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Abdominal infections guidelines

S van Steensel, A Bloemen, L C L van den Hil, J van den Bos, G J Kleinrensink, N D Bouvy
PURPOSE: The lumbar abdominal wall hernia is a rare hernia in which abdominal contents protrude through a defect in the dorsal abdominal wall, which can be of iatrogenic, congenital, or traumatic origin. Two anatomical locations are known: the superior and the inferior lumbar triangle. The aim of this systematic review is to provide a clear overview of the existing literature and make practical clinical recommendations for proper diagnosis and treatment of the primary lumbar hernia. METHODS: The systematic review was conducted according to the PRISMA guidelines...
October 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
B E Zucker, C Simillis, P Tekkis, C Kontovounisios
BACKGROUND: There are many options and little guiding evidence when choosing suture types with which to close the abdominal wall fascia. This network meta-analysis investigated the effect of suture materials on surgical site infection, hernia, wound dehiscence and sinus/fistula occurrence after abdominal surgery. The aim was to provide clarity on whether previous recommendations on suture choice could be followed with confidence. METHODS AND METHODS: In February 2017, the Cochrane Central Register of Controlled Trials, Medline, EMBASE and Science Citation Index Expanded were searched for randomised controlled trials investigating the effect of suture choice on these four complications in closing the abdomen...
October 5, 2018: Annals of the Royal College of Surgeons of England
D J Tubre, A D Schroeder, J Estes, J Eisenga, R J Fitzgibbons
PURPOSE: Surgical site infection is the most common hospital-acquired infection in surgical patients. Recently, public health organizations have updated prevention guidelines. This review discusses surgical site infections as a complication of abdominal wall reconstruction. METHODS: The authors reviewed guidelines on prevention of surgical site infections from the Center for Disease Control and Prevention, World Health Organization, and National Institute for Health and Care Excellence and put them into context with the relevant abdominal wall reconstruction literature...
October 1, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Shaheel Mohammad Sahebally, Kevin McKevitt, Ian Stephens, Fidelma Fitzpatrick, Joseph Deasy, John Patrick Burke, Deborah McNamara
Importance: Surgical site infections (SSIs) are common after laparotomy wounds and are associated with a significant economic burden. The use of negative pressure wound therapy (NPWT) has recently been broadened to closed surgical incisions. Objective: To evaluate the association of prophylactic NPWT with SSI rates in closed laparotomy incisions performed for general and colorectal surgery in elective and emergency settings. Data Sources: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched without language restrictions for relevant articles from inception until December 2017...
September 26, 2018: JAMA Surgery
Micaela Piccoli, Ferdinando Agresta, Grazia Maria Attinà, Dalia Amabile, Domenico Marchi
To date, there is no shared consensus on a definition of a complex abdominal wall in elective surgery and in the emergency, on indications, technical details, complications, and follow-up. The purpose of the conference was to lay the foundations for a homogeneous approach to the complex abdominal wall with the primary intent being to attain the following objectives: (1) to develop evidence-based recommendations to define "complex abdominal wall"; (2) indications in emergency and in elective cases; (3) management of "complex abdominal wall"; (4) techniques for temporary abdominal closure...
September 25, 2018: Updates in Surgery
Heather Lusby, Aaron Brooks, Eden Hamayoun, Amanda Finley
A 44-year-old Caucasian female with a history of endometriosis is admitted to the intensive care unit due to severe left lower quadrant abdominal pain, nausea and vomiting. With patients' positive chandelier sign on pelvic examination, leucocytosis, elevated erythrocyte sedimentation rate and elevated C-reactive protein indicated that she had pelvic inflammatory disease (PID). PCR tests were negative for Neisseria gonorrhoeae and Chlamydia trachomatis ; however, her blood and urine cultures grew Group A streptococci (GAS) with a negative rapid Streptococcus throat swab and no known exposure to Streptococcus On further review, patient met criteria for GAS toxic shock syndrome based on diagnostic guidelines...
September 23, 2018: BMJ Case Reports
Kambiz Diba, Khadijeh Makhdoomi, Elahe Nasri, Afsane Vaezi, Javad Javidnia, Davood Jabbari Gharabagh, Nima Hosseni Jazani, Ali Reza Chavshin, Parisa Badiee, Hamid Badali, Hamed Fakhim
Candidiasis is a major challenge among renal transplant recipients (RTRs) worldwide and is associated with high morbidity and mortality rates. Fluconazole is the most commonly used agent for Candida infections. However, frequent relapse and treatment failure are still reported among patients affected with this infection. In the present study, Candida species obtained from RTRs were characterized based on conventional and molecular assays. Furthermore, the antifungal susceptibility profiles of these species were determined...
September 18, 2018: Microbial Pathogenesis
Jamie Furlong-Dillard, Alaina Neary, Jennifer Marietta, Courtney Jones, Grace Jeffers, Lindsey Gakenheimer, Michael Puchalski, Aaron Eckauser, Claudia Delgado-Corcoran
Introduction: Feeding difficulties and malnutrition are important challenges when caring for newborns with critical congenital heart disease (CCHD) without clear available guidelines for providers. This study describes the utilization of a feeding protocol with the focus on standardization, feeding modality, and total parenteral nutrition (TPN) utilization postoperatively. Methods: Patients included neonates with CCHD undergoing complex biventricular repair using cardiopulmonary bypass...
May 2018: Pediatric quality & safety
Frank Bloos, Jürgen Held, Peter Schlattmann, Nicole Brillinger, Oliver Kurzai, Oliver A Cornely, Daniel Thomas-Rüddel
BACKGROUND: The time to diagnosis of invasive Candida infection (ICI) is often too long to initiate timely antifungal therapy in patients with sepsis. Elevated serum (1,3)-β-D-glucan (BDG) concentrations have a high diagnostic sensitivity for detecting ICI. However, the clinical significance of elevated BDG concentrations is unclear in critically ill patients. The goal of this study is to investigate whether measurement of BDG in patients with sepsis and a high risk for ICI can be used to decrease the time to empiric antifungal therapy and thus, increase survival...
September 4, 2018: Trials
Celestin Danwang, Temgoua Ngou Mazou, Joel Noutakdie Tochie, Rolf Nyah Tuku Nzalie, Jean Joel Bigna
INTRODUCTION: Acute appendicitis is a surgical emergency and the most frequent aetiology of acute surgical abdominal pain in developed countries. Universally, its widely approved treatment is appendectomy. Like all surgical procedures, appendectomy can be associated with many complications among which are surgical site infections (SSIs).Despite the increasing number of appendectomies done around the world and the associated morbidities related to SSI after appendectomy, there is still scarcity of data concerning the global epidemiology of SSI after appendectomy...
August 30, 2018: BMJ Open
Rosanne Sfe van Gestel, Johannes G Kusters, Jan F Monkelbaan
Dientamoeba fragilis (D. fragilis) is an intestinal parasite frequently detected in humans with abdominal pain and diarrhoea, but it is also commonly found in asymptomatic subjects. Hence its clinical relevance is often disputed. The introduction of polymerase chain reaction (PCR) is a versatile and sensitive diagnostic technique for the detection of intestinal parasites, and in some Western world countries PCR has almost completely replaced microscopic diagnostics. PCR has however resulted in an increase in the number of D...
August 31, 2018: Parasitology
Karla Bernardi, Gina L Adrales, William W Hope, Jerrod Keith, Heidi Kuhlens, Robert G Martindale, Alyson A Melin, Sean B Orenstein, John Scott Roth, Shinil K Shah, Shawn Tsuda, Mike K Liang
BACKGROUND: Ventral hernias are a common pathology encountered by surgeons. Multiple risk stratification tools have been developed in attempts to predict a patient's postoperative risk for complication. The aim of this systematic review was to identify published stratification tools, to assess their generalizability, and develop an ensemble risk score model. METHODS: A systematic review of the literature was performed using PubMed and following the PRISMA guidelines...
September 2018: Plastic and Reconstructive Surgery
Samuel N Grief, Julie K Loza
Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia...
September 2018: Primary Care
Hassan Fadel, Seong-Jin Moon, Neil V Klinger, Parthasarathi Chamiraju, Hazem A Eltahawy, Marc D Moisi, Murali Guthikonda
Candida parapsilosis is an incredibly rare cause of ventriculoperitoneal (VP) shunt infections, with only one adult case reported in the literature to date. We describe the case of a 45-year-old man admitted for a traumatic fall and subsequently treated with VP shunt placement for obstructive hydrocephalus secondary to a cerebellar contusion and intraventricular hemorrhage. Eight months following VP shunt placement, the patient presented with a two-month history of clear fluid leakage through a dehiscent surgical abdominal wound overlying the distal VP shunt...
August 13, 2018: World Neurosurgery
Benjamin D Kulwicki, Kasey L Brandt, Lauren M Wolf, Andrew J Weise, Lisa E Dumkow
PURPOSE: It is critical to engage ED providers in antimicrobial stewardship programs (ASP). Emergency medicine pharmacists (EMPs) play an important role in ASP by working with providers to choose empiric antimicrobials. This study aimed to determine the impact of an EMP on appropriate empiric antibiotic prescribing for community-acquired pneumonia (CAP) and intra-abdominal infections (CA-IAI). METHODS: A retrospective cohort study was conducted evaluating adult patients admitted with CAP or CA-IAI...
July 29, 2018: American Journal of Emergency Medicine
Mariana F Lima, Luiz Antonio Mondadori, Aline Y Chibana, Daniel B Gilio, Eduardo Henrique Giroud Joaquim, Frederic Michard
Hemodynamic and depth of anesthesia (DOA) monitoring are used in many high-risk surgical patients without well-defined indications and objectives. We implemented monitoring guidelines to rationalize hemodynamic and anesthesia management during major cancer surgery. In early 2014, we developed guidelines with specific targets (Mean arterial pressure > 65 mmHg, stroke volume variation < 12%, cardiac index > 2.5 l min-1  m-2 , central venous oxygen saturation > 70%, 40 < bispectral index < 60) for open abdominal cancer surgeries > 2 h...
August 3, 2018: Journal of Clinical Monitoring and Computing
Clare M Morkane, Helen McKenna, Andrew F Cumpstey, Alex H Oldman, Michael P W Grocott, Daniel S Martin
Background: Considerable controversy remains about how much oxygen patients should receive during surgery. The 2016 World Health Organization (WHO) guidelines recommend that intubated patients receive a fractional inspired oxygen concentration (FIO2 ) of 0.8 throughout abdominal surgery to reduce the risk of surgical site infection. However, this recommendation has been widely criticised by anaesthetists and evidence from other clinical contexts has suggested that giving a high concentration of oxygen might worsen patient outcomes...
2018: Perioperative Medicine
Rayo Morfin-Otero, Elvira Garza-Gonzalez, Guillermo Garcia Garcia, Hector R Perez-Gomez, Sara A Aguirre-Diaz, Esteban Gonzalez-Diaz, Sergio Esparza-Ahumada, Alfonso Fernandez-Ramirez, Francisco Cardenas-Lara, Adrian Martinez-Melendez, Rodrigo Escobedo-Sanchez, Margarita Ibarra-Hernandez, Gerardo Leon Garnica, Eduardo Rodriguez-Noriega
BACKGROUND: Clostridium difficile infection (CDI) is a leading cause of healthcare-associated diarrhea worldwide. Patients with chronic kidney disease (CKD) are especially vulnerable, as they are exposed to CDI risk factors including frequent antibiotics. MATERIALS AND METHODS: In order to identify the risk factors for CDI in CKD patients, a 33-month long case-control study was carried out at a tertiary-care hospital in Mexico. CDI was confirmed at the genetic level, and univariate and multivariate analyses were performed to identify the association between risk factors, biomarkers, and outcome options (survival, relapse, death)...
November 2018: Clinical Nephrology
R L Nelson, A Kravets, R Khateeb, M Raza, M Siddiqui, I Taha, A Tummala, R Epple, S Huang, M Wen
BACKGROUND: Among the techniques investigated to reduce the risk of surgical wound infection or surgical space infection (SSI) in patients having colorectal surgery are topical application of antimicrobials (antibiotics and antiseptics) to the open wound or immediately after closure. The aim of the present study was to perform a systematic review of the literature on those treatments, with the exception of antibiotic ointments applied to closed skin, which are adequately assessed elsewhere, and a meta-analysis...
August 2018: Techniques in Coloproctology
Bipadabhanjan Mallick, Harshal S Mandavdhare, Sourabh Aggarwal, Harjeet Singh, Usha Dutta, Vishal Sharma
Background: Chylous ascites is an uncommon presentation of mycobacterial infection. Methods: We report three cases of tubercular chylous ascites, and in addition, we performed a systematic review of the published literature for the clinical presentation, treatment, and outcomes of mycobacterial chylous ascites. We followed the PRISMA guidelines for the systematic review. Results: A total of 33 cases (including three of ours) were included...
July 2018: Therapeutic Advances in Infectious Disease
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