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https://www.readbyqxmd.com/read/28734498/surgical-site-infection-reduction-bundle-in-patients-with-gynecologic-cancer-undergoing-colon-surgery
#1
Maria B Schiavone, Lea Moukarzel, Kam Leong, Qin C Zhou, Anoushka M Afonso, Alexia Iasonos, Kara Long Roche, Mario M Leitao, Dennis S Chi, Nadeem R Abu-Rustum, Oliver Zivanovic
OBJECTIVE: Surgical site infections (SSIs) can lead to substantial morbidity, prolonged hospitalization, increased costs, and death in patients undergoing colorectal procedures. We sought to investigate the effect of using an SSI reduction bundle on the rate of SSIs in gynecologic cancer patients undergoing colon surgery. METHODS: We identified all gynecologic cancer patients who underwent colon resection at our institution from 2014 to 2016, during which time a service-wide SSI reduction bundle was introduced...
July 19, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28716179/surgical-treatment-of-chronic-rhinosinusitis-after-sinus-lift
#2
Nicole Tin-Lok Jiam, Andrew N Goldberg, Andrew H Murr, Steven D Pletcher
BACKGROUND: The sinus lift (or sinus augmentation) is a common procedure to improve maxillary bone stock before dental implantation. Chronic rhinosinusitis (CRS) is a potential complication of this procedure and may be refractory to medical treatment. Functional endoscopic sinus surgery has previously been used to address CRS, however, results of previous studies indicated that implant removal is required. There are limited follow-up data available. OBJECTIVE: The purpose of this study was to characterize the long-term outcomes and efficacy of endoscopic sinus surgery for refractory CRS after sinus lift, including the ability to salvage dental implants...
July 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28712540/aqueous-humor-tyrosinase-activity-is-indicative-of-iris-melanocyte-toxicity
#3
Sarmistha Mahanty, Ankush A Kawali, Shruthi Shirur Dakappa, Padmamalini Mahendradas, Mathew Kurian, Varun Kharbanda, Rohit Shetty, Subba Rao Gangi Setty
Antibiotics such as fluoroquinolones (FQLs) are commonly used to treat ocular infections but are also known to cause dermal melanocyte toxicity. The release of dispersed pigments from the iris into the aqueous humor has been considered a possible ocular side effect of the systemic administration of FQLs such as Moxifloxacin, and this condition is known as bilateral acute iris transillumination (BAIT). Bilateral acute depigmentation of iris (BADI) is a similar condition, with iris pigment released into the aqueous, but it has not been reported as a side effect of FQL...
July 13, 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/28708024/quality-improvement-initiative-preventative-surgical-site-infection-protocol-in-vascular-surgery
#4
David Parizh, Enrico Ascher, Syed Ali Raza Rizvi, Anil Hingorani, Michael Amaturo, Eric Johnson
Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. SUMMARY BACKGROUND DATA: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28704010/-smarter-medicine-in-ambulatory-care-beliefs-and-practices-of-family-doctors-and-training-of-future-clinicians
#5
Christine Cohidon, Kevin Selby, Jacques Cornuz, Jean-Michel Gaspoz, Nicolas Senn
Following an American and then international initiative, the Swiss Society of Internal Medicine launched the « Smarter Medicine » campaign in 2014 with five recommendations of activities to be avoided, focusing on low back pain, antibiotic prescriptions, pre-operative chest x-rays, prostate cancer screening and treatment with proton pump inhibitors. In 2016, 69 % of family physicians reported that they knew the recommendations and levels of agreement were very high. However, physicians reported differences between recommendations in how often they are followed in practice, and there remains room for improvement...
January 25, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28693661/bacterial-strain-changes-during-chronic-otitis-media-surgery
#6
G J Kim, S Yoo, S Han, J Bu, Y Hong, D-K Kim
OBJECTIVE: Cultures obtained from pre-operative middle-ear swabs from patients with chronic otitis media have traditionally been used to guide antibiotic selection. This study investigated changes in the bacterial strains of the middle ear during chronic otitis media surgery. METHODS: Pre-operative bacterial cultures of otorrhoea, and peri-operative cultures of the granulation tissue in either the middle ear or mastoid cavity, were obtained. Post-operative cultures were selectively obtained when otorrhoea developed after surgery...
July 11, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28691745/prospective-evaluation-of-the-whitt-neonatal-trigger-score-in-an-at-risk-neonatal-population
#7
Anna Robinson, Lucinda C Winckworth, Georgios Eleftheriou, Rebecca Hewitson, Harriet Holme
AIM: The aim of this study was to prospectively evaluate the Whitt Neonatal Trigger Score (W-NTS), determining optimum threshold scores for consideration of medical intervention and intensive care unit admission. METHODS: All neonates on the postnatal ward (PNW) with a set of pre-defined risk factors were scored on the W-NTS. Neonates were divided into three groups: 'unwell' admitted to neonatal intensive care unit (NICU); 'well', who remained on the PNW receiving standard care; and 'intervention', who received antibiotics but did not require admission to NICU...
July 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28690016/partial-titanium-mesh-explantation-cured-post-cranioplasty-implant-associated-scalp-infection
#8
Bo Chen, Wenchen Li, Dawei Chen, Shuanglin Fu, Yanli Gao, Ri Li, Fanyang Meng, Haifeng Wang, Shuyan Zhang
Titanium mesh cranioplasty is routinely used worldwide for skull defect patients given its advantages, such as stability and biocompatibility. However, there are very few reports concerning the treatment of implant-associated scalp infection, which is one of the most common complications. The aim of the study is to retrospectively evaluate a novel operation technique for the treatment of titanium mesh-associated scalp infection post-cranioplasty, namely partial titanium mesh explantation (PTME). A retrospective study was conducted in all patients who underwent surgical treatment for implant-associated scalp infection from January 2012 to September 2016 in our hospital...
July 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28664712/comparative-study-on-usefulness-of-gentamycin-containing-collagen-implants-in-the-treatment-of-patients-with-osteitis-and-osteomyelitis-of-the-craniofacial-skeleton
#9
COMPARATIVE STUDY
Paweł J Zawadzki, Konrad Perkowski, Michał Kotlarski, Anna Pietruczuk-Padzik, Lidia Chomicz
<b>Introduction and objective.</b> A reduction in incidences of peri-surgical complications due to infections is achieved by antibiotic prophylaxis The objective of the study was to assess the usefulness of gentamycin-containing collagen implants (GCCI) in the treatment of patients with osteitis and osteomyelitis of the craniofacial skeleton. <b>Materials and method.</b> The retrospective study included 103 patients with osteitis and osteomyelitis. 54 patients were treated intra-operatively with GCCI (Garamycin, EusaPharma, Europe)...
May 11, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28642141/added-diagnostic-value-and-impact-on-antimicrobial-therapy-of-16s-rrna-pcr-and-amplicon-sequencing-on-resected-heart-valves-in-infective-endocarditis-a-prospective-cohort-study
#10
Bart Peeters, Paul Herijgers, Kurt Beuselinck, Jan Verhaegen, Willy E Peetermans, Marie-Christine Herregods, Stefanie Desmet, Katrien Lagrou
OBJECTIVES: For adequate management and therapy of infective endocarditis (IE), identification of the causative pathogen is crucial but currently molecular testing results are not included in diagnostic criteria. The added diagnostic value and impact on antimicrobial therapy of 16S rRNA PCR and Amplicon Sequencing (16S rRNA PCR) performed on excised heart valves from IE patients was evaluated alongside with the effect of pre-operative antibiotics on the performance of blood culture (BC), valve culture (VC) and 16S rRNA PCR...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28629607/post-operative-management-of-perforated-appendicitis-can-clinical-pathways-improve-outcomes
#11
Robert R Gerard, Barrett A Kielhorn, Brent Petersen, Andrew J Mullard, Laurence E McCahill
BACKGROUND: We sought to decrease organ space infection (OSI) following appendectomy for perforated acute appendicitis (PAA) by minimizing variation in clinical management. OBJECTIVE: A postoperative treatment pathway was developed and four recommendations were implemented: 1) clear documentation of post-operative diagnosis, 2) patients with unknown perforation status to be treated as perforated pending definitive diagnosis, 3) antibiotic therapy to be continued post operatively for 4-7 days after SIRS resolution, and 4) judicious use of abdominal computed tomography (CT) scanning prior to post-operative day 5...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28620749/bundles-prevent-surgical-site-infections-after-colorectal-surgery-meta-analysis-and-systematic-review
#12
Aleksander Zywot, Christine S M Lau, H Stephen Fletcher, Subroto Paul
INTRODUCTION: Colorectal surgeries (CRS) have one of the highest rates of surgical site infections (SSIs) with rates 15 to >30%. Prevention "bundles" or sets of evidence-based interventions are structured ways to improve patient outcomes. The aim sof this study is to evaluate CRS SSI prevention bundles, bundle components, and implementation and compliance strategies. METHODS: A meta-analysis of studies with pre- and post-implementation data was conducted to assess the impact of bundles on SSI rates (superficial, deep, and organ/space)...
June 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#13
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28602900/multi-level-mycotic-aneurysms-due-to-salmonella-infection-case-report-and-review-of-the-literature
#14
E H Pasveer, R G Statius van Eps, J J Wever, H T C Veger
Infected or mycotic aneurysms (MA) of the aorta and adjacent arteries are rare and difficult to treat. We report a unique case of a Salmonella serotype enteritidis-induced rapidly expanding aortic and iliac pseudoaneurysm during pre-operative work-up. Based on the presented case, we postulate that the agressive nature of Salmonella Enteritidis MA should not be underestimated. If postponed intervention is chosen and the patient is managed conservatively with antibiotic therapy to create a window of definitive diagnosis one should consider close follow-up imaging to observe progression of the pseudo aneurysm...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28579135/urinary-tract-infection-after-voiding-cystourethrogram
#15
E K Johnson, N R Malhotra, R Shannon, D L Jacobson, J Green, C K Rigsby, J L Holl, E Y Cheng
BACKGROUND: Reported rates of post-procedural urinary tract infection (ppUTI) after voiding cystourethrogram (VCUG) are highly variable (0-42%). OBJECTIVE: This study aimed to determine the risk of ppUTI after cystogram, and evaluate predictors of ppUTI. STUDY DESIGN: A retrospective cohort study of children undergoing VCUG or radionuclide cystogram (henceforth 'cystogram') was conducted. Children with neurogenic bladder who underwent cystogram in the operating room and without follow-up at the study institution were excluded...
May 25, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28577723/postoperative-infections-after-limb-sparing-surgery-for-primary-bone-tumors-of-the-pelvis-incidence-characterization-and-functional-impact
#16
REVIEW
M Severyns, S Briand, D Waast, S Touchais, A Hamel, F Gouin
INTRODUCTION: Surgical site infections (SSI) represent the most common postoperative complication after limb sparing surgery for primary malignant bone tumors, with incidence ranging from 10 to 47%. There is no consensus concerning about the optimal surgical strategy, or the adequate antibiotic prophylaxis in pelvic resections. A greater knowledge of these infections and their surgical trajectories seem essential to obtain. MATERIALS AND METHODS: We retrospectively studied 45 cases of pelvic resection, including at least the periacetabular zone 2 of Enneking, performed between 1989 and 2013 in the same center...
June 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28554816/a-pre-operative-clinical-scoring-system-to-distinguish-perforation-risk-with-pediatric-appendicitis
#17
William Bonadio, Syeda Shahid, Lior Vardi, Carly Buckingham, Allison Kornblatt, Chloe Free, Peter Homel
IMPORTANCE: Appendicitis is a common, potentially serious pediatric disease. An important factor in determining management strategy [whether/when to perform appendectomy, duration of antibiotic therapy/hospitalization, etc.] and predicting outcome is distinguishing whether perforation is present. OBJECTIVE: The objective was to determine efficacy of commonly assessed pre-operative variables in stratifying perforation risk in children with appendicitis. DESIGN: A retrospective analysis of consecutive cases was performed...
May 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28552099/bacteriology-and-treatment-of-infections-in-the-upper-and-lower-airways-in-patients-with-primary-ciliary-dyskinesia-adressing-the-paranasal-sinuses
#18
Mikkel Christian Alanin
The respiratory tract is lined with motile cilia that transport respiratory mucus. Primary ciliary dyskinesia (PCD) is a chronic genetic disease caused by mutations in genes responsible for ciliary structure and function. Non-functional airway cilia impair the mucociliary clearance (MCC), causing mucostasis, lung infections and destruction, chronic rhinosinusitis (CRS) and hearing impairment. It is of paramount importance to postpone chronic lung infection mainly with Gram-negative bacteria (GNB) in patients with an impaired MCC...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28529869/septic-arthritis-of-the-shoulder-with-proximal-humerus-osteomyelitis-treated-by-ilizarov-shoulder-arthrodesis
#19
John Kendall, Martin McNally
Septic arthritis of the shoulder can destroy the glenohumeral joint resulting in significant pain, instability and poor function. Surgical treatment is notoriously difficult with significant risk of complications. Shoulder arthrodesis has been performed using both internal and external fixation but has high complication rates in the presence of infection. We present our experience of managing a patient with significant pain and loss of function as a result of septic arthritis of the shoulder following infected proximal humeral fracture fixation with associated proximal humeral osteomyelitis...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#20
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
2017: International Journal of Surgery Case Reports
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