P110 External ventricular drain-related infections: a single centre study

2019 ◽  
Vol 90 (3) ◽  
pp. e51.1-e51
Author(s):  
JC Duddy ◽  
MGJ O’Sullivan ◽  
C Lim ◽  
GF Kaar
Keyword(s):  
Average Length ◽  
External Ventricular Drain ◽  
Sampling Rate ◽  
University Hospital ◽  
Sampling Protocol ◽  
Retrospective Audit ◽  
Single Centre Study ◽  
Hospital Stays ◽  
One Year

ObjectivesTo quantify the External Ventricular Drain-related infection (ERI) rate in a one year period at Cork University Hospital, and to identify any risk factors for infection.DesignA retrospective audit of all External Ventricular Drains (EVDs) inserted in a one year period.SubjectsAll patients who had an EVD inserted between February 2017 and February 2018.MethodsPatients were identified from operating theatre logbooks. All relevant data was obtained from a retrospective review of medical and operative records. ERI was defined as evidence of positive CSF culture.Results41 EVDs were inserted in a total of 30 patients during the study period. The average age was 52.9 years. 46.6% of patients were female. The average length of EVD insertion was 8.85 days. The most common reason for EVD insertion was subarachnoid haemorrhage (31.7%) followed by supratentorial tumour (24.4%). 78% of EVDs were antibiotic-impregnated. Average EVD sampling rate was 0.7. ERI rate was 1/41 (2.4%). The infection occurred in a patient who had an EVD inserted for haemorrhage secondary to an AVM which had remained in situ for 13 days. The patient subsequently developed problems with repeated shunt infections resulting in a nine-month hospital stay.ConclusionsThe ERI rate in our patient cohort was 2.4%. We recommend using a strict EVD sampling protocol to minimise manipulation of EVDs and where possible to limit the length of time an EVD remains in situ. EVD-related infections can result in lengthy hospital stays and increased healthcare costs.

Prospective evaluation for gastrointestinal bleedings at the University Hospital St. Pölten – one year of follow-up

2019 ◽  
Author(s):  
M Stättermayer ◽  
F Riedl ◽  
S Bernhofer ◽  
A Stättermayer ◽  
A Mayer ◽  
...  
Keyword(s):  
University Hospital ◽  
Prospective Evaluation ◽  
One Year ◽  
The University

scholarly journals 755 Elective Surgery in the COVID-19 Pandemic: Outcomes of 100 Consecutive Cases

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Fisher ◽  
C Hadjittofi ◽  
Z Ali ◽  
P Antonas ◽  
K Parekh ◽  
...  
Keyword(s):  
Pain Management ◽  
Oral Surgery ◽  
Elective Surgery ◽  
University Hospital ◽  
Single Centre ◽  
Median Length ◽  
Microsoft Excel ◽  
Single Centre Study ◽  
Green Zone

Abstract Introduction The COVID-19 pandemic halted elective surgical activity. Basildon University Hospital established an elective Green Zone for COVID-19 swab negative patients who isolated for 14 days. This study reviewed the outcomes of the first 100 patients. Method A single-centre study was performed. Demographic and perioperative electronic data were supplemented with telephone follow-up for the first 100 Green Zone patients and analysed in Microsoft Excel. Results One hundred Green Zone patients underwent surgery between 21/05/2020 and 16/06/2020. The median age was 55 (14-88) years. 52% were female. Their operations were performed by General Surgery (39%), Gynaecology (17%), Vascular Surgery (14%), Oral Surgery (12%), ENT (9%), Urology (8%), and Pain Management (1%). Preoperatively, 100% had a negative SARS-CoV-2 swab and one had CT evidence of mild resolving COVID-19. Two patients had postoperative SARS-CoV-2 swabs, both negative. Median length of stay was 0 (0-7) days. 84% responded to telephone follow-up at a median 25 (13-54) postoperative days, 69% of whom were asymptomatic There were no 30-day major complications (>Clavien-Dindo IIIa) or 90-day mortality. Conclusions Elective surgery can be safe during the COVID-19 pandemic, with appropriate measures in place. This has significant implications in the context of an ever-expanding NHS waiting list during a pandemic of uncertain duration.

Complications after Functional Neck Dissection in Head and Neck Cancer Patients: An Observational, Retrospective, Single-Centre Study

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Carlos M. Chiesa-Estomba ◽  
Maria Soriano-Reixach ◽  
Izaskun Thomas-Arrizabalaga ◽  
Jon A. Sistiaga-Suarez ◽  
Jose A. González-García ◽  
...  
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Postoperative Period ◽  
Surgical Complications ◽  
Statistical Correlation ◽  
University Hospital ◽  
Common Complication ◽  
Neck Malignancy ◽  
Single Centre Study ◽  
Functional Neck Dissection

<b><i>Introduction:</i></b> Functional neck dissection (FND) represents a surgical procedure usually associated with less morbidity. <b><i>Methods:</i></b> An observational, retrospective, analysis of patients diagnosed with any type of head and neck malignancy was designed to summarize and report the incidence of postoperative complications in patients undergoing FND including just those levels described for selective neck dissections in a tertiary university hospital between June 2016 and June 2019. <b><i>Results:</i></b> 131 patients met the inclusion criteria. The total number of sides studied was 200. 40.5% of the patients suffer a complication in the postoperative period, being the spinal accessory nerve (SAN) injury the most common complication (10%). We did not find any statistical ­correlation between the previous organ-preservation treatments and surgical complications (<i>p</i> = 0.207). An advanced T stage (<i>p</i> = 0.009) and the need of bilateral FND (<i>p</i> = 0.034) were significantly correlated with a higher risk of surgical complications. <b><i>Conclusion:</i></b> FND represents a useful technique. In this study, 40.5% of the patients suffer a complication in the postoperative period, being the SAN injury the most common complication. However, these data contribute to increasing our knowledge about surgical complications related to FND.

scholarly journals Ventriculitis: a severe complication of central nervous system infections

2021 ◽  
Author(s):  
David Luque-Paz ◽  
Matthieu Revest ◽  
François Eugène ◽  
Sarrah Boukthir ◽  
Loren Dejoies ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Behavior Disorder ◽  
Severe Complication ◽  
Limited Attention ◽  
Neurosurgical Procedures ◽  
Imaging Features ◽  
Neurological Sequelae ◽  
Single Centre Study ◽  
One Year ◽  
Gait Disturbances

Abstract Background Ventriculitis, a dreaded complication of brain abscess, meningitis, and various neurosurgical procedures, has attracted limited attention in the medical literature. Methods Retrospective single-centre study. We screened medical files of all patients who had a brain imaging report including the word “ventriculitis” during years 2005-2019. Only patients with clinical, microbiological and imaging features of ventriculitis were included. Data were collected through a standardized questionnaire. Results Ninety-eight patients fulfilled inclusion criteria: 42 women and 56 men, median age 60 years [interquartile range 48-68]. Primary mechanism for ventriculitis was classified as follows: brain abscess (n=29, 29.6%), meningitis (n=27, 27.6%), intraventricular catheter-related (n=17, 17.3%), post-neurosurgery (n=13, 13.3%), and hematogenous (n=12, 12.2%). Main neuroimaging features were intraventricular pus (n=81, 82.7%), ependymal enhancement (n=70, 71.4%) and intraventricular loculations (n=15, 15.3%). Main pathogens were streptococci (n=44, 44.9%), Gram-negative bacilli (n=27, 27.6%), and staphylococci (n=15, 15.3%). In-hospital and one-year mortality rates were, respectively, 30.6% (n=30), and 38.8% (n=38). Neurological sequelae were reported in 34/55 (61.8%) survivors, including cognitive impairment (n=11), gait disturbances (n=9), paresis (n=7), behavior disorder (n=6), epilepsy (n=5). On multivariate analysis, age &gt; 65 years, Glasgow Coma Scale score &lt; 13 at initial presentation, status epilepticus, hydrocephalus and positive cerebrospinal fluid culture were associated with one-year mortality. We built a scoring system to stratify patients with ventriculitis into low-risk (12.5%), intermediate-risk (36.5%), and high-risk (71.4%) of death. Conclusion Ventriculitis is a severe complication of brain abscess, meningitis, or neurosurgery, with in-hospital mortality rate of 30%, and neurological sequelae in 60% of survivors.

scholarly journals A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure

2021 ◽  
Vol 18 (1) ◽  
pp. 278
Author(s):  
Jahyung Kim ◽  
Sanghyeon Lee ◽  
Jeong Seok Lee ◽  
Sung Hun Won ◽  
Dong Il Chun ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Simple Procedure ◽  
Wedge Resection ◽  
Operation Time ◽  
University Hospital ◽  
Wound Infections ◽  
Germinal Matrix ◽  
One Year ◽  
Ingrown Toenails

(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes.

ONE YEAR RETROSPECTIVE AUDIT OF CNS MALIGNANCY 2 WW REFERRALS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.126-e4
Author(s):  
Elizabeth Ashton ◽  
Benjamin Smeeton ◽  
Stuart Weatherby
Keyword(s):  
Waiting Times ◽  
Final Diagnosis ◽  
Referral Process ◽  
Radiological Imaging ◽  
Outpatient Appointment ◽  
Detection Rates ◽  
Subsequent Time ◽  
Retrospective Audit ◽  
One Year ◽  
Cns Malignancy

BackgroundSince its introduction in 2000, concerns have been raised about the two week wait (2 WW) referral system for suspected malignancy. Studies have demonstrated poor compliance to guidelines, low detection rates and questioned the time effectiveness of the referral process.MethodAll patients referred under the 2 WW system for suspected CNS malignancy to Derriford Hospital, Plymouth Hospitals NHS trust, over a one-year period were retrospectively audited. Data was gained from clinic letters and radiological imaging. The aims were to determine the number of referrals, their appropriateness and subsequent time taken to outpatient appointment, imaging and final diagnosis.Results103 referrals were made between September 2013 and September 2014 with just 48.5% fulfilling NICE referral guidelines for suspected CNS malignancy. Just three tumours were diagnosed with guidelines identifying all of these. Only 28% of 2 WW referrals received diagnostic imaging and an outpatient appointment within two weeks.ConclusionsUnnecessary referrals are placing strain on the 2 WW system. We suggest that a potential solution is for general practitioners to refer patients for imaging at the same time as they make their neurological 2 WW referral in order to cut down waiting times.

Observing microscopic phases of lichen life cycles on transparent substrata placed in situ

2005 ◽  
Vol 37 (5) ◽  
pp. 373-382 ◽  
Author(s):  
William B. SANDERS
Keyword(s):  
Life Cycle ◽  
Developmental Stages ◽  
Life Cycles ◽  
Potential Significance ◽  
Free Living ◽  
Lichen Community ◽  
One Year ◽  
The One ◽  
Observation Period

The utility of plastic cover slips as a substratum for in situ study of lichen developmental stages is further explored in a neotropical foliicolous lichen community and in a European temperate corticolous community. Twenty-one months after placement in the tropical forest, the cover slips bore foliicolous lichen thalli with several species producing characteristic ascocarps and ascospores, indicating the suitability of the substratum for completion of the life cycle of these lichens. On cover slips placed within the temperate corticolous community, lichen propagules anchored to the substratum with relatively short attachment hyphae but did not develop further within the one year observation period. Intimately intermixed microbial communities of short-celled, mainly pigmented fungi and chlorophyte algae developed upon the transparent substratum. Among the algae, Trebouxia cells, often in groups showing cell division and without associated lichenizing hyphae, were commonly observed. The potential significance of the free-living populations in the life cycle of Trebouxia and in those of Trebouxia-associated lichen fungi is discussed.

Abstract 19622: Trans-apical Off-pump Mitral Valve Repair With Neochords Implantation: One Year Clinical and Echocardiographic Follow-up

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Andrea Colli ◽  
Laura Besola ◽  
Lorenzo Bagozzi ◽  
Erica Manzan ◽  
Eleonora Bizzotto ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Type A ◽  
Mitral Valve Regurgitation ◽  
Disease Type ◽  
Reverse Remodeling ◽  
Off Pump ◽  
Single Centre Study ◽  
Type C ◽  
One Year

Introduction: TOP-MINI is a new micro invasive surgical procedure to treat degenerative mitral valve regurgitation due to flail/prolapse. Hypothesis: This prospective single centre study sought to assess the safety and effectiveness of the TOP-MINI procedure up to one year follow-up. Methods: Clinical and Echocardiographic outcomes were evaluated at 1, 3, 6 months and 1 year follow-up for all patients underwent TOP-MINI procedure from November 2013 to March 2015. Procedural success was defined as residual MR≤2+ at any time. Results: Sixty-one patients were treated during study period. One year survival was 96.7±2.3%. Freedom from MR>2+ is shown in figure 1 Panel A, Freedom from MR>2+ according to valve anatomy (Type A isolated P2 disease, Type B posterior multisegment disease, Type C anterior or bileaflet and/or calcified disease) is shown in Figure 1 Panel B. Freedom from MR>2+ according to STS risk profile is shown in Figure 2. The trend of Echocardiographic parameters is shown in Figure 3. Conclusions: TOP-MINI is a safe and effective procedure at 1 year FU. Residual MR is influenced by valve anatomy showing good results in Type A and B patients. Future techniques refinements are needed in order to improve outcomes of Type C patients. The lack of annuloplasty procedure does not influence negatively left ventricle reverse remodeling.

scholarly journals Methodology for determining rom size distribution

2014 ◽  
Vol 67 (4) ◽  
pp. 405-412
Author(s):  
Christiane Ribeiro da Silva ◽  
Vládia C. G. de Souza ◽  
Jair C. Koppe
Keyword(s):  
Size Distribution ◽  
Distribution Curve ◽  
Size Distributions ◽  
Sampling Protocol ◽  
Product Size ◽  
Operational Conditions ◽  
Specific Protocol ◽  
Open Side ◽  
Ore Dressing

A methodology to determine the size distribution curve of the ROM was developed in a Brazilian iron ore mine. The size of the larger fragments was determined taking photographs and setting the scale of the images to analyze their dimensions (length of their edges and areas). This was implemented according to a specific protocol of sampling that involves split and homogenization stages in situ of a considerable quantity of ore (about 259 metric tonnes). During the sampling process, larger fragments were separated and smaller size material was screened. The methodology was developed initially in order to preview the performance of a primary gyratory crusher that is fed directly from trucks. Operational conditions of the equipment such as closed and open-side settings could be adjusted previously, obtaining different product size distributions. Variability of size of the fragments affects subsequent stages of crushing and can increase circulating load in the circuit. This leads to a decrease of productivity or recovery of the ore dressing. The results showed insignificant errors of accuracy and reproducibility of the sampling protocol when applied to friable itabirite rocks.

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