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https://www.readbyqxmd.com/read/28427474/assessment-of-surgical-antimicrobial-prophylaxis-in-orthopaedics-and-traumatology-surgical-unit-of-a-tertiary-care-teaching-hospital-in-addis-ababa
#1
Nitsuh Alemayehu Argaw, Kibruyisfawe Zewdie Shumbash, Alemseged Ayele Asfaw, Segewkal Hawaze
BACKGROUND: Prophylactic antimicrobials have a starring role in prevention of surgical site infection. This study assesses the practice of surgical antimicrobial prophylaxis (SAP) and development of surgical site infection (SSI) based on patient chart review in patients who underwent surgery in the Orthopaedics and Traumatology Surgical Unit of Tikur Anbesa Specialized Hospital (TASH). RESULTS: Majority of the patients 144 (72%) were males. 108 (54%) of the surgical wounds were clean and 63 (31%) were clean contaminated...
April 20, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28426451/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)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28425579/myringoplasty-outcomes-from-the-swedish-national-quality-registry
#3
Malin Berglund, Rut Florentzson, Mattias Fransson, Malou Hultcrantz, Per O Eriksson, Erling Englund, Eva Westman
OBJECTIVES/HYPOTHESIS: Data from patients registered for myringoplasty during 2002 to 2012 in the Swedish National Quality Registry for Myringoplasty. STUDY DESIGN: Both conventional myringoplasty and fat-graft techniques were used aimed at healing the tympanic membrane in noninfected ears. METHODS: Analysis was performed on data in a national database collected from 32 ear, nose, and throat clinics. Surgical procedures and outcomes, and patient satisfaction from a questionnaire were studied...
April 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28402472/direct-sternal-administration-of-vancomycin-and-gentamicin-during-closure-prevents-wound-infection%C3%A2
#4
Martin Andreas, Moritz Muckenhuber, Doris Hutschala, Alfred Kocher, Florian Thalhammer, Paul Vogt, Tatjana Fleck, Guenther Laufer
OBJECTIVES: Deep sternal wound infection is still a major complication in patients undergoing cardiac surgery. We previously identified mammary artery harvesting as a risk factor for decreased antibiotic tissue penetration. In addition, other risk factors including diabetes may inhibit sufficient tissue penetration of perioperative antibiotic prophylaxis. A novel closure protocol applying 2 topical antibiotics and further recommendations for sternal wiring was introduced at our department to decrease the incidence of sternal wound infections...
April 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#5
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28400887/antibiotic-prophylaxis-in-orbital-fractures
#6
Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
PURPOSE: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. MAIN OUTCOME MEASURES: Development of orbital infection. RESULTS: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28399322/antibiotic-use-and-kirschner-wire-fixation-in-forefoot-surgery-a-national-survey
#7
Gregory Pace, Samuel Dellenbaugh, Brian Stapinski, Umur Aydogan, Jorge Bustillo, Paul Juliano
In foot and ankle patients, the use of Kirschner wires is common, and the population in the typical foot and ankle practice has higher rates of comorbidities associated with infection. This study assessed national trends regarding the use of postoperative prophylactic antibiotic therapy in patients undergoing foot and ankle surgery treated with percutaneous Kirschner wires. Attending physicians at foot and ankle fellowships were mailed a questionnaire that included 3 clinical vignettes containing questions on the use of postoperative antibiotics in patients treated with percutaneous Kirschner wires...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#8
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28385346/timing-of-surgical-antimicrobial-prophylaxis-a-phase-3-randomised-controlled-trial
#9
Walter P Weber, Edin Mujagic, Marcel Zwahlen, Marcel Bundi, Henry Hoffmann, Savas D Soysal, Marko Kraljević, Tarik Delko, Marco von Strauss, Lukas Iselin, Richard X Sousa Da Silva, Jasmin Zeindler, Rachel Rosenthal, Heidi Misteli, Christoph Kindler, Peter Müller, Ramon Saccilotto, Andrea Kopp Lugli, Mark Kaufmann, Lorenz Gürke, Daniel Oertli, Evelin Bucheli-Laffer, Julia Landin, Andreas F Widmer, Christoph A Fux, Walter R Marti
BACKGROUND: Based on observational studies, administration of surgical antimicrobial prophylaxis (SAP) for the prevention of surgical site infection (SSI) is recommended within 60 min before incision. However, the precise optimum timing is unknown. This trial compared early versus late administration of SAP before surgery. METHODS: In this phase 3 randomised controlled superiority trial, we included general surgery adult inpatients (age ≥18 years) at two Swiss hospitals in Basel and Aarau...
April 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28377567/chronic-granulomatous-disease-presenting-as-aspergillus-fumigatus-pneumonia-in-a-previously-healthy-young-woman
#10
David Williams, Dipen Kadaria, Amik Sodhi, Roy Fox, Glenn Williams, Stephen Threlkeld
BACKGROUND Chronic Granulomatous Disease (CGD) is a rare immunodeficiency disease caused by a genetic defect in the NADPH (nicotinamide adenine dinucleotide phosphate) oxidase enzyme, resulting in increased susceptibility to bacterial and fungal infections. The inheritance can be X-linked or autosomal recessive. Patients usually present with repeated infections early in life. We present an unusual case of a 23-year-old patient diagnosed with CGD. CASE REPORT A 23-year-old white woman with no previous history of recurrent infections presented with complaints of fever, shortness of breath, and diffuse myalgia...
April 5, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28375803/routine-use-of-prophylactic-antibiotics-during-laparoscopic-cholecystectomy-does-not-reduce-the-risk-of-surgical-site-infections
#11
Pinar Sarkut, Sadik Kilicturgay, Hikmet Aktas, Yilmaz Ozen, Ekrem Kaya
BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. METHOD: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010...
April 4, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28369234/postoperative-atrial-fibrillation-following-cardiac-surgery-a-persistent-complication
#12
Jason W Greenberg, Timothy S Lancaster, Richard B Schuessler, Spencer J Melby
Postoperative atrial fibrillation (POAF) is a common, expensive and potentially morbid complication following cardiac surgery. POAF occurs in around 35% of cardiac surgery cases and has a peak incidence on postoperative day 2. Patients who develop POAF incur on average $10 000-$20 000 in additional hospital treatment costs, 12-24 h of prolonged ICU time, and an additional 2 to 5 days in the hospital. POAF has been identified as an independent predictor of numerous adverse outcomes, including a 2- to 4-fold increased risk of stroke, reoperation for bleeding, infection, renal or respiratory failure, cardiac arrest, cerebral complications, need for permanent pacemaker placement, and a 2-fold increase in all-cause 30-day and 6-month mortality...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28361065/surgical-prophylaxis-with-gentamicin-and-acute-kidney-injury-a-systematic-review-and-meta-analysis
#13
Weeraporn Srisung, Jirapat Teerakanok, Pakpoom Tantrachoti, Amputch Karukote, Kenneth Nugent
BACKGROUND: Gentamicin has been increasingly used instead of cephalosporins for surgical prophylaxis in an attempt to reduce the rate of "Clostridium difficile" infection. There are limited data regarding nephrotoxicity related to gentamicin in these patients. METHODS: We have conducted a systematic review and meta-analysis to evaluate the risk of acute kidney injury (AKI) in gentamicin-containing surgical prophylactic regimens, compared to regimens without gentamicin, in several types of surgery...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28345769/best-practice-policy-statement-on-urodynamic-antibiotic-prophylaxis-in-the-non-index-patient
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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