Efficacy of intraoperative irrigation with saline for preventing shunt infection

2010 ◽  
Vol 6 (3) ◽  
pp. 273-276 ◽  
Author(s):  
Toshiaki Hayashi ◽  
Reizo Shirane ◽  
Michiko Yokosawa ◽  
Tomomi Kimiwada ◽  
Teiji Tominaga
Keyword(s):  
Infection Rate ◽  
Statistical Difference ◽  
Shunt Infection ◽  
Control Group ◽  
Operating Field ◽  
Group A ◽  
Shunt Infection Rate ◽  
Group B ◽  
Reducing Bacteria ◽  
Control Group Group

Object The rate of infection following shunt procedures is unacceptably high. The authors have hypothesized that the key to reducing the shunt infection rate is in reducing bacteria in the operating field and wound. This hypothesis has been tested in a prospective nonrandomized controlled manner. Methods Data obtained in all patients undergoing shunt insertions or revisions for hydrocephalus performed between October 1, 2003, and June 12, 2009, were reviewed. Starting in August 2006, we began routinely irrigating the operating field and wound with saline solution from a syringe. Prior to this, we had not used any irrigation techniques, providing an adequate control group (Group A) for the effect of the irrigation technique. Prior to November 2007, we used saline containing amikacin for irrigation (Group B). After that date, we used saline only for irrigation (Group C). Results A total of 150 shunt procedures were performed in 79 girls and 71 boys during the study period. The mean age of all patients was 44.0 ± 59.1 months. Groups A, B, and C comprised 61, 40, and 49 shunt procedures, respectively. There was no statistical difference in age among the 3 groups. Nine infections occurred within 90 days in the postoperative period. The overall infection rate was 6.0%. Eight infections occurred before introducing the irrigation procedure (infection rate 13.1%). One infection was noted after introducing irrigation (Group B [0.0%] + Group C [2.0%]; combined B and C infection rate = 1.1%). There was a statistical difference in the infection rate between Group A and Groups B and C combined (p = 0.003), Groups A and B (p = 0.021), and Groups A and C (p = 0.035). In contrast, no statistical difference was observed between Groups B and C (p > 0.99). Six of the 9 infections were due to staphylococcal species. Conclusions An irrigation technique used to reduce bacteria in the operating field and wound is effective for preventing shunt infection. Irrigation alone, and not antibiotics, contributed to the prophylaxis of shunt infection.

Efficacy of intraoperative wound irrigation for preventing shunt infection

2008 ◽  
Vol 2 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Toshiaki Hayashi ◽  
Reizo Shirane ◽  
Takahiro Kato ◽  
Teiji Tominaga
Keyword(s):  
Infection Rate ◽  
Pediatric Neurosurgery ◽  
Shunt Infection ◽  
Controlled Study ◽  
Control Group ◽  
Wound Irrigation ◽  
Operating Field ◽  
Shunt Procedure ◽  
Significant Difference ◽  
Reducing Bacteria

Object Although a cerebrospinal fluid shunt procedure is one of the most frequently performed operations in pediatric neurosurgery, the infection rate due to the procedure is not low. The authors have hypothesized that the key to reducing surgical shunt infections is to reduce bacteria from the operating field and wound. This hypothesis has been tested in a prospective nonrandomized controlled study at the authors' department. Methods Beginning in August 2006, during shunt procedures the authors began routinely irrigating the operating field and wound with amikacin containing saline, using a jet of fluid from a syringe. Prior to this new routine no irrigation techniques were used, providing an adequate control group for comparing the effect of the irrigation technique. Data obtained in all patients undergoing shunt insertions or revisions for hydrocephalus performed between October 1, 2003, and November 30, 2007, were reviewed. Results A total of 101 shunt procedures were performed in 63 patients (34 females and 29 males) during the study period. The mean age of all patients was 48.2 ± 61.8 months. A total of 61 shunt procedures were performed before August 2006, and 40 were performed after August 2006. There was no statistical difference between the ages of patients in the 2 groups (p = 0.64). Eight total infections occurred during the 90 days of the postoperative period (7.9% overall infection rate). All 8 infections occurred before implementation of the irrigation technique (13.1% infection rate), but no infections were noted after beginning use of the irrigation procedure (0% infection rate). There was a statistically significant difference in the infection rate between the 2 groups (p = 0.021). Conclusions Use of an irrigation strategy aimed at reducing bacteria from the operating field and wound can be considered an effective procedure for preventing shunt infection.

scholarly journals Microecological preparation combined with an modified low-carbon diet improves glucolipid metabolism and cardiovascular complication in obese patients

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jianguo Liu ◽  
Liehui Xiao ◽  
Hezhongrong Nie ◽  
Yong Pan ◽  
Yan Liu ◽  
...  
Keyword(s):  
Intestinal Barrier ◽  
Intestinal Barrier Function ◽  
Control Group ◽  
Obese Patients ◽  
Carotid Atherosclerotic Plaque ◽  
Low Carbon ◽  
Balanced Diet ◽  
Group A ◽  
Group B ◽  
Control Group Group

Abstract Objective To investigate the impact of microecological preparation combined with modified low-carbon diet on the glucolipid metabolism and cardiovascular complication in obese patients. Methods From August 2017 to July 2020, 66 obese patients were recruited, and administrated with an modified low-carbon diet with (group A) or without (Group B) microecology preparation and a balanced diet in control group (group C) for 6 months. Meanwhile, 20 volunteers administrated with a balanced diet were recruited as the healthy control group (group D). Results After 6-month intervention, obese subjects in group A and B showed significant improvement of body and liver fat mass, reduction of serum lipid levels, intestinal barrier function markers, insulin resistance index (IRI), high blood pressure (HBP) and carotid intima thickness, as compared with subjects in group C. More importantly, subjects in group A had better improvement of vascular endothelial elasticity and intimal thickness than subjects in group B. However, these intervention had no effect on carotid atherosclerotic plaque. Conclusion Administration of microecological preparation combined with modified low-carbon diet had better improvement of intestinal barrier function, glucose and lipid metabolism, and cardiovascular complications than low-carbon diet in obese patients, but the effect of a simple low-carb diet on carotid atherosclerotic plaque need to be further addressed.

Does laryngopharyngeal reflux affect healing and recovery after tonsillectomy?

2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy
Keyword(s):  
Wound Healing ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Control Group Group

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.

scholarly journals Protective effect of LIF-huMSCs on the retina of diabetic model rats

2021 ◽  
Vol 14 (10) ◽  
pp. 1508-1517
Author(s):  
Shan-Na Chen ◽  
◽  
Ying-Xue Ma ◽  
Song Chen ◽  
Guang-Hui He ◽  
...  
Keyword(s):  
Diabetic Rats ◽  
Control Group ◽  
Diabetic Model ◽  
Group A ◽  
Retinal Structure ◽  
Hs Crp ◽  
Group B ◽  
And Function ◽  
Group D ◽  
Control Group Group

AIM: To investigate the protective effect of human umbilical cord mesenchymal stem cells (hUCMSCs) modified by the LIF gene on the retinal function of diabetic model rats and preliminarily explore the possible mechanism. METHODS: A stably transfected cell line of hUCMSCs overexpressing leukemia inhibitory factor (LIF) was constructed. Overexpression was verified by fluorescent quantitative polymerase chain reaction (qPCR). Forty-eight adult Sprague-Dawley rats were randomly divided into a normal control group (group A), streptozotocin-induced diabetic control group (group B), diabetic rats at 3mo injected with empty vector-transfected hUCMSCs (group C) or injected with LIF-hUCMSCs (group D). Four weeks after the intravitreal injection, analyses in all groups included retinal function using flash electroretinogram (F-ERG), retinal blood vessel examination of retinal flat mounts perfused with fluorescein isothiocyanate-dextran (FITC-dextran), and retinal structure examination of sections using hematoxylin and eosin staining. Expression levels of adiponectin (APN), high-sensitivity C-reactive protein (hs-CRP), and neurotrophin-4 (NT-4) in each group was detected using immunohistochemistry, PCR, Western blotting, and ELISA, respectively. RESULTS: A stable transgenic cell line of LIF-hUCMSCs was constructed. F-ERG and FITC-dextran examinations revealed no abnormalities of retinal structure and function in group A, severe damage of the retinal blood vessels and function in group B, and improved retinal structure and function in group C and especially group D. qPCR, ELISA, and Western blot analyses revealed progressively higher APN and NT-4 expression levels in groups B, C, and D than in group A. hs-CRP expression was significantly higher in group B than in groups A, C, and D, and was significantly higher in group C than in group D (P<0.05). CONCLUSION: LIF-hUCMSCs protect the retina of diabetic rats by upregulating APN and NT-4 expression and downregulating hs-CRP expression in the retina.

Clinical and economic consequences of antibiotic-impregnated cerebrospinal fluid shunt catheters

2008 ◽  
Vol 1 (6) ◽  
pp. 444-450 ◽  
Author(s):  
Regina Eymann ◽  
Somar Chehab ◽  
Martin Strowitzki ◽  
Wolf-Ingo Steudel ◽  
Michael Kiefer
Keyword(s):  
Cerebrospinal Fluid ◽  
Infection Rate ◽  
Operating Time ◽  
Cost Benefit ◽  
Shunt Infection ◽  
Control Group ◽  
Shunt Insertion ◽  
Shunt Procedure ◽  
Shunt Infection Rate ◽  
The Cost

Object The authors evaluated the safety and efficacy of antibiotic-impregnated shunt catheters (AISCs) and determined the cost–benefit ratio related to the fact that AISCs increase the implant costs of a shunt procedure by ~ $400 per patient. Methods The control group comprised 98 adults with chronic hydrocephalus and 22 children, who were treated without AISCs (non-AISCs). In the treatment group, AISCs (Bactiseal, Codman, Johnson & Johnson) were implanted in 171 adults and 26 children. The minimum follow-up period was 6 months. Results Important risk factors for shunt infections (such as age, comorbidity, cause of hydrocephalus, operating time, and duration of external cerebrospinal fluid drainage prior to shunt placement) did not differ between the study and control groups. In the pediatric AISC group, the frequency of premature, shunt-treated infants and the incidence of external ventricular drainage prior to shunt insertion were actually higher than those in the non-AISC group. When using AISCs, the shunt infection rate dropped from 4 to 0.6% and from 13.6 to 3.8% in the adult and the pediatric cohort, respectively. Overall the infection rate decreased from 5.8 to 1%, which was statistically significant (p = 0.0145). The average costs of a single shunt infection were $17,300 and $13,000 in children and adults, respectively. The cost–benefit calculation assumed to have saved shunt infection–related costs of ~ $50,000 in 197 AISC–treated patients due to the reduction in shunt infection rate in this group compared with costs in the control group. Despite the incremental implant costs associated with the use of AISCs, the overall reduction in infection-related costs made the use of AISCs cost beneficial in the authors' department. Conclusions From clinical and economic perspectives, AISCs are seemingly a valuable addition in hydrocephalus therapy.

scholarly journals End-to-side nerve repair using fibrin glue in rats

2010 ◽  
Vol 25 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Daniel Nunes e Silva ◽  
Julice Coelho ◽  
Fabrício de Oliveira Frazílio ◽  
Alexandre Nakao Odashiro ◽  
Paulo de Tarso Camillo de Carvalho ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Axonal Regeneration ◽  
Nerve Repair ◽  
Control Group ◽  
Morphometrical Analysis ◽  
Walking Pattern ◽  
Group A ◽  
Nerve Anastomosis ◽  
Group B ◽  
Control Group Group

PURPOSE: To evaluate axonal regeneration after end-to-side nerve repair with fibrin glue in rats. METHODS: Forty-five Wistar rats were divided into three groups: group A (n=15), were not submitted to surgery (control group); group B (n=15) were submitted to fibular transection without repair; and group C (n=15), were submitted to fibular transection with end-to-side nerve anastomosis using fibrin glue, in the lateral surface of an intact tibial nerve. The three groups were submitted to walking track (30 and 90 days) and posterior morphometrical analysis (90 days). RESULTS: The functional tests demonstrated that there was no difference in the walking track during the study in group A (p>0.05). The group B had walking pattern impairment in the two tests (p>0.05). The group C had walking pattern impairment in the first test, with important recovery in the second test (p<0.05). The morphometrical assessment revealed significantly higher number of regenerated mielinates axons in group C, compared to group B (p<0.05). CONCLUSION: The end-to-side nerve repair with fibrin glue shows axonal recovery, demonstrated through functional and morphometrical ways in rats.

scholarly journals Effects of Dissolving Solutions on the Accuracy of an Electronic Apex Locator-Integrated Endodontic Handpiece

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Yakup Ustun ◽  
Ozgur Uzun ◽  
Ozgur Er ◽  
Murat Maden ◽  
Fatma Yalpı ◽  
...  
Keyword(s):  
Zinc Oxide ◽  
Control Group ◽  
Gutta Percha ◽  
Zinc Oxide Eugenol ◽  
Group A ◽  
Group B ◽  
Electronic Apex Locator ◽  
Control Group Group

The effects of three dissolving agents on the accuracy of an electronic apex locator- (EAL-) integrated endodontic handpiece during retreatment procedures were evaluated. The true lengths (TLs) of 56 extracted incisor teeth were determined visually. Twenty teeth were filled with gutta-percha and a resin-based sealer (group A), 20 with gutta-percha and a zinc oxide/eugenol-based sealer (group B), and 16 roots were used as the control group (group C). All roots were prepared to TL. Guttasolv, Resosolv, and Endosolv E were used as the dissolving solutions. Two evaluations of the handpiece were performed: the apical accuracy during the auto reverse function (ARL) and the apex locator function (EL) alone. The ARL function of the handpiece gave acceptable results. There were significant differences between the EL mode measurements and the TL (P<0.05). In these comparisons, Tri Auto ZX EL mode measurements were significantly shorter than those of the TL.

scholarly journals Effect of Liposome Curcumin Combined with PDGF-BB on Tendon Healing in Rats

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Wang TL ◽  
◽  
Wu WJ ◽  
Gu JX ◽  
Hou XR ◽  
...  
Keyword(s):  
Tendon Healing ◽  
Tendon Injury ◽  
Control Group ◽  
Combined Application ◽  
Healthy Control ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Group D ◽  
Control Group Group

Objective: To study the effect of liposomal curcumin combined with PDGFBB on tendon healing after tendon injury in rats and explore its mechanism. Methods Thirty-six rats were randomly divided into four groups: healthy control group (group A), liposomal curcumin group (group B), PDGF-BB group (group C) and combined application group (group D). The rats in each group were divided into groups according to the experimental group. At the 4th and 8th weeks after operation, the general morphology, histomorphology, biomechanics and other aspects of rat tendon were detected and statistically analyzed. Results: The degree of tendon adhesion in group B and D was significantly less than that in group A and C, and the difference was statistically significant. The biomechanical test showed that the tendons in group C and D had higher strength and could withstand greater stress than those in group A and B. Conclusion: Liposome curcumin combined with PDGF-BB can significantly reduce the degree of adhesion after tendon injury, increase the strength of tendon healing, and significantly promote tendon healing.

scholarly journals MICROSCOPIC CHANGES IN THE LIVER OF DEVELOPING RATS EXPOSED TO VALPRIOC ACID

1969 ◽  
Vol 5 (2) ◽  
pp. 685-688
Author(s):  
MUHAMMAD KHAN ◽  
INAYAT ULLAH ◽  
NAIK ZADA ◽  
MARIYA HIDAYAT
Keyword(s):  
Valproic Acid ◽  
Control Group ◽  
Central Vein ◽  
Microscopic Structure ◽  
Pregnant Rats ◽  
Histological Changes ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Control Group Group

BACKGROUND: Valproic Acid (VPA) is a broad - spectrum antiepileptic drug. Its use duringpregnancy has been associated with hapatotoxicity. This study was designed to assess the effects of VPAon the Microscopic structure of the Liver of developing rats exposed to the drug during varioustrimesters of pregnancy.OBJECTIVE: to evaluate the histological changes in developing liver in rats exposed to valproic acidduring different fetal periods. To correlate the extent of liver injury during various developmentalperiods.MATERIAL AND METHODS: In this Experimental Study pregnant rats were divided in to fourgroups A, B, C and D. Group D(n=10) was kept as control group. Group A (n=10) was given VPA in adose of 500 mg/kg/day intraperito-nealy (I/P) on days 3, 4, 5 of gestation. Group B (n=10) received thesame dose I/P on days 8, 9, 10 of gestation while Group C (n=10) received the same dose I/P on days16, 17, and 18 of gestation. On day 21 rats were euthanized and liver of the fetuses were dissected outfor examination.RESULTS: The central vein was significantly dilated in all the groups. Also, there was significantincrease in the size of hepatocytes in all the groups. Moreover, significant inflammation and congestionin portal areas and congestion in sinusoids were observed in all the experimental groups.CONCLUSION: VPA use during pregnancy produces hepatotoxicity in developing rats.KEY WORDS: Valproic Acid, Developing rats, Hepatotoxicity.

Mind reading improvements in mentalization-based therapy training

2021 ◽  
Vol 85 (1) ◽  
pp. 59-82
Author(s):  
Dagmar Steinmair ◽  
Richard Horn ◽  
Felix Richter ◽  
Guoruey Wong ◽  
Henriette Löffler-Stastka
Keyword(s):  
Social Cognition ◽  
Social Interactions ◽  
Health Care Providers ◽  
Social Withdrawal ◽  
Control Group ◽  
Care Providers ◽  
Therapy Training ◽  
Group A ◽  
Group B ◽  
Control Group Group

The psychological strain of many psychiatric disorders arises from difficulties encountered in social interactions. Social withdrawal is often the first symptom of neuropsychiatric disorders. The authors explore the various options for training social cognition skills. Social cognition was assessed using the Movie for the Assessment of Social Cognition (MASC). After completion of mentalization-based therapy (MBT) training, MASC scores improved significantly in health care providers (p = .006, r = .57). Mentalizing (operationalized with reflective functioning [RF]) was assessed in the MBT group (Group A) and compared with RF in a control group (Group B). RF was significantly higher in Group A (RF = 4.35, SD = 1.19) than in Group B (RF = 3.43, SD = 1.70) (p = .0385; Cohen's d = 0.65). MBT might be a promising intervention in social cognition training. Mentalizing skills might be associated with attitude.

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