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Infection risk score vascular

Andrea Perrotti, Giuseppe Gatti, Enrica Dorigo, Gianfranco Sinagra, Aniello Pappalardo, Sidney Chocron
BACKGROUND: The Gatti score is a weighted scoring system based on risk factors for deep sternal wound infection (DSWI) that was created in an Italian center to predict DSWI risk after bilateral internal thoracic artery (BITA) grafting. No external evaluation based on validation samples derived from other surgical centers has been performed. The aim of this study is to perform this validation. PATIENTS AND METHODS: During 2015, BITA grafts were used as skeletonized conduits in all 255 consecutive patients with multi-vessel coronary disease who underwent isolated coronary bypass surgery at the Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France...
December 8, 2016: Surgical Infections
Seri A, Marta Ds, Madalan A, Popescu M, Tiglea Ai, Moldoveanu E
Objective. Respiratory bacterial infections are associated with important coagulation disturbances that amplify the pulmonary lesions and determine a more severe course of the disease. The aim of our study was to investigate the correlation between the evolution of the general clinical parameters and the occurrence of thrombotic events on one side, and plasma levels of selected proteins involved in inflammation and coagulation on the other side, with the intent to establish and to validate a laboratory test panel for the assessment of the vascular risk in patients with bacterial respiratory infections...
October 2016: Journal of Medicine and Life
Wei Qin, Xiaoyu Zhang, Shuna Yang, Yue Li, Junliang Yuan, Lei Yang, Shujuan Li, Wenli Hu
BACKGROUND: Severe stroke patients have poor clinical outcome which may be associated with development of multiple organ dysfunction syndrome (MODS). Therefore, the aim of our study was to investigate independent risk factors for development of MODS in severe stroke patients. METHODS: Ninety seven severe stroke patients were prospective recruited from Jan 2011 to Jun 2015. The development of MODS was identified by Sequential Organ Failure Assessment (SOFA) score (score ≥ 3, at least two organs), which was assessed on day 1, 4, 7, 10 and 14 after admission...
2016: PloS One
V Pascual Fuster
Dyslipaemia is one of the main risk factors in the development of cardiovascular diseases. Currently, there are different alternatives available (amongst which statins occupy a pre-eminent place), to optimise the treatment of patients at high or very high cardiovascular risk. Despite this, the percentage of patients that achieve good lipid control is low. The causes of the mismatch with proposed objectives include lack of patient adherence and therapeutic inertia. This review uses available evidence and the latest clinical guides as a basis to assess the pharmacological treatment of dyslipaemia in patients with a background of arteriosclerotic vascular disease, diabetes, chronic kidney disease, cardiovascular risk at ≥5% calculated by SCORE and familial hypercholesterolaemia...
December 2016: Revista Española de Sanidad Penitenciaria
Matheus Lemos Azi, Alessandro Aprato, Irene Santi, Mauricio Kfuri Junior, Alessandro Masse, Alexander Joeris
BACKGROUND: This meta-analysis aimed to determine the bone union rate of bone defects treated with the different autologous bone graft techniques. METHODS: The PubMed and the Cochrane Library databases were searched using the terms: 'fracture' AND ('bone loss' OR 'defect' OR 'defects') AND 'bone graft', restricted to English language, to human species, and to a publication period from January 1999 to November 2014. Data were extracted by one of the reviewers and then checked by the second...
November 9, 2016: BMC Musculoskeletal Disorders
Karl Sörelius, Anders Wanhainen, Mia Furebring, Martin Björck, Peter Gillgren, Kevin Mani
BACKGROUND: No reliable comparative data exist between open repair (OR) and endovascular aneurysm repair (EVAR) for mycotic abdominal aortic aneurysms (MAAAs). This nationwide study assessed outcomes after OR and EVAR for MAAA in a population-based cohort. METHODS: All patients treated for MAAAs in Sweden between 1994 and 2014 were identified in the Swedish vascular registry. The primary aim was to assess survival after MAAA with OR and EVAR. Secondary aims were analyses of the rate of recurrent infections and reoperations, and time trends in surgical treatment...
December 6, 2016: Circulation
Byung-Joon Jeon, Hwan Jun Choi, Jin Seok Kang, Min Sung Tak, Eun Soo Park
Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic foot ulcers (DFUs). Lower extremity ulcers and amputations are ongoing problems among individuals with diabetes. There are several classification systems for DFUs; however, no prognostic system has to date been accepted as the gold standard or the optimum prediction tool for amputations. A retrospective study was designed. Demographic data and baseline laboratory data were gathered and scored or evaluated using five representative DFU classification systems...
October 10, 2016: International Wound Journal
Carlo Sposito, Stefano Di Sandro, Federica Brunero, Vincenzo Buscemi, Carlo Battiston, Andrea Lauterio, Marco Bongini, Luciano De Carlis, Vincenzo Mazzaferro
AIM: To develop a prognostic scoring system for overall survival (OS) of patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC). METHODS: Consecutive patients who underwent curative LR for HCC between 2000 and 2013 were identified. The series was randomly divided into a training and a validation set. A multivariable Cox model for OS was fitted to the training set. The beta coefficients derived from the Cox model were used to define a prognostic scoring system for OS...
September 28, 2016: World Journal of Gastroenterology: WJG
Hyo Jin Lee, Jae Ki Choi, Sung Yeon Cho, Si Hyun Kim, Sun Hee Park, Su Mi Choi, Dong Gun Lee, Jung Hyun Choi, Jin Hong Yoo
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are Gram-negative bacteria with increasing prevalence of infection worldwide. In Korea, 25 cases of CPE isolates were reported by the Korea Centers for Disease Control and Prevention in 2011. Most CPE cases were detected mainly at tertiary referral hospitals. We analyzed the prevalence and risk factors for carbapenem-resistant Enterobacteriaceae (CRE) in a mid-sized community-based hospital in Korea. MATERIALS AND METHODS: We retrospectively analyzed all consecutive episodes of Enterobacteriaceae in a mid-sized community-based hospital from January 2013 to February 2014...
September 2016: Infection & Chemotherapy
Mohammadreza Golbakhsh, Mirmostafa Sadaat, Fatemeh Noughani, Ahmadreza Mirbolook, Amirmohammad Gholizadeh, Sadegh Abedi
BACKGROUND: Implant removal is a common procedure in orthopedic surgery which can be associated with many complications such as scar formation, hematoma, nerve injury, infection, and refracture. Indications for orthopedic implant removal have declined in recent years. Most studies have considered orthopedic hardware removal as an unnecessary procedure in the absence of severe complications such as nonunion. Some studies have reported the complications of orthopedic hardware removal to be 24% to 50% dependent on their types and locations as well as on other factors such as patient's condition and the orthopedist's experience...
May 2016: Trauma Monthly
Katherine E Poruk, Joseph A Lin, Michol A Cooper, Jin He, Martin A Makary, Kenzo Hirose, John L Cameron, Timothy M Pawlik, Christopher L Wolfgang, Frederic Eckhauser, Matthew J Weiss
BACKGROUND: Although pancreaticoduodenectomy (PD) outcomes have improved, complications including surgical site infection (SSI) remain common. We present a stratification tool to predict risk for SSI after PD. METHODS: Data was retrospectively reviewed on all patients undergoing PD at a tertiary hospital (9/2011-8/2014). Potential SSI risk factors identified by univariate analysis were incorporated into a multivariate logistic regression model. The resulting odds ratios were converted into a point system to create an SSI risk score with internal validation...
September 10, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Elisabeth Coupez, Jean-François Timsit, Stéphane Ruckly, Carole Schwebel, Didier Gruson, Emmanuel Canet, Kada Klouche, Laurent Argaud, Julien Bohe, Maïté Garrouste-Orgeas, Christophe Mariat, François Vincent, Sophie Cayot, Olivier Cointault, Alain Lepape, Michael Darmon, Alexandre Boyer, Elie Azoulay, Lila Bouadma, Alexandre Lautrette, Bertrand Souweine
BACKGROUND: Intensive care unit (ICU) patients require dialysis catheters (DCs) for renal replacement therapy (RRT). They carry a high risk of developing end-stage renal disease, and therefore their vascular access must be preserved. Guidewire exchange (GWE) is often used to avoid venipuncture insertion (VPI) at a new site. However, the impact of GWE on infection and dysfunction of DCs in the ICU is unknown. Our aim was to compare the effect of GWE and VPI on DC colonization and dysfunction in ICU patients...
July 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
Paolo Raggi, Catherine Corwin
Many sources have highlighted the high incidence of premature cardiovascular events in HIV infected patients. This raises the suspicion of an accelerated ageing of the vascular system in this disease characterized by chronic systemic subliminal inflammation and immune dysregulation. Unfortunately all currently available risk assessment algorithms based on traditional risk factors, and even those containing more HIV-specific factors, fail to accurately predict risk in a large proportion of patients. In the general population several models have implemented imaging data to refine risk assessment, and the concept of vascular ageing has been of value in improving the performance of these algorithms...
July 13, 2016: Virulence
Ben De Brucker, Assaf Zeltzer, Katrin Seidenstuecker, Benoit Hendrickx, Nele Adriaenssens, Moustapha Hamdi
BACKGROUND: Breast cancer-related lymphedema affects multiple aspects of patients' daily lives. The main aim of this study was to assess the impact of vascularized lymph node transfer on the quality of life in patients with lymphedema. METHODS: Between 2007 and 2012, 25 female patients with breast cancer-related lymphedema underwent vascularized lymph node transfer. In 22 cases, the patients underwent a simultaneous deep inferior epigastric artery perforator flap breast reconstruction based on the superficial circumflex iliac artery...
June 2016: Plastic and Reconstructive Surgery
Cristina Macía-Rodríguez, Vanesa Alende-Castro, Lourdes Vazquez-Ledo, Ignacio Novo-Veleiro, Arturo González-Quintela
INTRODUCTION: Skin and soft-tissue infections (SSTIs) are common and are linked to a wide variety of clinical conditions. Few studies have analysed the factors associated with mortality and re-admissions in medical patients with SSTIs. Accordingly, this study sought to describe the clinical and microbiological characteristics of patients diagnosed with SSTIs, and identify mortality and re-admission related factors. PATIENTS AND METHODS: A total of 308 patients were included in the study...
April 6, 2016: Enfermedades Infecciosas y Microbiología Clínica
Emrah Şişli, Ali Aycan Kavala, Mustafa Mavi, Osman Nejat Sarıosmanoğlu, Öztekin Oto
OBJECTIVE: To elucidate the risk factors associated with amputation in cases with combat-related vascular injury (CRVI). MATERIAL AND METHODS: This retrospective study included 90 cases with CRVI treated between May 2011 and July 2013. The patients were divided into group I (n=69), in which the limb was salvaged and group II (n=21), in which the patients received amputation. RESULTS: The overall and the secondary amputation rates were 23% and 18%, respectively...
September 2016: Injury
Marlin W Causey, Ayman Ahmed, Bian Wu, Warren J Gasper, Alex Reyzelman, Shant M Vartanian, Jade S Hiramoto, Michael S Conte
OBJECTIVE: Clinical decision making and accurate outcomes comparisons in advanced limb ischemia require improved staging systems. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) was designed to stratify limb outcomes based on three major factors-wound extent, ischemia, and foot infection. The Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk score was developed to stratify patients by expected amputation-free survival (AFS) after surgical revascularization...
June 2016: Journal of Vascular Surgery
Efthymios Beropoulis, Konstantinos Stavroulakis, Arne Schwindt, Arne Stachmann, Giovanni Torsello, Theodosios Bisdas
BACKGROUND: The Society for Vascular Surgery Lower Extremity Guidelines Committee developed the Wound, Ischemia, foot Infection (WIfI) a classification system to predict the amputation risk in patients with critical limb ischemia (CLI). A number of published studies have already evaluated its prognostic value. However, most of the included patients were diabetic, and the validation was done independent of the revascularization procedure. This single-center study evaluated the prognostic value of WIfI stages in nondiabetic patients treated by endovascular means...
July 2016: Journal of Vascular Surgery
Surbhi Leekha, Brian D Lahr, Rodney L Thompson, Priya Sampathkumar, Audra A Duncan, Robert Orenstein
OBJECTIVE: The objective of this study was to develop a surgical site infection (SSI) prediction score for risk assessment before elective vascular surgery. METHODS: We conducted a nested case-control study among patients who underwent elective vascular (abdominal aortic and peripheral arterial) surgery from January 1, 2003, to December 31, 2007, at Mayo Clinic (Rochester, Minn) an academic tertiary surgical center. Cases were patients with SSI requiring hospitalization; controls (one or two per case) were matched on type of procedure and date of surgery...
July 2016: Journal of Vascular Surgery
Pei-Lun Kuo, Kun-Chang Lin, Pei-Ling Tang, Chin-Chang Cheng, Wei-Chun Huang, Cheng-Hung Chiang, Hsiao-Chin Lin, Tzu-Jung Chuang, Shue-Ren Wann, Guang-Yuan Mar, Jin-Shiung Cheng, Chun-Peng Liu
Although a possible association between hepatitis B and cardiovascular disease has been identified, the impact of viral hepatitis B on long-term prognosis after an acute myocardial infarction (AMI) is uncertain. Therefore, the aim of our study was to evaluate the specific impact of viral hepatitis B on survival after a first AMI through a retrospective analysis of data from the Taiwan National Health Insurance Research Database.This was a nationwide, propensity score-matched case-control study of patients admitted to hospitals between January 2000 and December 2012 with a primary diagnosis of a first AMI...
February 2016: Medicine (Baltimore)
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