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pre operative antibiotics

Tina Djernis Gundersen, Lone Krebs, Ellen Christine Leth Loekkegaard, Steen Christian Rasmussen, Julie Glavind, Tine Dalsgaard Clausen
OBJECTIVES: To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour...
March 14, 2018: BMJ Open
Juyuan Liu, Na Li, Jinjuan Hao, Yanming Li, Anlei Liu, Yinghong Wu, Meng Cai
BACKGROUND: Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial healthcare costs, with increased morbidity and mortality. To investigate the effects of the antibiotic stewardship program on prevention and control of SSI during clean surgery, we investigated this situation in our institution. PATIENTS AND METHODS: We performed a quasi-experimental study to compare the effect before and after the antibiotic stewardship program intervention...
February 20, 2018: Surgical Infections
Kislay Kishore, Manish Beniwal, Shilpa Rao, K V L N Rao, Vikas Vazhayil, Dwarkanath Srinivas, Sampath Somanna
BACKGROUND: Abscess co-existing within a brain tumor is a rare entity. Case reports in literature primarily consist of sellar pathology and parenchymal lesions including meningioma, glioma, and metastases. We report a case of glioblastoma with an intra-tumoral abscess in a middle-aged lady with no prior invasive procedure or systemic focus of infection. CASE DESCRIPTION: A 45-year old lady presented with new onset generalized seizures and rapidly progressive left hemiparesis...
February 14, 2018: World Neurosurgery
Ziquan Li, Chengxian Yang, Xinjie Bao, Yong Yao, Ming Feng, Kan Deng, Xiaohai Liu, Bing Xing, Renzhi Wang
OBJECTIVE: Pituitary abscess (PA) is a rare but serious intrasellar disorder with potentially high disability and mortality. Secondary PA following transsphenoidal surgery (TS) is extremely rare and only a few case reports were identified in the literature. This study explored the salient clinical manifestations and etiologies to determine appropriate treatment. METHODS: A retrospective review of 6,832 consecutive patients who had undergone transsphenoidal surgery for pituitary diseases in Peking Union Medical College Hospital between 2003 and 2017 was performed...
February 6, 2018: World Neurosurgery
Feng Liu, Ruo-Kun Huang, Ming Xie, Hao Pan, Jing-Jing Zhao, Bo Lei
BACKGROUND: To examine the safety and efficacy of Masquelet's technique as a surgical method for treating the first metatarsophalangeal joint in cases of gout accompanied by a massive bone defect. METHODS: From January 2010 to January 2016, eleven patients (7 males and 4 females; mean age 33.1 years; range, 23-43 years) received surgical treatment for a first metatarsophalangeal joint tophus which caused a serious bone defect. The first metatarsophalangeal bone defects ranged from 3-6cm, or nearly 50% of the length of normal bone...
February 17, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Lakshmi Srinivasan, Laurie Kilpatrick, Samir S Shah, Soraya Abbasi, Mary C Harris
BACKGROUND: Bacterial meningitis is challenging to diagnose in infants, especially in the common setting of antibiotic pre-treatment, which diminishes yield of cerebrospinal fluid (CSF) cultures. Prior studies of diagnostic markers have not demonstrated sufficient accuracy. Interleukin-23 (IL-23), interleukin-18 (IL-18) and soluble receptor for advanced glycation end products (sRAGE) possess biologic plausibility, and may be useful as diagnostic markers in bacterial meningitis. METHODS: In a prospective cohort study, we measured IL-23, IL-18 and sRAGE levels in CSF...
2018: PloS One
Tyler J Loftus, Camille G Dessaigne, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: We developed a protocol to identify candidates for non-operative management (NOM) of uncomplicated appendicitis. Our objective was to evaluate protocol efficacy with the null hypothesis that clinical outcomes, hospital readmission rates, and hospital charges would be unchanged after protocol implementation. METHODS: We performed a single-center 4-year propensity score matched retrospective cohort analysis of 406 patients with acute uncomplicated appendicitis...
February 2018: Journal of Trauma and Acute Care Surgery
Chenglong Wang, Dong Yin, Weifa Shi, Wenwen Huang, Deling Zuo, Qiang Lu
BACKGROUND: Many orthopaedic surgeons worry about asymptomatic bacteriuria (ASB) as a possible risk factor for prosthetic joint infection (PJI). However, available evidence establishing a direct link between ASB and PJI is limited. This meta-analysis aimed to investigate whether ASB is a factor for PJI and whether pre-operative antibiotic treatment shows benefit. METHOD: We systematically searched major databases such as PubMed, Web of Science, the Cochrane Library and EMBASE for studies...
January 24, 2018: International Orthopaedics
Giuseppe Rollo, Paolo Pichierri, Antonio Marsilio, Marco Filipponi, Michele Bisaccia, Luigi Meccariello
Introduction: The nonunion rate has been reported between 0.1% and 15%. There are also several predisposing factors for the onset of complications: general factors connected with the patient and specific factors related to the fracture site. The purpose of our study is to review the etiology of nonunion of the clavicle in its atrophic form and investigate the outcomes of the revision treatment in a single step. Materials and methods: Retrospective study on 71 patients suffering from nonunions due to the following treatments: conservative in 13 patients; plate fixation in 12; closed reduction and fixation with K-wire in 24; open reduction and fixation with K-wire...
September 2017: Clinical Cases in Mineral and Bone Metabolism
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Esophageal achalasia is a type of motility disorder characterized by incomplete relaxation of lower esophageal sphincter (LES) and absence of esophageal peristalsis. Peroral endoscopic myotomy (POEM) is a new treatment option for achalasia that is less invasive, more effective, and safe as compared to surgery. High-frequency electrotome is commonly used in POEM, but takes longer time to make the tunnel in the esophagus and causes many complications. The thulium laser decreases the risk of bleeding and perforation in endoscopy but has not been reported in digestive diseases, especially in POEM...
January 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Antonio Pellegrini, Claudio Legnani, Vittorio Macchi, Enzo Meani
INTRODUCTION: Management of periprosthetic shoulder infections (PSIs) still remains challenging. We conducted a retrospective case study to assess the outcomes of definitive articulating antibiotic spacer implantation in a cohort of elderly, low-demanding patients. We hypothesized that in patients with low functional demands seeking pain relief with chronic PSIs, treatment with a definitive articulating antibiotic spacer would lead to satisfying results concerning eradication of the infection, improvement of pain, and improving shoulder function...
January 15, 2018: Archives of Orthopaedic and Trauma Surgery
Sadaf Jafferbhoy, Mihir Chandarana, Maria Houlihan, Rishikesh Parmeshwar, Sankaran Narayanan, Soni Soumian, Simon Harries, Lucie Jones, Dayalan Clarke
Background: The last two decades have seen significant changes in surgical management of breast cancer. The offer of immediate breast reconstruction (IBR) following mastectomy is currently standard practice. Skin sparing and nipple sparing mastectomy with implant-based IBR have emerged as oncologically safe treatment options. Prepectoral implant placement and complete coverage of implant with acellular dermal matrix (ADM) eliminates the need to detach the muscle from underlying chest wall in contrast to the subpectoral technique...
December 2017: Gland Surgery
Cagri Senocak, Cihat Ozcan, Tolga Sahin, Gulden Yilmaz, Ekrem Ozyuvali, Selcuk Sarikaya, Berkan Resorlu, Ural Oguz, Omer Faruk Bozkurt, Ali Unsal, Oztug Adsan
PURPOSE: To determine the perioperative risk factors for postoperative infections among patients undergoing flexible uretero-renoscopy with laser lithotripsy (FURSLL). In addition, the resistance patterns of pathogens isolated from positive preoperative urine cultures were investigated. MATERIALS AND METHODS: We retrospectively reviewed data from 492 consecutive patients who had undergone FURSLL for stone disease in our department. Postoperative infection was defined as fever (? 38°C) with pyuria (? 10 white blood cells per high power field), or systemic inflammatory response syndrome, or sepsis...
January 4, 2018: Urology Journal
Patric Scheidegger, Lukas Weisskopf, Anja Hirschmüller
Issue: Lower extremity tendon injuries often occur in physically active individuals. Most ruptures not involving great force are diagnosed in patients presenting underlying tendon degenerations. This also applies to patients taking medications because of a disease. We have observed several cases of bilateral Achilles tendon ruptures in patients who have been taking cortisone for a long period. We treated a healthy colleague (neurologist) in our clinic who sustained ruptures of the Achilles tendon on the left side (2012) and the peroneus brevis tendon on left side (2015) and right side (2016) after minimal traumata...
2017: SAGE Open Medical Case Reports
Justin R Gregg, Caroline L Kang, Thomas R Talbot, Derek Moore, S Duke Herrell, Roger Dmochowski, Daniel A Barocas
Introduction: Symptomatic urinary tract infection (UTI) is a known complication of cystoscopy with ureteral stent removal. However, little is known about the incidence and risk factors for post-cystoscopy UTI in renal transplant recipients, who likely represent a high-risk cohort. Our aim was to determine the infection rate following cystoscopy with stent removal in this population and identify opportunities for care improvement. Methods: We performed a retrospective cohort study of office cystoscopies with stent removal in renal transplant recipients performed at a single institution from April 2012 through May 2014...
September 2017: Urology Practice
Nirmal Raj Gopinathan, Rakesh John, Himanshu Kanwat, Pebam Sudesh
Introduction: Impalement injuries of pelvis have been reported in children but are uncommon. Impalement could be associated with injuries to deep organs, wound contamination, crush injuries, and in certain instances, can even be fatal. Case Report: We present a bizarre case of a 2-year-old female child who presented to us with a tapestry needle embedded in the true pelvic cavity after a history of fall on the buttock while playing at home. The impaled needle was eventually successfully extracted surgically using the modified Stoppa's approach and the post-operative period was uneventful...
September 2017: Journal of Orthopaedic Case Reports
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
Ronny Langenhan, Stefanie Bushuven, Niklas Reimers, Axel Probst
PURPOSE: The aim of this study was to conduct a re-evaluation of current strategies for peri-operative prophylaxis of infections in orthopaedic surgery of geriatric patients (≥65 years) with proximal femoral fractures (PFF). METHODS: Between 01/2010 and 08/2014 all post-operative infections after stabilization of PFF of 1,089 geriatric patients were recorded retrospectively. All patients pre-operatively received a single dose of 1.5 g cefuroxime (group 1). These were compared to prospectively determined post-operative rates of surgical site infection (SSI) of 441 geriatric patients, which were operated on between 09/2014 and 03/2017 due to PFF...
December 9, 2017: International Orthopaedics
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
Alistair I W Mayne, Peter S E Davies, James M Simpson
BACKGROUND: There is significant debate as to whether routine antibiotic treatment of asymptomatic bacteriuria (ASB) in arthroplasty patients reduces the risk of subsequent PJI. No previous systematic reviews have been undertaken on this subject. The aim of this systematic review was to investigate whether antibiotic treatment of asymptomatic bacteriuria in arthroplasty patients reduces the risk of prosthetic joint infection and to investigate whether the organisms cultured in peri-operative urine samples are the same as those responsible for subsequent prosthetic joint infections...
November 21, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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