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Mobilization and Conditioning Regimens in Stem Cell Transplant for Autoimmune Diseases
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Patients with SLE may have a long history of high dose immune suppression prior to the referral for HSCT. Prophylactic anti-fungal, anti-viral, and anti-bacterial therapy should be considered during any neutropenia interval. HSCT studies indicate that high-dose cyclophosphamide may be used safely in patients with end stage renal failure (ESRF). While the pharmacokinetics of cyclophosphamide and its metabolites are not understood in ESRF, if dialysis is performed the morning after each cyclophosphamide infusion, treatment appears to be well tolerated. Patients in renal failure may produce residual urine that may allow stagnation of cyclophosphamide metabolites in the bladder, resulting in hemorrhagic cystitis. In order to minimize this, a Foley catheter with bladder irrigation and intravenous Mesna may be used during and for 24 hours after cyclophosphamide. SLE nephritis with renal insufficiency may be unusually sensitive to diuresis resistant volume overload, requiring aggressive volume-status monitoring and correction by dialysis. SLE patients may also be prone to thrombus formation from anti-phospholipid antibodies. Prophylactic anti-coagulation with subcutaneous Lovenox or fragmin has generally been well tolerated without bleeding during the HSCT.
In Vitro Fertilization and Embryo Transfer
Published in Asim Kurjak, Ultrasound and Infertility, 2020
The original approach to the follicles is through the abdominal wall and full urinary bladder. It is basically an outpatient method that requires practically no premedication. However, in some centers to improve the comfort of the patient, 10 mg of Diasepam is administered orally 1 h prior to retrieval.27 One hour prior to the procedure, the patient is either asked to drink 1 to 1.5 1 of water, or the bladder is artificially filled with 200 to 700 ml of normal saline via a Foley catheter until good visualization of the follicles is achieved. Some authors advocate rinsing the bladder with 200 to 300 ml of saline before introduction of the final quantity of saline.
Urinary system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The procedure is undertaken using an over-couch tube DDR fluoroscopic system with a large field image receptor or alternatively using a C-arm imaging system. Following catheterisation using a Foley catheter, the bladder is drained of urine, and with the patient supine an administration kit is connected to the catheter. 300-400 ml of contrast (20–30% weight/volume), is allowed to flow into the bladder under fluoroscopic control until the bladder is well filled. Once filled, the patient may be rolled through 180° to ensure that the bladder is evenly opacified.
A modified guidewire technique for deflating a non-deflating Foley catheter in the emergency department
Published in Journal of Medical Engineering & Technology, 2019
The guidewire technique for deflating the balloon of a stuck Foley catheter is easy and non-invasive. But due to the characteristics of the guidewire in some instances, it could not be passed through the tight and narrow inflation port and the procedure would be frustrating for the physician and the patient [3,4]. Extracting the core wire will provide us a thinner and firmer stylet. In our cases, all the balloons were successfully deflated and there was no need to perform further invasive steps including ultrasound-guided suprapubic puncture of the balloon [2]. Although removing the core wire is not difficult but in a busy ED, it takes time. If medical device companies produce this core wire in a sterile package, that would be very helpful. Although we did not encounter any problem, further research is necessary to evaluate the safety and effectiveness of our modification.
Development of a more clinically relevant bladder and urethral model for catheter testing
Published in Journal of Medical Engineering & Technology, 2021
Andrew Gammie, Roger Holmes, Hsing-Yu Chen, Andrew Conn, Nicola Morris, Marcus J. Drake
The test catheters were loaded with increasing weight starting at 0.2 kg, until either the drainage holes are occluded or the balloon passes into the urethra. The degree of vertical movement of the balloon (i.e., flex of the bladder floor) was measured, until the balloon passed into the urethra. If the drainage holes become occluded first, the traction force can be removed to check that the drainage holes become viable again. In the case of the Foley catheter under test, this was never the case, since the drainage holes are above the balloon. The catheter was able to remain in the bladder model with traction forces up to 0.7 kgf. A vertical flex of the bladder floor of 7 mm was observed at a load of 0.5 kgf. This flexion was judged to be realistic.
Application of intrauterine balloons in cervical ripening
Published in Expert Review of Medical Devices, 2023
In 1967, Embrey and Mollison first used a 26-gauge Foley catheter, the transurethral catheter, to ripen the cervix (Figure 1). They inserted a Foley catheter into the uterine cavity and distended the balloon with 50 mL of sterile water. Compared with consecutive orthodox surgical inductions (eg stripping of membranes, bougie induction, and rupture of membranes), this procedure greatly improved the success rate of inductions onset of labor within 48 hours (84% vs. 46%) [12].