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https://www.readbyqxmd.com/read/28213197/epileptic-seizures-in-patients-following-surgical-treatment-of-acute-subdural-hematoma-incidence-risk-factors-patient-outcome-and-development-of-a-new-scoring-system-for-prophylactic-antiepileptic-treatment-gate-24-score
#1
Sae-Yeon Won, Daniel Dubinski, Eva Herrmann, Colleen Cuca, Adam Strzelczyk, Volker Seifert, Juergen Konczalla, Thomas M Freiman
OBJECT: Clinically evident or subclinical seizures are common manifestation in acute subdural hematoma (aSDH); however, there is a paucity of research investigating the relationship between seizures and aSDH. The purpose of this study is, firstly to determine incidence, predictors of seizures and secondly establish a guideline in patients with aSDH to standardize the decision for prophylactic antiepileptic treatment. METHOD: The author analyzed 139 patients with aSDH treated from 2007 until 2015...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28205064/appropriateness-of-surgical-antibiotic-prophylaxis-for-breast-surgery-procedures
#2
Smeem Jaber, Crystal Rogers, Bruce Sunderland, Richard Parsons, Sarah MacKenzie, Jason Seet, Petra Czarniak
Background Guidelines for the appropriate use of antibiotic prophylaxis are provided in the Therapeutic Guidelines: Antibiotics (eTG) in Australia. Inappropriate use of antibiotics is problematic. Objective To examine adherence with therapeutic guidelines (eTG) in breast surgery and trends in non-adherence dependent on the type of breast surgery performed. Setting Major Western Australian teaching hospital. Method A retrospective cross-sectional study reviewed a random sample of 150 from 1049 eligible medical records of patients who underwent a breast surgical procedure in 2013 or 2014...
February 15, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28191315/emergency-surgery-for-lung-cancer-with-abscess-formation-after-transbronchial-biopsy
#3
Yusuke Takanashi, Koichi Miyashita, Shogo Tajima, Takamitsu Hayakawa, Hiroshi Neyatani, Kazuhito Funai
Abscess formation in lung cancer after transbronchial biopsy (TBB) is a rare complication with no standard consensus on a coping strategy or prophylaxis. We describe an instructive case of lung cancer which developed into an abscess after TBB. An 80-year-old man with poorly controlled diabetes mellitus underwent TBB for diagnosing a mass lesion in the left upper lobe. The TBB specimen confirmed a diagnosis of lung cancer, and he was scheduled for radical surgery. However, the tumour was revealed to have progressed into an enlarged abscess 24 days after TBB...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28185627/epidemiology-of-bleeding-in-critically-ill-children
#4
Lauren J White, Ryan Fredericks, Candace N Mannarino, Stephen Janofsky, Edward Vincent S Faustino
OBJECTIVE: To determine the epidemiology of bleeding in critically ill children. STUDY DESIGN: We conducted a cohort study of children <18 years old admitted to the pediatric intensive care unit for >24 hours and without clinically relevant bleed (CRB) on admission. CRB was defined as resulting in severe physiologic derangements, occurring at a critical site or requiring major therapeutic interventions. Using a novel bleeding assessment tool that we developed, characteristics of the CRB were abstracted from the medical records independently and in duplicate...
February 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28182821/intrawound-vancomycin-powder-reduces-early-prosthetic-joint-infections-in-revision-hip-and-knee-arthroplasty
#5
Jeffrey E Otte, Joel R Politi, Bryan Chambers, Craig A Smith
Intrawound vancomycin powder has shown efficacy and safety in decreasing postoperative spine infections, but its use in arthroplasty has not been well established. The purpose of this study was to compare the rate of early prosthetic joint infections (PJI) with and without the use of intrawound vancomycin powder during joint arthroplasty. A retrospective cohort of all patients who underwent primary or revision hip or knee arthroplasty by two surgeons over a two-year period at a single hospital system was evaluated...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28179620/effectiveness-of-antibiotic-use-management-in-tianjin-2011-2013-a-quasi-experimental-study
#6
Hai-Hong Zhang, Yue Du, Wei Liu, Shi-Duo Song, Wen Zhao, Guo-Wei Huang, He-Sheng Wang
BACKGROUND In this study we investigated changes in the status of antibiotic use in Tianjin since the implementation of the Antibiotic Stewardship Program (ASP) (2011-2013), as well as existing problems, strategies, and outcomes to promote rational clinical antibiotic use. MATERIAL AND METHODS A quasi-experimental study was performed to investigate situations of antibiotic use in secondary and tertiary general hospitals in Tianjin from April 2011 to 2013. Five major indicators were analyzed: percentage of antibiotic use in inpatient cases (%), antibacterial use density (AUD), proportion of prophylactic antibiotic application for type I surgical incision, compliance rate of medication administration 0...
February 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28176033/sudden-death-caused-by-acute-pulmonary-embolism-after-laparoscopic-total-extraperitoneal-inguinal-hernia-repair-a-case-report-and-literature-review
#7
REVIEW
C Yang, L Zhu
PURPOSE: Laparoscopic repair of inguinal hernias is an increasingly popular method of herniorrhaphy, providing advantages, including lower wound infection rates, faster recovery times and less postoperative pain compared with open procedures. The perioperative incidence of venous thromboembolism (VTE), which comprises deep vein thrombosis and pulmonary embolism, in laparoscopic inguinal hernia repair is low, but VTE is still one of the most common causes of postoperative mortality. Moreover, the VTE risk assessment and prophylaxis in inguinal hernia patients is not well defined...
February 7, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28166599/scoring-systems-for-estimating-risk-of-venous-thromboembolism-in-surgical-patients
#8
Benjamin Jacobs, Christopher Pannucci
Venous thromboembolism (VTE) is one of the most common and feared complications in surgical patients, and its prevention has been the subject of a Call to Action from the Surgeon General of the United States. Here, we review the literature on the use of risk assessment models for the stratification of surgical patients into risk groups to guide the administration of pharmacoprophylaxis. Despite some disagreement in the literature and among various guidelines, there is good evidence that risk stratification identifies a 7- to 20-fold variation in postoperative VTE risk among the overall surgical population, including patients at both low and high risk...
February 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28166598/scoring-systems-for-estimating-risk-of-venous-thromboembolism-in-hospitalized-medical-patients
#9
Sofia Barbar, Paolo Prandoni
Deep vein thrombosis and pulmonary embolism are associated with considerable morbidity and mortality in hospitalized patients, accounting for up to 10% of hospitalization-related deaths in both surgical and medical patients. Pharmacologic thromboprophylaxis has been demonstrated to be effective, safe, and cost-effective in preventing hospital-acquired venous thromboembolism (VTE) among medical inpatients, and clinician awareness of thrombotic risk promotes prescription of thromboprophylaxis. Guidelines recommend stratification of thrombotic risk for all patients and, unless contraindicated, administration of VTE prophylaxis...
February 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28166482/post-exposure-rabies-prophylaxis-in-humans-exposed-to-animals-in-lublin-province-eastern-poland-in-2012-2015-a-retrospective-study
#10
Joanna Krzowska-Firych, Krzysztof Tomasiewicz, Agata Kozøowska
Rabies continues to be one of the most important viral diseases and remains a significant threat to public health across the globe. The post-exposure prophylaxis in humans can effectively prevent death after exposure to a potentially infected animal. In Poland, recommendations for rabies PEP followed the  national guidelines which recommend that people should receive PEP when bitten by an animal suspected to be infected by rabies. PEP in humans  includes cleansing and disinfecting the wound or point of contact, and administering anti-rabies immunization...
February 6, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28165791/improving-documentation-in-surgical-operation-notes
#11
Hammad Parwaiz, Rushan Perera, John Creamer, Hamish Macdonald, Ian Hunter
BACKGROUND: Accurate documentation in surgical operation notes is crucial in facilitating the postoperative care of surgical patients and forms an important medicolegal document. This study audited the quality and completeness of documentation in surgical operation notes at a single district general hospital against the Royal College of Surgeons (2014) Good Surgical Practice guidelines, and looked to improve clinical practice through improved compliance with these guidelines. METHOD: A total of 101 operation notes were audited from a variety of surgical specialities in November 2014 (cycle 1) and 100 notes in May 2015 (cycle 2)...
February 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28158998/incidence-and-predictors-of-surgical-site-infection-in-ethiopia-prospective-cohort
#12
Tamrat Legesse Laloto, Desta Hiko Gemeda, Sadikalmahdi Hussen Abdella
BACKGROUND: Surgical site infections are commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations. The aim of this study was to determine incidence and predictors of surgical site infections at surgical ward of Hawassa University Referral Hospital, Southern Ethiopia. METHODS: We performed prospective study involving 105 patients that undergone major surgical procedure at Hawassa University Referral Hospital from March 2 to May 2, 2015...
February 3, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28146193/-cytomegalovirus-disease-in-post-heart-transplant-patients-at-a-national-reference-center
#13
Christian Rojas-Contreras, Gabriel De la Cruz-Ku, Bryan Valcarcel-Valdivia
INTRODUCTION: Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. AIMS: To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. MATERIALS AND METHODS: A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015...
December 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28145067/the-bundle-approach-to-reduce-the-surgical-site-infection-rate
#14
Fabrizio Bert, Sebastian Giacomelli, Viola Amprino, Giulio Pieve, Daniela Ceresetti, Marco Testa, Carla M Zotti
RATIONALE, AIMS, AND OBJECTIVES: In Italy, since 2008, the surveillance of surgical site infections (SSIs) has been conducted following ECDC recommendations, according to the protocol of the National System of Surveillance of Surgical Site Infections. In 2009, in Piedmont region, where the study was conducted, it was introduced a survey of a "bundle" for every patient under SSIs surveillance. The bundle includes 5 items: infection risk index calculation, preoperative shower, trichotomy, antibiotic prophylaxis, and body temperature control...
February 1, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28139320/extended-use-of-perioperative-antibiotics-in-head-and-neck-microvascular-reconstruction
#15
Stefanie Saunders, Stephen Reese, Jimmy Lam, Jacqueline Wulu, Scharkuh Jalisi, Waleed Ezzat
PURPOSE: Many head and neck surgical procedures are considered clean-contaminated wounds and antibiotic prophylaxis is recommended. Despite prophylaxis, the incidence of surgical site infections remains significant - especially in the setting of free tissue transfer. The antibiotic course is often of a longer duration after free tissue transfer than the recommended 24hour post-operatively. Currently, there is no consensus on appropriate antibiotic regimen or duration at this time. This study investigates the outcomes of a 7-day perioperative antibiotic regimen after microvascular reconstruction of the head and neck at our institution...
January 19, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28134674/clostridium-difficile-infection-an-orthopaedic-surgeon-s-guide-to-epidemiology-management-and-prevention
#16
Paul A Anderson, James Bernatz, Nasia Safdar
Clostridium difficile infection is a growing concern in health care and is a worrisome complication in orthopaedics. The incidence and severity of this infection are increasing, although the incidence following orthopaedic surgery is comparatively lower than that seen in patients in most other surgical specialties. The typical geriatric orthopaedic patient may have many risk factors that increase the likelihood of C difficile infection, including advanced age, residence in a long-term care facility, multiple comorbidities, the use of perioperative antibiotics, and a long length of stay...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28129961/-what-the-family-doctor-must-know-about-lung-transplant-part-1
#17
L Zurbano, F Zurbano
Lung transplant is a therapeutic, medical-surgical procedure indicated for pulmonary diseases (except lung cancer), that are terminal and irreversible with current medical treatment. More than 3,500 lung transplants have been performed in Spain, with a rate of over 6 per million and increasing. In this review, an analysis is made of the types of transplants, their indications and contraindications, the procedures, immunosuppressive treatments, their side effects and medical interactions, current prophylaxis...
January 24, 2017: Semergen
https://www.readbyqxmd.com/read/28128093/evaluation-of-total-body-weight-and-body-mass-index-cut-offs-for-increased-cefazolin-dose-for-surgical-prophylaxis
#18
Maya Hites, Guillaume Deprez, Fleur Wolff, Brigitte Ickx, Anita Verleije, Jean Closset, Patrizia Loi, Jessica Prévost, Fabio S Taccone, Judith Racapé, Frédéric Cotton, Frédérique Jacobs
French and American guidelines recommend increased dosage regimens of cefazolin (CFZ) for surgical prophylaxis in patients with a body mass index (BMI) ≥ 35 kg/m(2) or with a total body weight (TBW) ≥ 120 kg. The objective of this study was to evaluate the accuracy of these cut-offs in identifying patients who require CFZ dose adjustment. A pharmacokinetic study was conducted in patients of varying TBW and BMI who received 2 g of CFZ intravenously for prophylaxis prior to digestive surgery...
December 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28124850/a-quality-improvement-approach-to-reducing-the-caesarean-section-surgical-site-infection-rate-in-a-regional-hospital
#19
M O'Hanlon, C McKenna, E Carton, D Diviney, M R Costello, L O'Sullivan, J Fitzsimons, L Toland, G Dornikova, R Curran, C McCann, L O'Sullivan, T Doherty, C Crowley, S O'Coigligh
Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol...
September 9, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28123748/the-e-crabel-score-an-updated-method-for-auditing-medical-records
#20
Tharsika Myuran, Oliver Turner, Bijan Ben Doostdar, Bryony Lovett
In 2001 the CRABEL score was devised in order to obtain a numerical score of the standard of medical note keeping. With the advent of electronic discharge letters, many components of the CRABEL score are now redundant as computers automatically include some documentation. The CRABEL score was modified to form the e-CRABEL score. "Patient details on discharge letter" and "Admission and discharge dates on discharge letter" were replaced with "Summary of investigations on discharge letter" and "Documentation of VTE prophylaxis on the drug chart"...
2017: BMJ Quality Improvement Reports
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