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Neurosurgical infections

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https://www.readbyqxmd.com/read/28330494/pseudomonas-oryzihabitans-sepsis-in-a-1-year-old-child-with-multiple-skin-rashes-a-case-report
#1
Michael Owusu, Ellis Owusu-Dabo, Godfred Acheampong, Isaac Osei, John Amuasi, Nimako Sarpong, Augustina Annan, Hsin-Ying Chiang, Chih-Horng Kuo, Se Eun Park, Florian Marks, Yaw Adu-Sarkodie
BACKGROUND: Pseudomonas oryzihabitans is a Pseudomonas bacterial organism rarely implicated in human infections. The bacterium has been isolated in a few reported cases of neurosurgical infections and patients with end-stage cirrhosis, sickle cell disease, and community-acquired urinary tract infections. Limited information exists in developing countries, however, because of the lack of advanced microbiological tools for identification and characterization of this bacterium. This case report describes the isolation of a rare Pseudomonas bacterium in a patient presenting with sepsis and skin infection...
March 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28328648/the-economic-and-clinical-impact-of-sustained-use-of-a-progressive-mobility-program-in-a-neuro-icu
#2
Jeannette M Hester, Peggy R Guin, Gale D Danek, Jaime R Thomas, William L Titsworth, Richard K Reed, Terrie Vasilopoulos, Brenda G Fahy
OBJECTIVE: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. DESIGN: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28327980/frontal-sinus-breach-during-routine-frontal-craniotomy-significantly-increases-risk-of-surgical-site-infection-10-year-retrospective-analysis
#3
Joseph R Linzey, Thomas J Wilson, Stephen E Sullivan, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. OBJECTIVE: To compare the rate of cranial SSIs in patients undergoing frontotemporal craniotomies with and without frontal sinus breach (FSB)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327899/thirty-day-readmission-rates-following-deep-brain-stimulation-surgery
#4
Ashwin G Ramayya, Kalil G Abdullah, Arka N Mallela, John T Pierce, Jayesh Thawani, Dmitry Petrov, Gordon H Baltuch
BACKGROUND: Deep brain stimulation (DBS) has emerged as a safe and efficacious surgical intervention for several movement disorders; however, the 30-day all-cause readmission rate associated with this procedure has not previously been documented. OBJECT: To perform a retrospective cohort study to estimate the 30-day all-cause readmission rate associated with DBS. METHODS: We reviewed medical records of patients over the age of 18 who underwent DBS surgery at Pennsylvania Hospital of the University of Pennsylvania between 2009 and 2014...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28320357/outcome-of-neurological-early-rehabilitation-patients-carrying-multi-drug-resistant-bacteria-results-from-a-german-multi-center-study
#5
J D Rollnik, M Bertram, C Bucka, M Hartwich, M Jöbges, G Ketter, B Leineweber, M Mertl-Rötzer, D A Nowak, T Platz, K Scheidtmann, R Thomas, F von Rosen, C W Wallesch, H Woldag, P Peschel, J Mehrholz, M Pohl
BACKGROUND: Colonization or infection with multi-drug resistant (MDR) bacteria is considered detrimental to the outcome of neurological and neurosurgical early rehabilitation patients. METHODS: In a German multi-center study, 754 neurological early rehabilitation patients were enrolled and and reviewed in respect to MDR status, length of stay (LOS) and the following outcome variables: Barthel Index (BI), Early Rehabilitation Index (ERI), Glasgow Outcome Score Extended (GOSE), Coma Remission Scale (CRS), Functional Ambulation Categories (FAC)...
March 20, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28298047/development-of-a-prediction-rule-for-diagnosing-postoperative-meningitis-a-cross-sectional-study
#6
Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291426/case-report-of-a-6-year-old-girl-with-mycoplasma-hominis-ventriculoperitoneal-shunt-infection
#7
Masanori Sato, Noriko Kubota, Yoshihiko Katsuyama, Yota Suzuki, Yosuke Miyairi, Kisei Minami, Masashi Kasai
Mycoplasma hominis is a rare causative pathogen for surgical site infections after neurosurgical procedures. This organism lacks a cell wall, rendering it undetectable by Gram staining and making it resistant to beta-lactam antibiotics. In addition, some special techniques are required to identify this organism. Thus, it is very difficult to diagnose infections caused by this pathogen. Here, the authors report a pediatric case of M. hominis ventriculoperitoneal shunt (VPS) infection with central nervous system involvement for which beta-lactam antibiotics were not effective and Gram staining revealed no pathogens...
March 3, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#8
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28279778/readmission-and-other-adverse-events-after-transsphenoidal-surgery-prevalence-timing-and-predictive-factors
#9
David J Cote, Hormuz H Dasenbrock, Ivo S Muskens, Marike Ld Broekman, Hasan A Zaidi, Ian F Dunn, Timothy R Smith, Edward R Laws
BACKGROUND: Transsphenoidal surgery is a common neurosurgical procedure for accessing the pituitary and anterior skull base, yet few multicenter analyses have evaluated outcomes after this procedure. STUDY DESIGN: Patients undergoing transsphenoidal surgery from 2006 to 2015 were extracted from the ACS NSQIP database. Logistic regression was used to identify predictors of thirty-day complications. RESULTS: Of 1240 patients included in this analysis; 6...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28247111/prospective-review-of-30-day-morbidity-and-mortality-in-a-paediatric-neurosurgical-unit
#10
Emer Campbell, Thomas Beez, Lorraine Todd
PURPOSE: The purpose of this study is to record the 30-day and inpatient morbidity and mortality in paediatric patients in a tertiary neuroscience centre over a 2-year period. The intentions were to establish the frequency of significant adverse events, review the current published rates of morbidity in paediatric neurosurgical patients and propose three clinical indicators for future comparison. METHODS: All deaths and adverse events were prospectively recorded from 1 January 2014 to 31 December 2015...
February 28, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28215789/a-ten-year-review-of-total-hospital-onset-intensive-care-unit-bloodstream-infections-at-an-academic-medical-center
#11
Anna M Civitarese, Eric Ruggieri, J Matthias Walz, Deborah Ann Mack, Stephen O Heard, Michael Mitchell, Craig M Lilly, Karen E Landry, Richard T Ellison
OBJECTIVE: The rates of central line-associated bloodstream infections (CLABSIs) in United States intensive care units (ICU) have decreased significantly, and a parallel reduction in the rates of total hospital onset bacteremias in these units should also be expected. We report 10-year trends for total hospital onset ICU-associated bacteremias at a tertiary care academic medical center. DESIGN: This was a retrospective analysis of all positive blood cultures among patients admitted to seven adult ICUs for the period FY2005 through FY2014 according to Centers for Disease Control and Prevention National Healthcare Safety Network definitions...
February 16, 2017: Chest
https://www.readbyqxmd.com/read/28208914/enterobacter-meningitis-and-challenges-in-treatment
#12
Shaylika Chauhan, Jawad Noor, Balaji Yegneswaran, Hanish Kodali
Neurosurgical interventions are rarely associated with meningitis with a very low incidence rate ranging from 1.1% to 2.5%. Gram negative bacillary meningitis first described in the 1940's, previously uncommon has been increasing in the recent past associated with advanced age, immunosuppression and neurosurgery. Enterobacter meningitis though relatively uncommon is recently increasing in incidence and treatment is frequently complicated due to resistance to antibiotics making this a challenging, difficult to treat infection that may be associated with adverse clinical outcomes...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28193628/management-of-endocrine-disease-neuroendocrine-surveillance-and-management-of-neurosurgical-patients-non-pituitary
#13
Aoife Garrahy, Mark Sherlock, Chris J Thompson
Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognized acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life-threatening. While hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation...
February 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28187810/management-of-infections-associated-with-neurocritical-care
#14
REVIEW
L Rivera-Lara, W Ziai, P Nyquist
The reported incidence of hospital-acquired infections (HAIs) in the neurointensive care unit (NICU) ranges from 20% to 30%. HAIs in US hospitals cost between $28 and $45 billion per year in direct medical costs. These infections are associated with increased length of hospital stay and increased morbidity and mortality. Infection risk is increased in NICU patients due to medication side-effects, catheter and line placement, neurosurgical procedures, and acquired immune suppression secondary to steroid/barbiturate use and brain injury itself...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187809/management-of-bacterial-central-nervous-system-infections
#15
REVIEW
M C Brouwer, D van de Beek
Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e.g., after neurosurgical intervention, as a complication of severe neurotrauma or related to indwelling cerebrospinal fluid drains...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186476/risk-factors-for-surgical-site-infection-following-nonshunt-pediatric-neurosurgery-a-review-of-9296-procedures-from-a-national-database-and-comparison-with-a-single-center-experience
#16
Brandon A Sherrod, Anastasia A Arynchyna, James M Johnston, Curtis J Rozzelle, Jeffrey P Blount, W Jerry Oakes, Brandon G Rocque
OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28186474/morbidity-associated-with-30-day-surgical-site-infection-following-nonshunt-pediatric-neurosurgery
#17
Brandon A Sherrod, Brandon G Rocque
OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28179700/calvarial-remodelling-surgery-neurosurgical-experience-of-multidisciplinary-craniofacial-reconstruction
#18
Abdul Ghaffar, Zahid Hussain, Shahzad Ahmed Qasmi, Shahid Hameed Chaudhry
OBJECTIVE: To evaluate the safety, cosmetic and functional outcome of craniofacial reconstruction surgery for primary craniosynostosis and clefts. METHODS: This quasi-experimental study was conducted at the Combined Military Hospital, Rawalpindi, Pakistan, from June 2011 to December 2014, and comprised paediatric patients undergoing calvarial reconstructive procedures. Fronto-orbital advancement and reconstruction, total calvarial remodelling and box flap reconstruction techniques were used...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28178712/surgical-treatment-for-leptomeningeal-disease
#19
REVIEW
Andrey A Volkov, Andreas K Filis, Frank D Vrionis
BACKGROUND: Advancements in cancer treatment have led to more cases of leptomeningeal disease, which requires a multimodal approach. METHODS: Treatment modalities are reviewed from a neurosurgical standpoint, focusing on intrathecal chemotherapy and shunting devices. Potential complications and how to avoid them are discussed. RESULTS: The Ommaya reservoir and the chemoport are used for administering intrathecal chemotherapy. Use of ventriculo-lumbar perfusion can efficiently deliver chemotherapeutic agents and improve intracerebral pressure...
January 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28176963/expressive-aphasia-caused-by-streptococcus-intermedius-brain-abscess-in-an-immunocompetent-patient
#20
Misbahuddin Khaja, Darryl Adler, George Lominadze
BACKGROUND: Brain abscess is an uncommon but life-threatening infection. It involves a focal, intracerebral infection that begins in a localized area of cerebritis and develops into a collection of pus, surrounded by a well-vascularized capsule. Brain abscess still poses a significant problem in developing countries but rarely in developed countries. Predisposing factors vary in different parts of the world. With the introduction of antibiotics and imaging studies, the mortality rate has decreased between 5% and 15%...
2017: International Medical Case Reports Journal
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