The novel treatment device utilizing a super-thin catheter offers a minimally invasive and highly curative option for pneumothorax. These promising results suggest the potential for further development and human clinical trials, which could revolutionize the treatment of pneumothorax, reducing risks and improving outcomes. [ABSTRACT FROM AUTHOR]

In order to prevent catheter-associated urinary tract infections caused by biofilm, in this study, polydopamine (PDA) was polymerized in the presence of ammonia on the surface of the silicone samples selected from the urinary catheters used in medicine. The OH groups in polydopamine were alpha-brominated by nucleophilic substitution reaction in the presence of α-bromoisobutyryl bromide. Then, poly (2-hydroxyethyl methacrylate) (PHEMA) was polymerized on the functionalized polydopamine by ATRP polymerization. PHEMA-PDA-coated catheter was evaluated at each step using attenuated total reflection-Fourier transform infrared (ATR-FTIR), scanning electron microscope, thermal gravimetric analysis, and atomic force microscopy, and its hydrophilicity was assessed by water contact angle. The contact angle of water decreases from 115° for uncoated catheter to 84° for PHEMA-PDA-catheter. PHEMA-PDA-coated catheter prevented Pseudomonas aeruginosa adhesion and colonization during 24 and 48 h and Escherichia coli during 24 h compared to the uncoated sample. It is concluded that functionalization of catheters with PDA-PHEMA appears as a favorable candidate for indwelling urinary catheters. [ABSTRACT FROM AUTHOR]

Urinary incontinence is common and has many causes. A main one is urinary retention, and clean intermittent self-catheterisation is the gold standard for managing it. There are, however, complications associated with performing this, which affect patient experience, quality of life and compliance with the procedure. The most common complication is urinary tract infection (UTI), which can be debilitating and have serious consequences. On average, patients experience 2.7 UTIs a year. Infection often arises from residual urine left behind, this can be caused by mucosal suction into catheter eyelets giving the impression that the bladder has finished emptying and leading to early withdrawal of the catheter. Mucosal suction by catheter eyelets can also lead to micro-trauma. Hydrophilic catheters have long been used to prevent micro-trauma. A catheter using Micro-hole Zone Technology instead of conventional two eyelets was developed with the aim of reducing UTI risk by addressing risk factors for bladder micro-trauma and incomplete voiding. A recent evaluation of Coloplast's Luja male intermittent catheter found that 97% of nurses would recommend Luja, 96% of nurses felt confident their patients will learn how to completely empty their bladder with Luja, and 88% of nurses were less worried that their patients are at risk of getting UTIs due to incomplete bladder emptying. [ABSTRACT FROM AUTHOR]

Background: In rare cases, the catheter balloon cannot be deflated during catheter removal or replacement. In this study, we aimed to create a treatment algorithm for patients whose catheter balloon could not be deflated and to evaluate the effectiveness of a newly applied method. Materials and Methods: 55 male patients who applied to our clinic between January 2020 and July 2023 because the foley catheter could not be removed were evaluated. The methods applied in line with the algorithm we applied in our clinic were evaluated in terms of complications. However, a new method that has not been described before in the literature was evaluated in terms of complications and effectiveness Results: A total of 55 patients were included in the study. The average age of the patients was 73.8 years. The average foley catheter stay was 14.9±8 days. When we examine the reasons for patients' catheterization; A catheter was placed in 5 patients, due to neurogenic bladder, 30 patients due to immobility, and 10 patients due to inability to urinate due to bladder outlet obstruction. All patients were successfully treated with the algorithm we applied. Conclusions: In rare cases, failure to deflate the foley catheter balloon is a very disturbing situation for patients. However, complications, mostly minor, may occur during treatment. We think that this method and algorithm we have described is a method that can be used safely like other methods. [ABSTRACT FROM AUTHOR]

Background: Arterial catheter placement for hemodynamic monitoring is commonly performed in critically ill patients. The radial and femoral arteries are the two sites most frequently used; there is limited data on the use of the axillary artery for this purpose. The aim of this study was to investigate the rate of complications from ultrasound-guided axillary artery catheter placement in critically ill patients. Methods: A retrospective study at a tertiary care center of patients admitted to an intensive care unit who had ultrasound-guided axillary artery catheter placement during admission. Primary outcome of interest was catheter related complications, including bleeding, vascular complications, compartment syndrome, stroke or air embolism, catheter malfunction, and need for surgical intervention. Results: This study identified 88 patients who had an ultrasound-guided axillary artery catheter placed during their admission. Of these 88, nine patients required multiple catheters placed, for a total of 99 axillary artery catheter placement events. The median age was 64 [IQR 48, 71], 41 (47%) were female, and median body mass index (BMI) was 26 [IQR 22, 30]. The most common complication was minor bleeding (11%), followed by catheter malfunction (2%), and vascular complications (2%). Univariate analyses did not show any association between demographics and clinical variables, and complications related to axillary arterial catheter. Conclusion: The most common complication found with ultrasound-guided axillary artery catheter placement was minor bleeding, followed by catheter malfunction, and vascular complications. Ultrasound-guided axillary arterial catheters are an alternative in patients in whom radial or femoral arterial access is difficult or not possible to achieve. [ABSTRACT FROM AUTHOR]

Objective: Referrals to the on-call urology team for catheter-related problems are common. Experience and previous studies highlight that urology exposure and catheter skills are unsatisfactory in undergraduate training as well as in subsequent junior clinical practice. These deficiencies may compromise patient safety and delay appropriate treatment. This study aimed to assess catheter insertion confidence and associated knowledge in junior doctors and advanced nurse practitioners in a single teaching hospital and evaluate whether this could be improved by introducing a freely available catheter information and problem-solving guide. Methods: An online survey assessing confidence inserting two and three-way urethral catheters, changing suprapubic catheters and assessing knowledge related to common catheter problems was delivered to all non-registrar junior clinicians. Based on these results, an information guide was created and made freely available to these clinicians. The survey was then repeated to check for catheter-related knowledge and confidence. Results: A total of 58 junior clinicians responded to the initial survey and 61 to the repeat survey. Catheterisation confidence and knowledge was generally low in the first survey but improved in all areas and across all grades after the introduction of the information guide. Of the respondents, 100% thought the guide was helpful and 93.4% said they would use it in future. Conclusions: A catheter information guide is a simple and effective method of improving junior clinician confidence with catheter insertion and managing catheter-associated problems. Level of Evidence: This study does not directly correlate with a defined level of evidence. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (A-fib) is the most common type of heart arrhythmia, typically treated with radiofrequency catheter ablation to isolate the heart from abnormal electrical signals. Monitoring the formation of ablation-induced lesions is crucial for preventing recurrences and complications arising from excessive or insufficient ablation. Existing imaging modalities lack real-time feedback, and their intraoperative usage is in its early stages. A critical need exists for an imaging-based lesion indexing (LSI) method that directly reflects tissue necrosis formation. Previous studies have indicated that spectroscopic photoacoustic (sPA) imaging can differentiate ablated tissues from their non-ablated counterparts based on PA spectrum variation. In this paper, we introduce a method for detecting ablation lesion boundaries using sPA imaging. This approach utilizes ablation LSI, which quantifies the ratio between the signal from ablated tissue and the total tissue signal. We enhance boundary detection accuracy by adapting a regression model-based compensation. Additionally, the method was cross-validated with clinically used intraoperative monitoring parameters. The proposed method was validated with ex vivo porcine cardiac tissues with necrotic lesions created by different ablation durations. The PA-measured lesion size was compared with gross pathology. Statistical analysis demonstrates a strong correlation (R > 0.90) between the PA-detected lesion size and gross pathology. The PA-detected lesion size also exhibits a moderate to strong correlation (R > 0.75) with local impedance changes recorded during procedures. These results suggest that the introduced PA imaging-based LSI has great potential to be incorporated into the clinical workflow, guiding ablation procedures intraoperatively. [ABSTRACT FROM AUTHOR]

A challenge remains in the development of anti‐infectious coatings for the inert surfaces of biomedical devices that are prone to bacterial colonization and biofilm formation. Here, a facile photocuring method to construct functionalized polymeric coatings on inert polydimethylsiloxane (PDMS) surfaces, is developed. Using atom transfer radical polymerization (ATRP) initiator bearing thymol group, hydrophilic DMAEMA and benzophenone (BP)‐containing monomers are copolymerized to form polymers with end functional groups. An end‐functionalized biocidal coating is then constructed on the inert PDMS surface in one step using a photocuring reaction. The functionalized PDMS surfaces show excellent antibacterial and antifouling properties, are capable of completely eradiating MRSA within ≈6 h, and effectively inhibit the growth of biofilms. In addition, they have good stability and long‐lasting antibacterial activity in body fluid environments such as 0.9% saline and urine. According to bladder model experiments, the catheter's lifespan can be extended from ≈7 to 35 days by inhibiting the growth and migration of bacteria along its inner surface. The photocuring technique is therefore very promising in terms of surface functionalization of inert biomedical devices in order to minimize the spread of infection. [ABSTRACT FROM AUTHOR]

Hemodialysis (HD) is a treatment supporting decreased kidney function, via a catheter inserted into the heart’s Right Atrium (RA). Recirculation is a source of inefficiency for treatment, where blood is dialyzed again due to poor catheter design. Lab-testing is still relatively unexplored, hence, a mechanical testing system was designed with the intention of providing a consistent and repeatable environment for testing HD catheters. System geometry was composed using a Computer-Aided Design (CAD) model of a heart, with the RA scaled to appropriate dimensions, and a PolyDiMethylSiloxane (PDMS) model produced through 3D printing and negative wax casting. Pulsatile blood flow was mimicked by peristaltic pumps driving a blood analogue (BA). Recirculation was induced by adding dyed BA to the system via the catheter and measured using a colorimeter. The developed platform was initially evaluated using two catheters, demonstrating the capability to accurately replicate atrial hemodynamic conditions. Two step-tipped catheters, A and B, were tested at 350 ml/min, producing recirculation values of 13.11% and 18.58%, respectively. The results exhibit the ability of the system developed to evaluate HD catheter performance, with the potential to explore a wider range of tip geometries relevant to clinical preference. Furthermore, this advancement towards an anatomically accurate lab-based test system could be paired with computational methods to progress the evaluation of such medical devices and enhance their development. [ABSTRACT FROM AUTHOR]

To enable quantitative palpation in vivo, we previously developed a catheter-type tactile sensor with an outer diameter of 2 mm composed of a polyvinylidene fluoride (PVDF) film for minimally invasive surgery. However, our previous studies did not evaluate the effect of the PVDF film shape on the sensor output. In this study, we fabricated three types of prototype sensors with different PVDF film shapes and sizes using a simple cutting method. One of the films had the same shape as that used in one of our previous studies. We also prepared two types of PVDF film with a wide base and a narrow tip because we assumed that the deformation of the sensor gradually decreases from the root to the tip, similar to the first mode of the natural frequency. We evaluated the frequency response of the proposed sensors by vibrating the sensor tip and compared the results with the theoretical values. It was confirmed that the sensor output increased with PVDF film size. Although this tendency was observed for both the measured and theoretical values, the measured values were smaller than the theoretical values. Moreover, the effect of film size was larger than that of film shape. Improvements in the sensor structure and the theoretical equation and better evaluation methods are required in order to optimize the film shape and size. [ABSTRACT FROM AUTHOR]

Introduction: Four‐dimensional (4D) intracardiac echocardiography (ICE) is a novel cardiac imaging modality that has been applied to various workflows, including catheter ablation, tricuspid valve repair, and left atrial appendage occlusion (LAAO). The use of this type of advanced ICE imaging may ultimately allow for the replacement of transesophageal echocardiography (TEE) for LAAO, providing comparable imaging quality while eliminating the need for general anesthesia. Methods: Based on our initial clinical experience with 4D ICE in LAAO, we have developed an optimized workflow for the use of the NUVISION™ 4D ICE Catheter in conjunction with the GE E95 and S70N Ultrasound Systems in LAAO. In this manuscript, we provide a step‐by‐step guide to using 4D ICE in conjunction with compatible imaging consoles. We have also evaluated the performance of 4D ICE with the NUVISION Ultrasound Catheter versus TEE in one LAAO case and present those results here. Results: In our comparison of 4D ICE using our optimized workflow with TEE in an LAAO case, ICE LAA measurements were similar to those from TEE. The best image resolution was seen via ICE in 2‐dimensional and multislice modes (triplane and biplane). The FlexiSlice multiplanar reconstruction tool, which creates an en‐face image derived from a 4D volume set, also provided valuable information but yielded slightly lower image quality, as expected for these volume‐derived images. For this case, comparable images were obtained with TEE and ICE but with less need to reposition the ICE catheter. Conclusion: The use of optimized 4D ICE catheter workflow recommendations allows for efficient LAAO procedures, with higher resolution imaging, comparable to TEE. [ABSTRACT FROM AUTHOR]

Background: Atherosclerosis is a condition in which an adhesive substance called plaque accumulates over time inside the arteries. Plaque buildup results in the constriction of arteries, causing a shortage of blood supply to tissues and organs. Removing atherosclerotic plaques controls the development of acute ischemic stroke and heart diseases. It remains imperative for positive patient outcomes. Purpose: This study sought to develop a minimally invasive technique for removing arterial plaques by applying focused ultrasound (FUS) energy on the metal surface of a nitinol catheter wire to induce inertial cavitation. The induced cavitation can deplete plaque mechanically inside the arteries, leading towards improved recanalization of blood vessels. Methods: The enhanced cavitation effect induced by combining FUS with a metal catheter was first verified by exposing agar phantom gels with or without a 0.9‐mm diameter nitinol wire to an acoustic field produced by a 0.5‐MHz FUS transducer. The phenomenon was further confirmed in pork belly fat samples with or without a 3‐mm diameter nitinol catheter wire. Cavitation was monitored by detecting the peaks of emitted ultrasound signals from the samples using a passive cavitation detector (PCD). Cavitation threshold values were determined by observing the jump in the peak amplitude of signals received by the PCD when the applied FUS peak negative pressure (PNP) increased. To simulate arterial plaque removal, FUS with or without a catheter was used to remove tissues from pork belly fat samples and the lipid cores of human atherosclerotic plaque samples using 2500‐cycle FUS bursts at 10% duty cycle and a burst repetition rate of 20 Hz. Treatment outcomes were quantified by subtracting the weight of samples before treatment from the weight of samples after treatment. All measurements were repeated 5 times (n = 5) unless otherwise indicated, and paired t‐tests were used to compare the means of two groups. A p‐value of <0.05 will be considered significant. Results: Our results showed that with a nitinol wire, the cavitation threshold in agar phantoms was reduced to 2.6 MPa from 4.3 MPa PNP when there was no nitinol wire in the focal region of FUS. For pork belly fat samples, cavitation threshold values were 1.0 and 2.0 MPa PNP, with and without a catheter wire, respectively. Pork belly fat tissues and lipid cores of atherosclerotic plaques were depleted at the interface between a catheter and the samples at 2 and 4 MPa FUS PNP, respectively. The results showed that with a catheter wire in the focal region of a 3‐min FUS treatment session, 24.7 and 25.6 mg of lipid tissues were removed from pork belly fat and human atherosclerotic samples, respectively. In contrast, the FUS‐only group showed no reduction in sample weight. The differences between FUS‐only and FUS‐plus‐catheter groups were statistically significant (p < 0.001 for the treatment on pork belly samples, and p < 0.01 for the treatment on human atherosclerotic samples). Conclusion: This study demonstrated the feasibility of catheter‐assisted FUS therapy for removing atherosclerotic plaques. [ABSTRACT FROM AUTHOR]

Objective: Posterior left atrial wall isolation (PWI) plus traditional pulmonary vein isolation (PVI) has been proposed as a promising intervention to decrease atrial fibrillation (AF) recurrence. We aim to investigate the efficacy and safety of adding PWI to the traditional PVI in patients with AF. Methods: A systematic review and meta‐analysis was conducted using synthesizing randomized controlled trials (RCTs) retrieved by systematically searching PubMed, Web of Science, SCOPUS, EMBASE, and Cochrane through June 14, 2023. We used Stata version 17 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI) (PROSPERO ID: CRD42023446227). Results: We included 11 RCTs with a total number of 1534 patients. Combined ablation with PWI + PVI was not associated with any significant difference over PVI only regarding the recurrence of clinical AF (RR: 0.86 with 95% CI [0.70–1.06]), all atrial arrhythmia (RR: 0.93 with 95% CI [0.82–1.07]), nonatrial fibrillation arrhythmia (RR: 1.22 with 95% CI [0.97–1.53]), early AF (RR: 0.89 with 95% CI [0.62–1.27]), and antiarrhythmic drugs at discharge (RR: 0.83 with 95% CI [0.67–1.04]). However, it was associated with increased total ablation duration (minutes) (MD: 12.58 with 95% CI [6.80–18.37]) and total procedure duration (minutes) (MD: 16.77 with 95% CI [9.63–23.91]), without any significant difference regarding adverse events (RR: 1.05 with 95% CI [0.63–1.74]). Conclusion: While the pooled data from PWI + PVI using point‐by‐point radiofrequency did not suggest a benefit in the recurrence of various atrial arrhythmias compared to PVI alone, PWI+PVI using direct posterior wall ablation, especially with cryoballoon, demonstrated a significant reduction in recurrence of AF/atrial arrhythmias. Also, PWI + PVI significantly increased the ablation and total procedure durations. [ABSTRACT FROM AUTHOR]

Autologous hematopoietic stem cell transplant (HSCT), characterized by high intensity chemotherapy followed by the infusion of HSC previously collected from the peripheral blood, is a procedure used in the treatment of several malignancies. In pediatrics, the apheresis procedure represents a challenge, due to the need for insertion of a rigid central venous catheter (CVC) in small children. The CVC is usually used for stem cell collection and then removed. Later, the patient will need a new device for cell infusion. We propose the use of one single catheter for both apheresis and infusion. We present five children between 1 and 13 years of age who underwent apheresis using a high flow PICC catheter surgically inserted. All patients utilized a PICC line double lumen 5Fr (PowerPICC™ 5Fr DL BARD/USA) placed in the brachiocephalic vein tunneled on the chest, inserted under 24 h prior to apheresis to assure the devices were pervious. Three of the patients were diagnosed with solid tumor and one with acute lymphoblastic leukemia (ALL) awaiting Car-T Cell therapy. The four children who underwent autologous HSCT used the same catheter for cell infusion and remained with the catheter following discharge. The child who was submitted for Car-T Cell still awaits infusion and the catheter was removed. High flow PICC is a viable alternative for apheresis to maintain an adequate flow of 5 ml/s and can be used as a single catheter throughout the HSCT process, reducing the risks from anesthesia and the catheter insertion procedure. Clinical Research. [ABSTRACT FROM AUTHOR]

Nous rapportons un cas clinique rare d’infection par la bactérie Staphylococcus carnosus au niveau d’une émergence d’un cathéter de dialyse péritonéale (DP). Il s’agit d’un patient de 81 ans traité par DP pour une insuffisance rénale terminale. Le patient a débuté sa dialyse péritonéale le 12/08/2019 avec la pose d’un cathéter de Tenckhoff le 17/07/2019. Depuis le début de la DP, plusieurs infections d’émergence étaient survenues avec différents germes. Le 22/07/2024, lors de la réfection du pansement, l’infirmière libérale effectue un prélèvement bactériologique au vu d’une inflammation sans écoulement de l’émergence du cathéter. L’analyse bactériologique met en évidence la bactérie Staphylococcus carnosus, qui sera traitée par mupirocine pendant 8 jours. L’évolution clinico- biologique s’est révélée favorable avec un prélèvement de contrôle stérile. Ce cas semble être le premier connu à l’échelle mondiale et humaine, et s’ajoute aux connaissances sur les infections rares des émergences de cathéter de dialyse péritonéale. On note la présence de ce germe chez les animaux et dans l’alimentation.

Abstract Cardiovascular diseases (CVDs), including congenital heart diseases (CHD), present significant global health challenges, emphasizing the need for safe and effective treatment modalities. Fluoroscopy‐guided endovascular interventions are widely utilized but raise concerns about ionizing radiation, especially in pediatric cases. Magnetic resonance imaging (MRI) offers a radiation‐free alternative with superior soft tissue visualization and functional insights. However, the lack of compatible instruments remains a major obstacle. An adapted thermal drawing platform that enables low‐cost and rapid prototyping of instruments for MR‐guided endovascular interventions is introduced. This platform is demonstrated through the development of two exemplary catheter systems: a tendon‐driven steerable catheter with helical lumina and an active tracking Tiger‐shaped catheter with an embedded coaxial wire. These catheters exhibit mechanical properties comparable to commercial counterparts and show promising outcomes in both in vitro and in vivo feasibility testing. This scalable thermal drawing platform addresses the limitations of existing manufacturing approaches and facilitates the exploration of diverse designs, potentially accelerating advancements in catheter technologies for MR‐guided cardiovascular interventions.

Objectives Currently, there is no consensus on the optimal timing for the initiation of peritoneal dialysis (PD) after catheter placement.Design Systematic review and meta-analysis.Exact date of data collection From inception till July 31, 2023.Main outcome measures To assess the outcomes and safety of unplanned PD initiation (

Percutaneous transhepatic biliary drainage (PTBD) is commonly used in the treatment of malign and benign biliary pathologies. Certain complications after PTBD may occur, such as biliary fistula, biliary leakage, bilioma, and hematoma. The purpose of this study was to evaluate the safety and effectiveness of using a sterile gelatin sponge to seal the biliary tract after PTBD in patients with liver transplants to prevent complications. A total of 131 biliary drainages were introduced in 97 patients, and a sterile gelatin sponge was used to seal the biliary tract after removal of the biliary drainage catheter. The patients were immediately examined for complications using ultrasound and then followed up clinically unless imaging was required. Five fluid collections within the liver with a diameter

The use of catheters is very common in clinical care and is a highly invasive procedure, and catheter-associated urinary tract infection (CAUTI) is an important cause of hospital-acquired infections. CAUTI is a serious complication caused by catheter insertion, usually within 48 hours of catheterization or after removal of the catheter. This article reviews the nursing measures for the prevention of CAUTI in perspectives of influencing factors, selection of catheter, catheter placement and catheter maintenance, aiming to promote the development of long-term indwelling catheter technology and provide reference for prevention and treatment of CAUTI in clinical practice. (导管相关性尿路感染(CAUTI)是医院内感染最常见的类型之一。CAUTI是一种由插入尿管引起的严重的并发症, 通常出现在患者接受插管治疗后的48 h内或者在取出导尿管之后。本本研究就引发CAUTI的主要影响因素、导尿管的选取、导管的留置操作、管路维护以及医院管理等方面进行综述, 旨在为防治CAUTI提供可靠参考。)

Transesophageal echocardiography (TEE) has become an essential monitor for the management of most patients undergoing cardiothoracic surgery. TEE and central venous catheter placement are often used during cardiac surgeries. Here we conducted a study comparing TEE 3D probe as a surface probe with the ultrasound-guided (USG) vascular probe for guiding right internal jugular vein (IJV) catheterization. Context: USG vascular probe and TEE probe can help during central venous catheterization (CVC) and can confirm the location of guide wire in the neck vessels. We proposed this study, as there are only few studies comparing between TEE probe as surface probe and USG vascular probe for right IJV cannulation. Aims: To compare the TEE probe as a surface probe and USG vascular probe during right IJV catheterization in cardiac surgeries. Settings and Design: Prospective, comparative study. Methods and Material: One twenty-four patients of either sex posted for major elective cardiac surgery were included in this study. Patients were divided into two groups (TEE group and USG group) of 62 by assigning the study participants alternatively to each group. The goal of this study was to compare the puncture time, visualization of IJV to first successful puncture, quality of the imaging with needle tip positioning, and catheter positioning using both TEE probe and vascular probe. The primary outcome was comparison of time from visualization of the IJV to successful puncture using both TEE probe as a surface probe and vascular probe. Secondary outcome was to compare the quality of image with respect to needle tip positioning and compare quality of image with respect to catheter position using both probes. Statistical Analysis Used: Statistical analyses were performed by using a statistical software package SPSS, version 20.0. Results: The observation and results of our study clearly show the feasibility of TEE as surface probe for guiding central venous catheter in right IJV just like the vascular linear probe. There was no significant difference between the two groups (P > 0.05). No statistical differences were found in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between the two groups. All the P values were greater than 0.05. Conclusions: The TEE probe can be used as an alternative method to guide IJV puncturing and catheterization when the vascular probe is not available. It is feasible especially in cardiac surgeries where the TEE monitoring machine is a must in modern anesthesia and readily available than an ultrasound machine.

Catheter surgery is an effective treatment for vascular disease and has been investigated from a tribological perspective to prevent vascular damage. Endothelial glycocalyx layer (EGL), which is present on the most superficial surface of vascular endothelial cells plays an important role in maintaining vascular homeostasis, but, during catheter surgery, they are affected by frictional stimulation caused by direct contact with the catheter. In this study, to investigate and discuss the effects of frictional stimulation on the surface properties of vascular endothelial cells, we conducted nano friction tests using atomic force microscopy (AFM) on the surface of vascular endothelial cells. and evaluated mechanical properties, interaction structure, and surface properties of vascular endothelial cells and EGL. The results show that the elastic modulus of endothelial cells increased after the nano friction test. It was also found that EGL was worn away after several slides and the friction coefficient of vascular endothelial cells increased with the wear of the EGL. Furthermore, the adhesion force of endothelial cells increased by the wear of EGL. Besides that, the amount of adsorption to fatal bovine serum (FBS) was also examined using the QCM-D method, and a trend toward increased adsorption was observed for cells without EGL compared to cells with EGL.

Background and Aims: Perineural catheters inserted through the costoclavicular (CC) technique of infraclavicular brachial plexus are helpful for postoperative analgesia. This trial compared postoperative local anaesthetic (LA) consumption in an ultrasound (US)-guided perineural catheter inserted by the CC technique with the conventional lateral sagittal (LS) technique. Methods: Eighty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper limb orthopaedic surgery were randomly assigned to receive a perineural catheter by either the CC technique (Group CC) or LS technique (Group LS). Postoperatively, all patients received patient-controlled regional analgesia (PCRA): bolus-only regime with 0.125% bupivacaine 6 ml and a lock-out interval of 20 minutes. The primary outcome was the 24 h LA consumption. The secondary outcomes were time of activation of PCRA, pain scores, patient satisfaction scores, and block-related complications. Categorical variables are presented as frequency, while continuous variables are expressed as mean [standard deviation (SD)] or median [interquartile range (IQR)]. An independent t-test or Mann–Whitney U-test was used to compare these continuous variables. A P value less than 0.05 was considered to be statistically significant. Results: Patients in Group CC required less LA 24 h postoperatively (P < 0.001) and more time to activate PCRA (P = 0.003). The mean 24 h LA requirement was 83.35 (SD: 31.92) in Group CC as compared to 121.40 (SD: 48.51) ml in Group LS. They also reported better satisfaction scores (P = 0.001). Pain scores were comparable at all time points. Postoperatively, one patient in Group CC complained of paraesthesia, which subsided on removal of the catheter. Conclusion: Patients receiving post-operative analgesia by the CC catheter require lesser 24 h LA and report better satisfaction than those receiving analgesia through the LS technique.