scholarly journals Fascia Repair With Vicryl Suture in 636 Urologic Surgeries

2021 ◽  
Author(s):  
Hamed Mohseni Rad ◽  
Ahmad Ghazi
Keyword(s):  
Wound Infection ◽  
Double Layer ◽  
Medical Center ◽  
Vicryl Suture ◽  
Almost All ◽  
Low Rate

Abstract Objective: The procedure for closing the fascia after surgery should be quick, easy, and persistent, yet comfortable for the patient. Polydioxanone thread is not widely available in Iran and we use Vicryl kind instead for almost all patients. This study was conducted in two years from January 2018 to January 2020 at Imam Reza and Imam Khomeini Medical Center in Ardabil. Fascia was treated with Vicryl suture of 0 or 1 in a double layer and in continues form for all patients in the Urology Department.Results: 636 patients were evaluated in these two years. The fascia healing was at the site of inguinal, midline Gibson and flank. The fascia relief is bilaterally treated with Vicryl suture and continuously in all urologic surgeries with a very low rate of wound infection and hernia at the place of operation. At the same time, the amount of pain at the place of operation and the formation of sinus sores is very low.

scholarly journals EPIDEMIOLOGICAL STUDY OF PERIORBITAL HYPERMELANOSIS

2020 ◽  
pp. 1-4
Author(s):  
Sonal Khade Ahuja ◽  
Ashish Deshmukh ◽  
Sanmitra Aiholli ◽  
Omkar Kulkarni
Keyword(s):  
Quantitative Assessment ◽  
Medical Center ◽  
Sun Exposure ◽  
Age Group ◽  
Single Patient ◽  
Psychosocial Consequences ◽  
History Of ◽  
Grade 3 ◽  
Almost All ◽  
Sleeping Habits

Background: Periorbital hypermelanosis also called dark circles form the major percentage of dermatology consultations. Importance of these disorders is growing as they cause easy visible cosmetic disfigurement and significant psychosocial consequences. Aims: To assess the patients of POH disorders for demographic, etiological and clinical profile. Methods: This prospective hospital-based clinical study, conducted in a tertiary medical center over a period of two years, involved 200 patients with POH disorders, assessed using detailed history taking and clinical examination for demographic, etiological and clinical data. Data is statistically described in frequencies (number of cases) and percentages(%) . Results: Majority of patients were in age group 18-40 years. Females dominated the study with a number of 169 (84.5%) , only 31 (15.5%) were males. Most of the patients belonged to Grade 2 (53%), grade 3 was seen in 27% patients followed by grade 1 (16.5% ) and grade 4 (3.5% ) POH. Family history was positive in 81.5% patients. POH was observed mostly in housewives 93 (46.5%) and patients with indoor occupation 69 (34.5%) and less commonly in patients with outdoor occupation 29 (14.5%). Almost all cases of POH gave history of exacerbation following sun exposure. Not a single patient showed hepatic, renal complaints, hypothyroidism or ecchymosis. Majority of patients (86.5%) had altered Sleeping habits. Alcohol and smoking did not have a significant co-relation with POH. It was found that only five percent females on oral contraceptives developed POH and there was no change in Pigmentation of POH in relation to menstrual cycle in any of the females. Limitations: The quantitative assessment of melanin by specialized instrument ( mexameter) could not be done because of lack of resources.

scholarly journals History of Depression and Increased Risk of Sternal Wound Infection After Cardiothoracic Surgery: A Novel and Potentially Modifiable Risk Factor

2019 ◽  
Vol 6 (3) ◽  
Author(s):  
Deborah A Theodore ◽  
Renee D Goodwin ◽  
Yuan (Vivian) Zhang ◽  
Nancy Schneider ◽  
Rachel J Gordon
Keyword(s):  
Risk Factors ◽  
Wound Infection ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cardiothoracic Surgery ◽  
Sternal Wound Infection ◽  
Composite Variable ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression

Abstract Background Sternal wound infection (SWI) is a leading cause of postoperative disease and death; the risk factors for SWI remain incompletely understood. The goal of the current study was to investigate the relationship between a preoperative history of depression and the risk of SWI after cardiothoracic surgery. Methods Among patients undergoing cardiothoracic surgery in a major academic medical center between 2007 and 2012, those in whom SWI developed (n = 129) were matched, by date of surgery, with those in whom it did not (n = 258). Multivariable logistic regression was used to examine the strength of relationships between risk factors and development of infection. History of depression was defined as a composite variable to increase the sensitivity of detection. Results History of depression as defined by our composite variable was associated with increased risk of SWI (adjusted odds ratio, 2.4; 95% confidence interval, 1.2–4.7; P = .01). Staphylococcus aureus was the most common organism isolated. Conclusions History of depression was associated with increased risk of SWI. Future prospective studies are warranted to further investigate this relationship. Depression is highly treatable, and increased efforts to identify and treat depression preoperatively may be a critical step toward preventing infection-related disease and death.

scholarly journals Double layer versus Single layer Gastro-intestinal anastomosis in gastric cancer surgery in Mymensingh Medical College Hospital

2013 ◽  
Vol 2 (2) ◽  
pp. 30-34
Author(s):  
S Rahman ◽  
MA Khair ◽  
F Khanam ◽  
S Haque ◽  
MM Hoque ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Wound Infection ◽  
Anastomotic Leakage ◽  
Double Layer ◽  
Single Layer ◽  
Abdominal Sepsis ◽  
Pelvic Abscess ◽  
Cancer Surgery ◽  
College Hospital ◽  
Gastric Cancer Surgery

Introduction: In gastric cancer surgery, gastrojejunostomy is one of the most important procedures. Anastomosis between different parts of the stomach and the intestine is a basic technical component in all gastrointestinal procedure. Backgrounds and aims: This study evaluated complications of gastrojejunostomy in gastric cancer surgery with two methods: single-layer and double-layer anastomosis. Materials and methods: This study was carried out in the department of surgery in Mymensingh Medical College Hospital from January 1, 2009 to December 31, 2012. 100 patients with carcinoma stomach who needed gastrojejunostomy were included in this study. These patients with average age of 43.22 years were divided in two groups (50 in each group); single-layer and double-layer anastomosis. In single-layer anastomosis gastrojejunostomy was performed in interrupted method with absorbable suture (2/0 vicryl). Double-layer anastomosis was carried out with continuous suture (2/0 silk, 2/0 catgut). Possible post-operative complications like anastomotic leakage, pelvic abscess, abdominal sepsis, anastomotic stenosis and wound infection were evaluated. Results: In the single-layer group, 4 patients (8%) developed anastomotic leakage, wound infection and only 2 patients (4%) developed abdominal sepsis, pelvic abscess and anastomotic bleeding. No patient developed anastomotic stricture. In double-layer group, 2 (4%) patients developed anastomotic leakage, only 1 (2%) patient had pelvic abscess, abdominal sepsis and anastomotic bleeding but wound infection in 2 (4%) patients. Conclusion: Gastrojejunostomy with single-layer hand-sewn suture technique is safe without serious complications in comparison to double-layer suture technique. More-over operation time is less and cost is less in single-layer method.DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16695 Community Based Medical Journal 2013 July: Vol.02 No 02: 30-34

Risk Factors for Groin Wound Infection After Femoral Artery Catheterization A Case-Control Study

2006 ◽  
Vol 27 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Philip M. Polgreen ◽  
Daniel J. Diekema ◽  
Jeff VandeBerg ◽  
R. Todd Wiblin ◽  
Yi Yi Chen ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Wound Infection ◽  
Femoral Artery ◽  
Odds Ratio ◽  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
University Hospital ◽  
Hematoma Formation ◽  
Control Study

Objective.Groin wound infection (GWI) after femoral artery catheterization is unusual. However, several reports of GWI associated with the use of a Perclose device appear in the surgical literature.Design.A case-control study.Setting.We pooled 23 cases and 83 controls from a university hospital and a community medical center.Patients.A case was defined as a patient who developed a GWI after a femoral artery catheterization. At the university hospital, 3 controls were randomly selected from the at-risk population and matched to each case by time of procedure only (within 2 weeks). At the community medical center, 4 controls were selected and matched to each case by time of procedure (within 2 weeks), sex, and age (within 5 years).Results.We considered several covariates, including age, sex, body mass index, medical conditions, Perclose use, hematoma formation, and antithrombotic therapy. In a multivariate model, only hematoma formation (odds ratio, 68.8; 95% confidence interval, 12.1-391.4) and glycoprotein IIb/IIIa platelet inhibitor therapy (odds ratio, 6.1; 95% confidence interval, 1.1-33.6) were statistically significant predictors of GWI; Perclose use (odds ratio, 0.9; 95% confidence interval, 0.2-3.7) was not a statistically significant predictor of GWI. However, most of the hematomas (15/17) formed after procedures during which a Perclose device was used.Conclusion.Perclose use did not have any additional effect on GWI risk beyond the effect that hematoma formation had.

scholarly journals 1523. Clinical Epidemiology of Children with Orbital Cellulitis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S554-S555
Author(s):  
Meghna Sharma ◽  
Alexandra Espinel ◽  
Emily Ansusinha ◽  
Rana F Hamdy
Keyword(s):  
Clinical Epidemiology ◽  
Medical Center ◽  
Orbital Cellulitis ◽  
Surgical Drainage ◽  
Medical Problems ◽  
Duration Of Symptoms ◽  
National Medical ◽  
Intracranial Complications ◽  
Almost All ◽  
Viridans Group Streptococci

Abstract Background The microbiology of pathogens causing orbital cellulitis in children is evolving over time, with studies from around 10 years ago describing MRSA as responsible for anywhere from 0 to 13% of cases of orbital cellulitis. However, the prevalence of community-acquired MRSA infections has declined over the past decade. A current understanding of the bacteria most commonly found to be responsible for orbital cellulitis would be important to inform the empiric antibiotic regimens for cases of orbital cellulitis in which no microbiologic data are available. Methods This is a single-center retrospective cohort study of children ≤18 years hospitalized with orbital cellulitis at Children’s National Medical Center between January 1, 2017 and July 31, 2018. We excluded children with immunocompromising conditions, cystic fibrosis, underlying craniofacial abnormality, or recent craniofacial or otolaryngologic surgery. Baseline clinical characteristics, microbiologic data, clinical outcomes, and antibiotic treatment data were abstracted through structured chart review and summarized with descriptive statistics. Results We identified 68 children that met inclusion criteria, with an average age of 8.2 years; 66.2% were male, 48.5% were African American, and 14.7% were Hispanic. Most (67.6%) had no underlying medical problems, 14.7% had asthma, and 22.1% had allergic rhinitis. The median duration of symptoms prior to presentation was 4 days. An abscess or phlegmon was identified in 41 of the 68 (60.3%). Three patients (4.4%) developed intracranial complications. About one-quarter (27.9%) of all patients in the cohort underwent surgical drainage. The most commonly identified pathogens were viridans group streptococci (7/19, 36.8%), followed by Staphylococcus aureus (4/19, 21.1%). Anti-MRSA therapy was provided empirically in almost all (95.6%) of patients. Conclusion One-quarter of all patients hospitalized for orbital cellulitis underwent surgical drainage, and viridans group streptococci and S. aureus were the most commonly isolated pathogens. While MRSA was isolated in only one patient (5.2%), almost all received empiric anti-MRSA therapy. Disclosures All authors: No reported disclosures.

Perception of patients regarding telemedicine at times of COVID-19: Did they miss the personal touch?

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 260-260
Author(s):  
Shira Peleg Hasson ◽  
Barliz Waissengrin ◽  
Marah Hodruj ◽  
Eliya Shachar ◽  
Sharon Pelles ◽  
...  
Keyword(s):  
Medical Center ◽  
Gynecological Cancer ◽  
Treatment Interruption ◽  
Clinic Visit ◽  
Ambulatory Activity ◽  
Virtual Communication ◽  
Tel Aviv ◽  
Lung Malignancies ◽  
Almost All

260 Background: The patient-oncologist relationship is cultivated from the first clinic visit, trust and assurance established throughout the follow up period until the end of life. In March 2020, with the break of the COVID-19 pandemic, social distancing restrictions were implement throughout Israel. The adoptions of telemedicine services were incorporate as a response at our institution. Almost all ambulatory activity in the oncology division in Tel Aviv Medical Center was converted to telemedicine services. Several studies report favorable results regarding patient preference and cost effectiveness of telemedicine. Methods: We conducted a telephone interview questionnaire assessing patient satisfaction. Inclusion criteria included solid tumor patients over 18 years who utilized the telemedicine platform at Tel Aviv Sourasky Medical Center between March 2020 - May 2020. We aimed to evaluate patient's perspectives and preferences regarding telemedicine and assess whether this virtual communication affects the patient-doctor relationship. Results: Following the COVID-19 outbreak, 400 telephone calls were made to patients, 100 patients agreed to participate and surveyed. Fifty-two percent were female. The majority of patients independently downloaded the telemedicine application and did not encounter technical constraints (67%). Family members and friend attended 45% of telemedicine visits. Patients cancer diagnosis included colorectal cancer (47%), breast cancer (18%), genitourinary cancer (18%), sarcoma (9%) lung malignancies (6%), gynecological cancer (1%) and CNS tumors (2%). Visit intent included post-treatment follow up (40%), active treatment follow (53%), and first visit intake (7%). The majority of patients felt their emotional needs were met (88%) and felt that their treatment was not harmed due to absence of a physical visit (84%). Almost all patients (99%) felt their privacy was maintained. Ninety-five percent of patients affirmed that the virtual visit relieved their worries regarding treatment interruption. Importantly, 75% of patients affirmed their interest to continue telemedicine regardless of COVID-19 pandemic. Conclusions: Telemedicine is an acceptable platform that may replace follow up visits without comprising patients’ experience. Our data call for research and development of tools enabling long-term implementation of remote telemedicine and assess the patient-physician relationship and quality of care among oncology patients.

Paraspinal subfascial placement of lumbar intrathecal baclofen catheters: short-term outcomes of a novel technique

2012 ◽  
Vol 9 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Luigi Bassani ◽  
David H. Harter
Keyword(s):  
Wound Infection ◽  
Medical Center ◽  
Intrathecal Baclofen ◽  
Catheter Placement ◽  
Csf Leak ◽  
New York University ◽  
Short Term ◽  
Intrathecal Catheter ◽  
Catheter Migration ◽  
Lumbar Catheter

Object Techniques for the placement of intrathecal baclofen (ITB) systems have been described in detail, with special consideration given to complications from hardware placement. Risks including catheter kinking and migration, hardware erosion through the skin, and lumbar CSF leak are elevated given the often-low body mass index and poor nutritional status of this patient population. The bulk of a spinal catheter and fascial connector within the lumbar wound may increase the potential for the aforementioned risks, leading to potential risks for wound infection and breakdown. The authors' experience has led them to develop a novel method of paraspinal subfascial lumbar catheter placement to address these risks. The authors describe a novel lumbar intrathecal catheter placement technique as part of the ITB system. Methods All patients undergoing placement of an ITB system by the senior author at New York University Langone Medical Center between July 2010 and March 2011 underwent paraspinal subfascial lumbar catheter placement. Patients were followed-up by the surgeon 2 weeks after implantation and followed up and managed by their physiatrist thereafter, for an average of 5 months (range 0.5–9 months). Results Of the 20 patients who underwent this method of intrathecal catheter placement, none developed any hardware erosion, catheter migration, or CSF leak. One patient developed an abdominal wound infection 3 weeks after implantation, necessitating pump removal. Conclusions In this initial short-term experience, subfascial placement of the lumbar spine intrathecal catheter may be an improvement over the traditional method of catheter placement. There is reduced risk of catheter migration or kinking, hardware erosion, CSF leak, and decreased operative time, all yielding a decreased reoperation rate in this vulnerable population.

Depression in the Elderly Living in the Community

1987 ◽  
Vol 150 (2) ◽  
pp. 169-174 ◽  
Author(s):  
O. Ben-Arie ◽  
L. Swartz ◽  
B. J. Dickman
Keyword(s):  
Social Support ◽  
Depressed Mood ◽  
The Elderly ◽  
High Rate ◽  
Suicidal Intent ◽  
Prevalence Of Depression ◽  
Almost All ◽  
State Examination ◽  
Elderly Living ◽  
Low Rate

A prevalence of depression of 13% was found among 139 coloured persons aged 65 years and over, living in the community in Cape Town, which accords with figures elsewhere. A high rate of hypochondriasis was found, but there was a low rate of suicidal intent, which could be explained by good social support. Observed depression and a depressed mood occurred in almost all depressed patients; as defined in the Present State Examination, these items appear to be an excellent screen for depression.

scholarly journals Antifungal Susceptibilities of Candida Isolates Causing Bloodstream Infections at a Medical Center in Taiwan, 2009-2010

2014 ◽  
Vol 58 (7) ◽  
pp. 3814-3819 ◽  
Author(s):  
Yu-Tsung Huang ◽  
Chia-Ying Liu ◽  
Chun-Hsing Liao ◽  
Kuei-Pin Chung ◽  
Wang-Huei Sheng ◽  
...  
Keyword(s):  
Antifungal Agents ◽  
Medical Center ◽  
Bloodstream Infections ◽  
Wild Type ◽  
Diagnostic Systems ◽  
Content Type ◽  
Clinical Breakpoints ◽  
Candida Infections ◽  
Almost All ◽  
Dose Dependent

ABSTRACTWe used the Sensititre YeastOne (SYO) method (Trek Diagnostic Systems) to determine the MICs of nine antifungal agents against 474 nonduplicate bloodCandidaisolates. The MIC results were interpreted according to updated clinical breakpoints (CBPs) recommended by the Clinical and Laboratory Standards Institute (CLSI; document M27-S4) or epidemiology cutoff values (ECVs). The rates of fluconazole susceptibility were 99.2% (234/236) inCandida albicans, 86.7% (85/98) inC. tropicalis, and 97.7% (42/43) inC. parapsilosis. Among the 77 isolates ofC. glabrata, 90.9% showed dose-dependent susceptibility (S-DD) to fluconazole. Nearly all isolates ofC. albicans,C. parapsilosis, andC. kruseiwere susceptible to voriconazole; however, rates of voriconazole susceptibility were 78.6% inC. tropicalis. Few isolates ofC. albicans(n= 5; 2.1%) andC. glabrata(n= 3; 3.9%), no isolates ofC. parapsilosis,C. krusei, andC. guilliermondii, but 62.2% (n= 51) ofC. tropicalisisolates were non-wild type for posaconazole susceptibility. For itraconazole susceptibility, 98.3% ofC. albicansisolates were wild type, and 3.9% (n= 3) ofC. glabrataisolates were non-wild type. Almost all of the isolates tested (>97% for all species) were susceptible to both micafungin and anidulafungin. All isolates tested were found to be wild type for amphotericin B susceptibility, with MICs of <1μg/ml. Further evaluation is needed to establish CBPs of antifungal agents by the 24-h SYO method for the management of patients with candidemia or other invasive candida infections.

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