Hickman catheter dislodgement due to pendulous breasts.
*Catheterization; Adult; Aged; Breast/*anatomy & histology; Central Venous; Female; Gynecomastia/complications; Humans; Male; Middle Aged
Dislodgement of Hickman, Broviac, and Mediport catheters is a rare but recognized complication. To date, no specific etiology for this has been cited. We present five cases of dislodgement due to positional changes in large-breasted women and one man with gynecomastia. Apparently, motion in the subcutaneous tissue secondary to gravitational forces on large breasts causes downward and outward traction on the subcutaneous portion of the catheter. Variations in placement technique to help avoid this complication are described.
Moorman D W; Horattas M C; Wright D; Kaufman K; Ruf W
JPEN. Journal of parenteral and enteral nutrition
1987
1987-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0148607187011005502" target="_blank" rel="noreferrer noopener">10.1177/0148607187011005502</a>
Prolonged Clostridium difficile Infection May Be Associated With Vitamin D Deficiency.
*adult; *gastroenterology; *immunonutrition; *life cycle; *nutrition; *research and diseases; *sepsis; *vitamins; 80 and over; 80 and Over; Aged; Clostridium Infections – Etiology; Clostridium Infections – Mortality; Clostridium Infections – Physiopathology; Clostridium Infections/*etiology/mortality/physiopathology; Diarrhea – Microbiology; Diarrhea – Physiopathology; Diarrhea/microbiology/physiopathology; Female; Humans; Iatrogenic Disease – Epidemiology; Iatrogenic Disease/epidemiology; Length of Stay; Male; Middle Age; Middle Aged; Nutritional Status; Psychological Tests; Recurrence; Retrospective Design; Retrospective Studies; Sepsis – Epidemiology; Sepsis/epidemiology; Severity of Illness Index; Severity of Illness Indices; Vitamin D; Vitamin D – Blood; Vitamin D Deficiency – Blood; Vitamin D Deficiency – Complications; Vitamin D Deficiency/blood/*complications; Vitamin D/analogs & derivatives/blood
BACKGROUND: Clostridium difficile infection (CDI) is one of the leading causes of hospital-acquired infections, creating a financial burden for the U.S. healthcare system. Reports suggest that vitamin D-deficient CDI patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. The objective here was to evaluate the relationship between vitamin D level and CDI recurrence. MATERIALS AND METHODS: A retrospective chart review was conducted for 112 patients with vitamin D level drawn within 3 months of CDI diagnosis. Recurrence, severity of disease, 30-day mortality, and course of CDI were assessed. RESULTS: The vitamin D-deficient group included 56 patients, and the normal group included 56 patients. The mean age of vitamin D-deficient and -sufficient groups was 68 +/- 15.7 and 71 +/- 14.4 years, respectively. The mean 25(OH) D level in the deficient group was 11.7 +/- 4.6 ng/mL, and it was 36.2 +/- 16.2 ng/mL in the normal group. A longer course of diarrhea was apparent in the vitamin D-deficient group compared to the normal group: 6.1 days (95% confidence interval [CI], 4.9-7.2) vs 4.2 days (95% CI, 3.5-4.9; P = .01). Sepsis rate was 24% in vitamin D-deficient group and 13% in normal group (P = .03). There were no differences in CDI recurrence, length of stay, severity of illness, and mortality with respect to vitamin D status. CONCLUSION: There may be an association between course of diarrhea and increased rate of sepsis in vitamin D-deficient CDI patients.
Wong Ken Koon; Lee Rebecca; Watkins Richard R; Haller Nairmeen A
JPEN. Journal of parenteral and enteral nutrition
2016
2016-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0148607114568121" target="_blank" rel="noreferrer noopener">10.1177/0148607114568121</a>