scholarly journals Can a routine follow-up blood culture be justified in Klebsiella pneumoniaebacteremia? a retrospective case–control study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Chang Kyung Kang ◽  
Eu Suk Kim ◽  
Kyoung-Ho Song ◽  
Hong Bin Kim ◽  
Taek Soo Kim ◽  
...  
Keyword(s):  
Blood Culture ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Control Study

Evaluating the efficacy of topical vancomycin powder in the treatment of open lower extremity fractures

Trauma ◽  
2020 ◽  
pp. 146040862097814
Author(s):  
Justin Vaida ◽  
Alexander DB Conti ◽  
Justin J Ray ◽  
Daniel A Bravin ◽  
Michelle A Bramer
Keyword(s):  
Lower Extremity ◽  
Case Control Study ◽  
Smoking Status ◽  
Case Control ◽  
Wound Complications ◽  
Control Group ◽  
Retrospective Case ◽  
Vancomycin Powder ◽  
Control Study

Introduction Optimal management of lower extremity fractures includes early antibiotics administration, thorough irrigation and debridement, consideration of soft tissue injury, and definitive skeletal management. The purpose of this study was to evaluate the efficacy of topical vancomycin powder in the treatment of open lower extremity fractures. Methods This was a retrospective case control study in which open lower extremity fractures at our institution were reviewed for development of infection (including species and sensitivity if present) and the development of unanticipated wound complications requiring intervention. Patients from 2010-2015 were treated with standard of care consistent with evidence-based literature (IV antibiotics with external fixator, intramedullary nail, etc.). Patients from 2016–18 were additionally treated with vancomycin powder applied directly to the wound before closure. All patients were monitored per the treating surgeon’s standard follow-up protocol and had follow-up of at least two months. Results This retrospective case control study comprised 434 patients. The historical control group (n = 388 patients) and treatment group (n = 46 patients) were similar for age, sex, BMI (body mass index), diabetes, smoking status, and Injury Severity Score (ISS). There were 36 infections (9.28%) in the control group compared to four infections (8.70%) in the vancomycin powder group (p = 0.901). No significant difference was seen after adjusting for age, sex, BMI, diabetes, smoking status, and ISS. The vancomycin powder group experienced significantly more wound complications (15.2%) compared to the control group (6.4%; p = 0.039), which remained significant when adjusting for multiple covariates. Conclusions Topical vancomycin powder did not reduce the infection rate when applied in the surgical site of open lower extremity fractures. Instead, the addition of topical vancomycin powder resulted in significantly more wound complications in patients with open lower extremity fractures.

Efficacy of small-volume gastrografin videofluoroscopic screening for detecting pharyngeal leaks following total laryngectomy

2020 ◽  
Vol 134 (4) ◽  
pp. 350-353
Author(s):  
M Narayan ◽  
S Limbachiya ◽  
D Balasubramanian ◽  
N Subramaniam ◽  
K Thankappan ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Small Volume ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Retrospective Case ◽  
Control Study ◽  
Pharyngocutaneous Fistulae

AbstractObjectivesPharyngocutaneous fistulae are dreaded complications following total laryngectomy. This paper presents our experience using 3–5 ml gastrografin to detect pharyngeal leaks following total laryngectomy, and compares post-operative videofluoroscopy with clinical follow-up findings in the detection of pharyngocutaneous fistulae.MethodsA retrospective case–control study was conducted of total laryngectomy patients. The control group (n = 85) was assessed clinically for development of pharyngocutaneous fistulae, while the study group (n = 52) underwent small-volume (3–5 ml) post-operative gastrografin videofluoroscopy.ResultsIn the control group, 24 of 85 patients (28 per cent) developed pharyngocutaneous fistulae, with 6 requiring surgical correction. In the study group, 24 of 52 patients (46 per cent) had videofluoroscopy-detected pharyngeal leaks; 4 patients (8 per cent) developed pharyngocutaneous fistulae, but all cases resolved following non-surgical management. Patients who underwent videofluoroscopy had a significantly lower risk of developing pharyngocutaneous fistulae; sensitivity and specificity in the detection of pharyngocutaneous fistulae were 58 per cent and 100 per cent respectively.ConclusionSmall-volume gastrografin videofluoroscopy reliably identified small pharyngeal leaks. Routine use in total laryngectomy combined with withholding feeds in cases of early leaks may prevent the development of pharyngocutaneous fistulae.

scholarly journals Diagnostic Utility of Procalcitonin and Neutrophil-Lymphocyte Ratio in Bacterial Septicaemia - A Retrospective Case Control Study from a Tertiary Care Institute

2020 ◽  
Vol 7 (48) ◽  
pp. 2856-2861
Author(s):  
Mamatha T. Shenoy ◽  
Hariharan Alexander ◽  
Jeyakumar Manavalan ◽  
Suganthy K ◽  
Pradipta Kumar Mohanty
Keyword(s):  
Blood Culture ◽  
Case Control Study ◽  
Tertiary Care ◽  
Cost Effective ◽  
Case Control ◽  
Retrospective Case ◽  
Gram Negative ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Control Study

BACKGROUND Sepsis is a frequently encountered critical care problem wherein great emphasis is laid on early and accurate diagnosis of the infective organism. Blood culture though precise, is time consuming. Empiric antibiotic therapy leads to development of antibiotic resistance amongst organisms. Thus, there is a need for a biomarker that is cost effective, simple and rapid to perform. Procalcitonin elevates in response to chemical mediators produced due to bacteraemia within 2 - 4 hours and serves as an early marker. Neutrophil-Lymphocyte Ratio is available universally and is highly cost-effective. We wanted to assess the utility of Procalcitonin (PCT) and Neutrophil-Lymphocyte Ratio (NLR) in detecting the bloodstream infections and determine their usefulness in establishing the nature of infective organisms. METHODS A retrospective case control study was undertaken from January 2018 to December 2018 in a tertiary care teaching hospital in Madurai, Tamil Nadu. Patients tested for serum PCT, complete blood count and blood culture simultaneously prior to antibiotic therapy were included in the study (n = 288). The study cohort was classified into two groups. Group I, controls (n = 155) and group II, cases (n = 133). Out of 133 patients, 73 % (98) were infected by Gramnegative bacteria and 27 % (35) by Gram-positive bacteria. Data was analysed using SPSS V.16 software (SPSS Inc., Chicago, IL, USA). Students unpaired t test and Mann-Whitney U test were used for intergroup comparisons of continuous variables. p < 0.05 was considered to be statistically significant. Cut off for detecting bacteriemia and gram negative bacteriemia was created using Receiver Operating Characteristic (ROC) curve. RESULTS The area under ROC of PCT to detect gram negative bacteraemia was 0.752 (95 % CI = 0.692 – 0.812). CONCLUSIONS Escherichia coli was the most frequent cause of sepsis. Higher levels of PCT and NLR were associated with gram negative organisms. PCT levels can help in determining the cause of infection. NLR and PCT are able to establish the presence of bacteraemia in a short span of time, thus alleviating the over dependence on blood culture reporting. Such earlier decision-making tools help in reducing empirical antibiotic usage and thereby lessen the burden of bacterial resistance to antibiotics. KEYWORDS Procalcitonin, PCT, Neutrophil Lymphocyte Ratio, NLR, Gram Negative Bacteria, Sepsis, Biomarker

Predictors of Knee Arthrofibrosis and Outcomes after Arthroscopic Lysis of Adhesions following Ligamentous Reconstruction: A Retrospective Case–Control Study with Over Two Years' Average Follow-Up

2018 ◽  
Vol 32 (06) ◽  
pp. 536-543 ◽  
Author(s):  
Blake M. Bodendorfer ◽  
Laura E. Keeling ◽  
Evan M. Michaelson ◽  
Henry T. Shu ◽  
Nicholas A. Apseloff ◽  
...  
Keyword(s):  
Knee Injury ◽  
Case Control Study ◽  
Cruciate Ligament ◽  
Case Control ◽  
Retrospective Case ◽  
Inadequate Sample Size ◽  
Severity Of Injury ◽  
Ligamentous Reconstruction ◽  
Control Study

AbstractArthrofibrosis can be a devastating complication after ligamentous knee reconstruction. Beyond early range of motion (ROM), manipulation under anesthesia (MUA) and arthroscopic lysis of adhesions (LOAs) are the most frequently employed interventions for the condition. There is a paucity of data regarding predictive factors of arthrofibrosis requiring MUA and LOA, and even less data regarding changes in validated patient-reported outcome measures following the procedure. A retrospective case–control study was performed at an academic, urban Level I trauma center of patients that developed arthrofibrosis requiring MUA and LOA following ligamentous reconstruction. The indication for LOA was failure to achieve a 90° arc of ROM by 6 weeks. Seventeen cases and 141 controls were identified. Follow-up for cases was 26.9 ± 17.1 months (mean ± standard deviation). Time from initial reconstruction to LOA was 75.2 ± 27.9 days. Cases had higher body mass indices by a mean of 2.9 (p = 0.024). The most significant risk factors for stiffness were concomitant anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner/lateral collateral ligament injury (odds ratio [OR], 17.08), knee dislocation (OR, 12.84), and use of an external fixator (OR, 12.81, 95% confidence interval [CI], 3.03–54.20) (all p < 0.0026). Mean Knee Injury and Osteoarthritis Outcome Scores, Western Ontario and McMaster Universities Osteoarthritis Indices, and International Knee Documentation Committee scores improved by 47.5, 50.5, and 47.3% (all p < 0.0038), respectively. All patients reported improvement in pain, with maximum daily pain scores improving by a mean of 4.1 points on the Numeric Pain Rating Scale (p < 0.001). Mean ROM arc improved by 38.8° (p < 0.001). All 17 cases were satisfied with the procedure. Twelve cases (70.59%) reported a full return to preinjury level of activity. No factors were identified that predicted success from the procedure, likely due to inadequate sample size. Arthrofibrosis following knee injury and ligamentous reconstruction can be predicted by the severity of injury and early intervention with MUA and arthroscopic LOA can lead to a satisfactory outcome for the patient.

Does Physiologic Breakdown Mask Significant Pathology in Endometrial Biopsies? A Retrospective Case-Control Study

2006 ◽  
Vol 130 (12) ◽  
pp. 1847-1849
Author(s):  
Mark Galan ◽  
Young Bae Kim ◽  
Jonathan L. Hecht
Keyword(s):  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
Endometrial Biopsy ◽  
Control Group ◽  
Retrospective Case ◽  
Significant Pathology ◽  
Initial Sampling ◽  
Control Study

Abstract Context.—Adequacy criteria for endometrial biopsy samples do not exist. Objective.—To assess the sensitivity of endometrial sampling for detecting neoplasia in the setting of extensive glandular and stromal breakdown. Design.—Retrospective case-control study. Surgical pathology records between 1996 and 2005 at Beth Israel Deaconess Medical Center (Boston, Mass) were searched for endometrial samples with diagnoses containing the key words “menstrual” or “extensive breakdown.” Hospital records for these women were parsed for demographics, clinical indications, and follow-up with rebiopsy within 6 months. Age cutoffs enriched the population for women at higher risk for carcinoma. A control group, consisting of 2 age-matched control patients for each test patient, was also studied; each control patient had an endometrial sample taken within a 6-month period and was not diagnosed with extensive breakdown, menstrual endometrium, or neoplasia on initial sampling. Results.—Fifty-four cases were identified. The primary biopsy reports had benign descriptive diagnoses (ie, proliferative, secretory, polyp). Follow-up biopsies showed benign pathology in all cases and specific causes of bleeding—including polyp, leiomyoma, or endometritis—in 28 (52%) of 54. In the control group, neoplasia was found in 2 of the 108 follow-up biopsies. Only 5 other controls had specific diagnoses; all were polyps. Conclusions.—Extensive breakdown or menstrual-pattern endometrium may mask other specific benign pathologies but does not commonly mask cancer.

scholarly journals Volumetric changes and peri-implant health at implant sites with or without soft tissue grafting in the esthetic zone, a retrospective case-control study with a 5-year follow-up

2017 ◽  
Vol 28 (11) ◽  
pp. 1459-1465 ◽  
Author(s):  
Stefan P. Bienz ◽  
Ronald E. Jung ◽  
Vitor M. Sapata ◽  
Christoph H. F. Hämmerle ◽  
Jürg Hüsler ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Control Study

P1211IOT(INTERNET OF THINGS) FOLLOW-UP VS. CONVENTIONAL CARE IN PATIENTS WITH CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: A RETROSPECTIVE, CASE-CONTROL STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Aihua Li ◽  
Mengjun Liang ◽  
Zongpei Jiang
Keyword(s):  
Peritoneal Dialysis ◽  
Case Control Study ◽  
Compliance Rate ◽  
Case Control ◽  
Conventional Care ◽  
Conventional Group ◽  
Retrospective Case ◽  
Home Based ◽  
Control Study

Abstract Background and Aims Peritoneal dialysis (PD) has been accepted as a home-based, more cost-effective renal replacement therapy worldwide. Increasing evidence indicates that patients on PD have clinical outcomes that are not optimistic than those on hemodialysis. The reasons for these observations are multifactorial and include lack of experience on self health-care, limited modality of follow-up, belated prescription adjustments, and shortage of management of the various complications. Internet of things (IoT), a novel technology that would improve access to and compliance in PD patients, has been designed and deployed to PD patients in our center for the nursing follow-up. Method A retrospective, case-control study enrolled 30 patients on continuous ambulatory peritoneal dialysis (CAPD) in The Six Affiliated Hospital of Sun Yat-sen University from 2018.09 to 2018.10. The patients were categorized into IoT group (15 patients) and conventional group in which patients was selected by propensity score matching for the gender, age, dialysis age and basic nephropathy. All the patients had been followed up for 3 months to assess their quality and compliance of PD. IoT follow-up was defined as the framework of home-based sphygmomanometer, electronic scale, weighing scale and portable application description (PAD) via bluetooth and the nurses in PD group could review the data timely over the internet and provide care management advice. Conventional care was defined as telephone or outpatient follow-up monthly. Results There were no differences among gender, age, dialysis age, and basic nephropathy distribution between the two groups. After 3-month follow-up, the weight compliance rate in IoT group seemed better than that in conventional group, with rate of 100% and 80%, p=0.068; the blood pressure compliance rate in IoT group seemed higher than that in conventional group, with rate of 60% and 46.7%, p=0.464. Nine patients (the rate of 60%) in IoT group, while only 2 patients (13.3%) in conventional group, had got alterations of hypotensive drugs, p=0.008. Eight patients (53.3%) in IoT group had acquired adjustments of PD doses, while no patient in conventional group had any changes, p=0.001. Conclusion Our preliminary results had indicated that IoT technology could provide innovations and timeliness for basic nursing care in PD follow-up. IoT devices would help to improve the availability and effectiveness of peritoneal dialysis.

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