We investigated the impact of peripherally inserted central catheter (P iee) placement in spinal cord injury patients at high risk for infusion phlebitis . The rate and etiology of phlebitis was investigated in two phases. During Phase I, peripheral IV cannulae and conventional central venous catheters (eVe) were used. During Phase II , patie nts ide ntified to be at risk for phlebitis received Plees. The number of peripheraiiVs, eves and Plees was tabulated for both phases of the study. Technical , infectious and thrombotic complications we re studied prospectively for Plees and retrospective ly for eves. We found the rate of phlebitis was 16.5 percent and 2.4 percent for Phases I a nd II , respectively (p=0.0002). Three infections occurred in 38 Plees and one infection was documented in 13 conventional eves. The numbe r of peripheraiiVs and conventional eves was reduced significantly from Phase I to Phase 11. No procedural complicati ons, catheter sepsis or clinically apparent venous thrombosis occurred . In conclu sion, Plees reduced the rate of phle bitis thresholds with a low complication rate and reduced the use of periphe ral IVs and conventional eves. (J Spinal Cord Med 1997;20:341-344)
Background
this study investigated the phagocytic function of peripheral granulocytes and monocytes from adult individuals with Down syndrome (DS) and assessed the relation between phagocytic function and periodontal status.
Methods
55 DS individuals (18–56 years old), 74 mentally retarded (MR) individuals and 88 medically healthy controls (HC) participated in the study. Gingival inflammation index, plaque index, probing depth, periodontal attachment level (AL) and bleeding on probing were taken for each subject. Whole blood was collected for granulocyte/monocyte phagocytosis tests. Phagocytic function was determined by flow cytometry in terms of percentage of cells actively involved in phagocytosis, and phagocytic intensity (magnitude of the bacterial staining per cell).
Results
phagocytic intensity of both granulocytes and monocytes was comparable in HC and DS subjects. While AL was directly related to phagocytic intensity of both granulocytes (r=0.14, p=0.03) and monocytes (r=0.2, p=0.003) in all subjects, this relationship was stronger in DS than other subjects, even after controlling for known risk factors for periodontitis (p<0.05). Monocyte phagocytic intensity was the only necessary predictor of AL (p=0.003), indicating a similar relationship between AL and phagocytic activity in either cell type.
Conclusions
While granulocyte and monocyte phagocytic intensities are similar in Down and non-DS individuals, phagocytic intensity was associated with more AL in DS than non-DS individuals.
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