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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In spite of intensive efforts to reduce the risk of hepatitis B after heart operations, this complication is observed in 40 % or more of the cases. Over a period of three years (1974--1976) we examined 588 patients who had undergone open heart surgery. The following results were found: In 1974 the hepatitis frequency was 2.0 %, while in 1975 and 1976 it was 0.6 % hepatitis B and 0.6 % non-B hepatitis. We believe the reason for this improvement is a more careful selection of blood donors and their continuous control according to the following parameters: regular clinical observation; regular chest x-ray; determination of BSR, hemoglobin and aminotransferase; TPHA test; and search for antibodies. In 1974 hepatitis-B-surface-antigen (HBsAg) was detected by means of reverse hemagglutination tests. Since 1975 a modified radioimmunoassay has been used for this purpose. No donor blood with abnormal results was transfused, except for a very small number of extreme emergencies. The good results demonstrated can only be obtained by following the described program and by strictly avoiding pool preparations.
Thorac Cardiovasc Surg 1979 Aug
PMID:Frequency of hepatitis B after open heart surgery: a retrospective study over a three-year period (1974--1976). 49 21

The following guidelines for prevention of catheterization laboratory infections are based on standard precautions for infection prevention in surgical wounds. Specific recommendations for patient preparation include proper methods for hair removal, skin cleaning and draping, antibiotic prophylaxis, wound irrigation and dressing, and sheath removal. Sterile precautions should be more vigorous for cutdown procedures compared to percutaneous. Caps, masks, gowns, and gloves help to protect both the patient and operator. Handwashing is the most important procedure for preventing infections. Maintenance of the catheterization laboratory environment includes appropriate cleaning, limitation of traffic, and maintenance of adequate ventilation. Proper catheterization technique and appropriate use of sterile equipment will decrease the wound infection rate. Protection of personnel may be accomplished by proper gowning and gloving, disposal of contaminated equipment, and care of puncture wounds and lacerations. All personnel should receive vaccination for hepatitis B.
Cathet Cardiovasc Diagn 1992 Mar
PMID:Infection prevention guidelines for cardiac catheterization laboratories. Society for Cardiac Angiography and Interventions Laboratory Performance Standards Committee. 157 85

A multicenter study was conducted to test the efficacy and safety of fibrin sealant as a topical hemostatic agent in patients undergoing either reoperative cardiac surgery (redo) or emergency resternotomy. A total of 333 patients from 11 centers in the United States were included in the study. Patients were randomly assigned to initially receive the fibrin sealant or a conventional topical hemostatic agent when such was required during an operation. The end point used to evaluate the agent's efficacy was local hemostasis, the number of bleeding episodes controlled within 5 minutes. The fibrin sealant group from the prospective study was compared with historical matched control subjects for postoperative blood loss, need for resternotomy, blood products received, and hospital stay. It was also compared with historical nonmatched control subjects for the incidence of resternotomy and mortality. The results showed a 92.6% success rate for fibrin sealant in controlling bleeding within 5 minutes of application, compared with only a 12.4% success rate with conventional topical agents (p less than 0.001). Fibrin sealant also rapidly controlled 82.0% of those bleeding episodes not initially controlled by conventional agents. High-volume postoperative blood loss was significantly less (p less than 0.05) in the fibrin sealant group than in the matched controls. Additionally, resternotomy rates after redo operations were significantly lower in the fibrin sealant group (5.6%) than in the nonmatched historical control group (10%) (p less than 0.0089). There were no significant differences in hospital stay or blood products received between the fibrin sealant group and matched historical controls and no difference in mortality between the fibrin sealant group and nonmatched historical controls. There were no documented instances of adverse reactions, transmission of viral infection (hepatitis B, non-A/non-B hepatitis), or human immunodeficiency virus seroconversion. This study shows that fibrin sealant is safe and highly effective in controlling localized bleeding in cardiac operations. Fibrin sealant reduces postoperative blood loss and decreases the incidence of emergency resternotomy. These findings make fibrin sealant a valuable hemostatic agent in cardiac surgery.
J Thorac Cardiovasc Surg 1989 Feb
PMID:Randomized clinical trial of fibrin sealant in patients undergoing resternotomy or reoperation after cardiac operations. A multicenter study. 246 22

Twenty patients with endomyocardial fibrosis (EMF), the largest series reported to date, were operated upon between June, 1978, and June, 1980. Eleven were male and nine female, ranging in age from 6 to 23 years (mean 13.3 years). There were seven cases of right ventricular (RVEMF), six of left ventricular (LVEMF), and seven cases of bilateral EMF. All patients underwent endocardiectomy and atrioventricular valve replacement with a xenograft. Four patients had an additional valvular annuloplasty. There were four postoperative deaths (all bilateral EMF): two from low cardiac output and one each from hepatic failure and cerebral malaria. There was one late death from serum hepatitis. The other patients had a relatively difficult postoperative course, but none of the 20 patients atrioventricular block. The longest follow-up of the 15 survivors is 28 months (mean 16.7 months). All patients are symptom free. Three take digitalis and/or diuretics. Ten have been recatheterized from 6 months to 1 year after operation. Intracardiac pressures, the ventricular cineangiogram, liver, and heart size returned to normal in patients with LVEMF; in RVEMF, despite clinical improvement, most of these parameters remained abnormal. Of special interest were (1) our recognitions of an early type of LVEMF and (2) our surgical preservation of a thin juxta-annular rim of fibrosis in the right ventricle to avoid atrioventricular block. Operation is indicated in all patients with LVEMF, despite greater risk. Early intervention is advised in RVEMF to avoid irreversible liver damage and cardiac enlargement.
J Thorac Cardiovasc Surg 1982 Jan
PMID:Endomyocardial fibrosis: early and late results of surgery in 20 patients. 705 13

A 67-year-old Japanese man with exertional dyspnea was found by laminagraphy to have tracheal obstruction. The stricture was localized at the cervical and mediastinal trachea and was 5.0 cm long on an x-ray film. Eight tracheal rings were successfully resected and the ends of the trachea were anastomosed. The lumen of the removed trachea was narrowed by intramural and intraluminal polypoid growth originating from the tracheal wall. Histologically, the tumor was diagnosed as a mixed type of malignant lymphoma. The patient had serum hepatitis postoperatively, but now he is living normally without any difficulty in respiration. No signs of recurrence have been seen in the 5 years, 4 months since the operation. From this experience, the rarity and the possibility of curative operation of this tumor are discussed.
J Thorac Cardiovasc Surg 1981 Jun
PMID:Primary malignant lymphoma of the trachea. Report of a case successfully treated by primary end-to-end anastomosis after circumferential resection of the trachea. 723 Aug 54

Seven patients with infected arterial conduits (six with prosthetic bypass grafts and one autogenous vein anastomosis) with ten limbs at risk (three patients with bilateral groin infection) are reported. The most common site for infection was the groin and the most frequent organism cultured was Staphylococcus aureus. These patients were selected for arterial homograft implantation through infected fields as they were unsuitable for extra-anatomical prosthetic bypass or had inadequate autogenous tissue available for use as a bypass conduit, i.e. the alternative to homograft insertion was arterial ligation and potential limb sacrifice. The arterial homografts were obtained form brain-dead organ donors (human immunodeficiency virus, hepatitis B- and hepatitis C-negative) and stored at -80 degrees C until ready for use. All seven patients had initial success with their homograft procedures in terms of graft patency, limb salvage and control of infection, although two required early reoperation for haemorrhage. During the follow-up period (mean 24.5, range 6-52 months) three homografts have occluded at 6, 13 and 29 months resulting in limb loss. Two patients have died at 48 and 52 months from causes unrelated to their homograft procedures with functioning homografts and limb salvage. Two further patients remain alive with patent homografts at 7 and 20 months. The authors' experience suggests that arterial homografts have a role in overcoming arterial bypass infection, achieving wound healing and maintaining limb viability rather than resorting to arterial ligation and accepting major limb amputation.
Cardiovasc Surg 1996 Dec
PMID:Arterial homografts--a possible solution to an infective dilemma. 901 13

In the early years of diagnostic cardiac catheterization, strict sterile precautions were required for cutdown procedures. Thirteen years ago, when the original guidelines were written, the brachial arteriotomy was still frequently utilized, femoral closure devices were uncommon, "implantables," such as intracoronary stents and PFO/ASD closure devices, were in their infancy, and percutaneous valve replacement was not a consideration. In 2005, the cardiac catheterization laboratory is a complex interventional suite with percutaneous access routine and device implantation standard. Despite frequent device implantation, strict sterile precautions are often not observed. Reasons for this include a decline in brachial artery cutdown, limited postprocedure follow-up with few reported infections, limited use of hats and masks in televised cases, and lack of current guidelines. Proper sterile technique has the potential to decrease the patient infection rate. Hand washing remains the most important procedure for preventing infections. Caps, masks, gowns, and gloves help to protect the patient by maintaining a sterile field. Protection of personnel may be accomplished by proper gowning, gloving, and eye wear, disposal of contaminated equipment, and prevention and care of puncture wounds and lacerations. With the potential for acquired disease from blood-borne pathogens, the need for protective measures is as essential in the cardiac catheterization laboratory as is the standard Universal Precautions, which are applied throughout the hospital. All personnel should strongly consider vaccination for hepatitis B. Maintenance of the cardiac catheterization laboratory environment includes appropriate cleaning, limitation of traffic, and adequate ventilation. In an SCAI survey, members recommended an update on guidelines for infection control in the cardiac catheterization laboratory. The following revision of the original 1992 guidelines is written specifically to address the increased utilization of the catheterization laboratory as an interventional suite with device implantation. In this update, infection protection is divided into sections on the patient, the laboratory personnel, and the laboratory environment. Additionally, specific CDC recommendation sections highlight recommendations from other published guidelines.
Catheter Cardiovasc Interv 2006 Jan
PMID:Infection control guidelines for the cardiac catheterization laboratory: society guidelines revisited. 1633 49

Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure. This review outlines suggestions to establish a culture of safety in the interventional suite.
Cardiovasc Intervent Radiol 2013 Aug
PMID:Reducing blood-borne exposure in interventional radiology: what the IR should know. 2343 43

Systemic necrotizing vasculitis may be idiopathic or associated with a variety of diseases of known etiology. A typical example is polyarteritis nodosa, which is characterized by fibrinoid necrosis and severe inflammation leading to destruction of the wall, narrowing of the lumen, and interference with blood circulation. In addition to the idiopathic form, histologically similar lesions are seen in hepatitis B, rheumatoid arthritis, Kawasaki mucocutaneous lymph node syndrome, and other diseases. Microscopic polyangitis involves mainly small vessels-venules more often than arterioles-but occasionally also small arteries. Its characteristic feature is leukocytoclasia of neutrophilic leukocytes, but fibrinoid necrosis also occurs. Churg-Strauss syndrome consists of granulomas in patients with a background of severe allergy, such as asthma, allergic rhinitis, or occasionally drug sensitization.
Cardiovasc Pathol
PMID:Systemic necrotizing vasculitis. 2599 Sep 97

Under the circumstances of cardiovascular adaptations and immunomodulation, an uncommon but disastrous complication of infective endocarditis (IE) can occur in pregnancy. Almost all the cases reported earlier were caused by bacteria. We report a fatal case of zygomycotic valvular and mural endocarditis in a young non-diabetic primigravida with a positive hepatitis B serology.
Cardiovasc Pathol
PMID:Zygomycotic infective endocarditis in pregnancy. 2828 9


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