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At least 397 records · Page 22Linked to original sources

PubMed1997

Endoscopic transvaginal approach to the rabbit uterine cervix: improvement in the technique of selective tubal catheterization.

RATIONALE AND OBJECTIVES: The authors compared two methods of selective fallopian tube catheterization in female rabbits. METHODS: Technical success rates and procedure times in two groups of animals were compared. Group 1 consisted of 20 female rabbits catheterized with a fluoroscopic technique. Group 2 consisted of 55 rabbits catheterized with a combination of endoscopic and fluoroscopic guidance. RESULTS: The technique used in group 2 allowed a statistically significant reduction in the time required for cervical catheterization and the total procedural time (P < .01). There was a parallel statistically significant reduction in fluoroscopy time (P < .01). Technical success rates and adverse effects were similar for the two techniques. CONCLUSION: The combined endoscopic-fluoroscopic technique requires a shorter time than the established fluoroscopic technique and should be considered for future selective tubal catheterization experiments in rabbits.

Animals↗

PubMed2002

The effect of nursing interventions utilizing music therapy or sensory information on Chinese patients' anxiety prior to cardiac catheterization: a pilot study.

BACKGROUND: Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. Nursing interventions using music therapy or sensory information among patients with coronary artery disease has resulted in anxiety reduction, though results in Chinese subjects has not previously been published. AIMS: To determine the effects of using nursing interventions of music therapy or sensory information, on reducing anxiety and uncertainty, and improving negative mood among Chinese subjects immediately prior to cardiac catheterization. METHODS: An experimental three-group repeated measures design for this pilot study was used. Forty-five hospitalized adults (15/group) undergoing cardiac catheterization were randomly assigned to either (1) a music therapy intervention, (2) a sensory information intervention or (3) treatment as usual (control). Anxiety, uncertainty and mood state were measured using self-reported questionnaires and physiological measures were made at baseline, post-intervention to determine their effect and post-cardiac catheterization to determine whether these interventions had any long-lasting effect. RESULTS: The control group was found to be significantly older (P=0.001) than the two experimental groups. Older age was associated with lower anxiety scores (r=-0.31, P=0.04 at baseline; r=-0.30, P=0.04 post-intervention; r=-0.22, P=0.15 post-cardiac catheterization). After controlling for age, the use of music therapy or sensory information did not significantly reduce anxiety, improve mood state, reduce uncertainty, decrease heart or respiratory rate among subjects undergoing cardiac catheterization. CONCLUSION: The non-significant result may have been affected by the small sample, and the social and cultural expectations regarding the public display of emotions among Chinese populations.

Adult↗

PubMed2001

Transseptal left heart catheterization for cardiac ablation procedures.

UNLABELLED: Transseptal left heart catheterization has been performed as an alternative to the retrograde approach since 1958. However, this procedure can result in life-threatening complications, some of which may occur because of insufficient anatomical landmarks. Accordingly, we sought to assess the safety and efficacy of a new transseptal left heart catheterization technique designed for ablation procedures. Specifically, we examined whether electrode catheters could be used as anatomical landmarks, permitting identification of the aortic root and other critical structures. RESULTS: One hundred and eight consecutive patients underwent transseptal left heart catheterization under biplane fluoroscopy during catheter ablation. Electrode catheters positioned in the right atrial appendage, His bundle region, and coronary sinus were used as anatomical landmarks to guide the transseptal unit to the fossa ovalis. The angles of the right anterior and left anterior oblique projections were selected in each patient based on the orientation of the His bundle and coronary sinus catheters. Transseptal left heart catheterization was successfully performed in all patients without complications. In contrast to previous reports, the direction of the needle at the successful puncture site in the last 96 patients varied substantially: 2 o'clock in 13 patients (13 %); 3 o'clock in 43 patients (45 %); and 4 o'clock in 40 patients (42 %). CONCLUSION: The use of electrode catheters as anatomical landmarks and biplane fluoroscopy facilitates transseptal catheterization. This approach can be used safely during catheter ablation procedures.

Adolescent↗

PubMed1977

Individual renal clearances determined at renal vein catheterization.

Renal para-aminohippurate (PAH) clearances were predicted in 16 kidneys of eight hypertensive patients with renal artery stenosis, pyelonephritis, or obstructive nephropathy, without individual ureteral catheterization. Predictions of left or right kidney clearance (CL or CR) were based on roentgenographic renal frontal areas (A), on total PAH clearances (CT), and on individual PAH extractions (E) measured at renal vein catheterization according to the formula (formula: see text). When these patients underwent ureteral catheterization for diagnostic reasons, individual PAH clearances were measured and ranged from 22 to 286 cm3/min. After correction for differences in total PAH clearance on the two occasions, predicted and individually measured values corresponded closely along a line of identity. The 95% confidence limit (+/- 2 SEM) for predictions of individual PAH clearance was approximately +/- 38 cm3/min and for percet of total PAH clearance distributed to left or right kidney, +/- 6%. Individual renal PAH clearances can therefore be predicted at renal vein catheterization with acceptable error. Thus, the substantially invasive procedure of ureteral catheterization is not required to ascertain left and right kidney PAH clearance in patients already at risk from renal disease.

Adolescent↗

PubMed1995

Differences in urinary tract infections in male and female spinal cord injury patients on intermittent catheterization.

Intermittent catheterization has gained wide acceptance for use in hospitalized patients following spinal cord injury. Most studies evaluating this procedure, however, look only at the infection rate in the male SCI population. In this study the rate and type of infection encountered in the male and female SCI population were evaluated in an inpatient hospital environment. Fifty four patients who were undergoing intermittent catheterization with the MMG/O'Neil catheter system were evaluated. All patients were similar with regard to level of injury and bladder management. There were 45 males and nine females in our study group (n = 45). A total of 10,945 catheterizations were performed with 75 infections indentified. The overall infection rate was 0.68% or one infection for every 146 catheterizations. Of the 45 males there were 58 infections of which 11 (18%) were E. coli. This contrasts with the female population (9) in which there were 17 infections with nine (53%) being E. coli. While a variety of infecting organisms were present in males, females were colonized with either E. coli, enterococcus or Klebsiella. While hospital based intermittent catheterization would appear to be associated with an acceptable low incidence of urinary tract infections (0.68%), infected females have a higher incidence of E. coli (53%) compared to the male population (18%). This study also demonstrated that female patients had a significantly higher infection rate than males (nine females with 17 infections compared to 45 males with 58 infections over the same time period). The higher incidence of urinary tract infections in females with E. coli perhaps is related to the proximity of bowel/stool contamination.

Adult↗

PubMed1995

Compliance and complications of clean intermittent catheterization in the spinal cord injured patient.

The optimal management of the neuropathic bladder secondary to spinal cord injury remains unsettled. Some have advocated the use of chronic indwelling catheters in tetraplegic patients supposedly due to comparable complication rates with non-indwelling catheter management. We assessed the urological complication and compliance rates in a group of spinal cord injured patients followed over a mean of 5.9 years. Complication rates from clean intermittent catheterization were comparable if not better than the rates previously reported for clean intermittent catheterization and significantly better than chronically catheterized patients. The compliance rate in our series was 71% as determined by the number of patients remaining on clean intermittent catheterization at their last urological follow-up. We conclude that the use of clean intermittent catheterization can provide optimal management of the lower urinary tract in spinal cord injured patients.

Adolescent↗

PubMed2002

Complications of intermittent catheterization: their prevention and treatment.

STUDY DESIGN: Literature review to evaluate the complications seen in patients on intermittent catheterization (IC) and intermittent self-catheterization (ISC). OBJECTIVES: To find the prevalence of most complications seen in patients on IC. To study the prevention and the treatment of these complications. SETTING: An international literature review. METHODS: Most relevant articles on the subject are reviewed. CONCLUSION: Urinary tract infection is the most frequent complication in patients performing IC. Catheterization frequency and the avoidance of bladder overfilling are amongst the most important prevention measures. Asymptomatic bacteriuria does not need to be treated with antibiotics. Long-term antibacterial prevention does seem to bear a risk of development of bacterial resistance. Previous treatment with indwelling catheters is a risk factor for chronic infection and urinary sepsis. Prostatitis is more frequently present than often thought. Epididymitis and urethritis are rare. Trauma from catheterization occurs regularly, but lasting effects are more limited. However, the prevalence of urethral strictures and false passages increases with longer use of IC. The use of hydrophilic catheters might be able to lower the urethral complication rate but additional proof through comparative studies is needed. The most important prevention measures are good education of all involved in IC, good patient compliance, the use of a proper material and the application of a good catheterization technique.

Humans↗

PubMed2006

Depressive symptoms of patients using clean intermittent catheterization for neurogenic bladder secondary to spinal cord injury.

STUDY DESIGN: Prospective, cross-sectional study, based on cases of spinal cord injury (SCI). SETTING: Three outpatient medical departments in Seoul, Korea. OBJECTIVES: To assess depressive symptoms in patients on clean intermittent catheterization after SCI. METHODS: In total, 102 subjects (68 males and 34 females, mean age 39.5 with a range of 18-75 years) were included in the primary analysis. A control group of 110 was selected from the routine health checkup. All subjects completed the Beck Depression Inventory (BDI). RESULTS: For patients and controls, the average total BDI scores were 20.3+/-1.0 and 11.4+/-0.5, respectively (P<0.001). With regard to severity of depression among patient groups, three (3.0%) reported normal; four (3.9%) reported mild to moderate depression; 24 (23.5%) reported moderate to severe depression; and 71 (69.6%) reported severe depression. On the multivariate logistic regression analysis, a positive association with the risk of depression was observed in gender and type of catheterization. Female patients had a 3.8-fold higher risk (odds ratio (OR) 13.83; 95% confidence interval (CI) 1.42-10.31; P=0.008) of depression than male patients. In the same model, patients who were unable to perform catheterization independently had a 4.6-fold higher risk (OR 4.62; 95% CI 1.67-12.81, P=0.003) of depression than those who were able to perform self-catheterization. CONCLUSIONS: The results demonstrate that the patients with neurogenic bladder secondary to SCI have higher degrees of depression than normal population. In addition, our findings also suggest that depression is closely related to gender and patient's ability to perform self-catheterization.

Adolescent↗

PubMed1999

Non-invasive measurement of bladder volume as an indication for bladder catheterization after orthopaedic surgery and its effect on urinary tract infections.

A non-invasive ultrasound imaging technique (BladderScan) was used prospectively in an attempt to reduce the need for catheterization of the urinary bladder and the incidence of urinary tract infections after orthopaedic surgery. Over a 4-month period, in which 1920 patients were included, catheterization was performed if there was no spontaneous diuresis by 8 h after surgery. A total of 31% of these patients were catheterized, and 18 patients developed urinary tract infections. In a subsequent 4-month period, there were 2196 patients, catheterization was performed only if the bladder volume was more than 800 mL 8 h after surgery. The rate of catheterization decreased to 16%, and five patients developed urinary tract infections. In our patients, measuring bladder volume reduced the need for a urinary catheter and the likelihood of urinary infection.

Adult↗

PubMed1999

Suprapubic catheterization: a suitable procedure for clinical nurse specialists in selected patients.

OBJECTIVE: To assess the feasibility and advantages of urology clinical nurse specialists (NSs) extending their professional role to include inserting initial suprapubic catheters in selected patients in the hospital and community setting. PATIENTS AND METHODS: A urology NS, who is also the district continence adviser, was formally taught by a consultant urologist how to insert suprapubic catheters using the 'Add-a-Cath' introducer technique (Femcare, UK). Once deemed competent, the NS was indemnified by the Trust to carry out the procedure in carefully selected patients using a safe and unequivocal protocol. RESULTS: Over a period of 40 months, the NS undertook the procedure in 164 patients, with 64 being catheterized in the community. There were no serious complications in the series and during the period studied, only 17 patients were referred back to the urologists for catheterization under formal theatre conditions. CONCLUSION: Initial suprapubic catheterization can be carried out safely by trained NSs in selected patients. This extended professional role has helped to improve the continuity and quality of care for patients who require long-term catheterization. The NS was also a valuable source of training for junior medical staff who have limited experience with suprapubic catheterization.

Community Health Nursing↗

PubMed2001

The effects of music intervention on anxiety in the patient waiting for cardiac catheterization.

BACKGROUND: Hospitalization causes anxiety for many patients. It increases when patients anticipate their turn for cardiac catheterization. Music therapy reduces the psychophysiologic effects of anxiety and stress through the relaxation response. AIM: To determine the effects of music therapy an anxiety, heart rate and arterial blood pressure in patients waiting for their scheduled cardiac catheterization. METHODS: In a quasi-experimental, pretest-posttest design, 101 subjects were randomly assigned to either the test group: those who listened to 20 minutes of preselected music, or the control group: those who received treatment as usual. Subject anxiety levels and physiological values were measured while waiting their turn for cardiac catheterization and just prior to departure to the cardiac lab. RESULTS: 63 males and 38 females participated in the study. There was a statistically significant reduction in anxiety in the test group alone (P = 0.003) and in comparing the test to the control group (P = 0.004). In comparing the initial and departure physiologic values, it was noted that both heart rate and systolic blood pressure dropped in the test group, but increased in the control group. Within gender groups, there were no statistically significant differences in hemodynamics or STAI scores, but between gender groups there were significantly higher diastolic blood pressure in males and STAI initial and departure scores for females. DISCUSSION: Patients waiting for their cardiac catheterization benefit from music therapy. Anxiety and the heightened physiological values elicited by the stress response are reduced. Results also suggest that women waiting for cardiac catheterization experience a higher level of anxiety than males.

Adult↗

PubMed2006

[Peri-interventional risk in 1,384 cardiac catheterizations in patients aged 80 years or older].

BACKGROUND AND OBJECTIVE: Because of the rising life expectancy in the industrialized countries, ever more cardiac catheterizations are performed in patients aged 80 years or older. Little is known about the incidence of peri-interventional events in this age group. PATIENTS AND METHODS: Between January 1996 and September 2000, a total of 1,085 patients of that age (mean 82.6 +/- 2.6 years) underwent cardiac catheterization and intervention (3% of a total of 43,517 cardiac catheterizations). RESULTS: 827 patients (77%) had significant coronary artery stenoses. 373 of them (45%) were treated with balloon angioplasty, with or without stenting, and 331 (40%) underwent aortocoronary bypass procedures. 31 patients died while in hospital, 17 of them having been in cardiogenic shock on admission. Peri-interventional events, including damage to artery at the site of catheter entry occurred in 2.1% of patients undergoing diagnostic cardiac catheterization and in 11.6% in connection with a percutaneous interventional procedure. CONCLUSION: Both cardiac catheterization and interventional procedures can be done with a justifiable risk in patients aged 80 years or older. These cardiac investigations/interventions should not be withheld in this group of patients for reasons of age.

Age Factors↗

PubMed1981

Valve replacement without preoperative cardiac catheterization.

During the year 1978, the decision to perform cardiac catheterization in patients with valvular heart disease was delayed until clinical and noninvasive assessment have been completed. As a result, 184 patient underwent operation without invasive studies, and 59 had elective catheterization. Another 62 patients were referred during the same period for valve replacement after routine catheterization had been performed elsewhere. Age, sex distribution, symptoms, and cause of valve disease were similar in all three groups, although we managed emergencies and second operations more frequently without catheterization. In all patients, the preoperative diagnosis was confirmed, and no unexpected pathologic process was encountered. Operative mortality was the same in all three groups, and after two years of follow-up there was no difference in survival or symptoms. No uncorrected valve lesions became apparent in uncatheterized patients. We conclude that routine catheterization is unnecessary before valve replacement but can be reserved for specific indications in some patients.

Adolescent↗

PubMed1984

Right-sided infective endocarditis as a consequence of flow-directed pulmonary-artery catheterization. A clinicopathological study of 55 autopsied patients.

We studied 142 consecutively autopsied patients prospectively to determine the frequency and clinical importance of right-sided endocardial lesions in patients who had undergone flow-directed pulmonary-artery catheterization within one month of death. Of the 55 catheterized patients, 29 (53 per cent) had one or more right-sided endocardial lesions: 12 (22 per cent) had subendocardial hemorrhage, 11 (20 per cent) sterile thrombus, 2 (4 per cent) hemorrhage and thrombus, and 4 (7 per cent) infective endocarditis. Of 41 lesions seen in the 29 patients, 23 (56 per cent) were located on the pulmonic valve, 6 (15 per cent) on the tricuspid valve, 6 (15 per cent) in the right atrium, 4 (10 per cent) in the right ventricle, and 2 (5 per cent) in the main pulmonary artery. All four patients with infective endocarditis had had positive antemortem blood cultures while the catheter was in place, but in only one had the diagnosis of endocarditis been suspected clinically. The unusual locations of the infected vegetations (on the pulmonic valve in three and in the right atrium in one) and the similar location of the uninfected lesions suggest that the infective endocarditis was a consequence of catheter-induced endocardial damage with concurrent or subsequent bacteremia. Among the 87 non-catheterized patients, there were two subendocardial hemorrhages and one resolving right atrial thrombus. We conclude that endocardial damage from flow-directed pulmonary-artery catheterization is common and that right-sided infective endocarditis should be suspected in bacteremic catheterized patients.

Adolescent↗

PubMed2006

Postoperative voiding, bacteriuria and urinary tract infection with Foley catheterization after gynecological surgery.

BACKGROUND: The use of bladder drainage to avoid urinary retention after gynecological surgery is more or less custom based, and duration of drainage varies considerably. In this paper the use of 1-day drainage by transurethral Foley catheter was investigated with regard to impaired voiding, asymptomatic bacteriuria, and urinary tract infection. Furthermore, the use of methenamine hippurate was studied with regard to postoperative asymptomatic bacteriuria and urinary tract infection. METHODS. This summary is based on six published papers totaling 917 patients. In three case series, 1-day catheterization was used in women undergoing gynecological laparotomy, colposuspension, or vaginal plastic surgery. To compare 1- and 3-day Foley catheterization, two open, randomized trials were performed on women undergoing vaginal plastic surgery or colposuspension. The last study was a double-blind trial between methenamine hippurate and placebo as prophylaxis against urinary tract infection and asymptomatic bacteriuria using 1-day catheterization. RESULTS: Postoperative voiding problems and urinary tract infection occurred infrequently with 1-day catheterization, and no more frequently than with catheterization for three days. Methenamine hippurate decreased the incidence of urinary tract infection and asymptomatic bacteriuria by 80 and 40%, respectively. CONCLUSIONS: One-day bladder drainage by transurethral Foley catheter may be used routinely in common gynecological surgery with a low rate of voiding problems, asymptomatic bacteriuria, and urinary tract infection. Methenamine hippurate prophylaxis effectively reduces postoperative urinary tract infection.

Anti-Infective Agents, Urinary↗

PubMed1985

The problem of bacteriuria with indwelling urethral catheterization.

Bacteriuria following long-term catheterization is more likely to occur in elderly females over the age of 50 years, in patients with some abnormality of the bladder and when traumatic catheterization has taken place. Breaks in the closed system of drainage are the most important factors leading to bladder infections which, once there, are difficult to eradicate. Antiseptics are important at the time of catheterization but have little place afterwards except to reduce cross-infection and growth in the catheter bag. Systemic antimicrobials are only of use over a short period of catheterization and should be reserved in long-term catheterized patients for those with systemic manifestations of infection.

Aged↗

PubMed1990

Post-operative urinary retention in women: management by intermittent catheterization.

We have investigated the value of intermittent catheterization in the management of post-operative urinary retention occurring in elderly women after operative fixation of lower limb fracture. Eleven patients, aged 70-86, underwent intermittent catheterization two or three times daily for between 9 and 40 days as inpatients, and one patient continued intermittent self-catheterization at home for 3 months after discharge. Ten patients became continent. One severely disabled lady required an indwelling catheter. Intermittent catheterization is safe and practical, with several advantages over indwelling catheterization in the management of post-operative urinary retention during inpatient rehabilitation.

Aged↗

PubMed2004

NICE guidelines for central venous catheterization in children. Is the evidence base sufficient?

BACKGROUND: Recent guidelines from the National Institute for Clinical Excellence (NICE) recommend the use of ultrasound guidance for central venous catheterization in children. This study prospectively examined the use of ultrasound guidance for central venous catheterization in children undergoing heart surgery. METHODS: One hundred and twenty-four infants and children were randomized to either ultrasound-guided or traditional landmark-guided central venous catheterization. RESULTS: Success rates were significantly greater in the landmark group compared with the ultrasound group (89.3% vs 78%, P<0.002), and arterial puncture rates were significantly lower in the landmark group (6.2% vs 11.9%, P<0.03). There was no significant difference between the two groups in the time taken to perform the catheterization. CONCLUSIONS: These results are different from the published results on which the NICE guidelines were based; however, the evidence base in children is small. There is currently insufficient evidence to support the use of ultrasound guidance for central venous catheterization in children.

Carotid Artery Injuries↗