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https://www.readbyqxmd.com/read/28887250/analysis-of-patients-undergoing-major-lower-extremity-amputation-in-the-vascular-quality-initiative
#1
Joshua Gabel, Brice Jabo, Sheela Patel, Sharon Kiang, Christian Bianchi, Jason Chiriano, Theodore Teruya, Ahmed M Abou-Zamzam
BACKGROUND: Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Initiative (VQI). METHODS: The VQI amputation registry was reviewed to identify patients who underwent major LEAs. Patient factors, limb characteristics, procedure type, and intraoperative variables were analyzed by level of amputation...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28864361/healthcare-associated-infections-in-neonatal-intensive-care-unit-and-its-correlation-with-environmental-surveillance
#2
Sanjay Kumar, Binoy Shankar, Sugandha Arya, Manorma Deb, Harish Chellani
Healthcare-associated infections (HAI) are frequent complications in neonatal intensive care units (NICU) with varying risk factors and bacteriological profile. There is paucity of literature comparing the bacteriological profile of organisms causing HAI with the environmental surveillance isolates. Therefore, this study aimed to evaluate demographic profile, risk factors and outcome of HAI in NICU and correlate with environmental surveillance. Three hundred newborns with signs and symptoms of sepsis were enrolled in the study group and their profile, risk factors and outcome were compared with the control group...
August 29, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28846501/rapid-source-control-laparotomy-is-there-a-mortality-benefit
#3
James Vogler, Laura Bagwell, Leslie Hart, Sharon Holmes, Jason Sciaretta, John Mihran Davis
BACKGROUND: The purpose of this study was to determine the influence rapid source-control laparotomy (RSCL) has on the mortality rate in non-trauma patients with intra-abdominal infection. The hypothesis was that RSCL reduces deaths and hospital lengths of stay (LOS) in patients compared with definitive repair and primary fascial closure (PFC). METHODS: The International Classification of Diseases-10 codes for sepsis, gastric and duodenal ulcer perforation or hemorrhage, incisional or ventral hernia with obstruction, intestinal volvulus, ileus with obstruction, diverticulitis with perforation or abscess, vascular disorder of intestine, non-traumatic intestinal perforation, peritoneal abscess, and unspecified peritonitis were used to query the 2015 National Surgical Quality Improvement Project (NSQIP) database for all patients treated with either RSCL or PFC...
August 28, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28839941/factors-associated-with-high-cardiovascular-risk-in-a-primarily-african-american-urban-hiv-infected-population
#4
Shashwatee Bagchi, Shana Ab Burrowes, Lori E Fantry, Mian B Hossain, Gemechis H Tollera, Shyamasundaran Kottilil, C David Pauza, Michael Miller, Mona Baumgarten, Robert R Redfield
OBJECTIVE: To determine factors associated with increased risk of developing cardiovascular disease in a high-risk patient population. DESIGN: Cross-sectional analysis of a retrospective cohort study. METHODS: One-hundred patients at an inner city HIV clinic in 2008 were reviewed. The atherosclerotic vascular disease risk score was calculated using the Pooled Cohort Equation. Chi-square test was performed to identify associations of potential risk factors with elevated atherosclerotic vascular disease risk...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28806216/psoas-versus-femoral-blocks-a-registry-analysis-of-risks-and-benefits
#5
Hagen Bomberg, Andrea Huth, Stefan Wagenpfeil, Paul Kessler, Hinnerk Wulf, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Claudia Spies, Bernd Kutter, Jörg Winckelmann, Gerald Burgard, Oliver Vicent, Thea Koch, Daniel I Sessler, Thomas Volk, Alexander Raddatz
BACKGROUND AND OBJECTIVES: Psoas blocks are an alternative to femoral nerve blocks and have the potential advantage of blocking the entire lumbar plexus. However, the psoas muscle is located deeply, making psoas blocks more difficult than femoral blocks. In contrast, while femoral blocks are generally easy to perform, the inguinal region is prone to infection. We thus tested the hypothesis that psoas blocks are associated with more insertion-related complications than femoral blocks but have fewer catheter-related infections...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28798220/vascular-access-type-and-clinical-outcomes-among-elderly-patients-on-hemodialysis
#6
Timmy Lee, Mae Thamer, Qian Zhang, Yi Zhang, Michael Allon
BACKGROUND AND OBJECTIVES: The optimal type of initial permanent access for hemodialysis among the elderly is controversial. Duration of central venous catheter dependence, patient comorbidities, and life expectancy are important considerations in whether to place an arteriovenous fistula or graft. We used an observational study design to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed...
August 10, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28768786/posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis-using-a-convex-pedicle-screw-technique-a-novel-concept-of-deformity-correction
#7
A I Tsirikos, G Mataliotakis, N Bounakis
AIMS: We present the results of correcting a double or triple curve adolescent idiopathic scoliosis using a convex segmental pedicle screw technique. PATIENTS AND METHODS: We reviewed 191 patients with a mean age at surgery of 15 years (11 to 23.3). Pedicle screws were placed at the convexity of each curve. Concave screws were inserted at one or two cephalad levels and two caudal levels. The mean operating time was 183 minutes (132 to 276) and the mean blood loss 0...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28739464/prophylactic-groin-wound-vacuum-assisted-therapy-in-vascular-surgery-patients-at-enhanced-risk-for-postoperative-wound-infection
#8
Luke O Pesonen, Brian G Halloran, Abdulhameed Aziz
OBJECTIVE: Vascular groin wounds have higher than expected surgical site infection (SSI) rates and some patients are at enhanced risk. The Wiseman et al. paper suggests an objective scoring system that identifies patients at enhanced risk of postdischarge SSI. We hypothesize that prophylactic groin wound vacuum-assisted closure (VAC) therapy in enhanced risk patients will decrease SSI and readmission and the Wiseman model provides potential evidence that enhanced risk patients can be objectively identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28728556/influence-of-staphylococcus-aureus-on-outcomes-after-valvular-surgery-for-infective-endocarditis
#9
Sang Myung Han, Robert A Sorabella, Sowmya Vasan, Mark Grbic, Daniel Lambert, Rahul Prasad, Catherine Wang, Paul Kurlansky, Michael A Borger, Rachel Gordon, Isaac George
BACKGROUND: As Staphylococcus aureus (SA) remains one of the leading cause of infective endocarditis (IE), this study evaluates whether S. aureus is associated with more severe infections or worsened outcomes compared to non-S. aureus (NSA) organisms. METHODS: All patients undergoing valve surgery for bacterial IE between 1995 and 2013 at our institution were included in this study (n = 323). Clinical data were retrospectively collected from the chart review. Patients were stratified according to the causative organism; SA (n = 85) and NSA (n = 238)...
July 20, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28692690/risk-of-surgical-site-infection-acute-kidney-injury-and-clostridium-difficile-infection-following-antibiotic-prophylaxis-with-vancomycin-plus-a-beta-lactam-versus-either-drug-alone-a-national-propensity-score-adjusted-retrospective-cohort-study
#10
MULTICENTER STUDY
Westyn Branch-Elliman, John E Ripollone, William J O'Brien, Kamal M F Itani, Marin L Schweizer, Eli Perencevich, Judith Strymish, Kalpana Gupta
BACKGROUND: The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28674615/in-vivo-biocompatibility-and-pacing-function-study-of-silver-ion-based-antimicrobial-surface-technology-applied-to-cardiac-pacemakers
#11
James Shawcross, Ameet Bakhai, Ali Ansaripour, James Armstrong, David Lewis, Philip Agg, Roberta De Godoy, Gordon Blunn
INTRODUCTION: Evidence suggests that the rate of cardiovascular implantable electronic device (CIED) infections is increasing more rapidly than the rates of CIED implantation and is associated with considerable mortality, morbidity and health economic impact. Antimicrobial surface treatments are being developed for CIEDs to reduce the risk of postimplantation infection within the subcutaneous implant pocket. METHODS AND ANALYSIS: The feasibility of processing cardiac pacemakers with the Agluna antimicrobial silver ion surface technology and in vivo biocompatibility were evaluated...
2017: Open Heart
https://www.readbyqxmd.com/read/28664622/subclinical-atherosclerosis-in-low-framingham-risk-hiv-patients
#12
Rafael León, Sergio Reus, Nicolás López, Irene Portilla, José Sánchez-Payá, Livia Giner, Vicente Boix, Esperanza Merino, Diego Torrús, Óscar Moreno, Joaquín Portilla
BACKGROUND: Pathogenesis of atherosclerosis is complex and differences between HIV-infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score. MATERIALS AND METHODS: Case-control study. SETTING: outpatient Infectious Diseases clinic in a university hospital...
June 29, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28605923/bacterial-sepsis-in-neonates-single-centre-study-in-a-neonatal-intensive-care-unit-in-bosnia-and-herzegovina
#13
Izeta Softić, Husref Tahirović, Vincenzo Di Ciommo, Cinzia Auriti
OBJECTIVE: The aim of the study was to evaluate the incidence, mortality, risk factors, aetiology and the susceptibility to antibiotics of the bacteria responsible for sepsis. MATERIAL AND METHODS: A single centre, prospective, observational study, involving 200 neonates admitted over 12 months to the NICU of the University Children's Hospital, Tuzla, Bosnia and Herzegovina. RESULTS: The crude incidence of all neonatal sepsis was 68.0% (136/200) and that of late-onset sepsis (LOS) was 48...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28533166/risk-factors-for-30-day-mortality-in-patients-with-methicillin-resistant-staphylococcus-aureus-bloodstream-infections
#14
Pedro Ayau, Ana C Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler C Prentiss, Mary B Perri, Meredith Mahan, Vanthida Huang, Katherine Reyes, Marcus J Zervos
OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI. METHODS: This was a retrospective study performed in Southeast Michigan. Over a 9- year period, a total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records...
August 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28498056/risk-factors-for-surgical-site-infections-and-assessment-of-vancomycin-powder-as-a-preventive-measure-in-patients-undergoing-first-time-cranioplasty
#15
Kingsley O Abode-Iyamah, Hsiu-Yin Chiang, Nolan Winslow, Brian Park, Mario Zanaty, Brian J Dlouhy, Oliver E Flouty, Zachary D Rasmussen, Loreen A Herwaldt, Jeremy D Greenlee
OBJECTIVE Craniectomy is often performed to decrease intracranial pressure following trauma and vascular injuries. The subsequent cranioplasty procedures may be complicated by surgical site infections (SSIs) due to prior trauma, foreign implants, and multiple surgeries through a common incision. Several studies have found that intrawound vancomycin powder (VP) is associated with decreased risk of SSIs after spine operations. However, no previously published study has evaluated the effectiveness of VP in cranioplasty procedures...
May 12, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28457413/hepatic-artery-thrombosis-after-liver-transplantation-five-year-experience-at-the-state-university-of-campinas
#16
C H Puliti Reigada, E C de Ataide, T de Almeida Prado Mattosinho, I F S F Boin
BACKGROUND: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. METHODS: This was a retrospective study from January 2007 to December 2012 at the State University of Campinas. Variables analyzed were age, sex, cold and warm ischemia times, underlying disease, presence of hepatocellular carcinoma, Model for End-Stage Liver Disease (MELD) score, arterial anatomic variation in the graft, cytomegalovirus (CMV) infection, rejection, biliary complications, retransplantation rate, and survival...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28433336/the-association-of-postoperative-glycemic-control-and-lower-extremity-procedure-outcomes
#17
Todd R Vogel, Jamie B Smith, Robin L Kruse
OBJECTIVE: The effect of postoperative hyperglycemia in patients undergoing open and endovascular procedures on the lower extremities has not been fully characterized with regard to associated admission diagnoses, hospital complications, mortality, and 30-day readmission. This study evaluated the relationship of postoperative hyperglycemia on outcomes after lower extremity vascular procedures for peripheral artery disease. METHODS: Patients with peripheral artery disease admitted for elective lower extremity procedures between September 2008 and March 2014 were selected from the Cerner Health Facts (Cerner Corporation, Kansas City, Mo) database using International Classification of Diseases, Ninth Edition, Clinical Modification diagnosis and procedure codes...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28421878/cerebrovascular-injury-in-cryptococcal-meningitis
#18
Ajay Kumar Mishra, Vanjare Harshad Arvind, Divya Muliyil, Cijoy K Kuriakose, Anu Anna George, Reka Karuppusami, Ronald Albert Benton Carey, Sunithi Mani, Samuel George Hansdak
Background Cryptococcal meningitis continues to be one of the common causes of chronic central nervous system infection worldwide. Individuals with cryptococcal meningitis can occasionally present with small vessel vasculitis causing infarcts primarily in the basal ganglia, internal capsule, and thalamus. Literature regarding patterns of cerebrovascular injury among patients with cryptococcal meningitis is scanty, and outcome following these vascular involvements is unknown. Aim To study the clinical profile, imaging findings, and details of vascular territory involved among patients admitted with cryptococcal meningitis and central nervous system infarct in a tertiary care center from India...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28416826/-surgical-technique-and-early-clinical-outcomes-of-direct-anterior-approach-to-total-hip-arthroplasty
#19
M Lv, J Q Zhang, X S Wang, Y Huang, W Li, C Y Zhang
OBJECTIVE: To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes. METHODS: A series of 100 consecutive, unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed. There were 50 male patients and 50 female patients. The average patient age was 51 years, and the average body mass index was 24...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28410924/society-for-vascular-surgery-wound-ischemia-foot-infection-wifi-score-correlates-with-the-intensity-of-multimodal-limb-treatment-and-patient-centered-outcomes-in-patients-with-threatened-limbs-managed-in-a-limb-preservation-center
#20
William P Robinson, Lorraine Loretz, Colleen Hanesian, Julie Flahive, John Bostrom, Nicholas Lunig, Andres Schanzer, Louis Messina
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. METHODS: We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015)...
August 2017: Journal of Vascular Surgery
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