Impact of Eliminating Postprocedural Antibiotic Prophylaxis in Patients without Biliary Instrumentation or Bypass Undergoing Hepatic Artery Embolization for Hepatic Malignancies

Publication date: December 2019Source: Journal of Vascular and Interventional Radiology, Volume 30, Issue 12Author(s): Susan K. Seo, Zivile Gedrimaite, Deborah Fleischer, Nina Cohen, Elena Petre, Karen T. Brown, Anne CoveyAbstractPurposeTo assess the infection rate after eliminating postprocedural antibiotics in patients undergoing hepatic artery embolization (HAE) for primary and secondary hepatic malignancies.Material and MethodsIn this historical cohort study, adults ≥18 years of age without prior biliary instrumentation or bypass who underwent HAE and received pre- and postprocedure antibiotic prophylaxis between September 1, 2014, and August 31, 2015, comprised group A, whereas similar patients receiving only preprocedure antibiotic prophylaxis between October 1, 2015, and September 30, 2016, comprised group B. Procedures conducted between September 1, 2015, and September 30, 2015, were excluded. The primary outcome was any infection occurring within 30 days of HAE.ResultsA total of 150 patients underwent 204 HAE procedures in group A, and 171 patients underwent 221 procedures in group B. Cefazolin given as a 1-g dose (or 2 grams if obese) was administered in 391 of 425 evaluable procedures (92%). Clindamycin plus gentamicin was prescribed in 34 patients (8%) who had severe penicillin allergy. There was significant improvement in adherence to the postprocedure antibiotic regimen, from 68% (138 of 204 procedures) to 98% (216 of 221 procedures) (P
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research

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Epidemiological studies report that overweight or obese asthmatic subjects have more severe disease than those of a healthy weight. We postulated that accumulation of adipose tissue within the airway wall may occur in overweight patients and contribute to airway pathology. Our aim was to determine the relationship between adipose tissue within the airway wall and body mass index (BMI) in individuals with and without asthma. Transverse airway sections were sampled in a stratified manner from post mortem lungs of control subjects (n=15) and cases of nonfatal (n=21) and fatal (n=16) asthma. The relationship between airway adi...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: COPD and smoking, Asthma and allergy Original Articles: Asthma and COPD Source Type: research
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
Accumulation of adipose tissue within airway walls in obese individuals is linked to greater wall thickness and airway inflammation, according to a postmortem study.Reuters Health Information
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Pulmonary Medicine News Source Type: news
Objective: An important but little explored area is the mechanism governing obesity-induced lung inflammation. Ample evidence indicates that obesity induces chronic inflammation by insulin resistance (IR) and that PI3K/Akt signaling pathway mediates inflammatory signaling pathway. The focus of this study was the effect of IR acted on PI3K/Akt signaling pathway in lung inflammation in obese patients.Methods: The 7 normal weight patients (normal group) and 8 obesity patients (obesity group) which were diagnosed as pulmonary nodule and performed lobectomy were selected in this study. The insulin resistance index (HOMA-IR) was...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Research Objective: Assessment of the level of adipokines and their receptors in blood at young patients with bronchial asthma (BA) depending on the obesity phenotype.Material and Methods: 164 patients with BA were divided into 3 groups: BMI 30-34.9 kg/m2 + thickness of epicardial fatty tissue (EFT) ≥7 mm (1st gr.), BMI 30-34.9 kg/m2 + EFT
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Conclusions: Our study highlights an unrecognised role for HFD-induced, obesity-associated, NLRP3 inflammasome responses in steroid-resistant AHR. Furthermore, we identify a novel role for IL-5 and IL-13 responses upstream of the NLRP3 inflammasome in the development of obesity-associated, SSR asthma.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Background: Obese-related asthma (OBA) is an asthma sub-phenotype that often is severe. Inflamed adipose tissue may release pro (leptin) and anti-inflammatory (adiponectin) adipokines implicated in OBA. The effects of treatment with oral corticosteroids (OCS) on systemic levels of adipokines remains unknown.Subjects and Methods: Patients with mild to moderate asthma (MMA, n=55), severe asthma (SA= 72) and COPD (n=41) were from BIOAIR, a European multicenter study. After recruitment (visit 1), patients were optimized with medium doses of inhaled glucocorticosteroids (ICS) and LABA for four weeks (visit 2), then included in ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Background: There is little information on the state of asthma, particularly severe asthma, in China.Objectives: To determine the characteristics of severe asthma patients in China and their stability.Methods: We recruited adults with severe asthma (n=349 non-smokers, NSA, &n=114 smokers and ex-smokers, SSA), mild/moderate asthma (MMA; n=97) and healthy controls (HS, n=100) from 33 university hospitals in 15 provinces. Severe asthma was defined by 2014 ERS/ATS guidelines.Results: NSA was mostly female (70%) but SSA exclusively (96.5%), with both groups having most obese subjects (BMI>28) (NSA: 14.6% and SSA: 17.5% v...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
In French Polynesia, remote South Pacific tropical islands, asthma prevalence is estimated to 11%.Between 2016 and 2018, 498 patients consulting for asthma and/or chronic rhinitis in a respiratory medical center, were included to investigate risk factors associated with asthma control and exacerbations, on the basis of clinical, functionnal, biological and social findings.From them, 398 (80%) were Maohi people, 226 (45%) were adults, and 80% of these adults were obese. Among 464 (93%) patients living with asthma, 54 uncontroled patients yielded to more than 45% of 706 exacerbations, and 86 to 143 hospitalizations. The FEV1...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
This study’s goal is to compare major aspects of these two phenotypes.Methods: A retrospective study of adult patients with asthma diagnosis observed in our Asthma clinic between 2012 and 2016. Patients were divided into EOA (onset 18 years old) groups and their data was statistically analysed.Results: 606 patients were included, 351 had EOA and 233 LOA. In the EOA group, 71.2% were women (N=250), 47.3% (N=116) had smoking history and 27.1% (N=95) were obese. Rhinitis was found in 298 patients (84.9%), gastroesophageal reflux disease (GERD) in 71 (20.2%), anxiety or depression in 30 (8.5%), cardiac disease in 29 (8.2...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
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