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https://www.readbyqxmd.com/read/28642125/safety-and-efficacy-of-dual-lead-thalamic-deep-brain-stimulation-for-patients-with-treatment-refractory-multiple-sclerosis-tremor-a-single-centre-randomised-single-blind-pilot-trial
#1
Seth F Oliveria, Ramon L Rodriguez, Dawn Bowers, Daniel Kantor, Justin D Hilliard, Erin H Monari, Bonnie M Scott, Michael S Okun, Kelly D Foote
BACKGROUND: Efficacy in previous studies of surgical treatments of refractory multiple sclerosis tremor using lesioning or deep brain stimulation (DBS) has been variable. The aim of this study was to investigate the safety and efficacy of dual-lead thalamic DBS (one targeting the ventralis intermedius-ventralis oralis posterior nucleus border [the VIM lead] and one targeting the ventralis oralis anterior-ventralis oralis posterior border [the VO lead]) for the treatment of multiple sclerosis tremor...
June 19, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28638306/effect-of-maternal-obesity-on-maternal-fetal-transfer-of-preoperative-cefazolin-at-cesarean-section
#2
Stephanie McKenney Groff, Wareef Fallatah, Samuel Yang, Jamie Murphy, Christopher Crutchfield, Mark Marzinke, Joanne Kurtzberg, Carlton K K Lee, Irina Burd, Azadeh Farzin
OBJECTIVES: American Congress of Obstetricians and Gynecologists recommends a single dose of antibiotic prophylaxis before all cesarean sections (C/S). This recommendation is based on pharmacokinetic studies that include only non-obese patients. We sought to evaluate 1) cefazolin plasma concentrations among obese and non-obese patients after administration of a 2-g cefazolin dose for prevention of surgical wound infections, and 2) whether cefazolin concentration in fetal circulation may be protective against pathogens that cause early onset neonatal sepsis...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28637557/nomogram-derived-prediction-of-postoperative-ileus-after-colectomy-an-assessment-from-nationwide-procedure-targeted-cohort
#3
Ahmet Rencuzogullari, Cigdem Benlice, Meagan Costedio, Feza H Remzi, Emre Gorgun
Postoperative ileus (POI) is a clinical burden to health-care system. This study aims to evaluate the incidence and predictors of POI in patients undergoing colectomy and create a nomogram by using recently released procedure-targeted nationwide database. Patients who underwent elective colectomy in 2012 and 2013 were identified from American College of Surgeons National Surgical Quality Improvement Program using the new procedure-targeted database. Demographics, comorbidities, and 30-day postoperative outcomes were evaluated...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28625807/evidence-for-altered-levels-of-immunoglobulin-d-in-the-nasal-airway-mucosa-of-patients-with-chronic-rhinosinusitis
#4
Jin-Young Min, Jayakar V Nayak, Kathryn E Hulse, Whitney W Stevens, Paul A Raju, Julia H Huang, Lydia A Suh, Griet A Van Roey, James E Norton, Roderick G Carter, Caroline P E Price, Ava R Weibman, Ali R Rashan, Eliver E Ghosn, Zara M Patel, Tetsuya Homma, David B Conley, Kevin C Welch, Stephanie Shintani-Smith, Anju T Peters, Leslie C Grammer, Kathleen E Harris, Atsushi Kato, Peter H Hwang, Robert C Kern, Leonore A Herzenberg, Robert P Schleimer, Bruce K Tan
BACKGROUND: Immunoglobulin D (IgD) is an enigmatic antibody isotype best known when co-expressed with IgM on naïve B cells. However, elevated soluble IgD (sIgD) and increased IgD(+)IgM(-) B cell populations have been described in the human upper respiratory mucosa. OBJECTIVE: We assessed whether levels of sIgD and IgD(+) B cells are altered in nasal tissue from patients with chronic rhinosinusitis (CRS). We further characterized IgD(+) B cell populations and explored clinical and local inflammatory factors associated with tissue sIgD levels...
June 15, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28624841/the-neutrophil-to-lymphocyte-ratio-as-a-marker-of-recovery-status-in-patients-with-severe-dental-infection
#5
F Dogruel, Z-B Gonen, D Gunay-Canpolat, G Zararsiz, A Alkan
BACKGROUND: The aim of the study was to assess the value of pretreatment neutrophil/lymphocyte (N/L) ratio and mean platelet volume (MPV) and the correlation between these markers with progression in patients with severe odontogenic infection. MATERIAL AND METHODS: A cohort of 100 patients with severe odontogenic infection were divided into 2 groups according to their length of hospital stay. The N/L ratio and MPV was measured in all patients. The correlation in all patients between preoperative fever, preoperative antibiotic doses, postoperative antibiotic doses, total antibiotic doses and hospital stay with N/L ratio and MPV were analyzed...
June 18, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28616437/an-audit-of-perioperative-antimicrobial-prophylaxis-compliance-with-the-international-guidelines
#6
Sarah Mousavi, Elham Zamani, Faranak Bahrami
OBJECTIVE: Antimicrobial prophylaxis has been demonstrated to lower the incidence of postoperative infection in nearly all types of surgery. The American Society of Health-System Pharmacists (ASHP) guideline summarizes current data on the appropriate use of antibiotic for surgical prophylaxis. The objective of this study was to assess and audit the use of antibiotics in a tertiary care center according to the recommendation of ASHP guideline. METHODS: This cross-sectional study was performed using prospective data gathered from April to September 2015 in the surgical wards of Al Zahra Hospital, Isfahan, Iran...
April 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28614287/nasal-swab-screening-for-staphylococcus-aureus-in-spinal-deformity-patients-treated-with-growing-rods
#7
Scott J Luhmann, June C Smith
BACKGROUND: Surgical-site infections are one of the most concerning complications in patients treated with growing rods (GR). The purpose of this study was to evaluate the use of preoperative screening for Staphylococcus aureus (SA) for all growing spine procedures, and if this would permit alteration of prophylactic antibiotics to cover the identified resistances. METHODS: All patients were identified who had SA screening during the course of GR treatment. In otal, 34 patients [23 neuromuscular (NMS), 4 congenital, 4 idiopathic scoliosis (IS), and 3 syndromic] were identified who had 111 preoperative screenings [79 lengthenings, 23 insertions, 6 revisions, and 3 conversions to posterior spinal fusions (PSF)]...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28605452/optimizing-preoperative-prophylaxis-in-patients-with-reported-%C3%AE-lactam-allergy-a-novel-extension-of-antimicrobial-stewardship
#8
Alon Vaisman, Janine McCready, Sandy Hicks, Jeff Powis
Background: Use of alternative second-line antibiotics is associated with adverse events in patients reporting β-lactam allergy. In the perioperative setting, we hypothesized that structured allergy histories, without the use of skin testing, can reduce alternative prophylactic antibiotic use. Objectives: Assess the impact of structured allergy histories on patients with self-reported β-lactam allergy (SRBA) undergoing elective surgical procedures. Methods: Structured allergy histories were performed by a pharmacist and reviewed with an infectious diseases physician...
June 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28604404/perioperative-care-of-head-and-neck-free-flap-patients
#9
Michael R Kinzinger, Arnaud F Bewley
PURPOSE OF REVIEW: This article reviews the recent literature on the perioperative care of head and neck surgical patients undergoing free tissue transfer. RECENT FINDINGS: As the overall success of head and neck free flaps has plateaued above 95%, recent literature on perioperative flap management has focused on minimizing complications, length of stay, and cost of treatment. Current areas of research include preoperative risk stratification, preoperative and postoperative nutrition, intraoperative fluid management, postoperative level of care, postoperative antibiotic prophylaxis, defining the impact of comorbidities, and developing comprehensive evidence-based perioperative care protocols...
June 9, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28601567/impact-of-evidence-based-interventions-on-wound-complications-after-cesarean
#10
Lorene A Temming, Nandini Raghuraman, Ebony B Carter, Molly J Stout, Roxane M Rampersad, George A Macones, Alison G Cahill, Methodius G Tuuli
BACKGROUND: A number of evidence-based interventions have been proposed to reduce post cesarean wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥ 2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. OBJECTIVE: We sought to estimate the impact of a group of evidence-based surgical measures (prophylactic antibiotics administered prior to skin incision, chlorhexidine-alcohol for skin antisepsis, closure of subcutaneous layer, and subcuticular skin closure with suture) on wound complications after cesarean, and to estimate residual risk factors for wound complications...
June 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28601485/surgical-treatment-of-shoulder-infections-a-comparison-between-arthroscopy-and-arthrotomy
#11
Christoph Böhler, Alexander Pock, Wenzel Waldstein, Kevin Staats, Stephan E Puchner, Johannes Holinka, Reinhard Windhager
BACKGROUND: Management of bacterial shoulder infections includes antibiotic therapy and surgical joint decompression. Arthroscopy and open arthrotomy are recommended treatment options. Whether 1 of the 2 surgical options is superior remains unclear. The present study aimed (1) to compare the reinfection rates after arthroscopy and open arthrotomy and (2) to identify risk factors of reinfection after surgical intervention. MATERIALS AND METHODS: The data of 59 consecutive patients were available for final analysis...
June 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28594723/is-there-a-role-for-oral-antibiotic-preparation-alone-before-colorectal-surgery-acs-nsqip-analysis-by-coarsened-exact-matching
#12
Richard Garfinkle, Jad Abou-Khalil, Nancy Morin, Gabriela Ghitulescu, Carol-Ann Vasilevsky, Philip Gordon, Marie Demian, Marylise Boutros
BACKGROUND: Recent studies demonstrated reduced postoperative complications using combined mechanical bowel and oral antibiotic preparation before elective colorectal surgery. OBJECTIVE: The aim of this study was to assess the impact of these 2 interventions on surgical site infections, anastomotic leak, ileus, major morbidity, and 30-day mortality in a large cohort of elective colectomies. DESIGN: This is a retrospective comparison of 30-day outcomes using the American College of Surgeons National Surgical Quality Improvement Program colectomy-targeted database with coarsened exact matching...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28584431/hospital-acquired-infection-prevalence-and-outcome-in-infants-undergoing-open-heart-surgery-in-the-present-era
#13
Manoj Kumar Sahu, Ch Bharat Siddharth, Velayudham Devagouru, Sachin Talwar, Sarvesh Pal Singh, Shiv Chaudhary, Balram Airan
BACKGROUND: The aim of this study is to evaluate the causal relation between hospital-acquired infection (HAI) and clinical outcomes following cardiac surgery in neonates and infants and to identify the risk factors for the development of HAI in this subset of patients. MATERIALS AND METHODS: After Ethics committee approval, one hundred consecutive infants undergoing open heart surgery (OHS) between June 2015 and June 2016 were included in this prospective observational study...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28577157/analysis-of-the-incidence-and-risk-factors-of-male-urinary-tract-infection-following-urodynamic-study
#14
Z Huang, H Xiao, H Li, W Yan, Z Ji
The purpose of this study was to investigate the incidence and risk factors of male urinary tract infection (UTI) after urodynamic study (UDS). A total of 854 consecutive male patients, who underwent UDS at Peking Union Medical College Hospital from January 2010 to March 2016, were recruited in this study. Two to four weeks before the examination, urinalysis with bacterial culture was performed. Patients with negative results were selected for UDS. Immediately before the examination, urinalysis was repeated to rule out any preoperative UTI...
June 2, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28576531/the-clinical-efficacy-of-early-intervention-for-infected-preauricular-sinus
#15
Oak-Sung Choo, Top Kim, Jeong Hun Jang, Yun-Hoon Choung
OBJECTIVE: The study was designed to evaluate the outcomes of early surgical intervention, and to suggest the accurate operation time and surgical strategies. METHODS: A total of 190 cases (144 patients) of PAS excision were classified into 2 groups according to their time of surgery; early intervention group (n = 53), and non-early intervention group (n = 137). Early intervention was defined as excision performed within 3 weeks from their first hospital visit, and after acute infection control, surgical removal was followed regardless of their infection status...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28575903/do-mixed-flora-preoperative-urine-cultures-matter
#16
Michael R Polin, Amie Kawasaki, Cindy L Amundsen, Alison C Weidner, Nazema Y Siddiqui
OBJECTIVES: To determine whether mixed-flora preoperative urine cultures, as compared with no-growth preoperative urine cultures, are associated with a higher prevalence of postoperative urinary tract infections (UTIs). METHODS: This was a retrospective cohort study. Women who underwent urogynecologic surgery were included if their preoperative clean-catch urine culture result was mixed flora or no growth. Women were excluded if they received postoperative antibiotics for reasons other than treatment of a UTI...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28554808/acute-finger-tip-infection-management-and-treatment-a-103-case-series
#17
F Rabarin, J Jeudy, B Cesari, A Petit, N Bigorre, Y Saint-Cast, P-A Fouque, G Raimbeau
INTRODUCTION: Acute fingertip infections (AFTI) are common. Surgical treatment is the norm in case of effusion. There is, however, no consensus on treatment modalities, or on adjuvant antibiotic therapy (AT). We present the results of a consecutive cohort of 103 AFTIs treated in emergency consultation. MATERIALS AND METHOD: One hundred and one patients were treated by excision and extensive lavage under digital anesthesia, with systematic bacteriological sampling...
May 26, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28549960/mycotic-pseudoaneurysm-of-internal-carotid-artery-secondary-to-lemierre-s-syndrome-how-to-do-it
#18
Filippo Benedetto, David Barillà, Narayana Pipitò, Graziana Derone, Andrea Cutrupi, Chiara Barillà
We report the case of a patient with ICA mycotic pseudo-aneurysm secondary to Lemierre's syndrome, urgently treated. A 75 years old man presented to E.R. with a left swelling lesion of the neck and complaining left visions lost since that morning, fever, hypotension and dyspnoea. Since fifteen days before developing symptoms, he had sore throat and odynophagia treated with a broad coverage of antibiotic therapy for presumed streptococcal pharyngitis. Preoperative CTA images revealed a circular lesion, involving the common carotid artery, carotid bulb, and the proximal part of the internal and external carotid arteries...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28549013/effect-of-preoperative-diabetes-management-on-glycemic-control-and-clinical-outcomes-after-elective-surgery
#19
Rajesh Garg, Brooke Schuman, Angela Bader, Shelley Hurwitz, Alexander Turchin, Patricia Underwood, Cheyenne Metzger, Raquel Rein, Meghan Lortie
OBJECTIVE: The aim of this study was to evaluate whether preoperative diabetes management can improve glycemic control and clinical outcomes after elective surgery. BACKGROUND: There is lack of data on the importance of diabetes treatment before elective surgery. Diabetes is often ignored before surgery and aggressively treated afterwards. METHODS: Patients with diabetes were identified and treated proactively before their scheduled surgeries...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28537569/inguinal-pain-syndrome-the-influence-of-intraoperative-local-administration-of-0-5-bupivacaine-on-postoperative-pain-control-following-lichtenstein-hernioplasty-a-prospective-case-control-study
#20
Bartosz Cybułka
With current technological advancement and availability of synthetic materials used in inguinal hernia repair, a recurrence after first intervention is not a common and important adverse event. On the other hand, however, some patients complain about chronic pain of the operated site after surgeries using a polypropylene mesh. Many patients are constrained to a prolonged use of analgesics and increased frequency of control visits, which may eventually result in loss of trust in the operator. Every surgical intervention is associated with the risk of immediate or delayed complications...
April 30, 2017: Polski Przeglad Chirurgiczny
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