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https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#1
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28103397/the-economic-burden-of-nurse-sensitive-adverse-events-in-22-medical-surgical-units-retrospective-and-matching-analysis
#2
Eric Tchouaket, Carl-Ardy Dubois, Danielle D'Amour
AIMS: To assess the economic burden of nurse-sensitive adverse events (NSAEs) in 22 acute care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days. BACKGROUND: Recent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular...
January 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#3
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102784/model-systems-for-the-study-of-enterococcal-colonization-and-infection
#4
H M Sharon Goh, M H Adeline Yong, Kelvin Kian Long Chong, Kimberly A Kline
Enterococcus faecalis and Enterococcus faecium are common inhabitants of the human gastrointestinal tract, as well as frequent opportunistic pathogens. Enterococci cause a range of infections including, most frequently, infections of the urinary tract, catheterized urinary tract, bloodstream, wounds and surgical sites, and heart valves in endocarditis. Enterococcal infections are often biofilm-associated, polymicrobial in nature, and resistant to antibiotics of last resort. Understanding Enterococcal mechanisms of colonization and pathogenesis are important for identifying new ways to manage and intervene with these infections...
January 19, 2017: Virulence
https://www.readbyqxmd.com/read/28102166/stress-fractures-of-tibia-treated-with-ilizarov-external-fixator
#5
Radosław Górski, Sławomir Żarek, Piotr Modzelewski, Ryszard Górski, Paweł Małdyk
BACKGROUND: Stress fractures are the result of cyclic loading of the bone, which gradually becomes damaged. Most often they are treated by rest or plaster cast and, in rare cases, by internal fixation. There is little published data on initial reposition followed by stabilization with the Ilizarov apparatus in such fractures. MATERIAL AND METHODS: Six patients were treated with an external fixator according to the Ilizarov method for a stress fracture of the tibia between 2007 and 2015...
August 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28101794/diabetic-foot-infections-an-update-in-diagnosis-and-management
#6
REVIEW
Pinelopi Grigoropoulou, Ioanna Eleftheriadou, Edward B Jude, Nikolaos Tentolouris
Foot infections are a common problem in patients with diabetes and a risk factor for limb amputation. They occur as a result of skin ulceration, which facilitates penetration of pathogens to deeper tissues. The diagnosis of infection is clinical. Aerobic gram-positive cocci are the most common pathogens. Ulcers which are chronic, preceded by administration of antibiotics and hospitalization or complicated by severe infection are polymicrobial. Antibiotic therapy is initially empiric based on the severity of the infection...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28101722/the-effect-of-antibiotic-coated-sutures-on-the-incidence-of-surgical-site-infections-in-abdominal-closures-a-meta-analysis
#7
Basheer Elsolh, Lisa Zhang, Sunil V Patel
OBJECTIVE: This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence. METHODS: MEDLINE and EMBASE databases (1946-2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions. RESULTS: Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28101586/bone-cultures-from-war-wounded-civilians-in-the-middle-east-a-surgical-prospective
#8
Patrick Hérard, François Boillot, Rasheed M Fakhri
PURPOSE: Hidden infections in a reconstructive surgery program are frequently underestimated. METHODS: A retrospective study was undertaken of 1,891 civilian war-wounded patients from Iraq, Syria, Yemen and Gaza treated in Amman from August 2006 to January 2016. One thousand three hundred and fifty-three underwent surgical interventions for previous bone injury and had systematic bone cultures. RESULTS: Among patients (167) without any clinical, biological or radiological signs of infection, 46% demonstrated infection based on bone cultures...
January 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28100971/tricuspid-valve-replacement-in-an-hiv-infected-patient-with-severe-tricuspid-regurgitation-secondary-to-remote-endocarditis
#9
Merle Myerson, Ehrin J Armstrong, Eduard Poltavskiy, Jose Fefer, Heejung Bang
Surgical intervention for severe tricuspid regurgitation secondary to remote infective endocarditis has been infrequent, especially in patients also infected with the human immunodeficiency virus (HIV). We describe the case of a 62-year-old HIV-positive man, with a 24-year history of endocarditis caused by intravenous heroin use, who presented with severe tricuspid regurgitation. The patient was initially asymptomatic, was taking antiretroviral medications, and had a satisfactory CD4 count and an undetectable viral load, so we decided to manage the regurgitation conservatively...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28100943/comparison-of-the-clinical-outcome-and-complications-in-laparoscopic-hernia-repair-of-inguinal-hernia-with-mesh-fixation-using-fibrin-glue-vs-tacker
#10
Prasant Chandra, Deepak Phalgune, Shashank Shah
Although laparoscopic repair offers a quick and less morbid way of treating hernias, complications like hematoma, seroma, neuralgia, recurrence, mesh infection, hydrocele, etc. are known. The present study was undertaken to compare various clinical outcomes between mesh fixation using fibrin glue and mesh fixation with tacker in a 3-months follow-up. One hundred patients aged 18 to 60 years having inguinal hernia admitted in Poona Hospital and Research Centre, Pune, between October 2012 and November 2014 for laparoscopic hernia surgery and ready to participate in this study were included...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100942/potential-benefits-of-rib-fracture-fixation-in-patients-with-flail-chest-and-multiple-non-flail-rib-fractures
#11
Meiguang Qiu, Zhanjun Shi, Jun Xiao, Xuming Zhang, Shishui Ling, Hao Ling
The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n = 38) and multiple non-flail rib fracture groups (n = 124)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100522/intraoperative-dexamethasone-does-not-increase-the-risk-of-postoperative-wound-infection-a-propensity-score-matched-post-hoc-analysis-of-the-enigma-ii-trial-endex
#12
T Corcoran, J Kasza, T G Short, E O'Loughlin, M T V Chan, K Leslie, A Forbes, M Paech, P Myles
BACKGROUND: In a post hoc analysis of the ENIGMA-II trial, we sought to determine whether intraoperative dexamethasone was associated with adverse safety outcomes. METHODS: Inverse probability weighting with estimated propensity scores was used to determine the association of dexamethasone administration with postoperative infection, quality of recovery, and adverse safety outcomes for 5499 of the 7112 non-cardiac surgery subjects enrolled in ENIGMA-II. RESULTS: Dexamethasone was administered to 2178 (40%) of the 5499 subjects included in this analysis and was not associated with wound infection [189 (8...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100459/clinical-and-pathological-characteristics-of-hiv-and-hhv8-negative-castleman-disease
#13
Li Yu, Meifeng Tu, Jorge Cortes, Zijun Y Xu-Monette, Roberto N Miranda, Jun Zhang, Robert Z Orlowski, Sattva Neelapu, Prajwal C Boddu, Mary A Akosile, Thomas S Uldrick, Robert Yarchoan, L Jeffrey Medeiros, Yong Li, David C Fajgenbaum, Ken H Young
Castleman disease (CD) comprises three poorly-understood lymphoproliferative variants that share several common histopathological features. Unicentric CD (UCD) is localized to a single region of lymph nodes. Multicentric CD (MCD) manifests with systemic inflammatory symptoms and organ dysfunction due to cytokine dysregulation, and involves multiple lymph node regions. Human herpes virus-8 causes MCD (HHV-8-associated MCD) in immunocompromised individuals, such as HIV infected patients. However, greater than 50% MCD cases are HIV and HHV-8 negative, defined as idiopathic (iMCD)...
January 18, 2017: Blood
https://www.readbyqxmd.com/read/28100407/pressure-ulcer-reconstruction-in-patients-with-heterotopic-ossification-after-spinal-cord-injury-a-case-series-and-review-of-literature
#14
REVIEW
Kai Yang, Alexander Graf, James Sanger
Heterotopic ossification (HO) is widely recognized as a common occurrence among patients suffering from traumatic spinal cord injuries (SCI). The exact etiology of HO formation remains unknown. Published medical and surgical management strategies are often plagued with questionable effectiveness and frequent complications. There are minimal publications regarding the management strategies of HO in SCI patients as it pertains to plastic surgery. We present a case series of patients treated at our institution who underwent treatment for pressure ulcers with underlying HO to highlight the vast spectrum of clinical phenotypes present in this population...
December 21, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28100180/extensive-bilateral-corneal-edema-6%C3%A2-weeks-after-cataract-surgery-keratopathy-due-to-asclepias-physocarpa-a-case-report
#15
Kazuki Matsuura, Shiro Hatta, Yuki Terasaka, Yoshitsugu Inoue
BACKGROUND: Surgeons may be unaware of the ability of plant toxins to cause corneal damage. Therefore, corneal damage following intraocular surgery due to plant toxins may be misdiagnosed as postoperative infection. CASE PRESENTATION: A 74-year-old man presented with hyperemia and reduced visual acuity in both eyes 6 weeks after uneventful cataract surgery. We observed extensive hyperemia and corneal stromal edema with Descemet's folds in both eyes. After obtaining a detailed patient history, we diagnosed plant toxin-induced corneal edema due to Asclepias physocarpa, which can induce corneal edema by inhibiting the Na(+)/K(+) ATPase activity of the corneal endothelium...
January 18, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#16
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099608/subungual-squamous-cell-carcinoma
#17
Carolina Barbosa de Sousa Padilha, Laila Klotz de Almeida Balassiano, Julyana Calegari Pinto, Flávia Crespo Schueler de Souza, Bernard Kawa Kac, Curt Mafra Treu
Although subungual squamous cell carcinoma is rare, it is the most common primary malignant neoplasms in this location. The higher incidence occurs in the fingernails, but involvement of the toenails is also possible. Subungual squamous cell carcinoma often looks like other more common benign lesions, such as fungal infection, onychomycosis, or viral wart. These factors, together with a general lack of awareness of this disease among physicians, often result in delayed diagnosis. Therefore, it is underdiagnosed, with few reports in the literature...
November 2016: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28099357/bilayered-negative-pressure-wound-therapy-preventing-leg-incision-morbidity-in-coronary-artery-bypass-graft-patients-a-randomized-controlled-trial
#18
Yongchao Yu, Zhigang Song, Zhiyun Xu, Xiaofei Ye, Chunyu Xue, Junhui Li, Hongda Bi
BACKGROUNDS: The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial. METHODS: A single-center, pilot randomized controlled trial was conducted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099335/micronodular-pattern-of-organizing-pneumonia-case-report-and-systematic-literature-review
#19
François Lebargy, Davy Picard, Jean Hagenburg, Olivier Toubas, Jeanne-Marie Perotin, Sebastian Sandu, Gaëtan Deslee, Sandra Dury
RATIONALE: Organizing pneumonia (OP) is a clinicopathological entity characterized by granulation tissue plugs in the lumen of small airways, alveolar ducts, and alveoli. OP can be cryptogenic (primary) (COP) or secondary to various lung injuries. PATIENT CONCERNS: We report the case of a 38-year-old male smoker with COP presenting in the form of diffuse micronodules on computed tomography (CT) scan and describe the clinical, radiological, and functional characteristics of micronodular pattern of organizing pneumonia (MNOP) based on a review of the literature including 14 cases...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28098065/the-treatment-of-post-thrombotic-syndrome
#20
Karina Schleimer, Mohammad Esmaeil Barbati, Alexander Gombert, Volker Wienert, Jochen Grommes, Houman Jalaie
BACKGROUND: Post-thrombotic syndrome (PTS) arises in 20-50% of patients who have sustained a deep vein thrombosis and markedly impairs their quality of life. METHODS: This review is based on pertinent publications retrieved by a selective literature search in PubMed and the Cochrane Library, and on the guidelines of the German Societies of Phlebology and Vascular Surgery (Deutsche Gesellschaft für Phlebologie, Deutsche Gesellschaft für Gefässchirurgie). RESULTS: The treatment options are conservative treatment with compression and patient exercises, endovascular recanalization with stent angioplasty, and open bypass surgery of the iliac obstructions...
December 16, 2016: Deutsches Ärzteblatt International
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