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At least 649 records · Page 36Linked to original sources
PubMed1995

Home application of EMLA cream prior to venipuncture. Is it feasible in pediatric ENT day care surgery?

EMLA (Eutectic Mixture of Local Anaesthetics) cream is an emulsion made from lidocaine and prilocaine. The cream is well known among parents in Scandinavia, and it has become most popular in preventing pain during venipuncture in children. To be fully effective the cream must be applied at least 60 min before the painful stimulus, which is a major drawback in outpatient practice. Could this problem be eliminated by home application of EMLA cream? To answer this we performed a study comprising 228 consecutive patients (1-15 years of age) planned for outpatient surgery. All parents received a letter with detailed information about the procedure and a prescription of EMLA cream. Parents and anaesthesiology nurses answered questionnaires after the operation. Twenty-three children were excluded from the study due to failure in registration or they were called in to fill vacancies. One hundred and eighty out of 205 children had EMLA cream applied. Home application of EMLA cream reduced the waiting time at the ENT outpatient clinic by at least 60 min, and the study showed that home application of EMLA cream is safe, easy to perform and a well-tolerated procedure.

Adolescent↗
PubMed1991

Prior bleeding enhances the sensitivity of the in vivo micronucleus test.

It has been reported that the sensitivity of the in vivo mouse bone marrow micronucleus test can be increased by inducing erythropoiesis with exogenous erythropoietin prior to treatment (Suzuki et al., 1989). In these studies we demonstrate that removing approximately 0.5 ml of blood from an adult male BDF1 mouse, another method for increasing the rate of erythropoiesis, synergistically increased the frequency of bone marrow micronucleated polychromatic erythrocytes induced by mitomycin C, with maximal enhancement occurring when the mutagen was given 24 h after bleeding. This enhancement response was also demonstrated for benzo[a]pyrene and dimethylnitrosamine but not for 2-acetylaminofluorene. These results indicate that bleeding mice prior to chemical treatment is a simple method for increasing the sensitivity of the micronucleus assay.

Animals↗
PubMed1994

Effects of phlebotomy on a patient with secondary polycythemia and angina pectoris.

A 67-year-old man with polycythemia, secondary to chronic obstructive pulmonary disease, had angina attacks at rest treated successfully by supplementing conventional therapy with frequent phlebotomies. Although phlebotomy reduces arterial oxygen content, it also decreases blood viscosity, improves peripheral oxygen consumption and thus yields the clinical benefit.

Aged↗
PubMed1995

Serum aminotransferase levels as an indicator of the effectiveness of venesection for chronic hepatitis C.

BACKGROUND/AIMS: Iron cytotoxicity may play an important role in chronic hepatitis C. The effects of venesection suggest that a slight iron overload contributes to hepatic injury in subjects infected with hepatitis C virus. A better indication of the efficacy of venesection was studied in patients with and without overt iron overloading. METHODS: All 40 patients had chronic hepatitis C but none had hemochromatosis of a known etiology. A serum ferritin level of 10 ng/ml or less was chosen as the treatment goal. A mean blood volume of 2400 +/- 1100 ml was removed during treatments lasting 5 +/- 3 months. RESULTS: Treatment significantly reduced the mean serum levels of alanine aminotransferase activity from 128 +/- 74 to 63 +/- 28 IU/l (p < 0.01). The baseline enzyme activity was highly correlated with reduction in activity after treatment (r = 0.94, p < 0.01), but the baseline levels of ferritin and histochemistry for iron showed poor correlations with the reduction in enzyme activity (r = 0.63 with p < 0.01 and r = 0.38 with p < 0.05, respectively). CONCLUSIONS: Thus, serum levels of aminotransferases were a more important indicator for venesection than conventional indices of iron overload, probably because cytotoxic iron includes some reactive iron species rather than stored iron alone.

Adult↗
PubMed1992

Childhood-onset familial porphyria cutanea tarda: effects of therapeutic phlebotomy.

Cutaneous fragility at age 2 years with blistering, scarring, milia, and hypertrichosis at age 4 years were noted in an otherwise healthy girl who had no family history of porphyria. Results of porphyrin analyses of urine, serum, and red blood cells revealed a pattern consistent with porphyria cutanea tarda. Red blood cell uroporphyrinogen decarboxylase activity was diminished to approximately 50% of normal in the child and in her mother and maternal grandmother, who were without symptoms; activity was normal in her sister, father, and maternal grandfather. Therapeutic phlebotomies were followed by a biochemical and clinical remission.

Bloodletting↗
PubMed1991

Phlebotomy in inoculation risk patients: a questionnaire survey of knowledge and practices of hospital doctors in Liverpool.

To assess the knowledge of hospital doctors about patients at increased risk of infection with human immunodeficiency virus (HIV) or hepatitis B virus, and the precautions they took during phlebotomy in such patients, an anonymous postal questionnaire was sent to all 307 hospital doctors working at two District General Hospitals in Liverpool, UK. Two hundred and thirty-eight (77.5%) of the questionnaires were returned. More than 90% of respondents considered a history of male homosexuality, intravenous drug abuse, prostitution or a child of a prostitute to indicate an inoculation risk. There was uncertainty about a previous prison sentence in the 1980s, residence in a home for the mentally handicapped, previous residence in the tropics and hospital treatment in the tropics. Thirty-eight percent of doctors would never enquire about sexual preference, 54.1% about a previous prison sentence and 15.7% about intravenous drug abuse in their clinical history. Although 97.4% of doctors would sometimes or always wear gloves during phlebotomy of an inoculation risk patient, 25.5% always resheathed the needle after phlebotomy and 20.8% would never take the sharps box to the patient. More effort is required to identify accurately inoculation risk patients and greater care is needed in phlebotomy techniques.

Blood Specimen Collection↗
PubMed1992

An examination of needlestick injury rates, hepatitis B vaccination uptake and instruction on 'sharps' technique among medical students.

A 12-question survey designed to examine venepuncture techniques and instruction and uptake of hepatitis B vaccination was completed by 172 of the 275 medical students to whom it was distributed (a response rate of 62.5%). Seventy-five injuries were reported, at an average of 0.3 per student per year. Of the respondents, 63% resheathed needles after use, a practice frequently cited as a cause of needlestick injury. However, in this sample resheathing was not significantly associated with a higher or lower injury rate (chi 2 = 2.07, P > 0.1). Of the respondents from the most recent intake, only 20 out of 57 had completed a course of hepatitis B vaccinations prior to the commencement of venepuncture duties. There was almost universal ignorance concerning the correct course of action following 'sharps' injury. Recommendations are made concerning hepatitis B vaccination and teaching strategies for medical students.

Bloodletting↗
PubMed1994

Pseudobacteraemia.

Pseudobacteraemia occurs when bacteria isolated from blood cultures have originated from outside the patient's bloodstream. Failure to recognize that pseudobacteraemia is taking place and is not true infection may result in patient morbidity, unnecessary therapy and a significant waste of health care resources. Pseudobacteraemia may occur as a result of contamination introduced at any stage of blood culturing, from taking the blood to processing it in the laboratory. In most reported cases, contamination has occurred as a result of faulty aseptic technique, and thus pseudobacteraemia is usually preventable. Episodes of pseudobacteraemia require prompt investigation, but their recognition may be extremely difficult. Here we review pseudobacteraemia and recommend guidelines for its recognition, investigation and prevention.

Bacteremia↗
PubMed1990

Efficiency of skin sterilization for a venipuncture with the use of commercially available alcohol or iodine pads.

Skin sterilization for a venipuncture is routinely done with commercially available alcohol or iodine pads. Selection of the antiseptics, alcohol or iodine, however, in most situations has been made on the basis of very little scientific data. With many patients with granulocytopenia who are undergoing venipunctures, the choice of antiseptic may be an important factor in preventing infections. We investigated two widely and commercially available disinfectant pads, alcohol and iodine, in the efficacy of skin sterilization. Seventy subjects (35 adults and 35 children) were randomly selected for this study. A designated area of the right and left forearm was sterilized either with alcohol or with an iodine pad in a predetermined uniform fashion. Specimens were obtained for cultures before and after sterilization. The bacterial cultures were performed with the use of blood agar plates and trypticase soy broth. For data analysis growth of any organisms on agar plates or trypticase soy broth after sterilization was interpreted as a sterilization failure. The iodine swab was significantly more efficient than the alcohol swab; the former yielded an 80% sterilization rate whereas the latter resulted in a rate of 61% (p less than 0.02). If, however, the growth only in agar plates was compared, the alcohol wipe yielded no growth in 83% and iodine in 84%, virtually identical success rates. Bacillus spp. predominated the residual organisms after either the alcohol or the iodine wipe. A variety of other organisms, however, including Staphylococcus and Corynebacterium spp., grew after alcohol but not after iodine sterilization.(ABSTRACT TRUNCATED AT 250 WORDS)

1-Propanol↗
PubMed1984

Continuous blood-letting for congestion in replantation of the amputated finger.

Experimental and clinical studies have been made on the function of the venous system in the replantation of the contused severed finger. In experiments on rats replantation of severed limbs was more successful in a group treated by continuous blood-letting and anastomosis of the artery alone, compared with controls in which only the artery was anastomosed. Histologically, in the first group there was less congestion, thrombus-formation, oedema and exudative haemorrhage in the initial stage; in the reparative phase there was less granulation and the degree of muscular degeneration was very slight. Clinically, contused, severed fingers were successfully replanted when venous anastomosis was impossible or incomplete, by using the fish-mouth incision for continuous blood-letting. The resulting scar caused no problem aesthetically or functionally.

Adult↗
PubMed1989

Polycythemia: evaluation and management.

The approach to diagnosis and classification of patients with polycythemia is reviewed with presentation of general and specific guidelines for the management of patients with polycythemia vera, secondary polycythemia and relative polycythemia.

Adult↗
PubMed1990

Haemochromatosis.

Explore the source record for details and available documents.

Bloodletting↗
PubMed1994

Review of neonatal red cell transfusion practices.

In the United States in 1991, 290,000 or 7.1% of the 4,110,907 live births were premature infants; 53,299 or 1.3% were infants with birth weights of less than 1500 grams. Many if not all of these very low birth weight infants will require red blood cell transfusions for one of several reasons. These include exchange transfusions for hyperbilirubinemia, but most often transfusions are simple small volume transfusion also called 'topper' transfusions. Most of these small volume transfusions are given for iatrogenic blood loss or 'bleeding into the laboratory.' Studies have demonstrated that the sicker the infant, the more blood sampling is needed and the greater the exposure to red blood cell (RBC), platelet and plasma products. Simple RBC transfusions may also be given for specific clinical indications or to maintain a predetermined hemoglobin concentration. This manuscript will review the criteria for RBC transfusion in neonates and selection of product as regards anticoagulant and specialized processing. In addition, the results of recombinant erythropoietin (r-EPO) clinical trials in neonates will be discussed.

Blood↗