Skin and Soft Tissue Abscess: 1 Year's Experience

2009 ◽  
Vol 13 (5) ◽  
pp. 257-261 ◽  
Author(s):  
Sandhya Nalmas ◽  
Eliahu Bishburg ◽  
Monica Shah ◽  
Trini Chan
Keyword(s):  
Soft Tissue ◽  
Drug Users ◽  
Chart Review ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Underlying Disease ◽  
Recurrence Rates ◽  
Immunodeficiency Virus ◽  
Soft Tissue Abscess

Background: The incidence of skin and soft tissue abscesses (SSTAs) has increased owing to the emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Some of these patients are treated as outpatients (OPs) and some as inpatients (IPs). Objective: To review the microbiology and clinical features of SSTAs and the clinical parameters that may have influenced clinicians to treat patients as IPs. Methods: The study was conducted in a 673-bed teaching hospital between January and December 2005. A retrospective chart review of patients identified from a microbiology culture log was conducted. Data were collected for demographics, underlying disease, SSTA number and site, recurrence rates, and clinical presentation. Results: One hundred thirty-eight patients were identified; 76 (55%) were female, with a mean age of 42 years (range 18–80 years); 76 (55.5%) had no underlying disease, 27 (19.6%) had diabetes, 20 (14.5%) had human immunodeficiency virus (HIV) infection, and 13 (9.4%) were intravenous drug users. Common SSTA sites involved were the perineal area (43; 31.2%), upper extremities (35; 25.4%), lower extremities (19; 13.8%), head and neck (14; 10.1%), chest (13; 9.4%), and abdomen (8; 5.8%). Conclusions: CA-MRSA was the most commonly isolated organism overall and in patients treated as OPs. The decision to treat SSTA patients as IPs seems to be influenced by SSTA number and site and the presence of fever at presentation. SSTA number and site (variables that led to the decision to treat patients as IPs) were confirmed by demonstrating statistical significance in the analysis between the IP and OP groups, but the other determinant of admission, the presence of fever at presentation, was based on chart review statements and not confirmed by statistical analysis between the IP and OP groups.

scholarly journals The mortality of ill infants with false tooth extraction in a rural Ugandan emergency department

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Amyna Husain ◽  
M. Douglas Baker ◽  
Mark C. Bisanzo ◽  
Martha W. Stevens
Keyword(s):  
Emergency Department ◽  
Tooth Extraction ◽  
Chart Review ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Cultural Practice ◽  
Fluid Bolus ◽  
Significant Difference ◽  
To Receive

False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE−) was 14% (P=0.22). The FTE+ study group, and FTE− comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE− infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE− infants.

Utilization of Alexandrite Laser for Hair Removal in Pediatric Auricular Reconstruction

2021 ◽  
pp. 019459982110419
Author(s):  
Peng You ◽  
Tara L. Rosenberg ◽  
Yi-Chun Carol Liu
Keyword(s):  
Soft Tissue ◽  
Chart Review ◽  
Laser System ◽  
Retrospective Chart Review ◽  
Hair Removal ◽  
Procedural Sedation ◽  
Alexandrite Laser ◽  
Auricular Reconstruction ◽  
Laser Hair Removal ◽  
Soft Tissue Envelope

Auricular reconstruction with autologous rib cartilage involves using a soft tissue envelope to cover the cartilage framework. In patients with a low hairline, hair-bearing skin may be incorporated on the reconstructed ear, creating a difficult and conspicuous aesthetic problem. A retrospective chart review was conducted to summarize and share the experience of using the Candela GentleMax Pro 755-nm alexandrite laser system (Candela Corp) in children following auricular reconstruction. Nine patients received laser hair removal via the alexandrite laser system with good results. The number of completed sessions ranged from 1 to 5. The procedures were completed without the need for premedication or procedural sedation. Laser hair removal with an alexandrite laser system was safe, fast, and effective. With multistage auricular reconstruction, it was feasible to incorporate laser hair removal between the stages.

Incidence of non-infectious ‘acute mastoiditis’ in children

2011 ◽  
Vol 126 (3) ◽  
pp. 244-248 ◽  
Author(s):  
G Kontorinis ◽  
I Psarommatis ◽  
C Karabinos ◽  
Z Iliodromiti ◽  
M Tsakanikos
Keyword(s):  
Chart Review ◽  
Systemic Disease ◽  
Retrospective Chart Review ◽  
Underlying Disease ◽  
Acute Mastoiditis ◽  
Tertiary Referral Centre ◽  
Recurrent Case ◽  
Myelocytic Leukaemia ◽  
Histopathological Studies ◽  
Infectious Aetiology

AbstractObjective:The temporal bone may be the first involved site in cases of systemic disease, and may even present with acute, mastoiditis-like symptomatology. This study aimed to evaluate the incidence of such non-infectious ‘acute mastoiditis’ in children.Materials and methods:Retrospective chart review of 73 children admitted to a tertiary referral centre for acute mastoiditis.Results:In 71 cases (97.3 per cent), an infectious basis was identified. In the majority of cases (33 of 73; 45 per cent), the responsible bacteria was Streptococcus pneumoniae. However, histopathological studies revealed a non-infectious underlying disease (myelocytic leukaemia or Langerhans' cell histiocytosis) in two atypical cases (2.7 per cent).Conclusion:‘Acute mastoiditis’ of non-infectious aetiology is a rare but real threat for children, and a challenging diagnosis for otologists. A non-infectious basis should be suspected in every atypical, persistent or recurrent case of acute mastoiditis.

scholarly journals Evaluation of Serum Creatinine Changes With Integrase Inhibitor Use in Human Immunodeficiency Virus-1 Infected Adults

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Tara A. Lindeman ◽  
Joan M. Duggan ◽  
Eric G. Sahloff
Keyword(s):  
Human Immunodeficiency Virus ◽  
Clinical Trials ◽  
Adverse Events ◽  
Serum Creatinine ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Integrase Inhibitor ◽  
Serious Adverse Events ◽  
Immunodeficiency Virus ◽  
Human Immunodeficiency Virus 1

Abstract This retrospective chart review evaluated changes in serum creatinine and creatinine clearance (CrCl) after initiation of an integrase inhibitor (INSTI)-based regimen as initial treatment in human immunodeficiency virus-infected adults. Serum creatinine and CrCl changes were similar to those seen in clinical trials for INSTIs. No renal-related serious adverse events or discontinuations occurred.

scholarly journals Antibiotic use among twelve Canadian First Nations communities: A retrospective chart review of skin and soft tissue infections

2020 ◽  
Author(s):  
Dahn Jeong ◽  
Ha Nhan Thi Nguyen ◽  
Mark Tyndall ◽  
Yoko S Schreiber
Keyword(s):  
Soft Tissue ◽  
First Nations ◽  
Chart Review ◽  
Clinical Symptoms ◽  
Community Setting ◽  
Retrospective Chart Review ◽  
Indigenous Communities ◽  
Antibiotic Use ◽  
Soft Tissue Infections ◽  
Treatment And Prevention

Abstract Background Previous publications indicated an emerging issue with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), particularly skin and soft tissue infections (SSTIs), in Indigenous communities in Canada. The objectives of this analysis were to explore the prevalence of SSTIs due to CA-MRSA and patterns of antimicrobial use in the community setting. Methods A retrospective chart review was conducted as part of an environmental scan to assess antibiotic prescriptions in 12 First Nations communities across five provinces in Canada including Alberta, Saskatchewan, Manitoba, Ontario, and Québec. Charts were randomly selected from nursing stations and patients who had accessed care in the previous 12 months and were ≥18 years were included in the review. Data was collected from September to December, 2013 on antibiotic prescriptions, including SSTIs, clinical symptoms, diagnostic information including presence of CA-MRSA infection, and treatment. Results A total of 372 charts were reviewed, 60 from Alberta, 70 from Saskatchewan, 120 from Manitoba, 100 from Ontario, and 22 from Québec. Among 372 patients, 224 (60.2%) patients had at least one antibiotic prescription in the previous 12 months and 569 prescriptions were written in total. The prevalence of SSTIs was estimated at 36.8% (137 cases of SSTIs in 372 charts reviewed). In 137 cases of SSTIs, 34 (24.8%) were purulent infections, and 55 (40.2%) were due to CA-MRSA. Conclusions This study has identified a high prevalence of antibiotic use and SSTIs due to CA-MRSA in remote and isolated Indigenous communities across Canada. This population is currently hard to reach and under-represented in standard surveillance system and randomized retrospective chart reviews can offer complimentary methodology for monitoring disease burden, treatment and prevention.

Survival of the 8.5 mm osseointegrated abutment, and its utility in the obese patient

2013 ◽  
Vol 127 (7) ◽  
pp. 643-649 ◽  
Author(s):  
M D Darley ◽  
A A Mikulec
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Retrospective Cohort ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Mechanical Forces ◽  
Obese Patients ◽  
Hearing Rehabilitation ◽  
Obese Population ◽  
Bone Anchored Hearing Aid

AbstractBackground:Most of the literature regarding osseointegrated implantation for hearing rehabilitation focuses on the 5.5 mm abutment. This study aimed to add to the data available on the survival of the 8.5 mm abutment, and to describe its utility in obese patients.Objective:To review the outcomes of patients who received a bone-anchored hearing aid implant, and create a model comparing the mechanical forces acting upon combinations of fixture and abutment lengths.Methods:Retrospective chart review and mathematical modelling.Results:In this retrospective cohort study comprising 25 patients, less abutment overgrowth was observed in the 8.5 mm abutment recipients versus recipients of the 5.5 mm abutment. When the principle of equilibrium of a rigid body was applied, the 8.5 mm abutment was at a calculated mechanical disadvantage compared with the 5.5 mm abutment.Conclusion:The 8.5 mm abutment may be useful in patients with copious subcutaneous soft tissue as in the obese population. The 8.5 mm abutment has a calculated mechanical disadvantage, potentially putting the implant under greater mechanical stress; however, the clinical relevance of this is unclear.

scholarly journals Just the Facts: Methicillin-resistant Staphylococcus aureus and soft tissue abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 149-151
Author(s):  
Heather Murray ◽  
Kirk Leifso
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incision And Drainage ◽  
Methicillin Resistant ◽  
Soft Tissue Abscess ◽  
Mrsa Strains ◽  
Almost All

Soft tissue abscess used to be an easy emergency department (ED) presentation: perform an incision and drainage (I + D) and discharge your patient. Times have changed. Methicillin-resistant Staphylococcus aureus (MRSA) is now a major cause of soft tissue abscess in ED patients. MRSA is, by definition, resistant to cloxacillin and cephalosporins. Almost all Canadian strains are susceptible to vancomycin and linezolid. MRSA strains are variably susceptible to trimethoprim-sulfamethoxazole (TMP-SMX), tetra/doxycycline, and clindamycin, with pooled Canadian clindamycin resistance just over 40%.

scholarly journals Impact of Trimethoprim-Sulfamethoxazole Prophylaxis on Etiology and Susceptibilities of Pathogens Causing Human Immunodeficiency Virus-Associated Bacteremia

2002 ◽  
Vol 46 (2) ◽  
pp. 594-597 ◽  
Author(s):  
David A. Wininger ◽  
Robert J. Fass
Keyword(s):  
Staphylococcus Aureus ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Prophylactic Administration ◽  
Antimicrobial Susceptibilities ◽  
Immunodeficiency Virus ◽  
The Impact

ABSTRACT The impact of chronic prophylactic administration of trimethoprim-sulfamethoxazole (SXT) on the ecology and the antimicrobial susceptibilities of bloodstream pathogens in human immunodeficiency virus (HIV)-infected patients was studied using a retrospective chart review. Eighty-nine patients with advanced HIV infection developed 124 episodes of bacteremia with 156 pathogenic isolates. Staphylococcus aureus and Enterobacteriaceae tended to be less common among patients receiving SXT. Isolates from patients receiving SXT were likelier (75%) to be resistant to 20 μg of SXT/ml than those from patients not receiving SXT (33%) (P < 0.001).

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