Gentamycin Collagen Sponge Inclusion in Pacemaker Generator Change helps Decreasing Pocket Infection Rate to Zero: A Follow-up Analysis of 425 Patients

2021 ◽  
Author(s):  
H. Elfarra ◽  
T. Ghazy ◽  
I. Talipov ◽  
D. Sequeda-Cubides ◽  
M. Vondran ◽  
...  
Keyword(s):  
Infection Rate ◽  
Collagen Sponge ◽  
Pocket Infection

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infection Rate ◽  
Clinical Data ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Satisfactory Outcome ◽  
Tissue Damages ◽  
Tissue Reconstruction ◽  
Severe Soft Tissue

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

scholarly journals Intermediate to Long Term Clinical and Radiographic Outcomes of Triple Arthrodesis: A 422 Case Retrospective Review

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0025
Author(s):  
Jesse King ◽  
Karl Henrikson ◽  
Thomas Harper ◽  
Mike Anderson ◽  
Chris Stauch ◽  
...  
Keyword(s):  
Infection Rate ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Triple Arthrodesis ◽  
Non Union ◽  
Radiographic Outcomes ◽  
Diabetic Status ◽  
Radiographic Data

Category: Ankle Arthritis, Hindfoot Introduction/Purpose: Triple arthrodesis is a commonly performed surgical treatment for hindfoot arthritis and deformity. No study has clearly delineated correlates of both clinical and radiographic outcomes in a sample size this large. The purpose of this study is to explore predictive and demographic outcome measures with long-term followup after triple arthrodesis. Methods: With IRB approval, an institutional radiology database was queried for patients undergoing triple arthrodesis between 2004 and 2016, by a single surgeon at a single institution. A total of 465 cases were identified. Pre- and post-operative clinical and radiographic data was collected retrospectively. Demographic and predictive data included: age, Body Mass Index (BMI), American Society of Anesthesiologists Score (ASA), Charleston Comorbidity Index (CCI), diabetic status, osteoporosis, hypothyroidism, and neuromuscular disease status. Clinical outcomes including infection rate, reoperation rate and clinical nonunion were recorded. Unintended return to the operating room defined clinical failure. Radiographic data including non-union rate, pre- and post- operative ankle degenerative joint disease was also recorded. Statistical analysis was then performed to evaluate the relationship between predictive measures and various outcomes including reoperation, infection, and non-union rates. 23 cases were lost to follow-up. Results: A total of 442 feet (397 patients) were analyzed. The average age was 54 years (14 to 85) with the majority of cases being female (60%). Average follow up was 593 days (40 to 4079). Overall failure rate was 13.7% with clinical nonunion rate of 4.5%. Infection rate was 5.9%. Mortality rate was 0% at 2 years post-operatively. Predictors of failure included: increased BMI, elevated ASA, history of diabetes, underlying neuromuscular disorder (Figure 1). We found no significant difference between pre and post-operative degenerative joint disease rates in the midfoot (9.4%, 12.5%) and ankle (11.7%,13.7%), respectively. Conclusion: Triple arthrodesis is a highly effective procedure for treating hindfoot arthritis. Certain predictive measures including BMI, ASA score, diabetic status and underlying neuromuscular disorders significantly correlate with radiographic union. Additionally, diabetic status significantly correlates with infection status postoperatively. An understanding of these predictive measures may help surgeons in their preoperative planning to improve their clinical and radiographic success rates.

scholarly journals Effect of Influenza Vaccination of Children on Infection Rate in Hutterite Communities: Follow-Up Study of a Randomized Trial

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0167281 ◽  
Author(s):  
Biao Wang ◽  
Margaret L. Russell ◽  
Lorraine Moss ◽  
Kevin Fonseca ◽  
David J. D. Earn ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Randomized Trial ◽  
Infection Rate ◽  
Follow Up Study

The safety and efficacy of anterior cervical discectomy and fusion with polyetheretherketone spacer and recombinant human bone morphogenetic protein–2: a review of 200 patients

2008 ◽  
Vol 8 (6) ◽  
pp. 529-535 ◽  
Author(s):  
Luis M. Tumialán ◽  
Jeff Pan ◽  
Gerald E. Rodts ◽  
Praveen V. Mummaneni
Keyword(s):  
Bone Morphogenetic Protein ◽  
Clinical Outcomes ◽  
Collagen Sponge ◽  
Bone Morphogenetic Protein 2 ◽  
Ct Scans ◽  
Safety And Efficacy ◽  
Morphogenetic Protein ◽  
Human Bone Morphogenetic Protein ◽  
Recombinant Human Bone

Object The goal in this study was to demonstrate the safety and efficacy of anterior cervical discectomy and fusion ([ACDF]; single- or multilevel procedure) performed using titanium plates and polyetheretherketone (PEEK) spacers filled with recombinant human bone morphogenetic protein–2 (rhBMP-2) impregnated in a type I collagen sponge to achieve fusion. Methods The authors retrospectively reviewed 200 patients who underwent a single- or multilevel ACDF with titanium plate fixation and PEEK spacer filled with a collagen sponge impregnated with low-dose rhBMP-2. Clinical outcomes were assessed using pre- and postoperative Nurick grades and the Odom criteria. Radiographic outcomes were assessed using dynamic radiographs and computed tomography (CT) scans. Results The follow-up period ranged from 8 to 36 months (mean 16.7 months). A single-level ACDF was performed in 96 patients, 2-level ACDF in 62 patients, 3-level ACDF in 36 patients, and 4-level ACDF in 6 patients. Long-term follow-up was available for 193 patients. The Odom outcomes were rated as good to excellent in 165 patients (85%), fair in 24 (12.4%), and poor in 4 (2%). Among patients with myelopathy, Nurick grades improved from a preoperative mean of 1.42 to a postoperative mean of 0.26. All patients (100%) achieved solid radiographic fusion on dynamic radiographs and CT scans. Fourteen patients (7%) in this series experienced clinically significant dysphagia, and 4 (2%) required repeated operation for hematoma or seroma. Conclusions An ACDF performed using a PEEK spacer filled with rhBMP-2 leads to good to excellent clinical outcomes and solid fusion, even in multilevel cases and in patients who are smokers. The incidence of symptomatic dysphagia may be decreased with a lower dose of rhBMP-2 that is placed only within the PEEK spacer.

scholarly journals Efficacy of Antibiotic Laden Collagen Sponge In Treating Open Fracture

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Kularaj Subramaniam ◽  
Aminuddin Che Ahmad
Keyword(s):  
Internal Fixation ◽  
Open Fracture ◽  
Female Gender ◽  
Blood Parameters ◽  
Collagen Sponge ◽  
Open Fractures ◽  
Predisposing Factor ◽  
Observational Cohort ◽  
Grade 3

Introduction: Open fractures are known as a major predisposing factor for a higher incidence of infection. The aim of this study was to assess the efficacy of antibiotic impregnated collagen sponge in reducing the risk of infection in open fractures Grade 3. Materials and Methods: This was an observational cohort study, evaluating the incidence of infection in open fractures of the femur Grade 3A/3B following insertion of gentamicin impregnated collagen sponge (Collatamp®) during definitive fracture fixation. Eryhtrocyte Sedimentation Rate (ESR) and total white count (TWC) were used as blood parameters to observe for the possibility of infection from pre-operatively up to follow up visits at the clinic. Results: A total number of 36 patients, whom had sustained open fracture of the femur Grade 3A/B, underwent internal fixation with antibiotic impregnated collagen sponge insertion. Overall, ESR and TWC in both male and female gender were downgoing trend, with p values of <0.001, and clinically there was no evidence of infection. No infection was identified in 97.2% of patients, following the internal fixation and antibiotic impregnated collagen sponge insertion. There was only one patient (2.8%) who developed infection following the definitive internal fixation and antibiotics impregnated collagen sponge insertion. Conclusion: The use of antibiotic impregnated collagen sponge in open fractures reduced the occurrence of infection. Furthermore, this allows for an uncomplicated union of the bone following definitive fixation.

scholarly journals Real-world effectiveness of Ad26.COV2.S adenoviral vector vaccine for COVID-19

2021 ◽  
Author(s):  
Juan Corchado-Garcia ◽  
David Puyraimond-Zemmour ◽  
Travis Hughes ◽  
Tudor Cristea-Platon ◽  
Patrick Lenehan ◽  
...  
Keyword(s):  
Single Dose ◽  
Infection Rate ◽  
Real World ◽  
Large Scale ◽  
Vaccination Campaign ◽  
Reduction Rate ◽  
Health Records ◽  
Vector Vaccine ◽  
Fold Reduction

In light of the massive and rapid vaccination campaign against COVID-19, continuous real-world effectiveness and safety assessment of the FDA-authorized vaccines is critical to amplify transparency, build public trust, and ultimately improve overall health outcomes. In this study, we leveraged large-scale longitudinal curation of electronic health records (EHRs) from the multi-state Mayo Clinic health system (MN, AZ, FL, WN, IA). We compared the infection rate of 2,195 individuals who received a single dose of the Ad26.COV2.S vaccine from Johnson & Johnson (J&J) to the infection rate of 21,950 unvaccinated, propensity-matched individuals between February 27th and April 14th 2021. Of the 1,779 vaccinated individuals with at least two weeks of follow-up, only 3 (0.17%) tested positive for SARS-CoV-2 15 days or more after vaccination compared to 128 of 17,744 (0.72%) unvaccinated individuals (4.34 fold reduction rate). This corresponds to a vaccine effectiveness of 76.7% (95% CI: 30.3-95.3%) in preventing SARS-CoV-2 infection with onset at least two weeks after vaccination. This data is consistent with the clinical trial-reported efficacy of Ad26.COV2.S in preventing moderate to severe COVID-19 with onset at least 14 days after vaccine administration (66.9%; 95% CI: 59.0-73.4%). Due to the recent authorization of the Ad26.COV2.S vaccine, there are not yet enough hospitalizations, ICU admissions, or deaths within this cohort to robustly assess the effect of vaccination on COVID-19 severity, but these outcomes will be continually assessed in near-real-time with our platform. Collectively, this study provides further evidence that a single dose of Ad26.COV2.S is highly effective in preventing SARS-CoV-2 infection and reaffirms the urgent need to continue mass vaccination efforts globally.

Yogurt reduces the risk of infection of COVID—19

2021 ◽  
Vol 6 (2) ◽  
pp. 27-28
Author(s):  
Lei Hui ◽  
Xiang Tao
Keyword(s):  
Nucleic Acid ◽  
Infection Rate ◽  
Nucleic Acid Detection ◽  
Risk Of Infection ◽  
Positive Rate

Objective: To investigate whether yogurt reduces the risk of infection of COVID—19. Methods: 10000 citizens in Wuhan who drink yogurt every day and 10000 citizens in Wuhan who do not drink yogurt were retrospective reviewed by telephone follow-up. Results: The positive rate of COVID—19 nucleic acid detection was 0.13% among the 10000 people in Wuhan who drink yogurt every day. The positive rate of COVID—19 nucleic acid detection was 7.89% among the 10000 people in Wuhan who do not drink yogurt. The COVID—19 infection rate of the citizens who drink yogurt every day is significantly lower than that of the citizens who do not drink yogurt. Conclusion: Yogurt reduces the risk of infection of COVID—19.

Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal

2021 ◽  
Vol 15 (09) ◽  
pp. 1277-1280
Author(s):  
Milos Dusan Babic ◽  
Lazar Angelkov ◽  
Milosav Tomovic ◽  
Mihailo Jovicic ◽  
Darko Boljevic ◽  
...  
Keyword(s):  
Case Report ◽  
Delayed Diagnosis ◽  
Lead Removal ◽  
Pacemaker Lead ◽  
Cardiac Device ◽  
Delayed Treatment ◽  
Pocket Infection ◽  
Endocardial Lead ◽  
Lead Endocarditis

Introduction: The estimated infection rate after permanent endocardial lead implantation is between 1% and 2%. Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. In this case report, we present a patient with delayed diagnosis and treatment due to the COVID-19 outbreak. Case Report: An 88-year-old, pacemaker dependent woman with diagnosed pacemaker pocket infection was admitted to the University Cardiovascular institute. The patient had a prolonged follow-up time due to the COVID-19 outbreak. She missed her routine checkup and came to her local hospital when the generator had already protruded completely, to the point where she held it in her own hand. Transthoracic echocardiogram showed possible vegetations on the lead. Transesophageal echocardiography was not performed due to the COVID-19 pandemic. On the day after the admission the patient underwent transvenous removal of the pacemaker lead using a 9 French gauge rotational extraction sheathe (Cook Medical). The extracted lead was covered in a thin layer of vegetations. Further follow-ups showed good recovery with no complications. Conclusions: A case showing delayed treatment of pacemaker pocket infection, due to delayed follow-up time during the COVID-19 pandemic. This patient underwent successful transvenous removal of the infected pacemaker lead, along with adequate antibiotic therapy, which has proven to be the most effective method of treating cardiac device-related endocarditis.

scholarly journals A Study on Role of Follow up in Minor Surgical Procedures

2019 ◽  
Vol 2 (1) ◽  
pp. 34-39
Author(s):  
Shankar Raut ◽  
Yogendra Man Shakya ◽  
Yagya Laxmi Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Infection Rate ◽  
Surgical Procedures ◽  
P Value ◽  
Medical Illness ◽  
Daily Routine ◽  
Age Group ◽  
Cross Sectional ◽  
Minor Surgical Procedures ◽  
Duration Of Surgery

Background: Minor surgical procedures are surgeries that can be performed in the clinic under local anesthesia and doesn’t require preoperative and postoperative admission. In most of the institutions in our country, we advised patients to follow up within 7 to 10 days following minor surgical procedures. Unnecessary follow up increases stress to the patients in terms of not being able to manage daily routine work and would be costly as well. As a General Practitioner, majority of the cases done are the minor surgical procedures. Methods: The study was a prospective cross sectional study conducted in General Surgery Department at United Mission Hospital, Palpa from Dec 2013 to May 2013. 228 patients were divided in two groups of “No follow up” group and “Follow-up” group. No Follow-up Group was asked pre-formed questionnaires by telephone where as Follow-up group were asked to follow up routinely on day 7 to 10 days of surgery and asked the same questions. Statistical analysis was done using SPSS program and Microsoft excel. P value of <0.05 was considered statistically significant. P-value was determined by using Chi Square test. Result: The overall wound infection among 228 patients was found to be 14.5 percent with infection rate of 16.4 percent in No Follow up group and 12.7 percent in Follow-up group. The infection rate was found to be higher among the older age group of patient maximum being 36.4% in the age group of 50-59 years with p value of 0.053. Other risk factors like age, sex, residence, duration of surgery, socio economic status, history of medical illness and BMI didn’t have significant association with rate of infection following minor surgical procedure. Conclusion: The routine postoperative follow up in minor surgery is unnecessary unless there are any signs suggestive of infection.

scholarly journals Stunting Among Children in Rural Area of Indonesia: Five-Year Follow-Up Study

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 187-187
Author(s):  
Dini Suciyanti ◽  
Grace Wangge ◽  
Umi Fahmida ◽  
Taniawati Supali
Keyword(s):  
Rural Area ◽  
Infection Rate ◽  
Serum Zinc ◽  
Structured Interview ◽  
Hemoglobin Level ◽  
Wilcoxon Test ◽  
Household Food Security ◽  
Follow Up Study ◽  
Household Food

Abstract Objectives To follow-up the situation of stunting among children in Nangapanda, a subdistrict in East Nusa Tenggara, Indonesia after 5 years. Methods The design was 5-year follow-up study in rural area of Indonesia. A total of 89 children aged 6–9 years were included. Structured interview, nutritional assessment, blood and stool collection were performed to the subjects who had the same measurement in 2014. Socio-demography characteristics, weight, height, hemoglobin level, serum ferritin, serum zinc, CRP, worm infection and household food security were collected. To compare the baseline and 5-year follow-up data wilcoxon test, paired t-test, and Mc-Nemar test were used. Results After 5 years, stunting prevalence dropped considerably from 49.4% to 21.3%. There were 34.1% children remain stunted after 5 years. Among the stunted children, 80% remained underweight, 33.3% remained anemia, and 16.7% still had worm infection. According to sociodemographic data, those who remain stunted had low mother's education (66%), lived with 5–8 household members (53.3%), experienced household food insecurity (53.3%), and consumed unsafe drinking water (46.7%). Compared to their nutritional status in 2014, there are improvements in their HAZ-score and hemoglobin level (P &lt; 0.0001). In addition, worm infection rate reduced although the reduction was not significant (P = 0.077). Children whose HAZ-score improved were comparable in their sociodemographic status with those children who remained stunted children. Conclusions Within five year period, there was reduction in stunting prevalence which was accompanied by increase in HAZ-score, hemoglobin level and reduction in worm infection rate. No difference was found in characteristics of children who recovered and remained stunted. Funding Sources Pintermidi Grant from Universitas Indonesia with contract number 1908/UN2.R3.1/HKP.05.00/2019.

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