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https://www.readbyqxmd.com/read/28339500/detecting-congenital-malformations-lessons-learned-from-the-mpepu-study-botswana
#1
Gbolahan Ajibola, Rebecca Zash, Roger L Shapiro, Oganne Batlang, Kerapetse Botebele, Kara Bennett, Florence Chilisa, Erik von Widenfelt, Joseph Makhema, Shahin Lockman, Lewis B Holmes, Kathleen M Powis
INTRODUCTION: A large and increasing number of HIV-infected women are conceiving on antiretroviral treatment (ART). While most antiretrovirals are considered safe in pregnancy, monitoring for rare pregnancy and infant adverse outcomes is warranted. METHODS: We conducted a retrospective secondary analysis nested within a clinical trial of infant cotrimoxazole vs. placebo prophylaxis in Botswana (the Mpepu Study). Infants were examined at birth, and at least every 3 months through 18 months of age...
2017: PloS One
https://www.readbyqxmd.com/read/28327930/the-use-of-vancomycin-powder-for-surgical-prophylaxis-following-craniotomy
#2
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/28325458/chronic-subdural-hematoma-icu-management
#3
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#4
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28321988/a-quality-improvement-initiative-to-optimize-dosing-of-surgical-antimicrobial-prophylaxis
#5
Thomas J Caruso, Ellen Wang, Hayden T Schwenk, David Scheinker, Calida Yeverino, Mary Tweedy, Manjit Maheru, Paul J Sharek
BACKGROUND: The risk of surgical site infections is reduced with appropriate timing and dosing of preoperative antimicrobials. Based on evolving national guidelines, we increased the preoperative dose of cefazolin from 25 to 30 mg·kg(-1) . This quality improvement project describes an improvement initiative to develop standard work processes to ensure appropriate dosing. AIMS: The primary aim was to deliver cefazolin 30 mg·kg(-1) to at least 90% of indicated patients...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#6
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/28320342/enhanced-recovery-after-elective-caesarean-a-rapid-review-of-clinical-protocols-and-an-umbrella-review-of-systematic-reviews
#7
Ellena Corso, Daniel Hind, Daniel Beever, Gordon Fuller, Matthew J Wilson, Ian J Wrench, Duncan Chambers
BACKGROUND: The rate of elective Caesarean Section (CS) is rising in many countries. Many obstetric units in the UK have either introduced or are planning to introduce enhanced recovery (ER) as a means of reducing length of stay for planned CS. However, to date there has been very little evidence produced regarding the necessary components of ER for the obstetric population. We conducted a rapid review of the composition of published ER pathways for elective CS and undertook an umbrella review of systematic reviews evaluating ER components and pathways in any surgical setting...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28319472/infective-endocarditis-in-children-an-update
#8
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/28319411/does-thromboprophylaxis-cause-bleeding-after-laparoscopic-cholecystectomy
#9
R H Gundogdu, M Oduncu, B O Bozkirli, M O Yazicioglu, S Akbaba
OBJECTIVES: This study reports the results of a single center experience on the use of pharmacological venous thromboembolism (VTE) prophylaxis in laparoscopic cholecystectomy patients. BACKGROUND: The prevention of VTE is of crucial importance in surgical practice. However, the severity of thromboembolism risk and the necessity of thromboprophylaxis for laparoscopic cholecystectomy is still being debated. METHODS: The data of the patients, who underwent laparoscopic cholecystectomy for symptomatic cholelitiasis in a single center between the years 2005 and 2015 were analysed retrospectively for incidents of symptomatic VTE and bleeding complications...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28318531/national-survey-on-postoperative-care-and-treatment-circuits-in-neurosurgery
#10
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28301615/topical-approaches-to-improve-surgical-outcomes-and-wound-healing-a-review-of-efficacy-and-safety
#11
Kristin Totoraitis, Joel L Cohen, Adam Friedman
<p>Surgical procedures are an important piece of a dermatologist's daily practice. Therefore, the optimization of post-surgical wound healing is an area of utmost importance and interest. Although low risk, one notable barrier to proper wound healing is surgical site infection.</p> <p>In an attempt to mitigate this risk and improve surgical outcomes, multiple topical products continue to be used both pre- and postprocedure. Traditionally, this includes both topical antibiotics and antiseptics...
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28297002/use-of-computerized-clinical-decision-support-systems-to-prevent-venous-thromboembolism-in-surgical-patients-a-systematic-review-and-meta-analysis
#12
Zachary M Borab, Michael A Lanni, Michael G Tecce, Christopher J Pannucci, John P Fischer
Importance: Health care professionals do not adequately stratify risk or provide prophylaxis for venous thromboembolism (VTE) among surgical patients. Computerized clinical decision support systems (CCDSSs) have been implemented to assist clinicians and improve prophylaxis for VTE. Objective: To evaluate the effect of implementing CCDSSs on the ordering of VTE prophylaxis and the rates of VTE. Data Sources: PubMed, MEDLINE via OVID, EMBASE via OVID, Scopus, Cochrane CENTRAL Register of Controlled Trials, and clinicaltrials...
March 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28295643/prophylaxis-of-lymphocele-formation-after-kidney-transplantation-via-peritoneal-fenestration-a-systematic-review
#13
André Leopold Mihaljevic, Patrick Heger, Sepehr Abbasi Dezfouli, Mohammad Golriz, Arianeb Mehrabi
BACKGROUND: Lymphocele formation after kidney transplantation is a frequent complication which causes pain, secondary graft loss, rehospitalisations and reoperations. Therefore prophylaxis of lymphocele formation is of utmost importance. OBJECTIVE: To assess the effectiveness of peritoneal fenestration in renal transplantation to prevent lymphocele development METHODS: A systematic literature search was conducted combined with hand-searches on lymphocele prevention following renal transplantation using peritoneal fenestration...
March 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28286820/deep-vein-thrombosis-among-intensive-care-unit-patients-an-epidemiologic-study
#14
MirMohammad Miri, Reza Goharani, Mohammad Sistanizad
INTRODUCTION: Deep vein thrombosis (DVT) is a major cause of morbidity and mortality in intensive care unit (ICU) patients despite use of prophylactic anticoagulant therapy. The aim of the present study was to determine the incidence of DVT among medical and surgical ICU patients. METHODS: In this cross sectional study, patients older than 18 years who were hospitalized in the ICU of Imam Hossein educational Hospital, Tehran, Iran, for ≥ 2 days, during August 2008 to July 2011 were evaluated regarding DVT incidence...
2017: Emergency (Tehran, Iran)
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
#15
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/28282002/the-efficacy-of-dextran-40-as-a-venous-thromboembolism-prophylaxis-strategy-in-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#16
Jason M Foster, Richard Sleightholm, Duncan Watley, Steven Wahlmeier, Asish Patel
The incidence of venous thromboembolism (VTE) in peritoneal malignancies can approach 30 to 50 per cent without prophylaxis. Prophylaxis in cytoreductive surgeries (CRS) presents a challenge to preoperative heparin-based therapy because of an increased risk of coagulopathy and potential for bleeding. Herein, we report the large series of CRS and hyperthermic intraperitoneal chemotherapy receiving dextran-40 prophylaxis. Retrospective chart review of peritoneal malignancies patients undergoing CRS at University of Nebraska Medical Center identified 69 individuals who received dextran-40 between 2010 and 2013...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28281497/management-of-brain-tumor-related-epilepsy
#17
REVIEW
Neil V Klinger, Aashit K Shah, Sandeep Mittal
Seizures are common in both primary and metastatic brain tumors, although the rate of seizures differ significantly between the different types of neoplasms. Patients with brain tumor-associated seizures need treatment with antiepileptic drugs (AEDs) to prevent recurrence, whereas strong clinical data exists to discourage routine prophylaxis in patients who have not had seizures. The newer AEDs, such as levetiracetam, lamotrigine, lacosamide, topiramate, or pregabalin, are preferable for various reasons, primarily related to the side-effect profile and limited interactions with other drugs...
2017: Neurology India
https://www.readbyqxmd.com/read/28281234/portomesenteric-vein-thrombosis-post-laparoscopic-sleeve-gastrectomy-case-series-and-literature-review
#18
S Alman AlSabah, Mohammed AlRuwaished, Sulaiman Almazeedi, Eliana Al Haddad, Elie Chouillard
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is today one of the leading procedures in bariatric surgery, and portomesenteric vein thrombosis (PMVT) has been reported as one of its rare complications. The purpose of this study is to determine the prevalence, clinical presentation, and outcomes of PMVT in patients undergoing LSG. METHODS: A retrospective study of a database of all post-LSG patients was conducted on the patients who developed PMVT post-LSG from July 2011 to March 2016, at Amiri Hospital, Kuwait...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28277989/dialkylcarbamoyl-chloride-dacc-coated-dressings-in-the-management-and-prevention-of-wound-infection-a-systematic-review
#19
J P Totty, N Bua, G E Smith, A E Harwood, D Carradice, T Wallace, I C Chetter
OBJECTIVE: Dialkylcarbomoyl chloride (DACC)-coated dressings (Leukomed Sorbact and Cutimed Sorbact) irreversibly bind bacteria at the wound surface that are then removed when the dressing is changed. They are a recent addition to the wound care professional's armamentarium and have been used in a variety of acute and chronic wounds. This systematic review aims to assess the evidence supporting the use of DACC-coated dressings in the clinical environment. METHOD: We included all reports of the clinical use of DACC-coated dressings in relation to wound infection...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28274069/florid-osseous-dysplasia-report-of-two-cases-and-review-of-literature
#20
Gayathri Mahalingam, G V Murali Gopika Manoharan
Florid osseous dysplasia is a rare benign fibro-osseous multiquadrant dysplastic lesion confined to the alveolar process of jaws, generally asymptomatic and usually detected incidentally during radiologic examination and requires no treatment unless symptomatic or cosmetically concerning. In this article, we present two rare cases of florid osseous dysplasia in Indian women with their clinical, radiographic and histologic findings and a brief review of literature. The first case was asymptomatic and the lesion was detected during routine radiographic examination and required no treatment whereas, the second case presented with features of osteomyelitis...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
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