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https://www.readbyqxmd.com/read/28208046/mycobacterium-chimaera-and-cardiac-surgery
#1
Andrew J Stewardson, Rhonda L Stuart, Allen C Cheng, Paul Dr Johnson
There is an ongoing investigation into infections with non-tuberculous mycobacteria associated with contaminated heater-cooler units used in cardiac surgery. The overall risk is low, but surgical site and disseminated infections have been reported, including one possible case in Australia, mainly with surgery involving implantation of prosthetic material. Mycobacterium chimaera infection should be considered in patients who have previously undergone surgery with cardiopulmonary bypass and who present with cardiac or disseminated infection or sternal wound infection unresponsive to standard antibiotic therapy...
February 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28207669/is-intraoperative-local-vancomycin-powder-the-answer-to-surgical-site-infections-in-spine-surgery
#2
Hwee Weng Dennis Hey, Desmond Wei Thiam, Zhi Seng Darren Koh, Joseph Shantakumar Thambiah, Naresh Kumar, Leok-Lim Lau, Ka-Po Gabriel Liu, Hee-Kit Wong
STUDY DESIGN: This is a retrospective cohort comparative study of all patients who underwent instrumented spine surgery at a single institution. OBJECTIVE: To compare the rate of surgical site infection (SSI) between the treatment (vancomycin) and the control group (no vancomycin) in patients undergoing instrumented spine surgery. SUMMARY OF BACKGROUND DATA: SSI after spine surgery is a dreaded complication associated with increased morbidity and mortality...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28207269/a-biocompatible-injectable-hydrogel-with-potent-wound-healing-and-antibacterial-properties
#3
Jiaul Hoque, Relekar G Prakash, Krishnamoorthy Paramanandham, Bibek R Shome, Jayanta Haldar
Two component injectable hydrogels that cross-link in-situ have been used as non-invasive wound-filling devices, i.e., sealants. These materials carry a variety of functions at the wound sites such as seal leaks, cease unwanted bleeding, bind tissues together, and assist in wound healing process. However, commonly used sealants typically lack antibacterial properties. Since bacterial infection at the wound site is very common, bioadhesive materials with intrinsic antibacterial properties are urgently required...
February 16, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28198150/the-effectiveness-of-negative-pressure-therapy-on-infected-wounds-preliminary-results
#4
Federico Lo Torto, Marco Ruggiero, Paola Parisi, Zachary Borab, Manuel Sergi, Bruno Carlesimo
Vacuum-assisted closure (VAC) therapy is a sophisticated system that maintains a closed, humid, sterile and isolated environment. Wound infection is considered a relative contraindication. The objective of this study is to extend the indications for VAC therapy to include infected wounds by demonstrating its ability to increase the antibiotic concentration in the damaged and infected tissues. Patients who presented with ulcers infected with daptomycin-sensitive bacteria were eligible to be enrolled in this prospective study...
February 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28197792/laparoscopic-lavage-versus-surgical-resection-for-acute-diverticulitis-with-generalised-peritonitis-a-systematic-review-and-meta-analysis
#5
REVIEW
R Cirocchi, S Di Saverio, D G Weber, R Taboła, I Abraha, J Randolph, A Arezzo, G A Binda
This systematic review and meta-analysis investigates current evidence on the therapeutic role of laparoscopic lavage in the management of diverticular peritonitis. A systematic review of the literature was performed on PubMed until June 2016, according to preferred reporting items for systematic reviews and meta-analyses guidelines. All randomised controlled trials comparing laparoscopic lavage with surgical resection, irrespective of anastomosis or stoma formation, were analysed. After assessment of titles and full text, 3 randomised trials fulfilled the inclusion criteria...
February 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28188152/perineal-resuturing-versus-expectant-management-following-vaginal-delivery-complicated-by-a-dehisced-wound-preview-a-nested-qualitative-study
#6
L Dudley, C Kettle, J Waterfield, Khaled M K Ismail
OBJECTIVE: To explore women's lived experiences of a dehisced perineal wound following childbirth and how they felt participating in a pilot and feasibility randomised controlled trial (RCT). DESIGN: A nested qualitative study using semistructured interviews, underpinned by descriptive phenomenology. PARTICIPANTS AND SETTING: A purposive sample of six women at 6-9 months postnatal who participated in the RCT were interviewed in their own homes...
February 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28187042/can-methicillin-resistant-staphylococcus-aureus-silently-travel-from-the-gut-to-the-wound-and-cause-postoperative-infection-modeling-the-trojan-horse-hypothesis
#7
Monika A Krezalek, Sanjiv Hyoju, Alexander Zaborin, Emeka Okafor, Laxmi Chandrasekar, Vitas Bindokas, Kristina Guyton, Christopher P Montgomery, Robert S Daum, Olga Zaborina, Susan Boyle-Vavra, John C Alverdy
OBJECTIVE: To determine whether intestinal colonization with methicillin-resistant Staphylococcus aureus (MRSA) can be the source of surgical site infections (SSIs). BACKGROUND: We hypothesized that gut-derived MRSA may cause SSIs via mechanisms in which circulating immune cells scavenge MRSA from the gut, home to surgical wounds, and cause infection (Trojan Horse Hypothesis). METHODS: MRSA gut colonization was achieved by disrupting the microbiota with antibiotics, imposing a period of starvation and introducing MRSA via gavage...
February 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28186134/virulence-inhibitors-from-brazilian-peppertree-block-quorum-sensing-and-abate-dermonecrosis-in-skin-infection-models
#8
Amelia Muhs, James T Lyles, Corey P Parlet, Kate Nelson, Jeffery S Kavanaugh, Alexander R Horswill, Cassandra L Quave
Widespread antibiotic resistance is on the rise and current therapies are becoming increasingly limited in both scope and efficacy. Methicillin-resistant Staphylococcus aureus (MRSA) represents a major contributor to this trend. Quorum sensing controlled virulence factors include secreted toxins responsible for extensive damage to host tissues and evasion of the immune system response; they are major contributors to morbidity and mortality. Investigation of botanical folk medicines for wounds and infections led us to study Schinus terebinthifolia (Brazilian Peppertree) as a potential source of virulence inhibitors...
February 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28182821/intrawound-vancomycin-powder-reduces-early-prosthetic-joint-infections-in-revision-hip-and-knee-arthroplasty
#9
Jeffrey E Otte, Joel R Politi, Bryan Chambers, Craig A Smith
Intrawound vancomycin powder has shown efficacy and safety in decreasing postoperative spine infections, but its use in arthroplasty has not been well established. The purpose of this study was to compare the rate of early prosthetic joint infections (PJI) with and without the use of intrawound vancomycin powder during joint arthroplasty. A retrospective cohort of all patients who underwent primary or revision hip or knee arthroplasty by two surgeons over a two-year period at a single hospital system was evaluated...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182535/prevention-of-postsurgical-wound-dehiscence-after-abdominal-surgery-with-npwt-a-multicentre-randomised-controlled-trial-protocol
#10
K Sandy-Hodgetts, G D Leslie, R Parsons, N Zeps, K Carville
OBJECTIVE: The effectiveness of negative pressure wound therapy (NPWT) in the prevention of postoperative surgical wound dehiscence (SWD) is the subject of much debate and remains to be determined. This study will identify individuals at risk of postoperative SWD and trial the use of NPWT as a prophylactic measure against the occurrence of SWD, compared with a non-NPWT standard surgical dressing (SSD). METHOD: A prospective multicentre randomised controlled trial comparing NPWT dressing against standard surgical dressings (SSD) will be conducted...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28178058/risk-factors-for-postcesarean-maternal-infection-in-a-trial-of-extended-spectrum-antibiotic-prophylaxis
#11
Kim A Boggess, Alan Tita, Victoria Jauk, George Saade, Sherri Longo, Erin A S Clark, Sean Esplin, Kristin Cleary, Ronald Wapner, Kelli Letson, Michelle Owens, Sean Blackwell, Carmen Beamon, Jeffrey M Szychowski, William Andrews
OBJECTIVE: To identify maternal clinical risk factors for postcesarean maternal infection in a randomized clinical trial of preincision extended-spectrum antibiotic prophylaxis. METHODS: We conducted a planned secondary analysis of a randomized clinical trial. Patients were 24 weeks of gestation or greater and delivered by cesarean after a minimum of 4 hours of ruptured membranes or labor. All participants received standard preincision prophylaxis and were randomized to receive azithromycin or placebo...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28177877/antimicrobial-peptide-epinecidin-1-promotes-complete-skin-regeneration-of-methicillin-resistant-staphylococcus-aureus-infected-burn-wounds-in-a-swine-model
#12
Han-Ning Huang, Chieh-Yu Pan, Hung-Yi Wu, Jyh-Yih Chen
This report shows that the antimicrobial peptide (AMP) Epinecidin-1 (Epi-1) efficiently heals MRSA-infected heat burn injuries and provides protection from infection in a pig model. The presence of an optimal level of Epi-1 induces cell proliferation by promoting cell cycle progression through an increase in S-phase cells. Epi-1 also induces proliferation to cover the wounded region in an in vitro cell proliferation assay using immortalized human epithelial HaCaT cells. Next, the in vivo wound healing efficiency of Epi-1 was tested in heat-burned pig skin infected with MRSA under in vivo conditions...
February 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28176441/the-impact-of-subcutaneous-tissue-suturing-at-cesarean-section-on-wound-complications-a-meta-analysis
#13
Vasilios Pergialiotis, Anastasia Prodromidou, Despina N Perrea, Stergios K Doumouchtsis
BACKGROUND: Cesarean wound complications are frequently observed in everyday practice. OBJECTIVES: To study whether subcutaneous tissue closure following cesarean section results in decreased wound complications. SEARCH STRATEGY: We systematically searched Medline (1966-2016), Scopus (2004-2016), ClinicalTrials. gov (2008-2016) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2016) databases together with reference lists from included studies...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28170219/on-demand-dissolution-of-chemically-cross-linked-hydrogels
#14
Marlena D Konieczynska, Mark W Grinstaff
The formation and subsequent on-demand dissolution of chemically cross-linked hydrogels is of keen interest to chemists, engineers, and clinicians. In this Account, we summarize our recent advances in the area of dissolvable chemically cross-linked hydrogels and provide a comparative discussion of other recent hydrogel systems. Using biocompatible macromonomers, we developed a library of cross-linked dendritic hydrogels that possess favorable properties, including biocompatibility, tissue adhesion, and swelling...
February 7, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28170080/mesh-fixation-with-glue-versus-suture-for-chronic-pain-and-recurrence-in-lichtenstein-inguinal-hernioplasty
#15
REVIEW
Ping Sun, Xiang Cheng, Shichang Deng, Qinggang Hu, Yi Sun, Qichang Zheng
BACKGROUND: Chronic pain following mesh-based inguinal hernia repair is frequently reported, and has a significant impact on quality of life. Whether mesh fixation with glue can reduce chronic pain without increasing the recurrence rate is still controversial. OBJECTIVES: To determine whether tissue adhesives can reduce postoperative complications, especially chronic pain, with no increase in recurrence rate, compared with sutures for mesh fixation in Lichtenstein hernia repair...
February 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28168619/pure-endoscopic-management-of-epileptogenic-hypothalamic-hamartomas
#16
S Chibbaro, H Cebula, J Scholly, J Todeschi, I Ollivier, A Timofeev, M Ganau, P Di Emidio, M P Valenti, A M Staack, T Bast, B J Steinhoff, E Hirsch, P Kehrli, F Proust
Hypothalamic hamartomas (HH) are rare congenital malformations located in the region of the tuber cinereum and third ventricle. Their usual clinical presentation is characterized by gelastic/dacrystic seizures which often become pharmaco-resistant and progress to secondary focal/generalized intractable epilepsy causing mostly in children cognitive and behavioral problems (particularly in cases of progressive epileptic encephalopathy) and precocious puberty. Whereas gelastic seizures can be surgically controlled either by resection of the lesion or disconnection (tissue-destructive) procedures, aimed at functionally prevent the spreading of the epileptic burst; generalized seizures tend to respond better to HH excision rather than isolated neocortical resections, which generally fail to control them...
February 7, 2017: Neurosurgical Review
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/28163000/peri-operative-chemotherapy-with-or-without-bevacizumab-in-operable-oesophagogastric-adenocarcinoma-uk-medical-research-council-st03-primary-analysis-results-of-a-multicentre-open-label-randomised-phase-2-3-trial
#18
David Cunningham, Sally P Stenning, Elizabeth C Smyth, Alicia F Okines, William H Allum, Sam Rowley, Laura Stevenson, Heike I Grabsch, Derek Alderson, Thomas Crosby, S Michael Griffin, Wasat Mansoor, Fareeda Y Coxon, Stephen J Falk, Suzanne Darby, Kate A Sumpter, Jane M Blazeby, Ruth E Langley
BACKGROUND: Peri-operative chemotherapy and surgery is a standard of care for patients with resectable oesophagogastric adenocarcinoma. Bevacizumab, a monoclonal antibody against VEGF, improves the proportion of patients responding to treatment in advanced gastric cancer. We aimed to assess the safety and efficacy of adding bevacizumab to peri-operative chemotherapy in patients with resectable gastric, oesophagogastric junction, or lower oesophageal adenocarcinoma. METHODS: In this multicentre, randomised, open-label phase 2-3 trial, we recruited patients aged 18 years and older with histologically proven, resectable oesophagogastric adenocarcinoma from 87 UK hospitals and cancer centres...
February 2, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28161384/hospitalization-costs-and-clinical-outcomes-in-cabg-patients-treated-with-intensive-insulin-therapy
#19
Saumeth Cardona, Francisco J Pasquel, Maya Fayfman, Limin Peng, Sol Jacobs, Priyathama Vellanki, Jeff Weaver, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo E Umpierrez
BACKGROUND: The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known. METHODS: This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control...
January 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28159037/percutaneous-screw-fixation-of-unstable-ankle-fractures-in-patients-with-poor-soft-tissues-and-significant-co-morbidities
#20
Matthew Smith, Gareth Medlock, Alan J Johnstone
INTRODUCTION: We describe a minimally invasive technique to stabilise unstable ankle fractures by inserting a 100mm screw up the fibula medullary canal along with percutaneous screw fixation of the medial malleolus if required. This technique is utilised in patients with poor soft tissues and significant co-morbidities where the fracture cannot be adequately controlled by a cast alone. PATIENTS AND METHODS: Retrospective review of 23 patients the average age being 70 years (29-89) and 74% had significant co-morbidities...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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