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https://www.readbyqxmd.com/read/29050061/-perioperative-anaphylaxia-on-drugs
#1
Wolfgang Pfützner, Hinnerk Wulf
The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29045740/adding-vancomycin-to-perioperative-prophylaxis-decreases-deep-sternal-wound-infections-in-high-risk-cardiac-surgery-patients
#2
Sylvia Reineke, Thierry P Carrel, Verena Eigenmann, Brigitta Gahl, Urs Fuehrer, Christian Seidl, David Reineke, Eva Roost, Magi Bächli, Jonas Marschall, Lars Englberger
OBJECTIVES: Perioperative prophylaxis with cephalosporins reduces sternal wound infections (SWIs) after cardiac surgery. However, more than 50% of coagulase-negative staphylococci, an important pathogen, are cephalosporin resistant. The aim of this study was to determine the impact of adjunctive vancomycin on SWIs in high-risk patients. METHODS: We conducted a pre- and postintervention study in an academic hospital. Preintervention (2010-2011), all patients received prophylaxis with 1...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29045261/incidence-and-outcomes-of-central-venous-catheter-related-blood-stream-infection-in-patients-with-inflammatory-bowel-disease-in-routine-clinical-practice-setting
#3
Wataru Shibata, Masako Sohara, Rongrong Wu, Kota Kobayashi, Shin Yagi, Katsuki Yaguchi, Yuki Iizuka, Miho Iwasa, Hitomi Nakahata, Tadashi Yamaguchi, Hiromi Matsumoto, Mao Okada, Kenshiro Taniguchi, Aki Hayashi, Shin Inazawa, Naoko Inagaki, Tomohiko Sasaki, Ryonho Koh, Hiroto Kinoshita, Masafumi Nishio, Tsuyoshi Ogashiwa, Ai Ookawara, Eiji Miyajima, Mari Oba, Hiroki Ohge, Shin Maeda, Hideaki Kimura, Reiko Kunisaki
BACKGROUND: Patients with inflammatory bowel disease (IBD) occasionally require central venous catheter (CVC) placement to support a therapeutic plan. Given that CVC can predispose patients to infection, this investigation was undertaken to assess the incidence, risk factors, and outcomes of CVC-related blood stream infection (CRBSI) in patients with IBD during routine clinical practice. METHODS: Data were compiled using retrospective chart reviews of 1367 patients treated at our IBD center between 2007 and 2012 during routine clinical practice...
November 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29044978/early-postoperative-fever-in-pediatric-patients-undergoing-cochlear-implant-surgery
#4
Sabri El-Saied, Ben-Zion Joshua, Muhammad Abu Tailakh, Irit Jagev, Revital Gorali, Mordechai Kraus, Daniel M Kaplan
Early Post-Operative Fever after cochlear Implant surgery is not uncommon. We assessed all pediatric patients undergoing cochlear implants and addressed the patients with post-operative fever. A hundred and thirty surgeries were performed; of all patients 25 developed early postoperative fever. The workup did not identify the cause of fever in any of the patients. Fever resolved without any additional Intervention. There was no difference in fever or infection rate in patients that received prophylactic antibiotic, whether prolonged (one week) versus or only perioperative treatment (one day)...
October 16, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29038828/using-the-who-surgical-safety-checklist-to-direct-perioperative-quality-improvement-at-a-surgical-hospital-in-cambodia-the-importance-of-objective-confirmation-of-process-completion
#5
Naomi Y Garland, Sokhavatey Kheng, Michael De Leon, Hourt Eap, Jared A Forrester, Janice Hay, Palritha Oum, Socheat Sam Ath, Simon Stock, Samprathna Yem, Gerlinda Lucas, Thomas G Weiser
BACKGROUND: The WHO surgical safety checklist (SSC) is known to prevent postoperative complications; however, strategies for effective implementation are unclear. In addition to cultural and organizational barriers faced by high-income countries, resource-constrained settings face scarcity of durable and consumable goods. We used the SSC to better understand barriers to improvement at a trauma hospital in Battambang, Cambodia. METHODS: We introduced the SSC and trained data collectors to observe surgical staff performing the checklist...
October 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29037481/surgical-outcomes-among-elderly-women-with-endometrial-cancer-treated-by-laparoscopic-hysterectomy-a-nrg-gynecologic-oncology-group-study
#6
Erin A Bishop, James J Java, Kathleen N Moore, Nick M Spirtos, Michael L Pearl, Oliver Zivanovic, David M Kushner, Floor Backes, Chad A Hamilton, Melissa A Geller, Jean Hurteau, Cara Mathews, Robert M Wenham, Pedro T Ramirez, Susan Zweizig, Joan L Walker
OBJECTIVE: Tolerance of and complications due to minimally invasive hysterectomy and staging in the older endometrial cancer population is largely unknown despite the fact that this is the most rapidly growing age group in the United States. The objective of this retrospective review is to compare operative morbidity by age in patients on the Gynecologic Oncology Group (GOG) LAP2 trial. METHODS: This is a retrospective analysis of patients from GOG LAP2, a trial that included clinically early stage uterine cancer patients randomized to laparotomy vs...
October 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28993363/rare-postoperative-complication-clostridium-perfringens-septic-shock-following-elective-abdominal-surgery
#7
Michael Bath, Mark McKelvie, Khalid Canna
Postoperative infections are one of the most common complications in general surgery, and while rates have reduced with the routine administration of perioperative antibiotics, around 5% of patients undergoing a surgical procedure will develop an infective complication.(1) The Gram-positive, obligate anaerobe, Clostridium perfringens, is a well-known pathogen that forms part of both the environmental and gastrointestinal flora.(2) While more commonly associated with food poisoning, anaerobic cellulitis and traumatic gas gangrene, rare cases of spontaneous non-traumatic gas gangrene of abdominal viscera have also been recorded...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28991759/the-importance-of-perioperative-prophylaxis-with-cefuroxime-or-ceftriaxone-in-the-surgical-site-infections-prevention-after-cranial-and-spinal-neurosurgical-procedures
#8
Aleksandra Dimovska-Gavrilovska, Aleksandar Chaparoski, Andreja Gavrilovski, Zvonko Milenkovikj
Introduction Surgical site infections pose a significant problem in the treatment of neurosurgical procedures, regardless of the application of perioperative prophylaxis with systemic antibiotics. The infection rate in these procedures ranges from less than 1% to above 15%. Different antibiotics and administration regimes have been used in the perioperative prophylaxis so far, and there are numerous comparative studies regarding their efficiency, however, it is generally indicated that the choice thereof should be based on information and local specifics connected to the most probable bacterial causers, which would possibly contaminate the surgical site and cause infection, and moreover, the mandatory compliance with the principles of providing adequate concentration of the drug at the time of the anticipated contamination...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28984794/the-use-of-povidone-iodine-in-ophthalmology
#9
Andrzej Grzybowski, Piotr Kanclerz, William G Myers
PURPOSE OF REVIEW: Povidone-iodine (PVI) is a disinfectant and antiseptic agent used for preoperative preparation of the skin and mucous membranes, as well as for the treatment of contaminated wounds. Currently regimens for prophylaxis against postsurgical endophthalmitis are being modified, including a total withdrawal of antibiotics in intravitreal injections. The aim of this study was to evaluate the use of PVI in ophthalmology. RECENT FINDINGS: As a result of its broad spectrum of microbicidal activity, PVI is routinely used in ophthalmic surgery...
October 3, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28975694/a-european-survey-of-bowel-preparation-in-colorectal-surgery
#10
Liam A Devane, David Proud, P Ronan O'Connell, Yves Panis
AIM: Meta-analysis has shown that mechanical bowel preparation (MBP) does not improve outcomes in colonic surgery however there is uncertainty regarding MBP use in laparoscopic and rectal surgery and the addition of oral antibiotic regimens. The aim of this study was to assess current use of bowel preparation among European surgeons. METHOD: An online survey was circulated to members of the European Society of Coloproctology. Chi-squared analysis was used to compare subgroups...
October 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28975304/effect-of-post-cesarean-delivery-oral-cephalexin-and-metronidazole-on-surgical-site-infection-among-obese-women-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Amy M Valent, Chris DeArmond, Judy M Houston, Srinidhi Reddy, Heather R Masters, Alison Gold, Michael Boldt, Emily DeFranco, Arthur T Evans, Carri R Warshak
Importance: The rate of obesity among US women has been increasing, and obesity is associated with increased risk of surgical site infection (SSI) following cesarean delivery. The optimal perioperative antibiotic prophylactic regimen in this high-risk population undergoing cesarean delivery is unknown. Objective: To determine rates of SSI among obese women who receive prophylactic oral cephalexin and metronidazole vs placebo for 48 hours following cesarean delivery...
September 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28975112/topical-vancomycin-does-it-reduce-surgical-site-infection-in-bone-tumors
#12
Suman Byregowda, Ajay Puri, Ashish Gulia
INTRODUCTION: We retrospectively analyzed a consecutive group of patients operated for bone tumors of extremity and pelvis who received only perioperative antibiotics (Group A) against a similar group that had additional 1 g topical vancomycin sprinkled in the wound before closure (Group B). The aim was to determine if the addition of topical vancomycin decreases the incidence of deep surgical site infection (SSI). MATERIALS AND METHODS: A total of 221 patients operated between January 2011 and December 2011 were analyzed in Group A and 254 patients operated between April 2012 and March 2013 were analyzed in Group B...
July 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28971790/sepsis-after-elective-ureteroscopy
#13
Jonathan Bloom, Cristina Fox, Sean Fullerton, Gerald Matthews, John Phillips
INTRODUCTION: We sought to determine our rate of postoperative sepsis after ureteroscopy as well as identifying associative factors, common antibiotic practices along with culture data. MATERIALS AND METHODS: Records of all patients who underwent elective ureteroscopy from 2010 to 2015 at an urban tertiary care facility were retrospectively reviewed. Factors thought to be associated with infection were collected, along with comorbidities depicted as Charlson Age-Adjusted Comorbidity Index (CAACI) and American Society of Anesthesia (ASA) score...
October 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28967511/does-surgical-site-infection-after-caesarean-section-in-polish-hospitals-reflect-high-quality-patient-care-or-poor-postdischarge-surveillance-results-from-a-3-year-multicenter-study
#14
Anna Różańska, Andrzej Jarynowski, Katarzyna Kopeć-Godlewska, Jadwiga Wójkowska-Mach, Agnieszka Misiewska-Kaczur, Marzena Lech, Małgorzata Rozwadowska, Marlena Karwacka, Joanna Liberda, Joanna Domańska
BACKGROUND: Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. METHODS: The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net...
September 26, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28964729/-how-do-i-prevent-caesarean-wound-infections-in-obese-patients-in-2017
#15
B Ripamonti, T Raia-Barjat, C Chauleur, P Mathevet
Obesity is an important risk factor of cesarean section and is associated with an increased risk of wound complications such as infections. This review focuses on the available strategies to limit complications in this population. Choice of antiseptic solution, appropriate dose and type of antibiotic prophylaxy, suture closure of subcutaneous fat, suture skin closure and closed incision negative pressure wound therapy may reduce the risk of wound infections associated with cesarean section in obese patients...
September 27, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28942541/surgical-site-infections-in-emergency-abdominal-surgery-at-tamale-teaching-hospital-ghana
#16
Stephen Tabiri, Edwin Yenli, Martin Kyere, Theophilus T K Anyomih
BACKGROUND: Surgical site infections (SSIs) result in delayed wound healing, increased use of antibiotics and increased length of hospital stay, putting remarkable physical and financial burden on patients, their relatives and the healthcare facilities. Patient-related factors, such as pre-existing colonization with antibiotic-resistant bacteria, and clinical-related factors, such as adherence to sterile techniques, contribute to the development of SSIs. The objective of this study, therefore, was to determine the SSI rate and risk factors for emergency abdominal surgeries at Tamale Teaching Hospital, Ghana...
September 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28934542/complications-associated-with-pelvic-external-fixation
#17
Christopher McDonald, Reza Firoozabadi, M L Routt, Conor Kleweno
An external fixator is an essential tool for treating unstable pelvic ring injuries but its use carries risks, including pin-site infections and injury to the lateral femoral cutaneous nerve (LFCN). Surgeons currently lack data regarding these risks for patient counseling. This study aimed to identify the incidence of and risk factors for superficial and deep pin-site infection and LFCN damage. Fifty-two patients who underwent pelvic external fixation with anterior pin placement as part of definitive treatment for unstable pelvic ring disruption were retrospectively evaluated to identify factors associated with the development of infection...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28932266/risk-factors-for-surgical-site-infections-in-obstetrics-a-retrospective-study-in-an-ethiopian-referral-hospital
#18
Teshager Mamo, Tilaye Workneh Abebe, Tesfaye Yitna Chichiabellu, Antehun Alemayehu Anjulo
BACKGROUND: Pregnant women are at risk of infection during labor and delivery. Infection in obstetrics accounts for the second most common cause of maternal mortality next to post partum hemorrhage. Knowing the prevalence and associated risk factors would help to undertake optimal precautions and standard surgical techniques to reduce surgical site infection which poses increased hospital cost and total hospital stay of the patients. METHOD: Facility based retrospective observational study design was carried out purposively to assess the prevalence of surgical site infections and associated risk factors among mothers who had delivery related surgery at obstetric ward of Assela teaching referral hospital from April, 23, 2015 to September 5, 2015...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28930045/antibiotic-use-among-older-adults-on-an-acute-care-general-surgery-service
#19
André S Pollmann, Jon G Bailey, Philip J B Davis, Paul M Johnson
BACKGROUND: Antibiotics play an important role in the treatment of many surgical diseases that affect older adults, and the potential for inappropriate use of these drugs is high. Our objective was to describe antibiotic use among older adults admitted to an acute care surgical service at a tertiary care teaching hospital. METHODS: Detailed data regarding diagnosis, comorbidities, surgery and antibiotic use were retrospectively collected for patients 70 years and older admitted to an acute care surgical service...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929609/benchmarking-against-the-national-emergency-laparotomy-audit-recommendations
#20
Yiu Ming Ho, Julie Cappello, Ramin Kousary, Brian McGowan, Arkadiusz P Wysocki
BACKGROUND: The Royal College of Anaesthetists published the National Emergency Laparotomy Audit (NELA) to describe and compare inpatient care and outcomes of major emergency abdominal surgery in England and Wales in 2015 and 2016. The purpose of this article is to compare emergency abdominal surgical care and mortality in a regional hospital (Logan Hospital, Queensland, Australia) with NELA results. METHODS: Data were extracted from two databases. All deaths from May 2010 to April 2015 were reviewed and patients who had an emergency abdominal operation within 30 days of death were identified...
September 19, 2017: ANZ Journal of Surgery
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