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https://www.readbyqxmd.com/read/28319476/anesthesia-in-patients-with-infectious-disease-caused-by-multi-drug-resistant-bacteria
#1
Sharon Einav, Yonit Wiener-Well
PURPOSE OF REVIEW: Up to 50% of specific bacterial strains in healthcare admission facilities are multidrug-resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). RECENT FINDINGS: Anesthesiologists, their work area and tools have all been implicated in MDRO outbreaks. Causes include contamination of external ventilation circuits and noncontribution of filters to prevention, inappropriate decontamination procedures for nondisposable equipment (e...
March 17, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28284732/reduction-in-surgical-fog-with-a-warm-humidified-gas-management-protocol-significantly-shortens-procedure-time-in-pediatric-robot-assisted-laparoscopic-procedures
#2
B Meenakshi-Sundaram, J R Furr, E Malm-Buatsi, B Boklage, E Nguyen, D Frimberger, B W Palmer
INTRODUCTION: The adoption of robot-assisted laparoscopic (RAL) procedures in the field of urology has occurred rapidly, but is, to date, without pediatric-specific instrumentation. Surgical fog is a significant barrier to safe and efficient laparoscopy. This appears to be a significant challenge when adapting three-dimensional 8.5-mm scopes to use in pediatric RAL surgery. The objective of the present study was to compare matched controls from a prospectively collected database to procedures that were performed utilizing special equipment and a protocol to minimize surgical fog in pediatric RAL procedures...
February 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28282521/surgical-site-infections-in-patients-receiving-osteomyocutaneous-free-flaps-to-the-head-and-neck-does-choice-of-antibiotic-prophylaxis-matter
#3
James Murphy, Amal Isaiah, Donita Dyalram, Joshua E Lubek
PURPOSE: The most appropriate prophylactic antibiotic for clean-and-contaminated head and neck osteomyocutaneous free flap (OFF) tissue transfer procedures is unclear. The purpose of this study was to determine whether the choice of perioperative antibiotic was related to recipient surgical site infection (SSI) in patients receiving an OFF to the head and neck. MATERIALS AND METHODS: This retrospective cohort study evaluated SSI in relation to the perioperative antibiotic received from July 2010 through October 2013 at a tertiary care medical center...
February 16, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28280296/discharge-and-infection-in-retinoblastoma-post-enucleation-sockets
#4
Daphne L Mourits, Dyonne T Hartong, Andries E Budding, Machteld I Bosscha, H Stevie Tan, Annette C Moll
PURPOSE: To investigate the causes and treatment options for socket discharge and infection in patients enucleated for retinoblastoma (Rb). METHODS: A questionnaire was filled out by (parents of) ocular prosthesis-wearing patients with a history of enucleation as treatment for Rb. We collected data on patients' characteristics, cleaning habits of the prosthesis, frequency of socket irritation, discharge, and infection, and use of antibiotics. With ordinal logistic regression analysis, factors related to the outcome parameters (frequency of irritation, mucoid and purulent discharge) were identified...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28277409/randomized-controlled-trial-of-two-alcohol-based-preparations-for-surgical-site-antisepsis-in-colorectal-surgery
#5
Robyn B Broach, Emily C Paulson, Charles Scott, Najjia N Mahmoud
OBJECTIVE: To compare 2 alcohol-based, dual-action skin preparations for surgical site infection (SSI) prevention in elective colorectal surgery. BACKGROUND: Colorectal surgery is associated with the highest SSI rate among elective surgical procedures. Although evidence indicates that alcohol-based skin preparations are superior in SSI prevention, it is not clear if different alcohol-based preparations are equivalent in clean-contaminated colorectal procedures. METHODS: We performed a blinded, randomized, noninferiority trial comparing iodine povacrylex-alcohol (IPA) and chlorhexidine-alcohol for elective, clean-contaminated colorectal surgery...
March 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28269733/an-autoclavable-wireless-palpation-instrument-for-minimally-invasive-surgery
#6
Anish S Naidu, Abelardo Escoto, Omar Fahmy, Rajni V Patel, Michael D Naish
Minimally invasive surgery prevents surgeons from manually palpating organs to locate subsurface tumors and other structures. One solution is to use ultrasound; however, it is not always reliable. Various minimally invasive surgery instruments that provide tactile feedback have been proposed to augment ultrasound sensing for tumor localization; however, current designs have limitations such as cumbersome wiring, difficulty in manipulation, lack of sterilizability and high cost. This paper presents a novel, autoclavable, wireless, hand-held palpation instrument that uses a custom, low-cost, disposable tactile sensor to provide tactile and kinesthetic force feedback...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28266820/surgical-treatment-of-detrusor-underactivity-a-short-term-proof-of-concept-study
#7
Jerry G Blaivas, James C Forde, Jonathan L Davila, Lucas Policastro, Michael Tyler, Joshua Aizen, Anand Badri, Rajveer S Purohit, Jeffrey P Weiss
OBJECTIVES: To compare the surgical outcomes of men with bladder outlet obstruction (BOO) due to benign prostatic obstruction (BPO) to those with detrusor underactivity (DU) or acontractile detrusor (DA). MATERIALS AND METHODS: This retrospective, IRB approved study included men who underwent BPO surgery for refractory LUTS or urinary retention. Patients were grouped based on videourodynamic (VUDS) findings: 1) men with BOO, 2) men with DU and 3) men with DA. The primary outcome measure was the Patient Global Impression of Improvement (PGII)...
March 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28263778/evaluation-of-the-bundle-zero-surgical-site-infection-to-prevent-surgical-site-infection-in-vascular-surgery
#8
María Fernández-Prada, Carmen Martínez-Ortega, Livia Revuelta-Mariño, Ángeles Menéndez-Herrero, Juan F Navarro-Gracia
OBJECTIVE: To compare the incidence of Surgical Site Infections (SSIs) before and after the implementation of a bundle of care called 'Zero Surgical Site Infection'. Secondary goals included estimating measures of association and their potential impact, determining care management indicators in vascular surgery, and evaluating the level of compliance with the bundle. METHODS: This is a prospective observational study with a historic control group. The bundle included: 1) removal of body hair with clippers; 2) preoperative showering with chlorhexidine soap; 3) preparation of the surgical field with alcoholic chlorhexidine 2%; 4) adequacy of antimicrobial prophylaxis; 5) and 6) intra- and post-operative glycemic and central temperature control...
March 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28260560/hospital-impact-after-a-chemical-spill-that-compromised-the-potable-water-supply-west-virginia-january-2014
#9
Joy Hsu, Maria C Del Rosario, Erica Thomasson, Danae Bixler, Loretta Haddy, Mary Anne Duncan
In January 2014, a chemical spill of 4-methylcyclohexanemethanol and propylene glycol phenyl ethers contaminated the potable water supply of approximately 300,000 West Virginia residents. To understand the spill's impact on hospital operations, we surveyed representatives from 10 hospitals in the affected area during January 2014. We found that the spill-related loss of potable water affected many aspects of hospital patient care (eg, surgery, endoscopy, hemodialysis, and infection control of Clostridium difficile)...
March 6, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28251295/management-of-pin-tract-infection-in-pediatric-supracondylar-humerus-fractures-a-comparative-study-of-three-methods
#10
Di Lu, Te Wang, Hua Chen, Liao-Jun Sun
The objective of this study was to prospectively compare the incidence of pin tract infection in pediatric supracondylar humerus fractures managed with pin care daily or every other day or weekly. We hypothesized that there were some differences between these three methods. From June 2012 to May 2015, 135 children with supracondylar humerus fractures were randomized to postoperative pin care by cleaning pin tracts daily (group A, 45 cases) or cleaning every 2 days (group B, 45 cases) or cleaning weekly (group C, 45 cases)...
March 1, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28244579/prevention-of-healthcare-associated-infections-a-descriptive-study
#11
R Accardi, S Castaldi, A Marzullo, S Ronchi, D Laquintana, M Lusignani
BACKGROUND: This study aims to verify whether there are, and to which degree, knowledge and adherence to guidelines on the prevention and control of healthcare associated infections by nursing staff. Study design. A descriptive study was conducted on a sample of nurses in the areas of medicine, surgery, and its own specialties of the Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico in Milan from 1st December 2015 to 29th February 2016. METHODS: The knowledge of the nursing staff have been investigated through the use of questionnaires with anonymous self-reporting method; inspections in the wards using observational grids were carried out in order to verify adherence to best-practice principles...
March 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28241956/evidence-appraisal-of-takalkar-yp-namdeo-garale-m-somasundaram-s-venkataramani-k-gothwal-kn-pandrowala-sa-comparison-of-efficacy-of-chlorhexidine-alcohol-scrub-and-povidone-iodine-scrub-in-hand-cleansing-in-elective-clean-surgery-int-surg-j-2016-3-4-1937-1941
#12
https://www.readbyqxmd.com/read/28227997/an-autoclavable-wireless-palpation-instrument-for-minimally-invasive-surgery
#13
Anish S Naidu, Abelardo Escoto, Omar Fahmy, Rajni V Patel, Michael D Naish, Anish S Naidu, Abelardo Escoto, Omar Fahmy, Rajni V Patel, Michael D Naish, Abelardo Escoto, Omar Fahmy, Michael D Naish, Anish S Naidu, Rajni V Patel
Minimally invasive surgery prevents surgeons from manually palpating organs to locate subsurface tumors and other structures. One solution is to use ultrasound; however, it is not always reliable. Various minimally invasive surgery instruments that provide tactile feedback have been proposed to augment ultrasound sensing for tumor localization; however, current designs have limitations such as cumbersome wiring, difficulty in manipulation, lack of sterilizability and high cost. This paper presents a novel, autoclavable, wireless, hand-held palpation instrument that uses a custom, low-cost, disposable tactile sensor to provide tactile and kinesthetic force feedback...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28199275/assessing-the-cost-of-prophylactic-antibiotic-use-after-cleft-lip-and-lip-adhesion-procedures
#14
Kimberly M Daniels, Michael D Lappi, Susan Flath Sporn, Catherine Noonan Caillouette, Ronald Heald, John G Meara
The purpose of this study was to understand the true cost of administering prophylactic antibiotics postoperatively to patients undergoing cleft lip and lip adhesion procedures for which the rate of infection is historically low. Using time-driven activity-based costing (TDABC) methodologies, the plastic surgery department of one hospital created a process map with related time intervals and personnel cost rates for administering the antibiotic. The cost for each provider, based on standard salary information, was multiplied by the time required to complete his or her stage of the process, and this outcome was added to the supply costs...
July 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28182825/biosurgical-hemostatic-agents-in-neurosurgical-intracranial-procedures
#15
Roberto Gazzeri, Marcelo Galarza, Giorgio Callovini, Alex Alfieri
Intraoperative hemostasis during neurosurgical procedures is one of the most important aspects of intracranial surgery. Hemostasis is mandatory to keep a clean operative field and to prevent blood loss and postoperative hemorrhage. In neurosurgical practice, biosurgical hemostatic agents have proved to be extremely useful to complete the more classic use of electrocoagulation. During recent years, many biosurgical topical hemostatic agents were created. Although routinely used during neurosurgical procedures, there is still a great deal of confusion concerning optimal use of these products, because of the wide range of products, as absorbable topical agents, antifibrinolytics agents, fibrin sealants and hemostatic matrix, which perform their hemostatic action in different ways...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182149/anterior-segment-ischemia-after-strabismus-surgery
#16
Emine Seyhan Göçmen, Yonca Atalay, Özlem Evren Kemer, Hikmet Yavuz Sarıkatipoğlu
A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed...
January 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28166064/incidence-and-risk-factors-of-surgical-site-infections-in-kathmandu-university-hospital-kavre-nepal
#17
S Shrestha, P Wenju, R Shrestha, R M Karmacharya
Background Surgical site infections (SSI) are the common nosocomial infection in surgical patients, and are a significant source of postoperative morbidity resulting in increased hospital stay, morbidity and cost. Objective The objective of this study was to obtain the incidence of SSI and determine various risks factors influencing the SSI rate with special reference to the National Nosocomial Infections Surveillance System risk index in Kathmandu University Hospital, Kavre, Nepal. Method Six hundred and thirty eight patients who underwent various surgeries in Dhulikhel Hospital, Kathmandu University Hospital during a three-month period were included...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28159075/remote-video-auditing-in-the-surgical-setting
#18
Anne Pedersen, Elizabeth Getty Ritter, Megan Beaton, David Gibbons
Remote video auditing, a method first adopted by the food preparation industry, was later introduced to the health care industry as a novel approach to improving hand hygiene practices. This strategy yielded tremendous and sustained improvement, causing leaders to consider the potential effects of such technology on the complex surgical environment. This article outlines the implementation of remote video auditing and the first year of activity, outcomes, and measurable successes in a busy surgery department in the eastern United States...
February 2017: AORN Journal
https://www.readbyqxmd.com/read/28137542/developing-the-first-highly-specialized-neurosurgical-center-of-excellence-in-trujillo-peru-work-in-progress-first-four-months-results
#19
Joham Choque-Velasquez, Roberto Colasanti, Virginia Baffigo-Torre, Luisa Estela Sacieta-Carbajo, Jacqueline Olivari-Heredia, Yolanda Falcon-Lizaraso, Juan Huber Mallma-Torres, Humberto Elera-Florez, Juha Hernesniemi
BACKGROUND: Economic, cultural, and geographical reasons usually limit the access to specialized health centers in developing countries, especially in rural areas. Peruvian health system indicators still highlight significant unmet clinical need for neurosurgical patients. Our project is to develop the first highly specialized neurosurgical center in the EsSalud hospital of Trujillo, with the goal to improve the treatment of neurosurgical diseases in that region, thus optimizing their outcomes while decreasing expensive and risky patients transfer to the neurosurgical departments in the capital district...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28134674/clostridium-difficile-infection-an-orthopaedic-surgeon-s-guide-to-epidemiology-management-and-prevention
#20
Paul A Anderson, James Bernatz, Nasia Safdar
Clostridium difficile infection is a growing concern in health care and is a worrisome complication in orthopaedics. The incidence and severity of this infection are increasing, although the incidence following orthopaedic surgery is comparatively lower than that seen in patients in most other surgical specialties. The typical geriatric orthopaedic patient may have many risk factors that increase the likelihood of C difficile infection, including advanced age, residence in a long-term care facility, multiple comorbidities, the use of perioperative antibiotics, and a long length of stay...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
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