The microbiological profile of patients with Fournier’s gangrene: A retrospective multi-institutional cohort study

2021 ◽  
pp. 039156032110184
Author(s):  
Chiara Cipriani ◽  
Valerio Iacovelli ◽  
Marco Sandri ◽  
Riccardo Bertolo ◽  
Francesco Maiorino ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Scoring Systems ◽  
Fournier’S Gangrene ◽  
Fecal Diversion ◽  
Fournier's Gangrene ◽  
Related Factors ◽  
Microbiological Profile ◽  
Number Of Microorganisms ◽  
Group A ◽  
Group B

Objectives: To evaluate the role of the microbiological profile and of disease-related factors in the management of patients affected with Fournier’s gangrene (FG). Patients and methods: Data regarding patients admitted for FG at nine Italian Hospitals (March 2007–June 2018) were collected. Patients were stratified according to the number of microorganisms documented: Group A – one microorganism; Group B – two microorganisms; Group C – more than three microorganisms. Baseline blood tests, dedicated scoring systems, predisposing risk factors, disease’s features, management and post-operative course were analyzed. UpSet technique for visualizing set intersections in a matrix layout and Cuzick’s nonparametric test for trend across ordered groups were used. Results: Eighty-one patients were available for the analysis: 18 included in Group A, 32 in Group B, 31 in Group C. The most common microorganism isolated was Escherichia coli. In Group B-C, Escherichia coli was often associated to Enterococcus faecalis, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Statistically significant positive association was highlighted among the number of pathogens (Group A vs B vs C) and serum C-reactive Protein ( p < 0.001), procalcitonin ( p = 0.02) and creatinine ( p = 0.03). Scoring systems were associated with the number of microorganisms detected ( p < 0.02). A significant association between the number of microorganisms and the use of VAC therapy and need of a fecal diversion was found ( p < 0.02). The number of microorganisms was positively associated with the length of stay (LOS) ( p = 0.02). Ten weeks after initial debridement, wound closure was achieved in 11 (91.7%), 22 (84.6%) and 20 (80%) patients in Group A, B, and C, respectively, with no differences in overall survival. Conclusion: Polymicrobial infections in FG are positively associated with inflammatory scores, the need for fecal diversion and the LOS. This results may help the counseling and the clinical management of this rare niche of patients.

scholarly journals Effect of Topical Oxygen Therapy on Wound Healing in Diabetic Patients with Fournier's Gangrene

2021 ◽  
Vol 12 (1) ◽  
pp. 12-16
Keyword(s):  
Oxygen Therapy ◽  
Wound Care ◽  
Fournier’S Gangrene ◽  
The Body ◽  
Diabetic Patients ◽  
Fournier's Gangrene ◽  
Cross Sectional ◽  
Group A ◽  
Conventional Methods ◽  
Group B

Background: Diabetic patients presenting with Fournier gangrene have the highest mortality rate of all at-risk populations. Objective: To compare the efficacy of adjuvant topical oxygen therapy methods and conventional methods in the management of diabetic patients having Fournier's gangrene Methodology: This was a comparative cross-sectional study, in Surgical unit 3, Allied Hospital, Faisalabad, from 1st January to 30th June 2020. A total of 120 cases were included by systematic random sampling in the study, who were admitted either through OPD or the Emergency ward. In Group A, Topical Oxygen Therapy was given along with conventional methods. In Group B only conventional methods of wound care were applied. In group A, 100% oxygen was given in a bag with a routinely available oxygen cylinder exposing the whole affected part of the body or limb. Oxygen in the chamber was given for a maximum of one and a half hours twice daily in one sitting for 7 to 10 days. In the interval between cycles, the wound was covered with a soaked antiseptic dressing. After clinical improvement, the patient was discharged and called for follow-up in outdoor on weekly intervals initially and then fortnightly for up to 6 months. Results: Mean age was calculated as 36.45±10 and 35.38±9 years in Group-A and B respectively. Comparison of the efficacy of adjuvant topical oxygen therapy and conventional methods in the management of Fournier’s gangrene showed that 44 (73.3%) in Group-A and 29 (48.3%) in Group-B had efficacy (p=0.00). Conclusion: Efficacy of adjuvant topical oxygen therapy is significantly higher when compared with conventional methods in the management of Fournier's gangrene.

PREDICTABILITY OF RENAL NEPHROMETRY SCORING IN DETERMINING TYPE OF SURGICAL APPROACH IN THE TREATMENT OF LOCALIZED RENAL TUMOURS : A SINGLE TERTIARY CENTER EXPERIENCE.

2021 ◽  
pp. 36-38
Author(s):  
Jitendra Kumar Barad ◽  
Raghuveer Pedamallu ◽  
Rahul Devraj ◽  
Ram Reddy. Ch
Keyword(s):  
Partial Nephrectomy ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Individual Component ◽  
Scoring Systems ◽  
Nephrometry Score ◽  
Renal Tumours ◽  
Group A ◽  
Group B ◽  
Component Scores

Background: Partial nephrectomy became more preferred option in the treatment of localized small renal tumours due to recent advances in imaging modalities and surgical techniques. Renal scoring systems are known to compliment urologist in aiding surgical decision process on extent of surgery in small localized renal tumours. There are few scoring systems described in the literature with their own limitations. Methods: This is a retrospective study of patients with localized renal cell tumours who underwent nephrectomy at Nizam Institute of Medical Sciences (NIMS), Hyderabad fromJanuary 2017 to January 2019. Patients with advanced renal cell cancer disease at presentation were excluded. Total RENAL nephrometry Score (RNS), its individual component scores and complexity category were calculated based on CT report. The study cases were categorized into Group A (Partial Nephrectomy) and as Group B (Radical Nephrectomy). Mean and standard deviation value of the RENAL nephrometry scores and its component scores were calculated for each group. Statistical signicance was calculated using unpaired T-test, using SPSS statistics 21.0 software. Results: The mean age for all patients included in this study is 52.1 years. Out of 80 patients, 32 patients had partial nephrectomy (Group A) and 48 patients had radical nephrectomy (Group B). Based on RENAL nephrometry score complexity, Group A and Group B were further categorized into low, intermediate and high complexity score categories. The total RENAL score, individual component scores and RENAL score complexity were found to be signicantly different between the two group in addition to the tumor size. No statistical signicance was found between the two groups for age and type of tumour on histopathology (benign or malignant). Conclusion: We conclude that preoperative RENAL nephrometry scoring is a useful aid to surgeons to classify the renal tumour complexity before deciding on effective surgical strategy for better patient outcomes

Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier’s gangrene: a case series

2020 ◽  
Vol 13 (10) ◽  
pp. e236503
Author(s):  
Edgardo Solis ◽  
Yi Liang ◽  
Grahame Ctercteko ◽  
James Wei Tatt Toh
Keyword(s):  
Delayed Diagnosis ◽  
Case Series ◽  
Perianal Abscess ◽  
Scoring Systems ◽  
Fournier’S Gangrene ◽  
Necrotising Fasciitis ◽  
Risk Indicator ◽  
Fournier's Gangrene ◽  
Perianal Sepsis

Fournier’s gangrene (FG) is a rapidly progressing infective necrotising fasciitis of the perianal, perineal and genital region. It is characterised by its aggressive nature and high mortality rates of between 15% and 50%. While it has been commonly found to primarily develop from urological sources, there have been increasing reports of the role of colorectal sources as the underlying aetiology of FG. Presented is a case series of four FG presentations at a single institution during a 12-month period as a result of underlying untreated perianal disease highlighting its dangers in progressing to a deadly infection, advocating for early and aggressive surgical debridement, and the role of adjunct scoring systems, such as Laboratory Risk Indicator for Necrotising Fasciitis, in guiding clinical diagnosis.

scholarly journals Role of enteric pathogens in the aetiology of neonatal diarrhoea in lambs and goat kids in Spain

1996 ◽  
Vol 117 (1) ◽  
pp. 203-211 ◽  
Author(s):  
M. Muñoz ◽  
M. Álvarez ◽  
I. Lanza ◽  
P. Cármenes
Keyword(s):  
Escherichia Coli ◽  
Synergistic Effect ◽  
Cryptosporidium Parvum ◽  
Clinical Characteristics ◽  
Enteric Pathogens ◽  
E Coli ◽  
Neonatal Diarrhoea ◽  
Group A ◽  
Group B

SummaryFaeces samples from diarrhoeic and non-diarrhoeic lambs and goat kids aged 1–45 days were examined for enteric pathogens.Cryptosporidium parvumwas detected in both diarrhoeic lambs (45%) and goat kids (42%) but not in non-diarrhoeic animals. F5+(K99+) and/or F41+Escherichia colistrains were isolated from 26% and 22% of the diarrhoeic lambs and goat kids, respectively, although these strains, which did not produce enterotoxins ST I or LT I, were found with similar frequencies in non-diarrhoeic animals. A F5−F41−ST I+E. colistrain was isolated from a diarrhoeic lamb (0·6%). VerotoxigenicE. coliwas isolated from both diarrhoeic and non-diarrhoeic lambs (4·1% and 8·2%, respectively) and there was no association between infection and diarrhoea. The prevalence of group A rotavirus infection in diarrhoeic lambs was very low (2·1%). Groups A and B rotaviruses were detected in three (8·1%) and five (13·5%) diarrhoeic goat kids from two single outbreaks. Group C rotaviruses were detected in four non-diarrhoeic goat kids. An association of diarrhoea and infection was demonstrated only for group B rotavirus.Clostridium perfringenswas isolated from 10·8% of the diarrhoeic goat kids but not from non-diarrhoeic goat kids or lambs.Salmonella arizonaewas isolated from a diarrhoeic goat kid (2·7%) and the clinical characteristics of the outbreaks where these two latter enteropathogens were found different from the rest. Picobirnaviruses were detected in a diarrhoeic lamb. No coronaviruses were detected using a bovine coronavirus ELISA. No evidence was found of synergistic effect between the agents studied. Enteric pathogens were not found in four (8·7%) and three (20%) outbreaks of diarrhoea in lambs and goat kids, respectively.

Scoring Systems for the Prediction of Mortality in Patient with Fournier’s Gangrene: an Analysis of 60 Patients

2020 ◽  
Author(s):  
Mehmet Arif Usta ◽  
Mehmet Ulusahin ◽  
Serkan Tayar ◽  
Arif Burak Cekic ◽  
Ilke Onur Kazaz ◽  
...  
Keyword(s):  
Scoring Systems ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Prediction Of Mortality

scholarly journals Effect of Keishibukuryogan on Endothelial Function in Patients with at Least One Component of the Diagnostic Criteria for Metabolic Syndrome: A Controlled Clinical Trial with Crossover Design

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Yutaka Nagata ◽  
Hirozo Goto ◽  
Hiroaki Hikiami ◽  
Tatsuya Nogami ◽  
Makoto Fujimoto ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Clinical Trial ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Control Period ◽  
Crossover Design ◽  
Controlled Clinical Trial ◽  
Related Factors ◽  
Group A ◽  
Group B

We evaluated the effect of keishibukuryogan (KBG; Guizhi-Fuling-Wan), a traditional Japanese (Kampo) formula, on endothelial function assessed by reactive hyperemia peripheral arterial tonometry (Endo-PAT2000) in patients with metabolic syndrome-related factors by controlled clinical trial with crossover design. Ninety-two patients were assigned to group A (first KBG-treatment period, then control period; each lasting 4 weeks, with about one-year interval) or group B (first control, then KBG-treatment). In forty-nine (27, group A; 22, group B) patients completing all tests, the mean value of the natural logarithmic-scaled reactive hyperemia index (L_RHI) increased and those of serum nonesterified fatty acid (NEFA), malondialdehyde, and soluble vascular cell adhesion molecule 1 decreased significantly during the KBG-treatment period, but not during the control period, and 4-week changes of L_RHI, NEFA, and malondialdehyde between the 2 periods showed significance. These results suggest that KBG has beneficial effect on endothelial function in patients with metabolic syndrome-related factors.

S033: The prognostic factors and overview of different scoring systems in Fournier's gangrene: Experience with 39 patients

2014 ◽  
Vol 13 (7) ◽  
pp. e1432-e1432a
Author(s):  
O.G. Doluoglu ◽  
B.C. Ozgur ◽  
M.A. Karagoz ◽  
H. Sarici ◽  
T. Karakan ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Scoring Systems ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene

scholarly journals Comparison of the effect of two anti-adhesion materials on the formation of postoperative adhesions after myomectomy – an experimental study on rabbit does

2021 ◽  
Vol 90 (4) ◽  
pp. 407-414
Author(s):  
Soňa Pánková ◽  
Andrea Nečasová ◽  
Jana Lorenzová ◽  
Vladimír Jekl ◽  
Alois Nečas ◽  
...  
Keyword(s):  
Experimental Study ◽  
Statistical Evaluation ◽  
Scoring Systems ◽  
Control Group ◽  
Routine Practice ◽  
Postoperative Adhesions ◽  
Group A ◽  
Level Of Significance ◽  
Group B ◽  
High Level

This study compares the effect of Hyalobarrier Gel and 4DryField® PH on the formation of postoperative adhesions after myomectomy in an experimental study on rabbit does. Thirty experimental animals were divided into three groups: group A – control, group B – use of 4DryField® PH, and group C – use of the Hyalobarrier Gel. A simulated myomectomy was performed in each group. The animals were euthanised 14 days after the procedure and the antiadhesive effect of the above-mentioned preparations was evaluated according to the criteria. Statistical evaluation clearly showed differences in the antiadhesive effect in the scoring systems for groups B and C compared to control group A at a high level of significance. We demonstrated an obvious, statistically confirmed antiadhesive effect of the Hyalobarrier Gel and 4DryField® PH in an experimental model of the rabbit uterus. Comparing both preparations, the Hyalobarrier Gel shows a higher level of effectiveness. Based on the results of the experiment, both preparations can be unambiguously recommended for routine practice.

scholarly journals Model Driven Causal Factors of Panic Buying and Their Implications for Prevention: A Systematic Review

2021 ◽  
Vol 2 (3) ◽  
pp. 325-343
Author(s):  
Ravi Philip Rajkumar ◽  
S M Yasir Arafat
Keyword(s):  
Reflective Functioning ◽  
Health Administration ◽  
Buying Behavior ◽  
Related Factors ◽  
Model Driven ◽  
Study Results ◽  
Group A ◽  
Group B ◽  
Literature Group ◽  
And Control

Panic buying is a commonly observed response to disasters, and has been widely observed during the COVID-19 pandemic. However, little is known about the variables influencing this behavior. This review summarizes the existing research in this field and examines its implications for the prevention and control of panic buying. Methodology: All papers published prior to or during the pandemic, providing an empirically tested model of panic buying behavior (Group A) or a theoretical model supported by literature (Group B), were retrieved through a literature search. For papers in Group A, specific risk or protective factors were extracted and tabulated. Overlaps between Group A and Group B models were identified. Study results were analyzed to identify potential strategies which could limit panic buying behavior. Results: It was found that a wide variety of primary (crisis/disease-related), secondary (psychological, informational and sociopolitical), and tertiary (supply chain-related) factors were significantly associated with panic buying, while a single variable–reflective functioning was identified as protective. Conclusions: These results provide valuable leads for strategies aimed at preventing or reducing panic buying, particularly in countries still affected by the pandemic. It is hoped that these findings will be useful from both health administration and academic perspectives.

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