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Medical adjuvant treatment to increase the patency of arteriovenous fistulae and grafts used for renal dialysis | Cochrane

People with advanced kidney disease (end-stage renal disease) need dialysis to perform kidney functions. In haemodialysis, blood is filtered through a machine. To allow a large enough passage for blood to flow between the person and the machine, an artery and a vein can be surgically joined (to form an arteriovenous fistula) or an artificial graft (a substitute for a vein) is used to join the artery to the vein. These access points might last for years but can become blocked or infected. This review investigates if additional medical therapy can keep these dialysis access points functioning.  
cochrane.org
about 5 years ago
Sinaiem dark
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a-different-approach-to-central-line-placementu

Today’s pearl comes to you directly from Dr. Reuben Strayer (emupdates.com) and I think is particularly applicable to resident learners.  The traditional teaching for CVC placement has involved needle puncture and stabilization of said needle followed by detaching the syringe and threading a wire.  Many, typically less experienced providers (i.e. residents), have a tendency to move the needle (even while attempting to keep it stable) while removing the ultrasound or while unscrewing the syringe.  This process often dislodges the needle making it impossible to threat the wire.  A technique that has been around for some time, but is underutilized, is the wire through catheter technique, which allows you to thread a catheter over the needle so that it remains stable inside the vein, rather than having to perform the more difficult task of stabilizing the needle.  The two techniques are demonstrated in the video attached to the link that follows.  Also, do not forget your confirmatory techniques, which are discussed in the video as well.  Without further ado, the soothing voice of Dr. Strayer.  
sinaiem.org
about 5 years ago
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The use of intravenous antibiotics to treat pulmonary exacerbations in people with cystic fibrosis | Cochrane

Do intravenous antibiotics (antibiotics given via a vein) given to treat 'flare ups' of lung disease (pulmonary exacerbations) in people with cystic fibrosis improve clinical outcomes in the short term and the long term?  
cochrane.org
about 5 years ago
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Association between pulmonary vein orientation and atrial fibrillation-free survival in patients undergoing endoscopic laser balloon ablation

Aims Obtaining optimal pulmonary vein (PV) occlusion with the endoscopic laser balloon ablation system (EAS) can be difficult, hypothetically influenced by PV geometry. The aim of this study was to determine the impact of PV orientation on atrial fibrillation (AF)-free survival after PV isolation (PVI) using the EAS.  
ehjcimaging.oxfordjournals.org
about 5 years ago
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Over time, #varicose and #spider veins... - NE Laser Vein Institute | Facebook

Over time, #varicose and #spider veins make legs feel heavy and tired, making walking a burden. Visit our website to learn more about how we can help....  
facebook.com
about 5 years ago
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Intravenous in-line filters for preventing morbidity and mortality in neonates | Cochrane

Background: Preterm or sick newborn infants are often fed with nutrients and fluids that are delivered directly into a vein. This intravenous delivery can be associated with infection, toxins released by bacteria, and tiny particles that may be in the fluids, such as rubber and plastic, going into the blood. In adults, placing a filter in the intravenous line has been reported to be effective in reducing such risks, and filters are increasingly being recommended for use in newborn infants.  
cochrane.org
about 5 years ago
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Replacing a peripheral venous catheter when clinically indicated versus routine replacement | Cochrane

Most hospital patients receive fluids or medications via an intravenous catheter at some time during their hospital stay. An intravenous catheter (also called an IV drip or intravenous cannula) is a short, hollow tube placed in the vein to allow administration of medications, fluids or nutrients directly into the bloodstream. These catheters are often replaced every three to four days to try to prevent irritation of the vein or infection of the blood. However, the procedure may cause discomfort to patients and is quite costly.  
cochrane.org
about 5 years ago
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Optical Probe Looks for Signs of Shock Without a Blood Draw |

(a) Ultrasonograph of internal jugular central vein and (b) Monte Carlo simulation of photon paths within the tissues surrounding the veins. Clinicians som  
medgadget.com
about 5 years ago
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Nutritional support in children and young people with cancer undergoing chemotherapy | Cochrane

The provision of safe, appropriate and effective nutritional support for children and young people undergoing treatment for cancer is now well recognised as an important part of their care. It may help to reverse malnutrition seen at diagnosis, prevent malnutrition associated with the cancer, promote weight gain and growth and improve quality of life. Nutritional support may be provided by one of two methods: intravenous nutritional liquids delivered through a central or peripheral vein which bypass the gut (parenteral nutrition); or nutritional liquids or solids that pass through any part of the gut, regardless of method of delivery (e.g. orally or via a tube; enteral nutrition).  
cochrane.org
about 5 years ago
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Steroids inserted into the eye versus observation for macular edema secondary to central retinal vein occlusion | Cochrane

We aimed to examine the benefits and harms of inserting steroids into the eye for treating macular edema secondary to central retinal vein occlusion (CRVO-ME).  
cochrane.org
about 5 years ago
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Rutosides for prevention of post-thrombotic syndrome | Cochrane

Blood clots in the veins of the leg are a common problem and are termed deep vein thrombosis (DVT). One in three patients with a DVT develops a complication known as post-thrombotic syndrome (PTS). This syndrome involves ongoing swelling of the affected leg, pain, and also skin changes. At the current time the main way of preventing PTS is to wear compression stockings. However, it is known that patients frequently find the stocking uncomfortable and would prefer to take an oral medication to prevent the problem.  
cochrane.org
about 5 years ago
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Rutosides for treatment of post-thrombotic syndrome  | Cochrane

Blood clots in the veins of the leg are a common problem and are termed deep vein thrombosis (DVT). One in three patients with a DVT develops a complication known as post-thrombotic syndrome (PTS). This syndrome involves ongoing swelling of the affected leg, pain, cramps, burning or prickling, and itching. Darkening of the skin because of increased pigmentation and varicose veins, redness and skin irritation can also occur. At the current time the main way of treating PTS is to wear compression stockings. It is known however that patients frequently find the stocking uncomfortable and so they may prefer to take an oral medication to treat the problem. Rutosides are a herbal remedy which has been shown to be effective in other conditions affecting the veins (chronic venous insufficiency).  
cochrane.org
about 5 years ago
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Spontaneous Coronary Artery Dissection | Resus Review

Understanding SCAD including risk factors, triggers, angiographic diagnosis, and deciding between conservative and invasive treatment.  
charlesbruen.wpengine.com
about 5 years ago
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Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates | Cochrane

Review question: In newborn infants receiving parenteral nutrition, does delivery into deep veins (via percutaneous central venous catheters) versus superficial veins (via peripheral cannulae) affect nutrition, growth and development, and adverse events including infection or skin damage?  
cochrane.org
almost 5 years ago
Sinaiem dark
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weve-got-a-pumper-here

Hemostasis is an essential step in wound management. Most commonly, bleeding is caused by lacerated subdermal plexus and superficial veins which can be controlled with pressure alone. When lacerations are especially deep, an artery may also be affected. In these situations, special maneuvers are often necessary to obtain adequate hemostasis.  
sinaiem.org
almost 5 years ago
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Coronary Artery Diagramming | Resus Review

Understand the coronary artery anatomy with a free useful diagram that is easy to markup and helps facilitate communication.  
resusreview.com
almost 5 years ago
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Interventions for varicose veins and leg oedema in pregnancy | Cochrane

Varicose veins, sometimes called varicosity, occur when a valve in the blood vessel walls weakens and the blood stagnates. This in turn leads to problems with the circulation in the veins and to oedema or swelling. The vein then becomes distended, its walls stretch and sag, allowing the vein to swell into a tiny balloon near the surface of the skin. The veins in the legs are most commonly affected as they are working against gravity, but the vulva (vaginal opening) or rectum, resulting in haemorrhoids (piles), can be affected too. Pregnancy seems to increase the risk of varicose veins and they cause considerable pain, night cramps, numbness, tingling, the legs may feel heavy, achy, and they are rather ugly. Treatments for varicose veins are usually divided into three main groups: pharmacological treatments, non-pharmacological and surgery. The review identified seven trials involving 326 women. Although there was a moderate quality evidence to suggest that the drug rutoside seemed to be effective in reducing symptoms, the study was too small to be able to say this with real confidence. Similarly, with reflexology and water immersion, there were insufficient data to be able to assess benefits and harms, but they looked promising. Compression stockings do not appear to have any advantages. More research is needed.  
cochrane.org
almost 5 years ago
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Recurrence of Paroxysmal AF After Pulmonary Vein Isolation

A repeat ablation is performed in around 30 percent of patients due to arrhythmia recurrence, but the strategy for this repeat procedure is not defined.  
medscape.com
almost 5 years ago
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10-Year CHD Risk Prediction Using Coronary Artery Calcium

Are 10-year risk projections better when coronary calcium scores are part of the equation?  
medscape.com
almost 5 years ago