Comparison of Surgical Site Infections in Ankle Fracture Surgery With or Without the Use of Postoperative Antibiotics

2018 ◽  
Vol 39 (11) ◽  
pp. 1278-1282 ◽  
Author(s):  
James Robert Lachman ◽  
Justin I. Elkrief ◽  
Paul S. Pipitone ◽  
Christopher L. Haydel

Background: Surgeon preference has been replaced by an approach using evidence-based medicine in clinical decision making. The use of postoperative antibiosis in ankle fracture surgery is more common for inpatients but variable for outpatient surgery. Some surgeons prefer to prescribe 24 hours of oral antibiotics, whereas others give no antibiotics at all postoperatively. In this study, inpatients receiving 24 hours of intravenous antibiotics were compared to those patients receiving 24 hours of oral antibiotics and those receiving no postoperative antibiotics. Methods: A total of 1442 patients with ankle fractures requiring operative fixation were retrospectively reviewed in this multicenter study. Demographic data including age, sex, and body mass index were collected. Clinical data including diabetes status, smoking status, hepatitis C virus (HCV) or human immunodeficiency virus (HIV) status, infection requiring additional antibiotics, and infection requiring return to operating room (RTOR) were compared across the groups. Results: No differences in incidence of cellulitis or return to OR for infection were demonstrated between the 3 groups. No differences were noted among the groups for any risk factors for infection including body mass index, previous infection, smoking status, HCV/HIV status, or diabetes. The rates of cellulitis ( P = .402), infection requiring additional antibiotics ( P = .563), and infection requiring return to the operating room ( P = .878) showed no difference between the groups. Conclusion: The use of antibiotics postoperatively did not decrease the incidence of surgical site infection. The findings in this study suggest that the routine use of postoperative antibiotics after ankle fracture surgery is not beneficial. Level of Evidence: Level III, retrospective comparative study.

2021 ◽  
pp. 247412642198957
Author(s):  
Halward M.J. Blegen ◽  
Grant A. Justin ◽  
Bradley A. Bishop ◽  
Anthony R. Cox ◽  
James K. Aden ◽  
...  

Purpose: This work reports the association of obstructive sleep apnea (OSA) and cotton-wool spots (CWS) seen in patients with nonproliferative diabetic retinopathy (DR). Methods: A random sample of patients diagnosed with DR between January 1, 2015 and December 31, 2018, were selected from medical-billing codes. Dilated funduscopic examination findings and medical history were analyzed by reviewing medical records. Results: CWS were present in 12 of 118 patients without OSA, compared with 11 of 32 patients with OSA (10.2% vs 34.4%, respectively; P = .002). OSA was more common in men (68.8%, P = .03) and associated with a higher body mass index (30.0 ± 5.0 without OSA vs 33.6 ± 5.5 with OSA, P < .001). When comparing those with and without OSA, there was no association with age; glycated hemoglobin A1c; stage of DR; insulin dependence; presence of diabetic macular edema; smoking status; or a history of hypertension, hyperlipidemia, cardiovascular disease, or other breathing disorder. Conclusions: The presence of OSA is associated with CWS in patients with DR, as well as male sex and a higher body mass index. Further research is needed to determine the ophthalmologist’s role in the timely referral of patients with CWS for OSA evaluation.


2009 ◽  
Vol 90 (5) ◽  
pp. 1288-1294 ◽  
Author(s):  
Ellen A Nohr ◽  
Michael Vaeth ◽  
Jennifer L Baker ◽  
Thorkild IA Sørensen ◽  
Jorn Olsen ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Andrea Maugeri ◽  
Martina Barchitta ◽  
Roberta Magnano San Lio ◽  
Giuliana Favara ◽  
Claudia La Mastra ◽  
...  

Uncovering the relationship between body mass index (BMI) and DNA methylation could be useful to understand molecular mechanisms underpinning the effects of obesity. Here, we presented a cross-sectional study, aiming to evaluate the association of BMI and obesity with long interspersed nuclear elements (LINE-1) methylation, among 488 women from Catania, Italy. LINE-1 methylation was assessed in leukocyte DNA by pyrosequencing. We found a negative association between BMI and LINE-1 methylation level in both the unadjusted and adjusted linear regression models. Accordingly, obese women exhibited lower LINE-1 methylation level than their normal weight counterpart. This association was confirmed after adjusting for the effect of age, educational level, employment status, marital status, parity, menopause, and smoking status. Our findings were in line with previous evidence and encouraged further research to investigate the potential role of DNA methylation markers in the management of obesity.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Pengcheng Xun ◽  
Kiang Liu ◽  
Steve Morris ◽  
Martha Daviglus ◽  
Catherine Loria ◽  
...  

Background: Experimental studies have suggested that cadmium (Cd) exposure is a potential risk factor for early atherosclerosis and cardiovascular diseases as it can disrupt integrity of the endothelial cell layer. However, longitudinal data in humans relating Cd levels to sub-clinical atherosclerosis are lacking. Methods: 2589 participants from the CARDIA Study, aged 20-32 years in 1987 (baseline) with up to 18 years of follow-up were included in the analyses to examine prospectively the associations of toenail Cd concentrations with carotid intima-media thickness (CIMT) and coronary artery calcium score (CAC score). Toenail clippings were collected in 1987 and Cd was assessed by instrumental neutron-activation analysis. Common (c), bulb (b), and internal (i) CIMTs were measured in 2005 and CAC score in 2000 and 2005. CAC presence (score, >0 Agatston units) and CAC progression (incident CAC in 2005 or increase in CAC score by ≥10 Agatston units) were defined based on CAC score. General linear regression or logistic regression was used as appropriate. Results: Median Cd levels were 0.003, 0.006, 0.012 and 0.039 μ g/g from 1 st - 4 th quartile. We observed a positive linear relation of Cd levels with cCIMT, but not bCIMT and iCIMT ( Table 1 ). Null associations between Cd levels and CAC progression [Q 4 vs . Q 1 : OR=1.11 (95% CI: 0.73, 1.68); P trend =0.14] or presence of CAC [Q 4 vs . Q 1 : OR=1.05 (0.73, 1.53); P trend =0.56] were documented. Conclusions: In this young adult cohort, toenail Cd levels were positively associated with cCIMT, but not bCIMT, iCIMT and CAC score. Further studies are needed to determine whether there is an atherosclerotic mechanism linking Cd exposure to the risk of cardiovascular disease. Table 1 Multivariable-adjusted carotid intima-media thickness (mm) by toenail cadmium levels No. of participants Quartile of toenail cadmium levels P trend Q1 Q2 Q3 Q4 cCIMT 2587 0.781 (0.773-0.790) 0.784 (0.776-0.793) 0.789 (0.781-0.798) 0.791 (0.781-0.798) 0.03 bCIMT 2527 1.010 (0.990-0.1.031) 1.002 (0.982-1.022) 0.981 (0.962-1.001) 1.001 (0.980-1.022) 0.17 iCIMT 2436 0.787 (0.772-0.802) 0.790 (0.776-0.804) 0.784 (0.770-0.798) 0.778 (0.763-0.793) 0.86 Data are geometric means (95%CIs) adjusted for age, gender, race, study center, body mass index, physical activity, education, smoking status, alcohol consumption, systolic blood pressure, LDL/HDL, HOMA, body mass index, long-chain omega-3 polyunsaturated fatty acids intake with toenail zinc, chromium, lead and mass weight. cCIMT : common carotid intima-media thickness; bCIMT : bulb carotid intima-media thickness; iCIMT : internal carotid intima-media thickness.


2020 ◽  
Author(s):  
Jiang Li ◽  
Yongtong Cao ◽  
Cheng Xiao

Abstract Background: Previous studies reported that the association between lipid levels and cognitive function related with gender, age and specific cognitive domains, but the influence of body mass index (BMI) on this association is limited. This triggered our interest in exploring how serum lipids relate to cognitive function in different subgroups. Methods: Data was collected from 2009 wave and 2015 wave of China Health and Nutrition Survey (CHNS). Multivariable linear regression analyses examined serum lipids level as predictors of sex- and age-specific measure of cognitive function in different BMI levels, which were adjusted for nationality, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking status, alcohol consumption and education level. Results: Cognitive function score have different concentration curves in serum lipids quartile levels in different BMI categories. After adjustment for confounding factors, serum TG was positively associated with cognitive function score in underweight (β±SE: 2.06±0.88, P=0.023) and obese (β±SE: 1.44±0.71, P=0.045) male group, and serum HDL-C was positively associated with cognitive function score in overweight (β±SE: 1.89±0.92, P=0.041) and obese (β±SE: 5.04±1.62, P=0.002) female group. Serum TC was negatively associated with cognitive function score in overweight (β±SE: -2.55±1.26, P=0.043) mid-life adults, and serum HDL-C was positively associated with cognitive function score in overweight (β±SE: 2.15±0.94, P=0.022) and obese (β±SE: 5.33±2.07, P=0.011) older adults. Conclusion: The associations of serum lipids with cognitive function were related with BMI levels and differed between gender and age groups. This result indicated that better nutritional status has superior cognitive function performance.


2019 ◽  
Vol 10 ◽  
Author(s):  
Kinga Wytrychiewicz ◽  
Daniel Pankowski ◽  
Konrad Janowski ◽  
Kamilla Bargiel-Matusiewicz ◽  
Jacek Dąbrowski ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document