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L Oms

Publications and source records attributed to L Oms.

6 recordsLinked to original sources
PubMed1996

A clinical trial on the prevention of catheter-related sepsis using a new hub model.

BACKGROUND: Catheter hub contamination is being increasingly recognized as a source of catheter-related sepsis. The authors have investigated the efficacy of a new hub design in preventing endoluminal catheter contamination and catheter-related sepsis arising at the hub. METHODS: Adult surgical and intensive care patients requiring a subclavian catheter for at least 1 week were randomly assigned to receive catheters with standard connectors (control group, n=73) or equipped with a new hub model (new hub group, n=78). Skin, catheter tip, and hub cultures were performed at the time the catheter was withdrawn because therapy was terminated or because of suspicion of sepsis, in which case peripheral blood cultures were taken. RESULTS: Of the 151 patients included, 15 (10%) developed catheter-related sepsis. Catheters were more often withdrawn because suspicion of infection in the control group (42 vs. 19%, p<0.005). Catheter sepsis rate was higher in the control group (16 vs. 4%, p<0.01) because of the low rate of catheter sepsis arising at the hub observed in the new hub group (1 vs. 11%, p<0.01). The prevalence of culture-positive catheter hubs without associated bacteremia (colonization) was higher in the control group (18 vs. 5%, P<0.03). CONCLUSIONS: A new catheter hub has proved to be useful in preventing endoluminal bacterial colonization and catheter-related sepsis in subclavian lines inserted for a mean of 2 weeks.

Adult↗
PubMed1990

Reduced water and sodium intakes associated with high levels of natriuretic factor following common bile duct ligation in the rabbit.

Renal failure complicating obstructive jaundice (OJ) is probably linked to reduction of the extracellular water compartment. To elucidate the mechanism by which OJ leads to isotonic water depletion we studied a group of rabbits with OJ after common bile duct ligation (n = 17) and another group of sham operated rabbits (n = 14) for 10 days. Water intake and balance for two study periods (1-4 and 7-10 days after operation) were calculated. Renal function, sodium balance and plasma atrial natriuretic factor were determined on the fourth and tenth days after operation. Water intake and balance were lower in the OJ group both in the first study period (230 versus 519 ml/days 1-4, P less than 0.001; and -2.4 versus 219 ml/days 1-4, P less than 0.0001 respectively) and in the second study period (260 versus 865 ml/days 7-10, P less than 0.0001; and 11 versus 379 ml/days 7-10, P less than 0.0001 respectively). Sodium intake was negligible in the OJ group both on day four (0.73 versus 7.15 mM/24 h, P less than 0.0001) and on day 10 (0.78 versus 15.78 mM/24 h, P less than 0.0001). As a result plasma osmolality did not change. Day 10 urine osmolality and osmolar clearance were reduced in the OJ group (653 versus 1103 mOsm/kg, P less than 0.0001 and 0.09 versus 0.25 ml/min, P less than 0.0001 respectively) together with a decreased creatinine clearance (3 versus 11 ml/min, P less than 0.0001). Atrial natriuretic factor was increased in jaundiced rabbits (day 4, 22.7 versus 7.5 fmol/ml, P less than 0.0001; and day 10, 26.5 versus 11.2 fmol/ml, P less than 0.02). These findings suggest that OJ leads to an isotonic volume depletion resulting from abnormalities of the extracellular volume regulating mechanisms. These appear to be secondary to an inappropriate elevation of the atrial natriuretic factor plasma concentration.

Animals↗
PubMed1989

In vitro bacteriological study of a new hub model for intravascular catheters and infusion equipment.

We investigated in vitro the antibacterial properties of a simulated new hub model in which the female part has an antiseptic chamber through which the needle (male part) must pass before connection of the set and the catheter. To establish the time needed for disinfection, the magnitude of reduction of the contaminating inocula by the new hub model, and the antibacterial properties of the different components of the hub, we used needles contaminated with solutions containing high inocula (1.9 x 10(7) to 1.2 x 10(11) CFU/ml) of microorganisms involved in hub-related catheter sepsis. Sterilization of the needles was accomplished by allowing them to remain in the antiseptic chamber for 10 s in all assays with Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans. The rubber closures limiting the antiseptic chamber and the dilution effect of the antiseptic itself accounted for a minor part of the inoculum reduction achieved by the new hub model. This simulated hub provides good protection against endoluminal contamination. Further studies seem warranted to prove its industrial viability and clinical efficacy.

Candida albicans↗
PubMed1989

A new experimental model for secondary hyperparathyroidism.

We have developed an animal model to study the pathogenesis of secondary hyperparathyroidism by inducing stable uremia in Sprague-Dawley rats by selective microligation of terminal branches of the left renal artery, followed by right nephrectomy. After 4 weeks the animals were killed, the parathyroid glands were removed and weighed, and blood samples were obtained. Of 30 rats, uremia developed in 22 (73%; uremic group) and eight (27%) died or did not become uremic. A sham-operated group of 15 rats served as control (control group). Creatinine levels were 1.8 +/- 0.5 mg/dl in the uremic group versus 0.5 +/- 0.1 mg/dl in the control group (p less than 0.0001). Parathyroid glands were hyperplastic in all rats with uremia and were heavier than parathyroid glands of control animals (70.3 +/- 26 vs 19.1 +/- 8 micrograms; p less than 0.0001). In the group with uremia, parathyroid hormone levels were increased over those of the control group (112.6 +/- 13 vs 28.9 +/- 6.2 pg/ml; p less than 0.0001), whereas osteocalcin levels were similar (36.6 +/- 11 vs 37.5 +/- 1 ng/ml). Serum calcium, phosphate, and alkaline phosphatase levels were similar in both groups. Our model can be used to test hypotheses concerning the treatment of secondary hyperparathyroidism and the relative pathogenetic relevance of vitamin D deficiency and phosphate retention.

Alkaline Phosphatase↗
PubMedDate not supplied

[Catheter sepsis: pathogeny and prevention with a new connection model].

A revision is made of the issue regarding sepsis related to central intravenous catheterization. A special point was made on the relevance of latest discoveries in the field of pathogenicity in order to prevent, diagnose and treat this entity. Preventive measures should be geared to avoid intralumen infection, and success may depend on new connection models and industrial preparation of nutrient mixtures. Infected catheters must be removed, but in highly selected patients local and systemic antibiotic therapy may be attempted.

Catheterization, Central Venous↗