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https://www.readbyqxmd.com/read/28345769/best-practice-policy-statement-on-urodynamic-antibiotic-prophylaxis-in-the-non-index-patient
#1
REVIEW
Anne P Cameron, Lysanne Campeau, Benjamin M Brucker, J Quentin Clemens, Gregory T Bales, Michael E Albo, Michael J Kennelly
AIMS: Antibiotic prophylaxis before urodynamic testing (UDS) is widely utilized to prevent urinary tract infection (UTI) with only limited guidance. The Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) convened a Best Practice Policy Panel to formulate recommendations on the urodynamic antibiotic prophylaxis in the non-index patient. METHODS: Recommendations are based on a literature review and the Panel's expert opinion, with all recommendations graded using the Oxford grading system...
March 27, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28328622/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#2
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
March 21, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28327930/the-use-of-vancomycin-powder-for-surgical-prophylaxis-following-craniotomy
#3
Vinod Ravikumar, Allen L Ho, Arjun V Pendhakar, Eric S Sussman, Kevin Kwong-Hon Chow, Gordon Li
BACKGROUND: Intrawound vancomycin powder has been studied extensively in spinal fusion surgeries and been found to reduce rates of surgical site infections (SSIs) significantly. Despite its success in spinal surgeries, topical vancomycin has not been extensively studied with respect to cranial neurosurgery. OBJECTIVE: To evaluate the efficacy of intrawound topical vancomycin for prevention of SSIs following open craniotomies. METHODS: We retrospectively analyzed a large series of 350 patients from 2011 to 2015 in a pre/postintervention study of use of topical vancomycin to reduce postoperative craniotomy infection rates...
January 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#4
Jeffrey S Raskin, Daniel Hansen, Arvind Mohan, I-Wen Pan, Daniel J Curry, Sandi Lam
PURPOSE: Preoperative antibiosis contributes up to one third of total antibiotic use in major hospitals. Choice of antibiotic is not uniformly standardized, and polypharmacy regimens may be used without knowing the effect on rates of surgical site infection, nonsurgical infections, or antibiotic resistance. Careful examination of trends in surgical prophylaxis is warranted. In this study, we aimed to examine our institution's experience with vagus nerve stimulator (VNS) implantation, focusing on association between perioperative antibiotic practices and postoperative infectious outcomes...
March 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28319476/anesthesia-in-patients-with-infectious-disease-caused-by-multi-drug-resistant-bacteria
#5
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/28319472/infective-endocarditis-in-children-an-update
#6
Garth Dixon, Georgi Christov
PURPOSE OF REVIEW: Infective endocarditis in children remains a clinical challenge. Here, we review the impact of the updated 2015 American Heart Association and European Society of Cardiology guidelines on management as well as the significance of the new predisposing factors, diagnostic and treatment options, and the impact of the 2007-2008 change in prophylaxis recommendations. RECENT FINDINGS: The new 2015 infective endocarditis guidelines introduced the endocarditis team, added the new imaging modalities of computer tomography and PET-computer tomography into the diagnostic criteria and endorsed the concept of safety of relatively early surgical treatment...
March 17, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28302045/complications-following-stem-cell-therapy-in-inflammatory-bowel-disease
#7
Hongyun Wei, Xiaowei Liu, Chunhui Ouyang, Jie Zhang, Shuijiao Chen, Fanggen Lu, Linlin Chen
Pharmacotherapy and surgery constitute the mainstay of treatment for inflammatory bowel disease (IBD). However, post-treatment relapsing and recurrence persist as concerns in patients with IBD. Together with a considerable economic burden, stem cell therapy (SCT) has emerged as a promising treatment strategy in IBD, including hematopoietic stem cells (HST), mensenchymal stem cells (MSCs). HSCT could restore the immune tolerance following chemotherapy-induced immune ablation, and MSCs could affect immune cells or secret trophic factors to treat IBD...
March 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#8
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
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
#9
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/28275224/aggressive-versus-conservative-antibiotic-use-to-prevent-and-treat-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-comparison-of-two-case-series
#10
Arturo Chieregato, Paolo Malacarne, Francesco Cocciolo, Maurizio Ravaldini, Emanuele Russo, Bruno Viaggi, Michele Giardino, Carlotta Rossi, Bruno Simini, Guido Bertolini
BACKGROUND: In patients with traumatic brain injury (TBI), ventilator-associated pneumonia (VAP) is considered a dangerous complication, prompting early aggressive antibiotic treatment and prophylaxis. While this approach increases the selection of multidrug-resistant bacteria (MDR), its clinical benefit has not been demonstrated. METHODS: One-year incidence of VAP in severe TBI patients (ICU stay >48 hours, with either Glasgow Coma Scale 8 or receiving intracranial pressure monitoring, or having undergone emergency surgery) and the prevalence of MDR among those who eventually developed it, were compared in two Italian intensive care units (ICUs) adopting different antibiotic approaches...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28270114/violation-of-prophylactic-vancomycin-administration-timing-is-a-potential-risk-factor-for-rate-of-surgical-site-infections-in-cardiac-surgery-patients-a-prospective-cohort-study
#11
Paolo Cotogni, Cristina Barbero, Roberto Passera, Lucina Fossati, Giorgio Olivero, Mauro Rinaldi
BACKGROUND: Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections (SSIs) due to increasing length of stay (LOS), costs and mortality. The antimicrobial prophylaxis is one of the most important tools in the prevention of SSIs. The objective of this study was to investigate the relationship between the timing of antimicrobial prophylaxis administration and the rate of SSIs. METHODS: A prospective cohort study was carried out over 1-year period in all consecutive adult patients undergoing elective cardiac surgery...
March 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28266958/vancomycin-powder-regimen-for-prevention-of-surgical-site-infection-in-complex-spine-surgeries
#12
Michael Van Hal, Joon Lee, Dann Laudermilch, Chinedu Nwasike, James Kang
STUDY DESIGN: In total, 496 patients of a single surgeon cohort examining the surgical-site infection (SSI) rates with the addition of vancomycin powder in both diabetic and revision spine surgery cases. A historical control group of 652 patients were compared from the same surgeon over an earlier time period before the inception of using vancomycin powder prophylaxis. OBJECTIVE: The objective of this study was to describe and compare the rates of infection in high-risk patient populations while using vancomycin powder...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28263778/evaluation-of-the-bundle-zero-surgical-site-infection-to-prevent-surgical-site-infection-in-vascular-surgery
#13
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/28260599/peritonsillar-abscess-clinical-aspects-of-microbiology-risk-factors-and-the-association-with-parapharyngeal-abscess
#14
REVIEW
Tejs Ehlers Klug
PTA is a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is considered a complication of acute tonsillitis and is the most prevalent deep neck infection (approximately 2000 cases annually in Denmark) and cause of acute admission to Danish ENT departments. Teenagers and young adults are most commonly affected and males may predominate over females. However, no studies of age- and gender-stratified incidence rates have previously been published. Furthermore, smoking may be associated with increased risk of peritonsillar abscess (PTA) development, although the magnitude of the association has not been estimated...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28258383/-new-worldwide-guidelines-for-treatment-of-inguinal-hernia-the-most-important-recommendations-from-herniasurge
#15
D Weyhe
SURGICAL TECHNIQUES: In the HerniaSurge guidelines the highest evidence is found with respect to recommendations for mesh-based surgery techniques. This includes Lichtenstein as well as the minimally invasive TEP/TAPP surgery. For discreet symptomatic or asymptomatic inguinal hernia, watchful waiting is an option if the state of health and social situation are taken into account; however, femoral hernia should be treated promptly with a mesh technique, with laparoendoscopic techniques being the more favored option...
March 3, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28258021/sartorius-muscle-flaps-perioperative-outcomes-based-on-surgical-specialty
#16
Tammam Obeid, Satinderjit Locham, Isibor Arhuidese, Besma Nejim, Hanaa D Aridi, Mahmoud Malas
OBJECTIVE: Complicated groin wounds often require repair by Sartorius Muscle Flap (SMF). Operating surgical specialty differs based on SMF indication, hospital, and operating surgeon preference. We aim to assess the effect of operating surgical specialty, indication for SMF, and other patient-level factors on 30-day outcomes. METHODS: We collected data on all patients undergoing SMF performed at our institution from 2005-2015, including age, sex, body mass index, comorbidity index (hypertension, diabetes, dyslipidemia, peripheral arterial disease, coronary artery disease), smoking status, history of malignancy, indication for SMF (infection, non-infectious complication, prophylaxis), and operating surgeon's specialty (vascular, plastic, general, other)...
February 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28254373/dosing-antibiotic-prophylaxis-during-cardiopulmonary-bypass-a-higher-level-of-complexity-a-structured-review
#17
REVIEW
Fathima Paruk, Fekade B Sime, Jeffrey Lipman, Jason A Roberts
In highly invasive procedures such as open heart surgery, the risk of post-operative infection is particularly high due to exposure of the surgical field to multiple foreign devices. Adequate antibiotic prophylaxis is an essential intervention to minimise post-operative morbidity and mortality. However, there is a lack of clear understanding on the adequacy of traditional prophylactic dosing regimens, which are rarely supported by data. The aim of this structured review is to describe the relevant pharmacokinetic/pharmacodynamic (PK/PD) considerations for optimal antibiotic prophylaxis for major cardiac surgery including cardiopulmonary bypass (CPB)...
February 27, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28229205/-spectrum-of-pathogens-in-postoperative-complications-of-visceral-surgery-the-problem-of-multidrug-resistance
#18
A Kramer, J Pochhammer, P Walger, U Seifert, M Ruhnke, J C Harnoss
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, are the most common findings. Although in general surgery 10% of the S. aureus causing postoperative wound infections were methicillin resistant (MRSA), no cases of multidrug-resistant Gram-negative (MRGN) bacteria were reported...
February 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28222277/antibiotic-prophylaxis-in-blepharoplasty-review-of-the-current-literature
#19
REVIEW
Elie M Ferneini, Steven Halepas, Steven I Aronin
The purpose of this study was to provide an evidence-based overview of antibiotic prophylaxis in blepharoplasty. We performed a literature search that evaluated the risk of infection associated with blepharoplasty, as well as the risks and benefits of antibiotic prophylaxis. The overall infection rate associated with eyelid surgery is extremely low. However, the use of antibiotic prophylaxis has increased over the past 25 years in esthetic facial procedures. There is no standard of care for or against antibiotic prophylaxis, and routine practices vary widely...
February 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28220309/transseptal-suturing-technique-in-septoplasty-impact-on-bacteremia-and-nosocomial-colonization
#20
Onur Ismi, Cengiz Ozcan, Yusuf Vayısoğlu, Candan Öztürk, Sebahat Aslan Tek, Kemal Görür
Although effects of Merocel(®) nasal packs and silicone splints on nasal flora alterations and bacteremia formation after septoplasty were assessed before, the effect of transseptal suturing technique has not been studied yet. The objective of this study is to compare nasal flora alterations and bacteremia occurrence rates between Merocel packs, silicone splints, and transseptal suturing technique in septoplasty. Ninety patients were divided into three groups randomly: Merocel packing (Group M), silicone splint (Group S), and transseptal suturing without packing (Group T)...
February 20, 2017: European Archives of Oto-rhino-laryngology
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