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Surgical prophylaxis

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https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#1
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28077533/cefalotin-as-antimicrobial-prophylaxis-in-patients-with-known-intraoperative-anaphylaxis-to-cefazolin
#2
P H M Sadleir, R C Clarke, P R Platt
BACKGROUND: The most common trigger for intraoperative anaphylaxis in Western Australia for the period 2014-5 was an antibiotic used for surgical prophylaxis, cefazolin. In these patients who subsequently present for surgery, alternative cephalosporins are forbidden by current guidelines because of concerns regarding an increased risk of anaphylaxis. However, consideration of the structure-activity relationships relevant to anaphylaxis suggests that cefalotin is a safe alternative because of structural dissimilarities, although there are no pubished clinical data relevant to the perioperative setting...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28076624/quadricuspid-aortic-valve-a-comprehensive-review
#3
Shi-Min Yuan
Quadricuspid aortic valve (QAV) is a rare congenital heart disease. The functional status of QAV is predominantly a pure aortic regurgitation. Clinical manifestations of patients with a QAV depend on the functional status of the QAV and the associated disorders. Significant valvular regurgitation and (or) stenosis is often present with subsequent operation performed at the fifth to sixth decade of life. The functional status of QAV is predominantly regurgitant; whereas pure stenotic QAV can be as few as in only 0...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28074295/-neuraxial-anaesthesia-and-noacs
#4
T Standl
BACKGROUND: Cardiovascular comorbidities in surgical patients are frequent and have a substantial impact on the postoperative outcome. Neuraxial blockades are able to reduce perioperative morbidity and mortality. The increasing use of new oral anticoagulants (NOAC) requires a high level of attention, especially in patients undergoing neuraxial blockades or requiring postoperative analgesia. OBJECTIVE: The goal of this article is to present the benefit of neuraxial anaesthesia and analgesia in patients with cardiovascular risks and perioperative management of NOAC in this setting...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28071948/current-practice-of-antibiotic-prophylaxis-during-elective-laparoscopic-cholecystectomy
#5
Caw Macano, E A Griffiths, R S Vohra
INTRODUCTION Current guidelines do not recommend antibiotic prophylaxis in elective laparoscopic cholecystectomy. Despite this, there is wide variation in antibiotic prophylaxis during cholecystectomy in population-based studies. The aim of this survey was to establish the current rationale for antibiotic prophylaxis in elective laparoscopic cholecystectomy. METHODS A short questionnaire was designed and disseminated across collaborators for a population-based study investigating outcomes following cholecystectomy and via the Association of Upper Gastrointestinal Surgeons, Researchgate and Surginet membership...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28069040/anti-inflammatory-and-immune-regulatory-effects-of-acupuncture-after-craniotomy-study-protocol-for-a-parallel-group-randomized-controlled-trial
#6
Seung-Yeon Cho, Seung-Bo Yang, Hee Sup Shin, Seung Hwan Lee, Jun Seok Koh, Seungwon Kwon, Woo-Sang Jung, Sang-Kwan Moon, Jung-Mi Park, Chang-Nam Ko, Seong-Uk Park
BACKGROUND: Despite recent advances in the medical and surgical fields, complications such as infection, pneumonia, or brain swelling may occur after a craniotomy. In some patients, perioperative antibiotic prophylaxis causes adverse effects such as itching, rash, or digestive conditions. Certain patients still develop infections severe enough to require a repeat operation despite antibiotic prophylaxis. Acupuncture has been used to treat inflammatory conditions, and many basic and clinical studies have provided evidence of its anti-inflammatory and immune regulatory effects...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28067086/-prospective-randomized-study-regarding-the-effect-of-the-preoperative-antibiotic-and-chlorhexidine-rinse-on-wound-healing-after-mandibular-third-molar-surgery
#7
István Kaposvári, Kinga Körmöczi, Zsuzsa Beáta László, Ferenc Oberna, Ferenc Horváth, Árpád Joób-Fancsaly
INTRODUCTION AND AIM: The study compares the antibiotic prophylaxis combined with postoperative antibiotic therapy to preoperative chlorhexidine rinse combined with postoperative antibiotic therapy in preventing complications after surgical removal of a mandibular third molar. METHOD: 71 healthy patients in four groups were enrolled in the study: I. prophylactic dose of 2000 mg of amoxicillin clavulanate, continued with amoxicillin clavulanate postoperatively; II...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28063606/-assessment-of-antibiotic-use-and-impact-of-an-intervention-intended-to-modify-the-prescribing-behavior-in-surgical-prophylaxis-in-6hospitals-in-the-metropolitan-area-of-monterrey-mexico
#8
Gerardo Del Carmen Palacios-Saucedo, Mauricio de la Garza-Camargo, Evangelina Briones-Lara, Sandra Carmona-González, Ricardo García-Cabello, Luis Arturo Islas-Esparza, Gustavo Saldaña-Flores, Juan Roberto González-Cano, Román González-Ruvalcaba, Francisco Javier Valadez-Botello, Gerardo Enrique Muñoz-Maldonado, Carlos Alberto Montero-Cantú, Rita Delia Díaz-Ramos, Fortino Solórzano-Santos
BACKGROUND: Improper use of antibiotics increases antimicrobial resistance. OBJECTIVE: Evaluate the use of antibiotics and the impact of an intervention designed to improve antibiotic prescription for surgical prophylaxis in 6 hospitals of Monterrey, Mexico. MATERIAL AND METHODS: Design: A prospective multicenter survey and a pretest-postest experimental study. Phase 1: Survey to evaluate the use of antibiotics through an especially designed guide...
January 4, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28062950/efficacy-and-safety-of-folfirinox-in-locally-advanced-pancreatic-cancer-a-single-center-experience
#9
G Lakatos, A Petranyi, A Szűcs, L Nehéz, L Harsanyi, P Hegyi, G Bodoky
The management of locally advanced pancreatic cancer (LAPC) is a major challenge. Although new drugs are available for the treatment of metastatic disease, the optimal treatment of non-metastatic cases remains controversial. The role of neoadjuvant therapy is still a question of debate in this setting. The aim of the study was to prospectively collect and analyse data on efficacy and safety of a modified FOLFIRINOX regimen in LAPC patients treated in a single institution. Another major objective was to assess the capability of FOLFIRINOX to render primary non-resectable cancer to resectable...
January 6, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28052483/natural-language-processing-to-ascertain-two-key-variables-from-operative-reports-in-ophthalmology
#10
Liyan Liu, Neal H Shorstein, Laura B Amsden, Lisa J Herrinton
PURPOSE: Antibiotic prophylaxis is critical to ophthalmology and other surgical specialties. We performed natural language processing (NLP) of 743 838 operative notes recorded for 315 246 surgeries to ascertain two variables needed to study the comparative effectiveness of antibiotic prophylaxis in cataract surgery. The first key variable was an exposure variable, intracameral antibiotic injection. The second was an intraoperative complication, posterior capsular rupture (PCR), which functioned as a potential confounder...
January 3, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28044933/should-arterial-embolization-in-recurrent-spontaneous-hemophilic-hemarthroses-refractory-to-intensive-prophylaxis-be-the-first-invasive-resort
#11
E Carlos Rodriguez-Merchan
This paper reviews the role of arterial embolization (AE) in recurrent spontaneous hemarthroses (RSH) that are refractory to intensive prophylaxis (RIP) in people with hemophilia (PWH). There are six articles in the literature on the topic. The total number of AEs performed so far is 78 in 69 patients. Four second AEs were required (4/78), and a third AE in one (1/78). No serious adverse effects have been reported except for a pseudoaneurym (1/78) of the femoral artery at the puncture site (that eventually required surgical repair) and for one patient (1/78) that had recurrence of bleeding for whom surgical exploration was required...
December 16, 2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28042400/incidence-and-etiology-of-surgical-site-infections-in-appendectomies-a-3-year-prospective-study
#12
Humberto Guanche Garcell, Ariadna Villanueva Arias, Cristobal A Pancorbo Sandoval, Elias Guilarte García, Moraima E Valle Gamboa, Adam Bode Sado, Ramón N Alfonso Serrano
OBJECTIVES: Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks. METHODS: We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28034354/recombinant-activated-factor-vii-eptacog-alfa-activated-novoseven-%C3%A2-in-patients-with-rare-congenital-bleeding-disorders-a-systematic-review-on-its-use-in-surgical-procedures
#13
Matteo Nicola Dario Di Minno, Pasquale Ambrosino, Veronika A Myasoedova, Manuela Amato, Itala Ventre, Elena Tremoli, Alessandro Di Minno
In the absence of definite guidelines in the area, we have carried a systemic review to provide a thorough overview concerning the efficacy and safety of recombinant activated factor VII (rFVIIa, NovoSeven®, Novo Nordisk A/S, Bagsværd, Denmark) in patients with Glanzmann's thrombasthenia (GT) and FVII deficiency, undergoing surgical procedures. PubMed, Web of Science, Scopus and EMBASE databases was employed for the search. Three multicenter registries were identified: the Glanzmann's Thrombasthenia Registry (GTR), the Seven Treatment Evaluation Registry (STER), and a German post-marketing surveillance registry (the WIRK study)...
December 30, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28027730/vancomycin-paste-does-not-reduce-the-incidence-of-deep-sternal-wound-infection-after-cardiac-operations
#14
Heather L Lander, Julius I Ejiofor, Siobhan McGurk, Kaneko Tsuyoshi, Prem Shekar, Simon C Body
BACKGROUND: Deep sternal wound infection (DSWI) is a devastating complication that increases morbidity and death in cardiac surgical patients. Vancomycin is often administered intravenously for antibiotic prophylaxis in cardiac operations. Many cardiac surgeons also apply vancomycin paste topically to the sternal edges. We examined the effect of vancomycin paste on the incidence of DSWI in patients undergoing elective cardiac operations. METHODS: We retrospectively reviewed the medical records of all patients from 2003 to 2015 who underwent coronary artery bypass grafting, valve, or combined coronary artery bypass grafting and valve operations at a single institution...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28027257/evidence-based-medicine-reduction-mammaplasty
#15
Richard Greco, Barrett Noone
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand the multiple reduction mammaplasty techniques available for patients and describe the advantages and disadvantages associated with each. 2. Describe the indications for the treatment of macromastia in patients younger than 18 years. 3. Identify the preoperative indications for breast imaging before surgery. 4. Describe the benefits of breast infiltration with local anesthesia with epinephrine before surgery...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28026130/efficacy-and-safety-of-a-vwf-fviii-concentrate-wilate-%C3%A2-in-inherited-von-willebrand-disease-patients-undergoing-surgical-procedures
#16
A Srivastava, M Serban, S Werner, B A Schwartz, C M Kessler
INTRODUCTION: Surgical procedures in von Willebrand disease (VWD) patients may require prophylactic treatment with exogenous von Willebrand factor (VWF) and coagulation factor VIII (FVIII) to prevent excessive bleeding. Wilate(®) is a plasma-derived, double virus-inactivated, highly purified, freeze-dried VWF/FVIII concentrate, containing both factors in a physiological activity ratio of 1:1. AIM: To investigate the efficacy and safety of wilate(®) in maintaining haemostasis in VWD patients undergoing surgical procedures...
December 27, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28025309/safety-and-efficacy-of-prophylactic-negative-pressure-wound-therapy-following-open-saphenous-vein-harvest-in-cardiac-surgery-a-feasibility-study
#17
Arthur J Lee, Christina E Sheppard, William D T Kent, Holly Mewhort, Khokan C Sikdar, Paul W M Fedak
OBJECTIVES: Surgical site complications following great saphenous vein (GSV) harvest presents a significant risk of morbidity. Negative pressure wound therapy (NPWT) has shown promise in the treatment and prophylaxis of open wounds and surgical incisions but has not been studied following GSV harvest. We performed a feasibility study examining the use of NPWT following GSV harvest for coronary bypass surgery. METHODS: Sixty-four patients were recruited in this single-centre, single-blind, randomized controlled trial...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28019140/cutaneous-mucormycosis-as-result-of-insulin-administration-in-an-aml-patient-case-report-and-review-of-the-literature
#18
Anke Delie, Philip Vlummens, David Creytens, Eva Steel
We present a case of cutaneous mucormycosis in a patient with several important risk factors precipitating disease, namely underlying acute myeloid leukaemia and poorly controlled secondary diabetes. Inoculation was most likely caused by repeated minor trauma (insulin injection) at the site of infection. Treatment consisted of surgical debridement and liposomal Amphotericin B (LAmB) during 71 days. Posaconazole had already been initiated prior to infection as primary antifungal prophylaxis but was discontinued during follow-up as susceptibility testing later revealed resistance to posaconazole...
December 26, 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28010057/-assessment-of-antibiotic-prophylaxis-adequacy-in-rectal-surgery
#19
J A Del-Moral-Luque, E Colás-Ruiz, P Gil-Yonte, J M Fernández-Cebrián, M C Villar-Del-Campo, A Delgado-Iribarren, J F Valverde-Cánovas, G Rodríguez-Caravaca
OBJECTIVE: Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection (SSI), so the development of guidelines and assessment of its monitoring is essential. In this study protocol compliance of antibiotic prophylaxis in rectal surgery and the effect of its adequacy in terms of pre-ention of SSI was assessed. METHODS: Prospective cohort study was conducted from 1 January 2009 to 30 December 2015. The degree of compliance with antibiotic prophylaxis and causes of non-compliance in rectal surgery was evaluated...
December 23, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28009779/carbapenem-resistant-enterobacteriaceae-acquired-before-liver-transplantation-impact-on-recipient-outcomes
#20
M P Freire, I C V S Oshiro, L C Pierrotti, P R Bonazzi, L M de Oliveira, A T W Song, C H Camargo, I M van der Heijden, F Rossi, S F Costa, L A C D'Albuquerque, E Abdala
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) is an emergent microorganism of infections after liver transplant (LT). The aim of this study was to analyze the risk factors for CRE acquisition and infection after LT. METHODS: This was a prospective cohort study involving patients who underwent LT in the 2010-2014 period. Surveillance cultures for CRE were collected immediately before LT and weekly thereafter until hospital discharge. RESULTS: We analyzed 386 patients undergoing a total of 407 LTs...
December 22, 2016: Transplantation
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