A lost guidewire is a hazardous, yet completely preventable, and rare complication associated with central venous catheter insertion. Here, we report a case of a lost guidewire in a patient presented with persistent abdominal pain. The guidewire was retrieved completely during a surgical operation after the diagnosis had been confirmed by radiologic studies. Following some tips during insertion of a central venous catheter will help to prevent this mortal complication or at least, in rapid diagnosis of its loss. Interventional radiologic techniques are now readily used to retrieve a lost guidewire.
Abstract- Breast cancer is the most common cancer among the female population, and its prevalence is increasing worldwide. Trastuzumab (Herceptin) therapy improves prognosis in HER2 positive patients, but Heart Failure (HF) is one of its known complications. In this study, we aimed to assess the potential benefits of prophylactic carvedilol therapy in patients receiving Herceptin. Sixty five patients with HER2 positive breast cancer were enrolled in the study. All of the patients received Herceptin. Twenty seven patients also received carvedilol 6.25 mg twice daily, and 38 patients had usual care. Echocardiography was performed at baseline, and after three months in both groups and changes in cardiac function, parameters were compared between two groups. After 3 months, LA volume index (P=0.012), TAPSE (P=0.009), Tei index (P=0.015) and Lateral Longitudinal Strain (P=0.024) were significantly better in patients receiving carvedilol. Carvedilol can be effective in the prevention of systolic and diastolic dysfunction following Herceptin therapy.
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