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Neurosurgical infection rates

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https://www.readbyqxmd.com/read/30075267/impact-of-staphylococcal-decolonization-regime-and-change-in-antibiotic-prophylaxis-regime-on-incidence-of-post-craniotomy-aseptic-meningitis
#1
Ankush Gupta, Reman R Nair, Ranjith K Moorthy, Vedantam Rajshekhar
OBJECTIVE: To study the effect of a staphylococcal decolonization regime (SDR) and change in antibiotic prophylaxis regime on postoperative meningitis (bacterial and aseptic) rates in patients undergoing elective cranial surgeries. METHODS: Data of elective craniotomies (supratentorial and infratentorial) were collected retrospectively over a total period of 4 years - two years prior to (2011-12; Group A) and two years after (2014-15; Group B) initiation of a SDR and a change in antibiotic prophylaxis regime (from chloramphenicol to ceftriaxone) in a neurosurgical unit of a tertiary care hospital...
July 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29966789/complications-predicting-perioperative-mortality-in-patients-undergoing-elective-craniotomy-a-population-based-study
#2
Nicholas J Goel, Arka N Mallela, Prateek Agarwal, Kalil G Abdullah, Omar A Choudhri, David K Kung, Timothy H Lucas, H Isaac Chen
OBJECTIVE: The objective of this study was to assess the independent effect of complications on 30-day mortality in 32,695 patients undergoing elective craniotomy. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was queried for patients undergoing elective craniotomy from 2006 to 2015. Multivariate logistic regression was used to examine the effect of complications on mortality independent of preoperative risk and other postoperative complications...
June 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29955942/topical-vancomycin-for-surgical-prophylaxis-in-non-instrumented-pediatric-spinal-surgeries
#3
John G D Cannon, Allen L Ho, Jyodi Mohole, Arjun V Pendharkar, Eric S Sussman, Samuel H Cheshier, Gerald A Grant
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if topical vancomycin irrigation reduces the incidence of post-operative surgical site infections following pediatric spinal procedures. Surgical site infections (SSIs) following spinal procedures performed in pediatric patients represent a serious complication. Prophylactic use of topical vancomycin prior to closure has been shown to be effective in reducing incidence of SSIs in adult spinal procedures...
June 28, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29949011/accuracy-and-safety-of-external-ventricular-drain-placement-by-physician-assistants-and-nurse-practitioners-in-aneurysmal-acute-subarachnoid-hemorrhage
#4
Alejandro Enriquez-Marulanda, Luis C Ascanio, Mohamed M Salem, Georgios A Maragkos, Ray Jhun, Abdulrahman Y Alturki, Justin M Moore, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND: In the current dynamic health environment, increasing number of procedures are being completed by advanced practitioners (nurse practitioners and physician assistants). This is the first study to assess the clinical outcomes and safety of external ventricular drain (EVD) placements by specially trained advanced practitioners. OBJECTIVE: Compare the safety and outcomes of EVD placement by advanced practitioners in patients with subarachnoid hemorrhage (SAH)...
June 11, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29920393/treating-pediatric-hydrocephalus-at-the-neurosurgery-education-and-development-institute-the-reality-in-the-zanzibar-archipelago-tanzania
#5
Andreas Leidinger, Jose Piquer, Eliana E Kim, Hadia Nahonda, Mahmood M Qureshi, Paul H Young
BACKGROUND: Pediatric hydrocephalus is a health burden for East African countries, with an estimated incidence of 6000 new cases per year. The objective of this study is to describe the epidemiology and surgical outcomes of patients treated for pediatric hydrocephalus in the single neurosurgical center of Zanzibar. METHODS: From December 2016 to December 2017, we prospectively collected data on all patients admitted with the diagnosis of hydrocephalus. Information was gathered regarding demographics, maternal health, preoperative imaging, surgical procedures, and postsurgical complications...
June 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29890539/hybrid-technique-for-cranial-defect-reconstruction-surgical-results-over-a-10-year-period-in-a-single-institution
#6
Pablo David Guerrero-Suarez, Paola Guerrero-López, Abarin Ortiz-Leon, Haydee Samantha Sosa-Castillo, Lenny Marlene Velazquez-Gonzalez, Jaime Jesus Martinez-Anda
Decompressive craniectomy is an urgent procedure that is increasingly used for treatment of intracranial hypertension. After recovery, reconstruction of the cranial defect is necessary. Cranioplasty is an elective procedure with a high potential for morbidity if care is not taken on different surgical factors such as the material used as the cranial flap. In Latin America, high costs in some materials used in cranioplasty make its use prohibitive for some patients and institutions, and looking for alternatives has become a priority in neurosurgical centers...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29863558/post-neurosurgical-temporal-deformities-various-techniques-for-correction-and-associated-complications
#7
Gabriel F Santiago, Jordan Terner, Amir Wolff, Jeffrey Teixeira, Henry Brem, Judy Huang, Chad R Gordon
INTRODUCTION: An irregular craniofacial contour along the temporal fossa, known commonly as 'temporal hollowing deformity,' (THD) can arise from multiple etiologies. In fact, up to half of all patients who undergo neurosurgical pterional dissections develop some form of temporal contour deformities. Unfortunately, temporal hollowing correction remains surgically challenging with many techniques resulting in high rates of failure and/or morbidity. METHODS: Herein, we describe anatomy contributing to postsurgical temporal deformity as well as time-tested prevention and surgical correction techniques...
May 31, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29800828/intra-cerebrospinal-fluid-antibiotics-to-treat-central-nervous-system-infections-a-review-and-update
#8
REVIEW
Oliver D Mrowczynski, Sara T Langan, Elias B Rizk
Central nervous system infections can be complications of neurosurgical procedures or can occur spontaneously, and occasionally lead to devastating neurological complications, increased rate of mortality, and lengthier stays in the hospital, subsequently increasing costs. The use of intrathecal antibiotics to bypass the blood brain barrier and provide effective concentrations to the central nervous system has been described as an adjunct treatment option. However, the regimens of antibiotics utilized intrathecally have not been standardized...
July 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29772402/serious-adverse-events-following-normal-pressure-hydrocephalus-surgery
#9
Vikas Kotagal, Elizabeth Walkowiak, Jason A Heth
OBJECTIVE: Recent Normal Pressure Hydrocephalus (NPH) practice guidelines describe a serious adverse event (SAE) rate following surgery of 11%. PATIENTS & METHODS: We conducted a retrospective review of 162 consecutive patients who have undergone work-up at our center's multidisciplinary NPH clinic over a 47 month time period (2/2014-12/2017). Of these, 22 ultimately underwent neurosurgical ventricular shunt surgery as treatment for NPH. Clinical records were reviewed for SAEs categorized as possibly/probably/definitely related to NPH surgery...
July 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29758367/clinical-and-neurosurgical-management-of-cranial-machete-injuries-the-experience-of-a-tertiary-referral-center-in-nicaragua
#10
Luis Zapata, Ernest J Wright, Peter Nakaji
BACKGROUND: The neurosurgical literature rarely describes managing open head injuries caused by machetes, although this is a common head injury in developing countries. We present our experience managing cranial machete injuries in Nicaragua over a 5-year period. METHODS: A retrospective chart review identified patients admitted to a neurosurgery service for cranial machete injury. RESULTS: Among 51 patients studied, the majority (n = 42, 82%) presented with mild neurologic deficits (Glasgow Coma Scale score ≥14)...
August 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29753621/analysis-of-hospital-infection-register-indicates-that-the-implementation-of-who-surgical-safety-checklist-has-an-impact-on-early-postoperative-neurosurgical-infections
#11
Marjut Westman, Harri Marttila, Melissa Rahi, Esa Rintala, Eliisa Löyttyniemi, Tuija Ikonen
WHO surgical safety checklist has been proven to reduce postoperative infections in several studies. The aim of our study was to focus on surgical site infections (SSIs) after neurosurgical operations, and to determine whether the checklist implementation would have an impact on the reported SSIs. We used hospital-acquired infection (HAI) register to evaluate the effects of WHO surgical safety checklist in neurosurgery. The HAI register was searched for superficial and deep SSIs, deep organ SSIs, infections following orthopaedic implantation, and other surgical infections of 4678 neurosurgical patients operated on between 2007 and 2011...
July 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29749908/predictors-of-primary-autograft-cranioplasty-survival-and-resorption-after-craniectomy
#12
Tommi K Korhonen, Sami Tetri, Jukka Huttunen, Antti Lindgren, Jaakko M Piitulainen, Willy Serlo, Pekka K Vallittu, Jussi P Posti
OBJECTIVE Craniectomy is a common neurosurgical procedure that reduces intracranial pressure, but survival necessitates cranioplasty at a later stage, after recovery from the primary insult. Complications such as infection and resorption of the autologous bone flap are common. The risk factors for complications and subsequent bone flap removal are unclear. The aim of this multicenter, retrospective study was to evaluate the factors affecting the outcome of primary autologous cranioplasty, with special emphasis on bone flap resorption...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29726795/complication-rates-for-preexisting-baclofen-pumps-and-ventricular-shunts-following-scoliosis-correction-a-preliminary-study
#13
Jonathan Dallas, Katherine D Sborov, Bradley S Guidry, Silky Chotai, Christopher M Bonfield
OBJECTIVE Many patients undergoing spinal fusion for neuromuscular scoliosis have preexisting neurosurgical implants, including ventricular shunts (VSs) for hydrocephalus and baclofen pumps (BPs) for spastic cerebral palsy. Recent studies have discussed a possible increase in implant complication rates following spinal fusion, but published data are inconclusive. The authors therefore, sought to investigate: 1) the rate of implant complications following fusion, 2) possible causes of these complications, and 3) factors that place patients at higher risk for implant-related complications...
July 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29663282/the-frozen-brain-state-of-cryptococcus-gattii-a-globe-trotting-tropical-neurotropic-fungus
#14
Paul T Akins, Brian Jian
Initially reported in tropical regions, Cryptococcus gattii infection is now diagnosed globally. METHODS: case report; Literature review. Although initial reports described outbreaks of pulmonary and central nervous system (CNS) disease in tropical regions such as Australia and New Guinea, it is now clear that Cryptococcus gattii is a global, neurotropic pathogen. In contrast with C. neoformans, C. gattii patients are more likely to present with cryptococcomas in the brain and lungs and are often HIV negative...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29656619/impact-of-resident-involvement-in-neurosurgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-database-analysis-of-33-977-patients
#15
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Warren R Selman, Nicholas C Bambakidis
OBJECTIVE: There is conflicting and limited literature on the effect of intraoperative resident involvement on surgical outcomes. Our study assessed effects of resident involvement on outcomes in patients undergoing neurosurgery. METHODS: We identified 33,977 adult neurosurgical cases from 374 hospitals in the 2006-2012 National Surgical Quality Improvement Program, a prospectively collected national database with established reproducibility and validity. Outcomes were compared according to resident involvement before and after 1:1 matching on procedure and perioperative risk factors...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29629575/adult-hospital-admissions-associated-with-multiple-sclerosis-in-finland-in-2004-2014
#16
Anna-Leena Pirttisalo, Jussi O T Sipilä, Merja Soilu-Hänninen, Päivi Rautava, Ville Kytö
INTRODUCTION: Treatment of multiple sclerosis (MS) has developed significantly and several new immunotherapeutic drugs have become available in Finland since 2004. We studied whether this is associated with changes in hospital admission frequencies and healthcare costs and whether admission rates due to infection have increased. METHODS: The national Care Register for Health Care was searched for all discharges from neurological, medical, surgical, neurosurgical and intensive care units with MS as a primary diagnosis or an auxiliary diagnosis for primary infection diagnosis in 2004-2014...
June 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29626685/discrepancy-between-neurosurgery-morbidity-and-mortality-conference-discussions-and-hospital-quality-metric-standards
#17
Lauren E Rotman, Matthew C Davis, Arsalaan A Salehani, Devin R Broadwater, Nathaniel H Reeve, Kristen O Riley
OBJECTIVE: Medical institutions use quality metrics to track complications seen in hospital admissions. Similarly, morbidity and mortality (M&M) conferences are held to peer review complications. The purpose of this study was to compare the complications identified in a cohort of patients within 30 days of neurosurgical intervention with those captured in a cohort of M&M conferences. METHODS: All complications that occurred within 30 days of surgery were obtained for patients admitted to the neurosurgical service between May and September 2013...
July 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29625304/independent-factors-affecting-postoperative-complication-rates-after-custom-made-porous-hydroxyapatite-cranioplasty-a-single-center-review-of-109-cases
#18
Megan Still, Abdoulaye Kane, Alexandre Roux, Marc Zanello, Edouard Dezamis, Eduardo Parraga, Xavier Sauvageon, Jean-François Meder, Johan Pallud
BACKGROUND: Cranioplasties are an important neurosurgical procedure not only for improved cosmesis but also for improved functional recovery after craniectomy with a large cranial defect. The aim of this study was to identify predictive factors of postcranioplasty complications using custom-made porous hydroxyapatite cranioplasty. METHODS: Retrospective review was performed of all patients who underwent a reconstructive cranioplasty using custom-made hydroxyapatite at our institution between February 2008 and September 2017...
June 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29618119/external-ventricular-drain-placement-accuracy-and-safety-when-done-by-midlevel-practitioners
#19
Nathaniel R Ellens, D Luke Fischer, Jason E Meldau, Brett A Schroeder, Sanjay E Patra
BACKGROUND: External ventricular drains (EVDs) measure intracranial pressure, divert cerebrospinal fluid, and allow for orthotropic administration of pharmacologic agents. Currently, neurosurgeons and neurosurgery residents are the primary practitioners placing EVDs. Due to the urgency of neurosurgical pathologies and the lack of qualified residents at most hospitals, midlevel practitioner (MLP) placement of EVDs would be advantageous. OBJECTIVE: To assess the accuracy and complication rates of MLP and neurosurgeon EVD placement...
March 29, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29582969/incidence-and-risk-factors-of-neurosurgical-site-infections-results-of-a-prospective-multicenter-cohort-study-on-6359-surgeries
#20
Laura Valentini, Francesca Chiaffarino, Nicoletta Bonfanti, Marilou Pannacci, Paolo Cortellazzi, Caterina Uberti-Foppa, Marika Furlanetto, Francesco DI Meco, Luca Massimi
OBJECTIVES: Neurosurgical surgical site infections (SSI) are life-threatening complications, requiring medical treatment and additional surgeries and remain a substantial cause of morbidity. In order to identify the incidence and the main risk factors for SSI, we developed the Prophylaxis with Antibiotic protocol for neuroSurgical Site Infections Study (PASSIS), a prospective observational multicenter cohort study for examining a large number of neurosurgical procedures. METHODS: The study PASSIS involved four Italian Neurosurgical Departments applying the same antibiotic prophylaxis (ABP) protocol on 6359 consecutive neurosurgical procedures...
March 26, 2018: Journal of Neurosurgical Sciences
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