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https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#1
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107284/postsurgical-perforation-of-the-esophagus-can-be-treated-using-a-fully-covered-stent-in-children
#2
Chantal Chauvet, Arnaud Bonnard, Alexis Mosca, Marc Bellaïche, Pascale Philippe-Chomette, Jérôme Viala
OBJECTIVES: Surgery and conservative treatment of esophageal or gastric perforations are both often associated with poor results and carry a high morbidity and mortality rate. The aim of the present study was to evaluate the effectiveness and safety of using fully covered self-expending metallic stents (SEMS) in children with upper digestive leaks. METHODS: This retrospective study reviewed all children with esophageal or gastric perforation who were treated with placement of an SEMS from January 2011 to January 2015...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28107224/abdominal-sepsis
#3
Quirine J J Boldingh, Fleur E E de Vries, Marja A Boermeester
PURPOSE OF REVIEW: To summarize the recent evidence on the treatment of abdominal sepsis with a specific emphasis on the surgical treatment. RECENT FINDINGS: A multitude of surgical approaches towards abdominal sepsis are practised. Recent evidence shows that immediate closure of the abdomen has a better outcome. A short course of antibiotics has a similar effect as a long course of antibiotics in patients with intra-abdominal infection without severe sepsis. SUMMARY: Management of abdominal sepsis requires a multidisciplinary approach...
January 19, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#4
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#5
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28105610/antithyroid-drug-induced-agranulocytosis-state-of-the-art-on-diagnosis-and-management
#6
Nuno Vicente, Luís Cardoso, Luísa Barros, Francisco Carrilho
Agranulocytosis is a rare but serious complication of antithyroid drug therapy, and an up-to-date understanding of this topic is important. Both direct toxicity and immune-mediated responses have been described as possible mechanisms. Some major susceptibility loci have recently been identified, which may lead the diagnosis of agranulocytosis into a genomic era. Onset is acute and patients present with symptoms and signs of infection together with high fever. Clinical suspicion is pivotal and should prompt blood sampling...
January 19, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28104524/the-role-of-antibiotic-prophylaxis-in-the-clean-neurosurgery
#7
YiYao Cao, Ke Pu, Quodong Li, XueJiang Yan, Yue Ma, Kai Xue, ZhiMing Sun, QingGuo Li
OBJECTIVE: To investigate the efficacy of antibiotic prophylaxis (AP) and the risk factors for postoperative infections in clean neurosurgery. METHODS: Data were retrospectively collected on all patients who had undergone clean neurosurgical operation at our institution between January 2009 and December 2014.From January 2009 until October 2011, antibiotic prophylaxis was administered to every clean neurosurgical patient. From November 2011 to December 2014, no antibiotic prophylaxis (n-AP) was prescribed for all clean neurosurgical operations...
January 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28104075/challenges-in-infective-endocarditis
#8
REVIEW
Thomas J Cahill, Larry M Baddour, Gilbert Habib, Bruno Hoen, Erwan Salaun, Gosta B Pettersson, Hans Joachim Schäfers, Bernard D Prendergast
Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations...
January 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28101722/the-effect-of-antibiotic-coated-sutures-on-the-incidence-of-surgical-site-infections-in-abdominal-closures-a-meta-analysis
#9
Basheer Elsolh, Lisa Zhang, Sunil V Patel
OBJECTIVE: This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence. METHODS: MEDLINE and EMBASE databases (1946-2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions. RESULTS: Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28101154/minimally-invasive-open-nephrectomy-on-children-with-multicystic-dysplastic-kidney
#10
Dongchuan Feng, Xiaoyu Zhu, Fang Sun, Tongsheng Ma, Yuan Li, Shujing Chen
The aim of the study was to summarize the preliminary experience of minimally invasive open nephrectomy operation on children with multicystic dysplastic kidney (MCDK). A retrospective review was performed on the clinical materials of the 15 children that had accepted consecutive minimally invasive open nephrectomies during the previous 2 years. The enrolled children were diagnosed with unilateral MCDK under computed tomography, emission computerized tomography and ultrasound and no anomaly in the contralateral functioning kidney was found...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28100949/rosai-dorfman-disease-presenting-with-recurrent-unilateral-submandibular-lymph-adenitis-a-case-report
#11
Vipan Kumar, J S Bhandari, Sukirty Awasthi, Mohammad Rashid, Ankita Sharma
Rosai-Dorfman Disease (RDD) is a rare disease of unknown aetiology, initially described as a separate entity in 1969 by Rosai and Dorfman. We describe here a case of RDD presenting with acute, recurrent lymphadenitis and massive lymphadenopathy. The patient's good response to the antibiotics was a false pointer towards infective pathology. The repeated fine needle aspiration cytology was inconclusive or suggested nonspecific reactive hyperplasia. The excision biopsy confirmed the diagnosis of RDD and was supported by immune-histochemistry for S-100 antigen...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28099198/osteomyelitis-of-the-navicular-bone-a-case-report
#12
Nobuyuki Kumahashi, Suguru Kuwata, Shinji Imade, Yuji Uchio
A 16-year-old boy developed left foot pain of unknown cause that was unresponsive to conservative treatment, associated with fever and difficulty walking. He was admitted to our hospital with osteomyelitis of the accessory and body of the navicular bone. Surgery could not be performed because the patient had been diagnosed with Wiskott-Aldrich syndrome. After antibiotic therapy, laboratory abnormalities and pain had resolved. One year after treatment, the patient had returned to his original level of sports activity...
January 17, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28094301/the-occurrence-rate-of-acute-onset-postoperative-endophthalmitis-after-cataract-surgery-in-chinese-small-and-medium-scale-departments-of-ophthalmology
#13
Yanan Zhu, Xinyi Chen, Peiqing Chen, Jianjun Wu, Huixia Hua, Ke Yao
Endophthalmitis can be a devastating complication after cataract surgery. Therefore, this study sought to better understand the occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small and medium-scale departments of ophthalmology, as well as identify its risk factors and assess the treatment options. This investigation revealed 52 postoperative endophthalmitis cases in 46,185 operations at 30 hospitals from 2011 to 2013, at an occurrence rate of 0.11%. A small cataract surgery volume of less than 500 cases per year (OR 2...
January 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28094160/a-case-of-generalized-lymphatic-anomaly-causing-skull-base-leakage-and-bacterial-meningitis
#14
Kenichi Suga, Aya Goji, Miki Inoue, Masami Kawahito, Masako Taki, Kazuhiro Mori
Generalized lymphatic anomaly is a multifocal lymphatic malformation that affects the skin, thoracic viscera, and bones. A 3year-old Japanese boy presented with right facial palsy due to cystic tumors in the ipsilateral petrous bone. Pericardial effusion had been found incidentally and generalized lymphatic anomaly had been diagnosed by pericardial biopsy. Petrous bone tumor had been followed up without surgery. At the age of seven he presented with fever and disturbance of consciousness, and bacterial meningitis due to Streptococcus pneumoniae was diagnosed...
January 13, 2017: Brain & Development
https://www.readbyqxmd.com/read/28094033/vancomycin-added-to-the-wash-solution-of-the-cell-saver-effect-on-bacterial-contamination
#15
A Perez-Ferrer, E Gredilla-Díaz, J de Vicente-Sánchez, R Navarro-Suay, F Gilsanz-Rodríguez
OBJECTIVES: The aim of this study is to test whether the addition of a low-dose of antibiotic (vancomycin) to the wash solution (saline) of the cell-saver reduces the incidence of bacterial contamination of the autologous red blood cell (RBCs) concentrate recovered. MATERIAL AND METHOD: Experimental, randomized, double-blind, parallel group study performed on 20 consecutive patients scheduled for posterior spinal fusion surgery. Intraoperative bleeding was processed through a cell-saver: HaemoLite(®) 2+, in which the RBCs were washed according to randomization group, with saline (control group) or saline+10μg/ml(-1) vancomycin (vanco group)...
January 13, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28093434/forty-years-of-shunt-surgery-at-rigshospitalet-denmark-a-retrospective-study-comparing-past-and-present-rates-and-causes-of-revision-and-infection
#16
Philip Kofoed Månsson, Sofia Johansson, Morten Ziebell, Marianne Juhler
OBJECTIVE: The objective of this study is to review our experience of shunt surgery by investigating 40 years of development in terms of rates of revision and infection, shunt survival and risk factors. DESIGN AND PARTICIPANTS: Medical records and operative reports were reviewed retrospectively for all patients who underwent primary shunt surgery at our department in the years 2010 to 2012. All results were compared with a previous study from our department. A mixed population consisting of 434 patients was included...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#17
Luis Manuel Souza-Gallardo, José Luis Martínez-Ordaz
Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28092097/complications-and-parent-satisfaction-in-pediatric-osseointegrated-bone-conduction-hearing-implants
#18
Kenny H Chan, Dexiang Gao, Emily L Jensen, Gregory C Allen, Stephen P Cass
OBJECTIVE: To assess long-term complication rate and parental satisfaction of osseointegrated bone conduction hearing implants (OBCHIs). STUDY DESIGN: Retrospective chart review of children undergoing OBCHIs. METHODS: A retrospective chart review of children undergoing OBCHIs for the treatment of conductive, mixed, and single-sided sensorineural hearing loss in children. RESULTS: Forty-five subjects were identified with 0...
January 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28091937/ocular-mycobacteriosis-dual-infection-of-m-tuberculosis-complex-with-m-fortuitum-and-m-bovis
#19
Kusum Sharma, Natasha Gautam, Megha Sharma, Mohit Dogra, Priya Bajgai, Basavaraj Tigari, Aman Sharma, Vishali Gupta, Surya Prakash Sharma, Ramandeep Singh
BACKGROUND: We report unfavorable outcome in a patient with subretinal granuloma caused by dual infection of Mycobacterium tuberculosis complex with Mycobacterium fortuitum and Mycobacterium bovis in an immunosuppressed, non-HIV patient. We did a systematic review of literature on dual infection due to M. tuberculosis and M. fortuitum via MEDLINE and PUBMED and could not find any case reported of causing this kind of dual infection in the eye. RESULTS: A 38-year-old Indian male patient presented with decreased vision in the left eye for 3 months, diagnosed as tubercular choroidal granuloma with associated retinal angiomatosis proliferans (RAP) lesion...
December 2017: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/28091841/transumbilical-abdominal-incision-for-laparoscopic-colorectal-surgery-does-not-increase-the-risk-of-postoperative-surgical-site-infection
#20
Mizunori Yaegashi, Koki Otsuka, Toshimoto Kimura, Masanori Hakozaki, Megumu Kamishima, Tomoki Hatanaka, Kei Sato, Hitoshi Fujii, Teppei Matsuo, Akira Sasaki
PURPOSE: Besides antibiotic prophylaxis, antiseptic skin preparation is an important measure to prevent surgical site infection (SSI). No reports have detailed the relationship between SSI and umbilical microflora following laparoscopic colorectal cancer with a transumbilical longitudinal incision. METHODS: Risk factors and the rate of SSI were investigated in 453 patients who underwent laparoscopic colorectal resection over a 3-year period. Microbiological samples were collected from the umbilicus and SSI areas...
January 13, 2017: International Journal of Colorectal Disease
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