ABSTRACT
Infections associated with central catheters are a significant source of morbidity in cancer patients. The first evaluation done as part of a continuous catheter surveillance program included the 913 central catheters inserted in 1995. Three of these catheters are still in place. All were tunneled subcutaneously, and most were inserted via the subclavian route. There were 839 simple silicone catheters and 74 catheters with a cuff. Two groups were defined based on whether the central catheter was inserted for administering inpatient or outpatient chemotherapy (n = 704) or for another reason (perioperative care, symptomatic or palliative therapy; n = 209). Catheter-related infection was defined as an infection at the catheter site or as septicemia retrospectively shown to be related to the catheter. The risk of catheter-related infection was expressed as the number of cases per 1000 days of catheterization. Reasons for catheter removal were distributed in table I.
Subject(s)
Bacterial Infections/etiology , Catheterization, Central Venous/adverse effects , Cross Infection/etiology , Neoplasms/complications , Sepsis/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/adverse effects , Bacterial Infections/epidemiology , Breast Neoplasms/complications , Breast Neoplasms/therapy , Cross Infection/epidemiology , Equipment Contamination , Female , Humans , Immunocompromised Host , Male , Middle Aged , Neoplasms/therapy , Paris/epidemiology , Population Surveillance , Retrospective Studies , Sepsis/epidemiologyABSTRACT
A case of bilateral blindness in a 47-year-old patient after buccal tumorectomy and bilateral neck dissection is reported. The diagnosis of posterior optic ischaemia was substantiated by the features of blindness and the negativity of cerebral CT-scanography and NMR imaging. The respective roles of atherosclerosis, arterial hypotension, acute anaemia and increased intracranial pressure are discussed. Preventive measures include a strict control of blood pressure, blood loss and head position.
Subject(s)
Blindness/etiology , Mouth Neoplasms/surgery , Neck Dissection/adverse effects , Optic Nerve Diseases/etiology , Postoperative Complications , Humans , Ischemia/etiology , Male , Middle AgedABSTRACT
Postoperative blindness due to ischemic optic neuropathy is a rare and dramatic complication. A review of the literature from 1960 until nowadays reveal several physiopathological mechanisms of the blindness. Through the description of their clinic case of a fourty seven years old man showing definitive postoperative blindness after sustaining surgery for epidermoid carcinoma of the mouth floor, the authors suggest as etiology the conjunction of the following factors: brain venous high pressure, head and neck oedema, hypotension and the vascular state of the patient. Special perioperative care taking in account the risk factors is needed to prevent this complication.
