Prospective Evaluation of Surgical Wound Dressings and the Incidence of Surgical Site Infections in Dogs Undergoing a Tibial Plateau Levelling Osteotomy

Objective The main aim of this study was to evaluate the efficacy of a topical 2-octyl cyanoacrylate (2OC) tissue adhesive and an adhesive barrier dressing (BD) in minimizing the incidence of surgical site infections (SSI) in dogs undergoing a tibial plateau levelling osteotomy (TPLO). Materials and Methods In a prospective clinical study, 437 client-owned dogs undergoing a TPLO as treatment for cranial cruciate ligament disease with or without concurrent patellar luxations from July 2015 to September 2016 were included. In each dog, the type of postoperative wound dressing was randomly selected as either no dressing (ND), a 2OC tissue adhesive or an adhesive BD. Direct examination by a veterinarian was performed at 14, 30, 60 and 90 days postoperatively. If dogs did not return for direct examination, owners were contacted with a questionnaire for the final follow-up of at least 90 days. Results The overall rate of SSI was 2.3% (10/437). Methicillin-resistant Staphylococcus pseudintermedius was the most common bacteria isolated in 9/10 cases. Infection was confirmed in 2.76% (4/145) of dogs with ND, 2.01% (3/149) of dogs with 2OC and 2.10% (3/143) of dogs with BD. Of the dogs that developed an SSI, type of dressing was not a significant risk factor (p = 0.5305) for infection. Increasing body weight was the only significant risk factor that increased the risk of overall infection (odds ratio = 1.03 [95% confidence interval: 1.02–1.05]). Clinical Significance In dogs undergoing a TPLO, there may be no clear benefit in the usage of postoperative wound dressings for the prevention of SSI. Increasing body weight was the only significant factor associated with the development of an SSI.

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The Critical Role of Biliary Candidiasis in Development of Surgical Site Infections after Pancreatoduodenectomy: Results of Prospective Study Using a Selective Culture Medium for Candida Species

BioMed Research International ◽

10.1155/2018/5939724 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Hiroyuki Kato ◽

Yusuke Iizawa ◽

Kei Nakamura ◽

Kazuyuki Gyoten ◽

Aoi Hayasaki ◽

...

Keyword(s):

Risk Factor ◽

Candida Species ◽

Critical Role ◽

Significant Risk ◽

Surgical Site Infections ◽

Preoperative Assessment ◽

Significant Risk Factor ◽

High Level ◽

New Evidence

In accordance with previous reports, the incidence of biliary candidiasis (BC) after pancreaticoduodenectomy (PD) was reported to be 0 to 5%, and the clinical significance of BC still has been elusive. In this study, we prospectively evaluated the precise incidence of BC after PD using the CHROMagar Candida plate in an attempt to elucidate whether BC has a significant impact on the clinical outcomes after PD.Patients and Method. From November 2014 to March 2016, the consecutive 51 patients who underwent PD were enrolled for this study. The bile juice was prospectively collected through the biliary stent tube on postoperative days (POD) 3, 7, and 14 and directly incubated onto the CHROMagar Candida plate for the cultivation of various Candida species. In the presence or absence of BC, we compared the incidence of SSIs.Results. The incidence of postoperative BC was 15% on POD 3, 24% on POD 7, and 39% on POD 14, respectively. Taken together, 22 patients out of 51 (43.1%) developed BC after PD. Moreover, the incidence of SSIs was significantly higher in patients with BC than in those without it (71% versus 7%, p=0.005). BC was selected as the only significant risk factor of SSIs after PD among the various risk factors. Even though a cause of BC is unknown, high level of alkaline phosphatase (cut-off line >300 IU/L) was selected as the only preoperative risk factor of the development of BC.Conclusion. We elucidated new evidence in which BC could be the independent cause of SSIs after PD and should not be recognized as just contamination artifacts. Preoperative assessment for identifying carriers of Candida species might be essential for reducing the incidence of SSIs after PD.

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Past Obesity as well as Present Body Weight Status Is a Risk Factor for Diabetic Nephropathy

International Journal of Endocrinology ◽

10.1155/2013/590569 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Shu Meguro ◽

Yusuke Kabeya ◽

Karin Tanaka ◽

Toshihide Kawai ◽

Masuomi Tomita ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Risk Factor ◽

Diabetic Nephropathy ◽

Weight Status ◽

Significant Risk ◽

Significant Risk Factor ◽

The Past ◽

Body Weight Status

Aims. We analyzed the prevalence of nephropathy according to past body weight status in Japanese subjects with type 2 diabetes because the influence of past obesity on diabetic complications is not certain.Methods. We examined the prevalence of nephropathy in 2927 subjects with type 2 diabetes mellitus according to current BMI and maximum BMI in the past. We defined “current obesity” as BMI on hospitalization of 25 or more, “previous obesity” as BMI on hospitalization of less than 25 and self-reported maximum BMI in the past of 25 or more, and “continuously lean” as maximum BMI of less than 25.Results. The prevalence of nephropathy was significantly higher in subjects with current obesity (40.6%) or previous obesity (35.6%) than in those who were continuously lean (24.3%) (P<0.017). In logistic regression analysis, previous obesity, as well as current obesity, was a significant risk factor for nephropathy, independent of sex, age, disease duration, hypertension, dyslipidemia, HbA1c, and diabetic retinopathy.Conclusions. Obesity in the past, as well as the present body weight status, was a risk factor for diabetic nephropathy.

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Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽

10.1027/0227-5910/a000271 ◽

2014 ◽

Vol 35 (5) ◽

pp. 330-337 ◽

Cited By ~ 14

Author(s):

Cun-Xian Jia ◽

Lin-Lin Wang ◽

Ai-Qiang Xu ◽

Ai-Ying Dai ◽

Ping Qin

Keyword(s):

Risk Factor ◽

Family Income ◽

Rural China ◽

Significant Risk ◽

Significant Risk Factor ◽

Health Condition ◽

Physical Illness ◽

Rural Residents ◽

Increased Risk ◽

Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

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Higher premature atrial complex burden from the Holter examination predicts poor cardiovascular outcome

Scientific Reports ◽

10.1038/s41598-021-91800-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ting-Chun Huang ◽

Po-Tseng Lee ◽

Mu-Shiang Huang ◽

Pei-Fang Su ◽

Ping-Yen Liu

Keyword(s):

Risk Factor ◽

Dose Response ◽

Cox Model ◽

Significant Risk ◽

Significant Risk Factor ◽

Cardiovascular Death ◽

Specific Model ◽

Distribution Model ◽

All Cause Mortality ◽

Quartile Group

AbstractPremature atrial complexes (PACs) have been suggested to increase the risk of adverse events. The distribution of PAC burden and its dose–response effects on all-cause mortality and cardiovascular death had not been elucidated clearly. We analyzed 15,893 patients in a medical referral center from July 1st, 2011, to December 31st, 2018. Multivariate regression driven by ln PAC (beats per 24 h plus 1) or quartiles of PAC burden were examined. Older group had higher PAC burden than younger group (p for trend < 0.001), and both genders shared similar PACs distribution. In Cox model, ln PAC remained an independent risk factor for all-cause mortality (hazard ratio (HR) = 1.09 per ln PAC increase, 95% CI = 1.06‒1.12, p < 0.001). PACs were a significant risk factor in cause-specific model (HR = 1.13, 95% CI = 1.05‒1.22, p = 0.001) or sub-distribution model (HR = 1.12, 95% CI = 1.04‒1.21, p = 0.004). In ordinal PAC model, 4th quartile group had significantly higher risk of all-cause mortality than those in 1st quartile group (HR = 1.47, 95% CI = 1.13‒1.94, p = 0.005), but no difference in cardiovascular death were found in competing risk analysis. In subgroup analysis, the risk of high PAC burden was consistently higher than in low-burden group across pre-specified subgroups. In conclusion, PAC burden has a dose response effect on all-cause mortality and cardiovascular death.

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DIGEORGE SYNDROME IS A SIGNIFICANT RISK FACTOR FOR THE DEVELOPMENT OF INFECTIOUS ENDOCARDITIS FOLLOWING TRANSCATHETER PULMONARY VALVE REPLACEMENT WITH THE MELODY VALVE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)01805-2 ◽

2021 ◽

Vol 77 (18) ◽

pp. 446

Author(s):

Graham Stockdale ◽

Joseph Graziano ◽

Wayne Franklin ◽

Jordan Awerbach ◽

Byron Garn ◽

...

Keyword(s):

Risk Factor ◽

Valve Replacement ◽

Digeorge Syndrome ◽

Pulmonary Valve ◽

Significant Risk ◽

Significant Risk Factor ◽

Pulmonary Valve Replacement ◽

Infectious Endocarditis ◽

Melody Valve ◽

Transcatheter Pulmonary Valve Replacement

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Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1344 ◽

2020 ◽

pp. 1-7

Author(s):

Stephanie M. Cabral ◽

Katherine E. Goodman ◽

Natalia Blanco ◽

Surbhi Leekha ◽

Larry S. Magder ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Risk Adjustment ◽

Community Hospital ◽

Significant Risk ◽

Significant Risk Factor ◽

Bivariate Analysis ◽

Patient Admissions ◽

Clostridioides Difficile ◽

Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

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Intoxication is a Significant Risk Factor for Severe Craniomaxillofacial Injuries in Standing Electric Scooter Accidents

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2020.09.026 ◽

2020 ◽

Author(s):

Kyle Shiffler ◽

Khal Mancini ◽

Melissa Wilson ◽

Allen Huang ◽

Eric Mejia ◽

...

Keyword(s):

Risk Factor ◽

Significant Risk ◽

Significant Risk Factor ◽

Electric Scooter

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Type-2 Diabetes as a Risk Factor for Severe COVID-19 Infection

Microorganisms ◽

10.3390/microorganisms9061211 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1211

Author(s):

Mahnaz Norouzi ◽

Shaghayegh Norouzi ◽

Alistaire Ruggiero ◽

Mohammad S. Khan ◽

Stephen Myers ◽

...

Keyword(s):

Type 2 Diabetes ◽

Risk Factor ◽

Inflammatory Responses ◽

Significant Risk ◽

Significant Risk Factor ◽

Diabetic Patients ◽

Angiotensin Converting Enzyme 2 ◽

Immune System Dysfunction ◽

Current Outbreak

The current outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), termed coronavirus disease 2019 (COVID-19), has generated a notable challenge for diabetic patients. Overall, people with diabetes have a higher risk of developing different infectious diseases and demonstrate increased mortality. Type 2 diabetes mellitus (T2DM) is a significant risk factor for COVID-19 progression and its severity, poor prognosis, and increased mortality. How diabetes contributes to COVID-19 severity is unclear; however, it may be correlated with the effects of hyperglycemia on systemic inflammatory responses and immune system dysfunction. Using the envelope spike glycoprotein SARS-CoV-2, COVID-19 binds to angiotensin-converting enzyme 2 (ACE2) receptors, a key protein expressed in metabolic organs and tissues such as pancreatic islets. Therefore, it has been suggested that diabetic patients are more susceptible to severe SARS-CoV-2 infections, as glucose metabolism impairments complicate the pathophysiology of COVID-19 disease in these patients. In this review, we provide insight into the COVID-19 disease complications relevant to diabetes and try to focus on the present data and growing concepts surrounding SARS-CoV-2 infections in T2DM patients.

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