scholarly journals Implementation of a Bundle of Care in Colorectal Surgery to Reduce Surgical Site Infections Successfully at Cantonal Hospital Lucerne: Study Protocol for a Prospective Observational Study

2021 ◽  
Vol 25 (1) ◽  
pp. 220-226
Author(s):  
Stefanie Brunner ◽  
Jule Liesenberg ◽  
Lana Fourie ◽  
Jürg Metzger ◽  
Andreas Scheiwiller ◽  
...  

2016 ◽  
Vol 5 (2) ◽  
pp. e90 ◽  
Author(s):  
Audrey CHM Jongen ◽  
Joanna WAM Bosmans ◽  
Serdar Kartal ◽  
Tim Lubbers ◽  
Meindert Sosef ◽  
...  


2009 ◽  
Vol 36 (S 02) ◽  
Author(s):  
B Hotter ◽  
S Pittl ◽  
M Ebinger ◽  
G Oepen ◽  
K Jegzentis ◽  
...  




Medicine ◽  
2019 ◽  
Vol 98 (1) ◽  
pp. e13937 ◽  
Author(s):  
Joerg C. Schefold ◽  
Anna S. Messmer ◽  
Stefanie Wenger ◽  
Lionel Müller ◽  
Stephan von Haehling ◽  
...  


2020 ◽  
Vol 11 ◽  
Author(s):  
Bernd Schulte ◽  
Kirsten Lehmann ◽  
Christiane Sybille Schmidt ◽  
Elke Rühling ◽  
Bernd Weber ◽  
...  

Introduction: Once-weekly or once-monthly injectable depot buprenorphine is a new opioid substitution treatment (OST) medication that provides clinically relevant plasma concentrations without daily peaks. Together with a high tolerability and acceptance reported by patients, the prolonged release of injectable depot buprenorphine might have beneficial implications on the patients' quality of life and social participation. The primary objective of this prospective non-interventional observational study is to evaluate the effects of subcutaneous injectable depot buprenorphine on the quality of life of patients in routine OST care in Germany. Secondary outcomes like illicit substance use, psychological distress, social participation and activity are assessed to provide an overall evaluation toward addiction recovery.Methods and Analysis: The present study is a non-randomized prospective observational study with a control group (treatment-as-usual). To ensure comparability between both patient groups, suitable control patients (n = 213) from the same OST unit will be matched pairwise to each patient treated with injectable depot buprenorphine (n = 213). Matching variables are gender, duration of OST, take-home prescription and psychosocial functioning (according to the Global Assessment of Functioning scale). Primary study endpoint is the difference of change in quality of life, assessed with the recently developed Opioid Substitution Treatment Quality of Life scale (OSTQOL), within the depot buprenorphine group between baseline and month 12. The primary analysis will be carried out according to the intention-to-treat principle (ITT) by comparing OSTQOL mean scores using dependent t-tests. For secondary analyses, group comparisons will be done by mixed model approaches with baseline OSTQOL score and the (pairwise) cluster term as covariates.Discussion: The study combines clinical, routine OST care data with relevant patient reported outcome data. The pairwise matching allows conclusions on effects of different OST medications. The study findings will provide new insights in the addiction recovery processes of OST patients treated with depot buprenorphine.Ethics and Dissemination: The study protocol has been approved by the Ethics Committee of the Hamburg Chamber of Physicians (Ärztekammer Hamburg) (reference number: PV7078). The study results will be disseminated through peer-reviewed publications and presentations on scientific conferences.Clinical Trial Registration: German Clinical Trials Register DRKS-ID: DRKS00020797



BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giziew Bawoke ◽  
Segni Kejela ◽  
Abebe Alemayehu ◽  
Girmaye Tamirat Bogale

Abstract Background Modified radical mastectomy is the procedure of choice in centers with little to no radiotherapy services. Studying the in-hospital outcome and complications associated with the procedure is important in low-income countries. Methods This is a multi-center prospective observational study involving all patients operated with modified radical mastectomy with curative intent. Results A total of 87 patients were studied with 10.3% of which were male and 54% were between the age of 30–49 years. Clinical stage IIB and IIIA were reported in 33 (37.9%) and 25 (28.7%) respectively and 62.1% had clinically positive lymph nodes at presentation. All of the studied patients underwent curative surgery, with an average lymph node dissection of 10.2 ± 0.83. Seroma rate was 17.2% and was significantly associated with diabetes (AOR: 6.2 (CI 1.5–8.7)) and neoadjuvant chemotherapy (AOR: 8.9 (CI 1.2–14.2)). Surgical site infection occurred in 14.9% and was significantly associated with Retroviral infections (AOR: 4.2 (CI 2.1–5.8)) and neoadjuvant chemotherapy (AOR: 1.8 (CI 1.3–3.9)). No in-hospital mortality occurred during the course of the study. Conclusion Seroma rate was lower than published studies while surgical site infections rate was higher. Neoadjuvant chemotherapy was associated with increase in seroma and surgical site infection rates. Additionally, diabetes increased the rate of seroma. Surgical site infections were higher in patients with retroviral infections.



BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049592
Author(s):  
Hiroyuki Seki ◽  
Norifumi Kuratani ◽  
Toshiya Shiga ◽  
Yudai Iwasaki ◽  
Kanae Karita ◽  
...  

IntroductionSodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antihyperglycaemic agents that promote urinary glucose excretion in the renal proximal tubule and have cardio-protective and renal-protective properties. However, there are several safety concerns related to increased risks of hypoglycaemic, urinary tract infections and ketoacidosis. Ketoacidosis is a potentially fatal complication that often presents as euglycaemic ketoacidosis during SGLT2 inhibitor treatment. Furthermore, invasive treatment and related surgical stress may increase the risk of ketogenesis. Therefore, this study aims to clarify the incidence of SGLT2 inhibitor-associated postoperative ketoacidosis (SAPKA) among patients who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia.Methods and analysisThis multicentre, prospective, observational study will recruit 750 adult Japanese patients with diabetes who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia. Urine samples will be collected on postoperative days 0, 1, 2 and 3. Blood gas analysis will be performed when urine ketone positivity is detected. The incidence of postoperative ketoacidosis will be identified based on urine ketone positivity and a blood pH of ≤7.3. The study will also collect data to identify risk factors for SAPKA.Ethics and disseminationThe study protocol has been approved by the ethics committee of Kyorin University (approval number: 785, 26 October 2020) and local ethical approval will be required at each participating centre. Study findings will be submitted to peer-reviewed journals and abstracts will be submitted to relevant national and international meetings.Trial registration numberUMIN000042795



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