scholarly journals EP.FRI.469 A closed-loop audit regarding the practice of sending Pus Swab for culture and sensitivity in Pilonidal abscess drainage

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Varun Sarodaya ◽  
Mohammad Zeeshan Nasser ◽  
Mubashar Hussain
Keyword(s):  
Closed Loop ◽  
Treatment Protocol ◽  
Cost Savings ◽  
Incision And Drainage ◽  
Patient Demographics ◽  
High Infection ◽  
Theatre Staff ◽  
Time Required ◽  
Pilonidal Abscess

Abstract Aim The purpose of this study was to determine the role of Microbiological swabs taken during an Incision and drainage for Pilonidal abscess in patient management. Method We performed a closed-loop audit to determine the role of pus swabs in the management of pilonidal abscess. Parameters like patient demographics, date of surgery, whether or not pus sent for microbiological examination, the subsequent report, the time required for sample processing, antibiotics prescribed were considered. The data was collated, analysed, and presented at clinical governance. We then implemented in our treatment protocol to stop the practice. This data was again, prospectively collected to complete the audit cycle. Result A total of 250 patient were included in this study. Prior to the change of practice, swabs were sent in 77% of the cases. The average reporting time of the swabs was 4.3 days and 92% of the patients were discharged on antibiotics. After conducting multiple teaching sessions for the trainees and educating the theatre staff, the percentage of swabs sent was brought down to 58%. Conclusion The pilonidal abscess has high infection and recurrence rate. Hence, the management involves incision, drainage and antibiotics cover in most cases. In our study, the swab results did not alter patients management. Most of them were treated with Co-Amoxiclav and some required additional Metronidazole. Hence, we suggested the routine use of swab for culture in pilonidal abscess cases are unwarranted. This change of practice resulted in huge cost savings at our hospital.

A New Fixed-wire, ‘Stent-on-a-wire’, Very-low-profile Stent Delivery System – Rationale, Design and Update

2010 ◽  
Vol 5 (1) ◽  
pp. 20 ◽  
Author(s):  
Tim A Fischell ◽  
Keyword(s):  
Delivery System ◽  
Cost Savings ◽  
Coronary Stenting ◽  
Bleeding Complications ◽  
Need For Closure ◽  
Procedural Cost ◽  
Low Profile ◽  
Direct Stenting ◽  
Coronary Artery Stenting ◽  
Time Required

Coronary artery stenting has evolved substantially since the first use of coronary stenting as an adjunct to balloon angioplasty in the early 1990s. The performance (and particularly the deliverability) of coronary stents has improved such that coronary stenting is now the primary mode of revascularisation for percutaneous coronary interventions (PCIs) in more than 95% of cases. The new Svelte™ stent-on-a-wire (SOAW) delivery system represents one of the first substantive innovations in stent delivery systems (SDS) in more than a decade. This SDS uses a shapeable ‘fixed wire’ as an integral part of the SDS. This allows a significant reduction in SDS profile (~0.029 inches) compared with conventional monorail or over-the-wire SDS. This SOAW SDS is intended to facilitate direct stenting. It has the potential to provide substantial procedural cost savings by eliminating the need for a coronary guidewire and balloon pre-dilatation and/or post-dilatation, and by reducing contrast use and the time required to complete the procedure. The SOAW system is compatible with 5Fr guiding catheters, and may reduce the need for closure devices, facilitate stenting via the radial approach and (potentially) reduce bleeding risks. In conclusion, the Svelte SOAW SDS represents a new very-low-profile balloon-expandable SDS that should promote direct stenting in PCIs. The efficiency and small profile of this SDS may allow procedural cost savings, a reduction in procedure time and a reduced risk of bleeding complications. These theoretical advantages will need to be demonstrated in clinical trials.

scholarly journals 63 Chronic Femoral Osteomyelitis Case Series: Outcomes and Economic Impact at A United Kingdom Based Tertiary Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Lau ◽  
Z Arshad ◽  
A Aslam ◽  
A Thahir ◽  
M Krkovic
Keyword(s):  
Economic Impact ◽  
Treatment Protocol ◽  
Case Series ◽  
Consecutive Series ◽  
Financial Loss ◽  
Patient Demographics ◽  
Tertiary Centre ◽  
The Mean ◽  
Eq Vas

Abstract Introduction Osteomyelitis refers to an inflammatory process affecting bone and bone marrow. This study reviews chronic femoral osteomyelitis treatment and outcomes, including economic impact. Method We retrospectively collected data from a consecutive series of 14 chronic femoral osteomyelitis patients treated between January 2013 and January 2020. Data collected include patient demographics, comorbidities, pathogens, complications, treatment protocol and costs. Functional outcome was assessed using EuroQOL five-dimensional interview administration questionnaire (EQ-5D-5L™) and EuroQOL Visual Analogue Scale (EQ-VAS™). Results Of these, 92.9% had one or more osteomyelitis risk factor, including smoking and diabetes. Samples from 78.6% grew at least one pathogen. Only 42.9% achieved remission after initial treatment, but 85.7% were in remission at final follow-up, with no signs of recurrence throughout the follow-up period (mean: 21.4 months). The average treatment cost was £39,249.50 with a net mean loss of £19,080.10 when funding was considered. The mean-derived EQ-5D score was 0.360 and the mean EQ-VAS score was 61.7, lower than their values for United Kingdom’s general population, p = 0.0018 and p = 0.013 respectively. Conclusions Chronic femoral osteomyelitis treatment is difficult, resulting in significant economic burden. With previous studies showing cheaper osteomyelitis treatment at specialist centres, our net financial loss incurred suggests the need for management at specialised centres.

scholarly journals Towards 6G IoT: Tracing Mobile Sensor Nodes with Deep Learning Clustering in UAV Networks

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3936
Author(s):  
Yannis Spyridis ◽  
Thomas Lagkas ◽  
Panagiotis Sarigiannidis ◽  
Vasileios Argyriou ◽  
Antonios Sarigiannidis ◽  
...  
Keyword(s):  
Deep Learning ◽  
Heuristic Method ◽  
Sensor Nodes ◽  
Convolutional Network ◽  
Received Signal Strength Indicator ◽  
Anchor Nodes ◽  
Time Required ◽  
Rf Signal ◽  
Deep Learning Model

Unmanned aerial vehicles (UAVs) in the role of flying anchor nodes have been proposed to assist the localisation of terrestrial Internet of Things (IoT) sensors and provide relay services in the context of the upcoming 6G networks. This paper considered the objective of tracing a mobile IoT device of unknown location, using a group of UAVs that were equipped with received signal strength indicator (RSSI) sensors. The UAVs employed measurements of the target’s radio frequency (RF) signal power to approach the target as quickly as possible. A deep learning model performed clustering in the UAV network at regular intervals, based on a graph convolutional network (GCN) architecture, which utilised information about the RSSI and the UAV positions. The number of clusters was determined dynamically at each instant using a heuristic method, and the partitions were determined by optimising an RSSI loss function. The proposed algorithm retained the clusters that approached the RF source more effectively, removing the rest of the UAVs, which returned to the base. Simulation experiments demonstrated the improvement of this method compared to a previous deterministic approach, in terms of the time required to reach the target and the total distance covered by the UAVs.

scholarly journals Using Social Media in Tourist Sentiment Analysis: A Case Study of Andalusia during the Covid-19 Pandemic

2021 ◽  
Vol 13 (7) ◽  
pp. 3836
Author(s):  
David Flores-Ruiz ◽  
Adolfo Elizondo-Salto ◽  
María de la O. Barroso-González
Keyword(s):  
Social Media ◽  
Sentiment Analysis ◽  
Cost Savings ◽  
Mass Scale ◽  
Tourism Sector ◽  
The Social ◽  
Analytical Tools ◽  
Media Data

This paper explores the role of social media in tourist sentiment analysis. To do this, it describes previous studies that have carried out tourist sentiment analysis using social media data, before analyzing changes in tourists’ sentiments and behaviors during the COVID-19 pandemic. In the case study, which focuses on Andalusia, the changes experienced by the tourism sector in the southern Spanish region as a result of the COVID-19 pandemic are assessed using the Andalusian Tourism Situation Survey (ECTA). This information is then compared with data obtained from a sentiment analysis based on the social network Twitter. On the basis of this comparative analysis, the paper concludes that it is possible to identify and classify tourists’ perceptions using sentiment analysis on a mass scale with the help of statistical software (RStudio and Knime). The sentiment analysis using Twitter data correlates with and is supplemented by information from the ECTA survey, with both analyses showing that tourists placed greater value on safety and preferred to travel individually to nearby, less crowded destinations since the pandemic began. Of the two analytical tools, sentiment analysis can be carried out on social media on a continuous basis and offers cost savings.

Arthrocladiella mougeotii. [Descriptions of Fungi and Bacteria].

1998 ◽  
Author(s):  
V. P. Heluta
Keyword(s):  
Czech Republic ◽  
Geographical Distribution ◽  
Disease Transmission ◽  
Russian Far East ◽  
Far East ◽  
Republic Of Georgia ◽  
Lycium Barbarum ◽  
Initial Stage ◽  
High Infection

Abstract A description is provided for Arthrocladiella mougeotii. Information is included on the disease caused by the organism, its transmission, geographical distribution, and hosts. DISEASE: Powdery mildew of Lycium species only. The mycelium, conidiophores, conidia and ascomata form first white, then dirty-grey patches on damaged green parts of the host. Infected parts are deformed slightly and, in cases of high infection, plants can lose their ornamental qualities. Damaged leaves can fall prematurely. HOSTS: Lycium barbarum (= L. europaeum), L. chinense, L. dasystemum, L. halimifolium, L. ovatum, L. potaninii, L. rhombifolium, L. ruthenicum. [Type host - Lycium barbarum] GEOGRAPHICAL DISTRIBUTION: Africa: Canary Islands. Asia (temperate areas only): Armenia, Azerbaijan, China, Republic of Georgia, Israel, Japan, Kazakhstan, Kirghizistan, Korea, Russia (Russian far east), Tadzhikistan, Taiwan, Turkey, Turkmenistan, Uzbekistan. Australasia: New Zealand (introduced). Europe: Austria, Belgium, Bulgaria, Czech Republic, Estonia, France, Germany, Hungary, Italy, Netherlands, Norway, Poland, Rumania, Slovakia, Sweden, Switzerland, UK, Ukraine (southern), former Yugoslavia. North America: USA (introduced). TRANSMISSION: By wind-dispersed conidia. The rôle of ascospores in disease transmission is unknown, although it has been supposed that they can cause the initial stage of the disease.

EP.FRI.537 Post-operative antibiotics for cutaneous abscess after incision and drainage: Variations in Clinical Practice or lack of guidelines

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sarah Zhao ◽  
Ahmad Najdawi ◽  
Aggelios Laliotis ◽  
Rhys Thomas ◽  
Michael El Boghdady
Keyword(s):  
Clinical Practice ◽  
Treatment Protocol ◽  
University Teaching ◽  
Systemic Complications ◽  
Incision And Drainage ◽  
Evidence Based Treatment ◽  
Superficial Skin ◽  
Retrospective Data Collection ◽  
Local And Systemic Complications ◽  
Surgical Condition

Abstract Aims Acute cutaneous abscess is a common surgical condition which mostly require incision and drainage. Despite this, there is no standardised national or international guidance on the post-operative antibiotics prescription. Traditionally, antibiotics are not indicated unless complications and/or risk factors such as immunocompromisation, diabetes or cellulitis exist. We aimed to study the local practice of the post-operative antibiotics prescription for cutaneous abscesses in a University teaching hospital in London. Methods A retrospective data collection of emergency general surgical admissions for a period of six months from July to December 2020 was carried out. All patients with superficial skin abscess were included in this analysis. Scrotal, breast and limb abscesses were excluded. Patients’ demographics, Co-morbidities, local and systemic complications were studied. Results A total of 149 patients presented during this period. Mean age was 40 (54% were male). Most common site of abscess was perianal (24%), followed by pilonidal, axilla, back, gluteal, neck, abdominal wall and groin. At total of 108 (72.5%) were managed surgically with incision and drainage, 70 (65%) got antibiotics and only 23 (33%) had indications for it (i.e. diabetic, immunocompromised, sepsis, cellulitis, MRSA carriage) = (χ2[1] =22.03, p<.0001). Co-amoxiclav was the most common post-operative empirical antibiotic prescribed in 61% of the patients.  Conclusions This study has identified significant variation in clinical practice regarding post-operative antibiotic usage in superficial abscesses. Further research is required in cooperation with microbiologists to develop standardised evidence-based treatment protocol for management of such common surgical condition.  

Abstract 94: Patient Selection using CT Perfusion (CTP) Imaging Improves Effectiveness of Stroke Thrombolysis in the 0-4.5 Hour Time Window

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Dulka Manawadu ◽  
Shankranand Bodla ◽  
Laszlo Sztriha ◽  
Josef Jarosz ◽  
Lalit Kalra
Keyword(s):  
Patient Selection ◽  
Functional Outcomes ◽  
Time Window ◽  
Ct Perfusion ◽  
Treatment Protocol ◽  
Early Improvement ◽  
Nihss Score ◽  
Ct Perfusion Imaging ◽  
Mean Blood Glucose

Background: The role of CT perfusion (CTP) in thrombolysis decisions remains controversial and there are no studies that compare outcomes of thrombolysis in patients with or without mismatch on CT perfusion imaging. Methods: We analysed registry data between Jan 2009 and December 2010 for patients thrombolysed within 0-4.5 hours of stroke onset in whom CTP studies were performed prior to thrombolysis. The centre followed thrombolysis guidelines but patients >80 years were included. CTP was not obligatory in the treatment protocol and failure to demonstrate a mismatch was not a contraindication to thrombolysis. We retrospectively analysed data for estimated CTP mismatch of ≥ 100% according to pre-defined criteria and compared outcomes of thrombolysed patients showing perfusion mismatch with those showing no mismatch. Findings: The sample included 160 patients aged between 32-95 years of whom 63 had no mismatch and 97 had a significant mismatch. The two groups were comparable for mean age (73 v 70 years, p=0.18), sex (49% v 54% male, p=0.75), premorbid Rankin Score (mRS) 0-2 (81% v 92%, p=0.77), vascular risk factors profile, mean baseline BP (148/87 v 148/79 mm Hg, p=0.92), mean blood glucose (6.6 v 6.6 mmols/L, p=0.98) and mean National Institute of Health Stroke Scale (NIHSS) score (14.0 v 12.6,p=0.12). Patients who had mismatch prior to thrombolysis showed lower mean 24 hour NIHSS score (7.6 v 11.8, p=0.002) and greater mean 24 hour improvement in NIHSS score (5.1 v 2.0, p=0.010). A higher proportion of patients with mismatch achieved mRS 0-1 and mRS 0-2 at 3 months (36% v 18%, p= 0.012 and 51% v 32%, p=0.015 respectively) but there were no differences in symptomatic sICH rates (1.1% v 0%). Mortality (29% v 18%) and any intracranial haemorrhages (19% v 13%) were lower in mismatch patients but did not achieve significance. Regression analyses showed that PCT mismatch prior to thrombolysis was an independent predictor of both early improvement and functional outcomes at 3 months. Conclusion: Stroke patients who have perfusion mismatch on CTP imaging prior to thrombolysis within the 4.5 hour time window show better early and 3 month outcomes compared with those in whom mismatch cannot be demonstrated. Patient selection using multimodal CT may improve the effectiveness of thrombolysis.

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