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https://www.readbyqxmd.com/read/29656387/a-nationwide-analysis-of-30-day-adverse-events-unplanned-readmission-and-length-of-hospital-stay-after-peripheral-nerve-surgery-in-extremities-and-the-brachial-plexus
#1
Enrico Martin, Ivo S Muskens, Joeky T Senders, David J Cote, Timothy R Smith, Marike L D Broekman
BACKGROUND: Little is known on adverse events and their timing after peripheral nerve surgery in extremities. The aim of this study is to identify predictors and typical timing of complications, unplanned readmission, and length of hospital stay for patients undergoing peripheral nerve surgery in the extremities. METHODS: Data were extracted from the National Surgical Quality Improvement Program (NSQIP) registry from 2005 to 2015. Adult patients undergoing peripheral nerve surgery in the extremities were included...
April 15, 2018: Microsurgery
https://www.readbyqxmd.com/read/29655672/effect-of-pulsed-xenon-ultraviolet-room-disinfection-devices-on-microbial-counts-for-methicillin-resistant-staphylococcus-aureus-and-aerobic-bacterial-colonies
#2
John E Zeber, Christopher Pfeiffer, John W Baddley, Jose Cadena-Zuluaga, Eileen M Stock, Laurel A Copeland, Janet Hendricks, Jwan Mohammadi, Marcos I Restrepo, Chetan Jinadatha
BACKGROUND: Inadequate environmental disinfection represents a serious risk for health care-associated infections. Technologic advancements in disinfection practices, including no-touch devices, offer significant promise to improve infection control. We evaluated one such device, portable pulsed xenon ultraviolet (PX-UV) units, on microbial burden during an implementation trial across 4 Veterans Affairs hospitals. METHODS: Environmental samples were collected before and after terminal room cleaning: 2 facilities incorporated PX-UV disinfection into their cleaning protocols and 2 practiced manual disinfection only...
April 11, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29652296/validation-of-the-aast-egs-grade-for-skin-and-soft-tissue-infection
#3
Mohamed D Ray-Zack, Matthew C Hernandez, Moustafa Younis, Wyatt B Hoch, Dylan S Soukup, Nadeem Haddad, Martin D Zielinski
INTRODUCTION: Skin and soft tissue infections (SSTI) present with variable severity. The American Association for the Surgery of Trauma (AAST) developed an emergency general surgery (EGS) grading system for several diseases. We aimed to determine whether the AAST EGS grade corresponds with key clinical outcomes. METHODS: Single institution retrospective review of patients (≥18 years) admitted with SSTI during 2012-2016 was performed. Patients with surgical site infections or <18 years were excluded...
February 27, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29650263/-should-surgeons-keep-performing-drainage-after-breast-reduction
#4
N Vidali, A Chevet-Noel, P Ringenbach, J B Andreoletti
OBJECTIVE: Despite the absence of "evidence-based medicine", the use of closed suction drainage in breast surgery is currently the standard practice. Its goal is to minimize the amount of fluid at the operation site, the dead space that can involve postoperative complications. The purpose of this study is to demonstrate that with or without drainage the complication rate is unchanged. METHODS: We conducted a retrospective and comparative study of two groups of breast reduction with and without drainage...
April 9, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29649915/filifactor-alocis-manipulates-human-neutrophils-affecting-their-ability-to-release-neutrophil-extracellular-traps-induced-by-pma
#5
Cortney L Armstrong, Christopher K Klaes, Aruna Vashishta, Richard J Lamont, Silvia M Uriarte
Neutrophils operate at the site of injury or inflammation in the periodontal pocket to ensure periodontal health and clearance of bacterial pathogens. Filifactor alocis is recently identified as a potential periodontal pathogen, and in this study, we assessed the formation of neutrophil extracellular traps (NETs), in response to the presence of the organism . NET formation by human neutrophils was not induced when challenged with F. alocis, independent of opsonization, viability, time, or bacterial dose. F...
January 1, 2018: Innate Immunity
https://www.readbyqxmd.com/read/29643543/-airway-foreign-body-caused-by-aspiration-of-artificial-nasal-sponge-a-case-report
#6
T X Fu, X Wang, M L Liu
57-year-old male was admitted to hospital for severe headache and seizure attacks on November 6th, 2016. After radiology and spinal fluid examination, he was diagnosed with viral encephalitis and treated with antiviral medicine, antibiotics and mannitol, but he was in sustained unconsciousness and weak in expectorating. The patient was given oxygen through artificial nasal after bedside tracheotomy. At 1:00 am on January 12th, 2016, there was a sudden drop in blood pressure, heart rate and oxygen saturation with left lung breath sounds slightly lower than the other side...
April 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29642728/tunnelling-a-midline-catheter-when-the-traffic-light-shifts-from-yellow-to-green
#7
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
INTRODUCTION: A safe, largely used practice for difficult venous access patients is positioning a catheter in deeper veins under ultrasound guide. However, the risk of complications is increased when there is a high catheter-to-vein ratio or when the insertion site is in a zone with particular anatomical/physiological characteristics. CASE DESCRIPTION: A 60-year-old woman admitted to a post-operative intensive care unit after cardiac surgery had a complicated post-operative course...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29629896/the-v-y-flap-technique-in-complicated-and-recurrent-pilonidal-sinus-disease
#8
Yavuz Savas Koca, Ihsan Yıldız, Mustafa Ugur, Ibrahim Barut
OBJECT VES: This study presents early and long term (5 years) outcome of 61 complicated pilonidal sinus disease cases undergoing V-Y advancement flap method together with the literature data. METHOD: Data of 336 patients undergoing surgery for pilonidal sinus disease between 2008 and 2012 were retrospectively analyzed. Patients with defect size ≥ 10 cm, and more than one subcutaneous sinus tunnels were assumed to have complicated pilonidal sinus disease. A total of 61 patients were included in the study...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29629890/infective-complications-after-free-flaps-reconstruction-in-patients-affected-by-head-and-neck-cancer-our-experience-on-77-cases
#9
Giovanni Dell'Aversana Orabona, Raffaele Corvino, Fabio Maglitto, Vincenzo Abbate, Paola Bonavolontà, Antonio Romano, Giovanni Salzano, Luigi Califano
AIM: The success rates of free flaps in patients undergoing head and neck cancer (HNC) surgery are very high (95%- 97%) but the development of a surgical site infection (SSI) can put flap viability at risk. The aim of our study is to identify the risk factors for SSI in patients undergo free flaps reconstruction after head and neck cancer removal. MATERIAL OF STUDY: Seventyseven patients (44 male and 33 female) from April 2006 to April 2015 admitted at the Department of Maxillofacial Surgery of the University of Naples "Federico II" were included in this study...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29629584/improving-quality-and-safety-in-paediatric-spinal-surgery
#10
F Miyanji, B Greer, S Desai, J Choi, J Mok, M Nitikman, A Morrison
Aims The aim of this study was to evaluate improvements in the quality and safety of paediatric spinal surgery following the implementation of a specialist Paediatric Spinal Surgical Team (PSST) in the operating theatre. Patients and Methods A retrospective consecutive case study of paediatric spinal operations before (between January 2008 and December 2009), and after (between January 2012 and December 2013) the implementation of PSST, was performed. A comparative analysis of outcome variables including surgical site infection (SSI), operating time (ORT), blood loss (BL), length of stay (LOS), unplanned staged procedures (USP) and transfusion rates (allogenic and cell-saver) was performed between the two groups...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29628671/scrotal-reconstruction-with-integra-following-necrotizing-fasciitis
#11
Briar L Dent, Anant Dinesh, Khuram Khan, Ryan Engdahl
Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. IntegraTM bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. We report the successful use of Integra and a subsequent split-thickness skin graft for reconstruction of the anterior scrotum and coverage of the exposed testes in a 43-year-old man who developed Group A Streptococcus necrotizing fasciitis of his right lower extremity, groin, and scrotum requiring serial operative debridements...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29627850/clinical-outcomes-with-the-corticotomy-first-technique-associated-with-the-ilizarov-method-for-the-management-of-the-septic-long-bones-non-union
#12
Gamal Ahmed Hosny, Abdel-Salam Abdel-Aleem Ahmed, Mohamed Abd-Elaal Hussein
PURPOSE: Corticotomy is an integral part of the Ilizarov method on management of infected nonunited fractures that are challenging orthopaedic surgeons. However, the presence of active draining sinuses may contaminate the operative field with the potential of developing corticotomy site infection. The authors present a surgical technique aiming at minimizing or avoiding the risk of surgical site infection (SSI) in the corticotomy zone. PATIENTS AND METHODS: A total of 144 cases of draining infected nonunions were treated by Ilizarov fixator using the corticotomy-first technique...
April 7, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29626286/multidetector-ct-of-expected-findings-and-complications-after-hysterectomy
#13
REVIEW
Massimo Tonolini
Indicated to manage a variety of disorders affecting the female genital tract, hysterectomy represents the second most common gynaecological operation after caesarean section. Performed via an open, laparoscopic or vaginal approach, hysterectomy is associated with non-negligible morbidity and occasional mortality. Iatrogenic complications represent a growing concern for gynaecologists and may result in prolonged hospitalisation, need for interventional procedures or repeated surgery, renal impairment and malpractice claims...
April 6, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29624484/early-inflammatory-biomarkers-as-predictive-factors-for-freedom-from-infection-after-colorectal-cancer-surgery-a-prospective-cohort-study
#14
André Goulart, Carla Ferreira, Alexandra Estrada, Fernanda Nogueira, Sandra Martins, António Mesquita-Rodrigues, Nuno Sousa, Pedro Leão
PURPOSE: Different biomarkers are useful in diagnosing infections. The aim of this work was to clarify the relation between different inflammatory biomarkers (white blood cell [WBC] count, C-reactive protein [CRP], procalcitonin [PCT], and C-reactive protein-to-albumin ratio [CAR]) and early infectious complications after colorectal surgery. METHODS: This prospective single-center cohort study included 130 patients undergoing elective colorectal surgery. The WBC count, CRP, and PCT were measured at post-operative day one (POD1) and POD3 and albumin on POD3...
April 6, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29624409/validation-of-a-host-response-assay-septicyte%C3%A2-lab-for-discriminating-sepsis-from-sirs-in-the-icu
#15
Russell R Miller Iii, Bert K Lopansri, John P Burke, Mitchell Levy, Steven Opal, Richard E Rothman, Franco R D'Alessio, Venkataramana K Sidhaye, Neil R Aggarwal, Robert Balk, Jared A Greenberg, Mark Yoder, Gourang Patel, Emily Gilbert, Majid Afshar, Jorge P Parada, Greg S Martin, Annette M Esper, Jordan A Kempker, Mangala Narasimhan, Adey Tsegaye, Stella Hahn, Paul Mayo, Tom van der Poll, Marcus J Schultz, Brendon P Scicluna, Peter Klein Klouwenberg, Antony Rapisarda, Therese A Seldon, Leo C McHugh, Thomas D Yager, Silvia Cermelli, Dayle Sampson, Victoria Rothwell, Richard Newman, Shruti Bhide, James T Kirk, Krupa Navalkar, Roy F Davis, Roslyn A Brandon, Richard B Brandon
RATIONALE: A molecular test to distinguish between sepsis and systemic inflammation of non-infectious etiology could potentially have clinical utility. OBJECTIVES: This study evaluated the diagnostic performance of a molecular host response assay (SeptiCyte™ LAB) designed to distinguish between sepsis and non-infectious systemic inflammation in critically ill adults. METHODS: The study employed a prospective, observational, non-interventional design, and recruited a heterogeneous cohort of adult critical care patients from seven sites in the USA (N=249)...
April 6, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29624147/risk-factors-for-surgical-site-infection-after-intracranial-electroencephalography-monitoring-for-epilepsy-in-the-pediatric-population
#16
Ying Meng, Mathew R Voisin, Suganth Suppiah, Zamir Merali, Ali Moghaddamjou, Naif M Alotaibi, Arbelle Manicat-Emo, Shelly Weiss, Cristina Go, Blathnaid McCoy, Elizabeth J Donner, James T Rutka
OBJECTIVE Intracranial electroencephalography (iEEG) monitoring is an important method of identifying the seizure focus in patients with medically refractory epilepsy. While previous studies have demonstrated low rates of surgical complications, reported rates of surgical site infection (SSI) are highly variable. To date, no studies have specifically evaluated the patient or operative risk factors contributing to SSI. The goals of this study were to examine the rate of SSI after iEEG monitoring for epilepsy workup in pediatric patients and to determine the variables that might contribute to the development of SSI...
April 6, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29623673/the-relationship-between-age-and-chronic-kidney-disease-in-patients-undergoing-pancreatic-resection
#17
Derrick Antoniak, Chandrakanth Are, Chad Vokoun, Kaeli Samson, Lynette Smith, Jason Shiffermiller
BACKGROUND: Severe chronic kidney disease (CKD) predicts adverse outcomes in patients undergoing pancreatectomy, but the impact of milder CKD is unknown. Additionally, some authors have suggested that, due to physiologic changes of aging, CKD is over-diagnosed in patients above age 65. METHODS: Patients undergoing pancreatectomy for malignancy from 2005 to 2014 were identified from the National Surgical Quality Improvement Program. Primary outcomes were all-cause mortality and major complication, defined as myocardial infarction, cardiac arrest, stroke, venous thromboembolism, respiratory failure, deep surgical site infection, pneumonia, acute kidney injury, coma > 24 h, or re-operation occurring within 30 days of surgery...
April 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29623470/laparoscopy-in-management-of-appendicitis-in-high-middle-and-low-income-countries-a-multicenter-prospective-cohort-study
#18
(no author information available yet)
BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study...
April 5, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29623100/youth-health-outcomes-from-the-connect-to-protect-coalitions-to-prevent-adolescent-hiv-infections
#19
Robin Lin Miller, Kyung-Sook Lee, Danielle Chiaramonte, Olga J Santiago-Rivera, Ignacio Acevedo-Polakovich, Cherrie B Boyer, Jonathan M Ellen
We assessed the relationships among HIV-related social and behavioral outcomes resulting from an adolescent-focused HIV structural change initiative in eight urban sites operating Connect to Protect (C2P) coalitions. Over a 4-year period, annual cross-sectional panels of adolescents (N = 2,248) completed an audio-computer-assisted interview, providing data on satisfaction with their communities as adolescent-supportive environments, internalized HIV stigma, lifetime HIV-testing, lifetime sexual risk-taking, and number of sexual partners in the prior year...
2018: Vulnerable Children and Youth Studies
https://www.readbyqxmd.com/read/29622354/perioperative-risk-factors-for-hospital-readmission-after-elective-endovascular-aortic-aneurysm-repair
#20
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Fady Gabra, Roy M Fujitani
BACKGROUND: Elective endovascular aneurysm repair (EVAR) is generally well tolerated. However, the incidence of hospital readmission after EVAR and the risk factors and reasons for it are not well studied. This study sought to determine the incidence, to characterize the indications, and to identify perioperative patient-centered risk factors for hospital readmission within 30 days after elective EVAR. METHODS: All patients who underwent EVAR electively in 2012 to 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program Targeted Vascular database (n = 3886)...
April 2, 2018: Journal of Vascular Surgery
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