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tertiary hospital infection

Dnyaneshwar D Athavale, Robin Jones, Brett A O'Donnell, Martin Forer, Nigel Biggs
PURPOSE: To describe the non-exenteration management of sino-orbital fungal infection, a life-threatening condition for which orbital exenteration is generally considered a first-line treatment. METHODS: A retrospective case series is presented of 7 orbits in 6 consecutive patients admitted and treated at 2 major metropolitan tertiary teaching hospitals in Sydney, New South Wales, Australia. RESULTS: Seven orbits in 6 consecutive patients with sino-orbital fungal infection were treated conservatively with surgical debridement and intravenous antifungal agents...
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
E B Thorgersen, M A Goscinski, M Spasojevic, A M Solbakken, A B Mariathasan, K Boye, S G Larsen, K Flatmark
BACKGROUND: High morbidity, increased mortality, and impaired long-term oncologic outcome have been reported after deep surgical site infection (SSI) in rectal cancer surgery. The rate, risk factors and consequences of deep SSI after (chemo)radiotherapy [(C)RT], and surgery for locally advanced rectal cancer (LARC) in a tertiary university hospital single centre cohort of 540 patients are presented. METHODS: Patients with LARC, operated between January 1, 2007 and December 31, 2015, were identified in the institutional prospective database...
October 20, 2016: Annals of Surgical Oncology
Sebastien Breurec, Coralie Bouchiat, Jean-Marie Sire, Olivier Moquet, Raymond Bercion, Moussa Fafa Cisse, Philippe Glaser, Ousmane Ndiaye, Sidy Ka, Helene Salord, Abdoulaye Seck, Haby Signate Sy, Remy Michel, Benoit Garin
BACKGROUND: Neonatal infection constitutes one of Senegal's most important public health problems, with a mortality rate of 41 deaths per 1,000 live births. METHODS: Between January 2007 and March 2008, 242 neonates with suspected infection were recruited at three neonatal intensive care units in three major tertiary care centers in Dakar, the capital of Senegal. Neonatal infections were confirmed by positive bacterial blood or cerebrospinal fluid culture. The microbiological pattern of neonatal infections and the antibiotic susceptibility of the isolates were characterized...
October 20, 2016: BMC Infectious Diseases
Yarelis Alvarado Reyes, Alexandra Perez, Gloria Rodriguez-Vega
OBJECTIVE: Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency had any effect in aneurysmal subarachnoid hemorrhage (aSAH) clinical outcomes. METHODS: A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. Adult patients admitted to the neurosurgical intensive care unit (NICU) with a diagnosis of aSAH from January 2013 to July 2014, who had a 25-hydroxyvitamin-D level drawn, were included...
October 15, 2016: World Neurosurgery
Cameron C Wick, Daniel E Killeen, Michael Clark, Joe Walter Kutz, Brandon Isaacson
OBJECTIVE: Describe the diagnosis and management of spontaneous lateral skull base cerebrospinal fluid (CSF) leaks that originate from the posterior fossa. STUDY DESIGN: Retrospective case review. SETTING: Tertiary university hospital. PATIENTS: Adult patients from 2005 to 2015 who underwent surgical repair of a spontaneous lateral skull base CSF leak with intraoperative confirmation of a posterior fossa leak source...
October 14, 2016: Otology & Neurotology
Emily S Wong, Claire W Y Chow, W K Luk, Kitty S C Fung, Kenneth K W Li
PURPOSE: To characterize epidemiological data on methicillin-resistant Staphylococcus aureus (MRSA) ocular infections over a 10-year period in Hong Kong; to compare the characteristics between hospital-associated methicillin-resistant Staphylococcus aureus (h-MRSA) and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) ocular infections; and to review the treatment regimen and outcome of identified cases. METHODS: A retrospective case review of ocular samples testing positive for MRSA at a tertiary eye center from July 2005 to June 2015 was performed...
October 14, 2016: Cornea
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November 2016: Advances in Skin & Wound Care
Aaron Pinkhasov, Deepan Singh, Benjamin Kashan, Julie DiGregorio, Theresa M Criscitelli, Scott Gorenstein, Harold Brem
GENERAL PURPOSE: To provide information about the effect of psychiatric comorbidities on wound healing in patients with diabetes mellitus (DM). TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Discuss the connection between DM and the development of psychiatric comorbidities...
November 2016: Advances in Skin & Wound Care
Chan Joo Lee, Yeongmin Woo, Byeong-Keuk Kim, Kyung Bong Yoon, Hae-Young Lee, Sungha Park
A 30-year-old woman was referred to our hospital due to high blood pressure, dizziness, headache and blurred vision. She had past history of preeclampsia and gestational hypertension 4 years ago but she had not taken antihypertensive medication in spite of remained hypertension after delivery. She was hospitalized for fever due to urinary tract infection and severe hypertension which was above 210/140 mmHg. Despite maximal medical treatment with telmisartan 80 mg, nifedipine 120 mg, carvedilol 50 mg, doxazocin 8 mg, chlorthalidone 50 mg, spironolactone 50 mg#2, isosorbide dinitrate 80 mg and intermittent intravenous administration of nicardipine and labetalol, her systolic blood pressure remained above 160 mmHg and repeatedly measured above 200 mmHg...
September 2016: Journal of Hypertension
Adam W Bartlett, Ben Smith, C R Robert George, Brendan McMullan, Alison Kesson, Monica M Lahra, Dip Paed, Pamela Palasanthiran
BACKGROUND: Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (<7 days) GBS disease has been well characterized, whereas the epidemiology of late onset disease (LOD, 7-89 days) and very late onset disease (VLOD, ≥90 days) is less well understood. The aims of this study were to assess risk factors, presentation, management, and outcome for GBS LOD and VLOD. METHODS: Microbiology laboratory databases and hospital diagnostic coding for Sydney Children's Hospital and the Children's Hospital at Westmead were investigated for patients ≥ 7 days of age diagnosed with GBS bloodstream infection or meningitis from 1st January 2000 to 31st December 2014 (15 years)...
October 3, 2016: Pediatric Infectious Disease Journal
Ravinder Kaur Sachdeva, Aman Sharma, Surjit Singh, Subhash Varma
BACKGROUND & OBJECTIVES: There is scarcity of data on the frequency of malignancies in HIV infected individuals from India. The objective of this study was to determine the type and frequency of malignancies in HIV infected individuals attending a tertiary care hospital in north India. METHODS: The study design included retrospective analysis of data of all HIV infected individuals registered in the Immunodeficiency clinic from December 2009 to December 2011 and a prospective analysis of HIV infected individuals registered from January 2012 to April 2013...
May 2016: Indian Journal of Medical Research
Sabyasachi Paik, Agnik Pal, Sukanta Sen, Netai Pramanick, Santanu K Tripathi
A 23-year-old human immunodeficiency virus (HIV)-infected Indian woman was admitted to a tertiary care hospital with generalized erythematosus rash all over her body with difficulty in swallowing for the previous 3 days. She also presented with swelling of the lips and redness of both eyes along with nausea, anorexia, slight headache, and fever, which appeared immediately after the initiation of a new regime of antiretroviral treatment with tenofovir (300 mg once daily), lamivudine (300 mg once daily), and efavirenz (600 mg once daily)...
December 2015: Drug Saf Case Rep
Vishnu Kaniyarakkal, Shabana Orvankundil, Saradadevi Karunakaran Lalitha, Raji Thazhethekandi, Jahana Thottathil
Chromobacterium violaceum is a gram negative oxidase positive bacillus that causes human infections infrequently. It is a normal inhabitant of soil and stagnant water of the tropical and subtropical areas. In humans, it can cause infections ranging from life threatening sepsis with metastatic abscesses to skin infections and urinary tract infections. The organism is notoriously resistant to most cephalosporins and Ampicillin. Fluoroquinolones and aminoglycosides show good in vitro susceptibility. High mortality rates associated with these infections necessitate prompt diagnosis and appropriate antimicrobial therapy...
2016: Case Reports in Infectious Diseases
Stefan Erb, Reno Frei, Marc Dangel, Andreas F Widmer
BACKGROUND Infections and colonization with multidrug-resistant organisms (MDROs) identified >48 hours after hospital admission are considered healthcare-acquired according to the definition of the Centers for Disease Control and Prevention (CDC). Some may originate from delayed diagnosis rather than true acquisition in the hospital, potentially diluting the impact of infection control programs. In addition, such infections are not necessarily reimbursed in a healthcare system based on the diagnosis-related groups (DRGs)...
October 17, 2016: Infection Control and Hospital Epidemiology
Noor-Ahmad Latifi, Hamid Karimi
BACKGROUND: Many burn patients are needed to be referred to a tertiary burn hospital according to the American Burn Association (ABA) criteria. The purpose of this study was to verify the reasons for referring of the burn patients to the hospital. MATERIALS AND METHODS: For 2 years, we prospectively surveyed the burn patients referred to a tertiary teaching burn hospital. Data for the following variables were collected and analyzed with SPSS software V21.0: causes of burn; age; gender; total body surface area (TBSA) measured at the referring center; TBSA measured at the receiving center; concomitant diseases and traumas; the reason for referral; condition of patients before and during the transportation; transportation time; presence of infection; presence of inhalation injury, electrical injury, and chemical injury; child abuse; insurance coverage; and results and outcomes of patients...
October 12, 2016: Burns: Journal of the International Society for Burn Injuries
David van Duin, Paula D Strassle, Lauren M DiBiase, Anne M Lachiewicz, William A Rutala, Timothy Eitas, Robert Maile, Hajime Kanamori, David J Weber, Bruce A Cairns, Sonia Napravnik, Samuel W Jones
BACKGROUND: Infections are an important cause of morbidity and mortality after burn injuries. Here, we describe the time line of infections and pathogens after burns. METHODS: A retrospective study was performed in a large tertiary care burn center from 2004-2013. Analyses were performed on health care-associated infections (HAIs) meeting Centers for Disease Control and Prevention criteria and on all positive cultures. Incidence rates per 1,000 days were calculated for specific HAI categories and pathogens and across hospitalization time (week 1, weeks 2-3, and week ≥4)...
October 11, 2016: American Journal of Infection Control
C M Wickramatilake, R A Dharmadasa, M H A D De Silva
Lower respiratory tract infections (LRTIs) in children are a frequent health problem and, although the majority of LRTIs are self-limiting, most of the children who develop them receive antibiotic treatment (1). The main objective of our study was to determine the pattern of antibiotic use among children with LRTIs admitted to pediatric units in a tertiary care centre in Southern Sri Lanka. This was a descriptive, cross-sectional study and was conducted over a one-year period from 1 January to 31 December 2013...
October 14, 2016: Acta Paediatrica
Yik-Kei Chan, Rity Yk Wong, Margaret Ip, Nelson Ls Lee, Joyce Hs You
BACKGROUND: To describe direct medical costs of influenza in hospitalized elderly, with and without intensive care unit (ICU) admission, during the 2014-2015 season in Hong Kong. METHODS: A retrospective study was conducted in 110 inpatients aged ≥65 years with laboratory-confirmed influenza treated by antiviral therapy during season 2014-2015 in a tertiary hospital. Resource utilization of influenza-related diagnostic and laboratory tests, medications for influenza treatment, usage of general medical ward and ICU during the influenza-related length of hospital stay (IR-LOS) were collected...
October 14, 2016: Antiviral Therapy
Guillaume Butler-Laporte, Matthew P Cheng, Alexandre P Cheng, Emily G McDonald, Todd C Lee
BACKGROUND: Bloodstream infections with Staphylococcus aureus are clinically significant and are often treated with empiric methicillin resistance (MRSA) coverage. However, vancomycin has associated harms. We hypothesized that MRSA screening correlated with resistance in S. aureus bacteremia and could help determine empiric vancomycin requirement. METHODS: We reviewed consecutive S. aureus bacteremias over a five-year period at two tertiary care hospitals. MRSA colonization was evaluated in three ways: as tested within 30 days of bacteremia (30-Day criteria), as tested within 30 days but accounting for any prior positive results (ever positive criteria), or if the patient was known positive with patients with unknown MRSA status being labeled negative (known positive criteria)...
October 10, 2016: Antimicrobial Agents and Chemotherapy
Ujjwayini Ray, Soma Dutta, Suresh Ramasubban, Dhiman Sen, Indrajeet Kumar Tiwary
OBJECTIVE: Melioidosis caused by the Gram-negative bacterium Burkholderia pseudomallei is a very serious infection and has been sporadically reported from the Indian subcontinent. This disease entity can have acute and chronic presentations involving different organ systems. The purpose of this study is to analyze the risk factors, clinical presentations, therapy and outcome of culture proven cases of melioidosis. METHODS: We carried out a retrospective study of eight culture proven cases of melioidosis at a tertiary care hospital in West Bengal...
May 2016: Journal of the Association of Physicians of India
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