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https://www.readbyqxmd.com/read/28321988/a-quality-improvement-initiative-to-optimize-dosing-of-surgical-antimicrobial-prophylaxis
#1
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
#2
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/28317802/port-site-infections-by-nontuberculous-mycobacterium-a-retrospective-clinico-microbiological-study
#3
Roumi Ghosh, Soumen Das, Asmita De, Harish Kela, Makhan Lal Saha, Prasanta Kumar Maiti
BACKGROUND: Port-site infection (PSI) is a prevailing, chronic, nagging, treatment refractory complication of laparoscopic surgery (LS). It neutralizes the advantages of minimally invasive surgery and increases morbidity, treatment cost of patient, leading to loss of confidence on operating surgeon. PSIs are preventable with appropriate preoperative, intraoperative, and postoperative measures. Atypical mycobacterium is most commonly associated with nonhealing postlaparoscopic wound infections, causing outbreaks or sporadic cases worldwide...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28317676/effect-of-the-administration-period-of-perioperative-topical-levofloxacin-on-normal-conjunctival-bacterial-flora
#4
Ryohei Nejima, Kimiya Shimizu, Takashi Ono, Yukari Noguchi, Akiko Yagi, Takuya Iwasaki, Nobuyuki Shoji, Kazunori Miyata
PURPOSE: To assess the long-term and short-term effects of post-cataract surgery antibiotic therapy on the drug-resistance profile of normal conjunctival bacterial flora. SETTING: Miyata Eye Hospital, Miyazaki, Japan. DESIGN: Randomized prospective clinical trial. METHODS: Patients aged 20 years or older who had cataract surgery between May and September 2015 were given levofloxacin 1.5% ophthalmic solution for 3 days preoperatively...
January 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#5
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28299218/can-surgery-be-avoided-exclusive-antibiotic-treatment-for-pelvic-actinomycosis
#6
M P Ruiz, E M Williams, C M Markey, A M Johnson, P B Morales-Ramirez
Pelvic actinomycosis is an uncommon, slowly progressing granulomatous infection that has been associated with the presence of intrauterine devices. Due to its unspecific clinical and radiologic findings, it can mimic pelvic or intra-abdominal malignancy leading to mutilating surgery of high morbidity. Rarely, diagnosis is made preoperatively and in most cases surgical intervention is necessary. The patient in our case is a 42-year-old female with an IUD for 15 years diagnosed with pelvic actinomycosis. Patient was uniquely diagnosed preoperatively through paracentesis and treated conservatively with prolonged antibiotic therapy and without any type of surgical intervention...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#7
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28287012/low-sensitivity-of-implant-sonication-when-screening-for-infection-in-revision-surgery
#8
Floor M Van Diek, Christiaan G M Albers, Miranda L Van Hooff, Jacques F Meis, Jon H M Goosen
Background and purpose - Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods - 252 consecutive revision arthroplasty cases were enrolled. These cases were determined as being suspected or unsuspected of having infection according to standard criteria...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28285096/periprosthetic-joint-infection-by-propionibacterium-acnes-clinical-differences-between-monomicrobial-versus-polymicrobial-infection
#9
Raúl Figa, David Muñetón, Lucía Gómez, A Matamala, Mayli Lung, Eva Cuchi, Pablo S Corona
OBJECTIVE: To compare a series of monomicrobial Propionibacterium acnes (P. acnes) knee and hip periprosthetic joint infection (PJI) cases with cases of polymicrobial PJI which included P. acnes. We hypothesized that the presence of a polymicrobial P. acnes infection would lead to worse outcomes than those in cases of monomicrobial P. acnes PJI. METHODS: Retrospective multicentre study. All patients with hip or knee PJIs including P. acnes diagnosed from August-2002 to July-2013 in two university hospitals were included...
March 8, 2017: Anaerobe
https://www.readbyqxmd.com/read/28280717/impact-of-preoperative-screening-for-rectal-colonization-with-fluoroquinolone-resistant-enteric-bacteria-on-the-incidence-of-sepsis-following-transrectal-ultrasound-guided-prostate-biopsy
#10
John J Farrell, Jennifer L Hicks, Stephanie E Wallace, Allen D Seftel
With the universal adoption of antibiotic prophylaxis prior to prostate biopsy, the current risk of post-biopsy infection (including sepsis) is <2%. Preoperative prophylactic antibiotic regimens can vary, and although fluoroquinolones have emerged as the standard of care, there is no universally agreed upon preoperative antibiotic regimen. Recently, an increase in the proportion of postoperative infections caused by fluoroquinolone-resistant Escherichia coli (as well as other Enterobacteriaceae) has led to the exploration of simple, practical, and cost-effective methods to minimize this postoperative infection risk...
2017: Research and Reports in Urology
https://www.readbyqxmd.com/read/28277297/prevention-of-ventriculoperitoneal-shunt-complications-after-intraperitoneal-urological-surgeries
#11
Takashi Ikeda, Sayaka Akiyama, Woo Jin Kim, Susumu Ito, Yuichiro Yamazaki
PURPOSE: To evaluate perioperative management for the prevention of postoperative shunt infection and malfunction after intraperitoneal urological surgery in patients with myelodysplasia and a ventriculoperitoneal shunt. METHODS: From 2005 to 2015, 20 consecutive patients with myelodysplasia and a ventriculoperitoneal shunt who underwent intraperitoneal urological surgeries were managed with the same perioperative regimen. Intraperitoneal surgeries involved opening gastrointestinal tracts, including bladder augmentation by enterocystoplasty, creating continent catheterizable channels and Malone antegrade continent enema...
October 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28276003/a-case-of-primary-gastric-undifferentiated-high-grade-pleomorphic-sarcoma-diagnosed-with-chief-complaint-of-fever-a-case-report-and-literature-review
#12
Akira Kabashima, Koichi Kimura, Kensaku Sanefuji, Satoru Masunari, Seiji Haraoka, Soichiro Maekawa
BACKGROUND: Undifferentiated high-grade pleomorphic sarcoma in gastrointestinal tract is extremely rare, and its prognosis is poor. CASE PRESENTATION: An 82-year-old man visited a previous hospital complaining of fever, general fatigue, and shaking chill, for which he received antibiotics therapy. As the fever continued, he was referred to our hospital, where computed tomography and upper gastrointestinal endoscopy showed a 6-cm gastric tumor. A preoperative biopsy was consistent with a malignant mesenchymal tumor, but could not provide a definitive pathological diagnosis nor prove a cause-and-effect relationship between the chief complaint and the gastric tumor...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28272928/prospective-clinical-and-radiographic-outcomes-after-concomitant-anterior-cruciate-ligament-reconstruction-and-meniscal-allograft-transplantation-at-a-mean-5-year-follow-up
#13
Bryan M Saltzman, Maximilian A Meyer, Alexander E Weber, Sarah G Poland, Adam B Yanke, Brian J Cole
BACKGROUND: Concomitant anterior cruciate ligament reconstruction and meniscal allograft transplantation (ACLR/MAT) has demonstrated short-term success in small, retrospective cohort studies. Patient- and disease-specific predictors of success after ACLR/MAT are largely unknown. PURPOSE: To (1) prospectively evaluate the subjective and objective clinical and radiographic outcomes after ACLR/MAT and (2) conduct a subgroup analysis to identify patient- or disease-related factors that correlate with failure...
March 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28259167/diagnostic-accuracy-of-arthroscopic-biopsy-in-periprosthetic-infections-of-the-hip
#14
Florian Pohlig, Heinrich M L Mühlhofer, Ulrich Lenze, Florian W Lenze, Christian Suren, Norbert Harrasser, Rüdiger von Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND: Diagnosis of a low-grade periprosthetic joint infection (PJI) prior to revision surgery can be challenging, despite paramount importance for further treatment. Arthroscopic biopsy of synovial and periprosthetic tissue with subsequent microbiological and histological examination can be beneficial but its specific diagnostic value has not been clearly defined. METHODS: 20 consecutive patients who underwent percutaneous synovial fluid aspiration as well as arthroscopic biopsy due to suspected PJI of the hip and subsequent one- or two-stage revision surgery at our institution between January 2012 and May 2015 were enrolled...
March 4, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28258920/odontogenic-sinusitis-maxillaris-a-retrospective-study-of-121-cases-with-surgical-intervention
#15
Matthias Zirk, Timo Dreiseidler, Matthias Pohl, Daniel Rothamel, Johannes Buller, Franziska Peters, Joachim E Zöller, Matthias Kreppel
PURPOSE: Otolaryngologists, dentists and maxilla-facial surgeons see patients suffering from odontogenic maxillary sinusitis on a daily routine. The study was performed to investigate the different origins of the odontogenic maxillary sinusitis ranging from periodontitis to augmentative implant surgery. Furthermore, the microbial flora of purulent odontogenic maxillary sinusitis was analyzed in order to present a proper antibiotic treatment in addition to a surgical approach. MATERIALS AND METHODS: A retrospective study was performed, analyzing the clinical trials of 121 patients suffering from odontogenic maxillary sinusitis who undergone surgery...
February 4, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28255504/usefulness-of-urinoculture-to-patients-with-dementia-and-femoral-neck-fracture-at-admission-to-hospital-preliminary-results
#16
Laura Garcia-Nuño, Carlos Villamil, Araceli González-Cuevas, David Martí, Silvia Capilla, Maria José Vives, Xavier Oncins, Pere Torner, Juan Castellanos, Lluís Font-Vizcarra
INTRODUCTION: While preoperative urinary tract infection (UTI) has the potential to cause bacteremia and postsurgical acute prosthetic joint infections (APJIs), the influence of asymptomatic bacteriuria (AB) in these infections remains unclear. So the majority of guidelines not recommend the treatment of AB prior to the surgery. However, as patients with dementia usually cannot explain the symptoms of dysuria, the differential diagnosis between AB and UTI may be very difficult in this group of patients...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255256/postcesarean-wound-infection-prevalence-impact-prevention-and-management-challenges
#17
REVIEW
Sivan Zuarez-Easton, Noah Zafran, Gali Garmi, Raed Salim
Surgical site infection (SSI) is one of the most common complications following cesarean section, and has an incidence of 3%-15%. It places physical and emotional burdens on the mother herself and a significant financial burden on the health care system. Moreover, SSI is associated with a maternal mortality rate of up to 3%. With the global increase in cesarean section rate, it is expected that the occurrence of SSI will increase in parallel, hence its clinical significance. Given its substantial implications, recognizing the consequences and developing strategies to diagnose, prevent, and treat SSI are essential for reducing postcesarean morbidity and mortality...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28253941/arthrodesis-of-the-ankle
#18
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28252875/effect-of-preoperative-topical-diclofenac-on-intraocular-interleukin-12-concentration-and-macular-edema-after-cataract-surgery-in-patients-with-diabetic-retinopathy-a-randomized-controlled-trial
#19
Aleksej Medić, Tomislav Jukić, Anita Matas, Katarina Vukojević, Ada Sapunar, Ljubo Znaor
AIM: To determine if preoperative treatment with a topical non-steroidal anti-inflammatory drug (NSAID) lowers the concentration of intraocular interleukin (IL)-12 and the incidence of postoperative macular edema in patients with non-proliferative diabetic retinopathy undergoing cataract surgery. METHODS: A total of 55 patients were randomized to diclofenac (n=27) or placebo (n=28). Patients receiving diclofenac started preoperative treatment with 0.1% topical diclofenac four times a day 7 days before cataract surgery and the therapy was discontinued 30 days after surgery...
February 28, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/28236547/screening-for-beta-lactam-allergy-in-joint-arthroplasty-patients-to-improve-surgical-prophylaxis-practice
#20
Deanna L McDanel, Antoine E Azar, Amy M Dowden, Samantha Murray-Bainer, Nicolas O Noiseux, Melissa Willenborg, Charles R Clark, John J Callaghan, Ambar Haleem
BACKGROUND: The reliability of patient-reported penicillin allergies has been disputed. A Drug Allergy Clinic (DAC) was established at our institution in combination with an electronic best practice alert (BPA) in the Orthopedic Clinic. Joint arthroplasty patients with a reported history of beta-lactam allergy (HOBA) were preoperatively referred via the BPA to the DAC. The purpose of this study was to determine the effectiveness of beta-lactam allergy screening in enabling the surgical team to optimize antimicrobial prophylaxis...
January 17, 2017: Journal of Arthroplasty
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