Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis

OBJECT The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis. METHODS Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis RESULTS Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and Acinetobacter spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Enterobacter cloaceae, Proteus mirabilis) represented 88% of the pathogens. Acinetobacter and Klebsiella spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001). CONCLUSIONS Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics.

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LIMBERG FLAP A BETTER METHOD OF CLOSURE OF LUMBAR MYELOMENINGOCELE DEFECTS: A PROSPECTIVE STUDY

10.36106/ijar/8312981 ◽

2021 ◽

pp. 3-4

Author(s):

Prem Shanker ◽

Raghavendra Gupta ◽

Rajesh Kumar ◽

Adiveeth Deb

Keyword(s):

Tertiary Care ◽

Wound Dehiscence ◽

Patient Characteristics ◽

Csf Leak ◽

Controlled Study ◽

Limberg Flap ◽

Tertiary Care Centre ◽

Direct Repair ◽

Group B ◽

A Prospective Study

Background: Myelomeningocele is the most common and complex congenital malformation of the central nervous system with an incidence of approximately 1 in 1000 live births. The lumbosacral area is the commonest site for defect. Early closure of a myelomeningocele defect is advocated because it reduces infection rates even though it is not associated with an improved neurological outcome. Aims & objectives: The aim of this study was to evaluate the effectiveness and outcome of direct repair and a Limberg ap repair for skin defects that occur in myelomeningocele. Settings and Design: This was a prospective, randomized controlled study. Material and methods: A tertiary care centre based, non-randomized, prospective, comparative study was conducted in the Department of Neurosurgery, GSVM Medical College, Kanpur, from January 2018 to October 2019, in 22 patients with lumbar myelomeningocele. 7 patients who underwent Limberg ap repair constituted Group A and 15 patients who underwent direct repair constituted Group B. Post operatively the outcomes were compared at 6 months, on the basis of cosmetic appearance and complications such as wound dehiscence, CSF leak, neurological decit, hydrocephalus, necrosis and wound infection. Results : Lesser complications and a better cosmetic outcome were seen post operatively at 6 months with Limberg ap technique compared to direct repair. Our study show better result with Limberg ap over direct repair of myelomeningocele defect closure up to the follow up period of 6 months. Conclusion: Because of various defect sizes and patient characteristics, no single protocol exists for the reconstruction of myelomeningocele defects. Most lumbar myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local aps may be used to cover the defect. Overall, Limberg ap is a better technique for closure in these patients.

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A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non - modifiable risk factors

10.21203/rs.2.16681/v1 ◽

2019 ◽

Author(s):

Sofia Artemi ◽

Panteleimon Vassiliu ◽

Nikolaos Arkadopoulos ◽

Maria - Eleni Smyrnioti ◽

Pavlos Sarafis ◽

...

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Erectile Function ◽

Pelvic Surgery ◽

Modifiable Risk Factors ◽

Analysis Model ◽

History Of ◽

Male Patients ◽

A Prospective Study

Abstract Objective: Erectile dysfunction can be caused iatrogenically, due to pelvic surgery. The purpose of this study was to evaluate sexual function at various times after pelvic surgery in male patients and to investigate the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. Results: The mean age of the participants was 66.16 ± 13.07 years old. Regarding comorbidity, 47.2% reported various cardiovascular problems, 20.8% hypertension, 9.4% diabetes mellitus and 5.7% depression. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p <0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function ( p <0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.

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A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non - modifiable risk factors

10.21203/rs.2.16681/v3 ◽

2019 ◽

Author(s):

Sofia Artemi ◽

Panteleimon Vassiliu ◽

Nikolaos Arkadopoulos ◽

Maria - Eleni Smyrnioti ◽

Pavlos Sarafis ◽

...

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Prospective Study ◽

Erectile Function ◽

Pelvic Surgery ◽

Control Group ◽

Modifiable Risk Factors ◽

Analysis Model ◽

Male Patients ◽

A Prospective Study

Abstract Objective: A pelvic surgery can cause erectile dysfunction. The purpose of this study was to evaluate erectile function at various times after pelvic surgery in male patients; to search the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. This prospective study used the erectile dysfunction IIEF scale. Results: The study population comprised of 106 male patients who had undergone minor pelvic surgery at least 9 months before and during the 2010–2016 period in the 4th Surgical Clinic. A control group of healthy males (N=106) who underwent no pelvic surgery matched for age was also used for reference values. The main age of the participants was 66.16 ±13.07 years old. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p<0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function (p<0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.

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A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non - modifiable risk factors

10.21203/rs.2.16681/v2 ◽

2019 ◽

Author(s):

Sofia Artemi ◽

Panteleimon Vassiliu ◽

Nikolaos Arkadopoulos ◽

Maria - Eleni Smyrnioti ◽

Pavlos Sarafis ◽

...

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Prospective Study ◽

Erectile Function ◽

Pelvic Surgery ◽

Control Group ◽

Modifiable Risk Factors ◽

Analysis Model ◽

Male Patients ◽

A Prospective Study

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Risk Factors of Difficult Pharyngeal Accidental Fishbones Ingestion

Ear Nose & Throat Journal ◽

10.1177/01455613211036770 ◽

2021 ◽

pp. 014556132110367

Author(s):

Yi-Bo Huang ◽

Fan Zhang ◽

Hui-Ju Chen ◽

Dong-Dong Ren ◽

Hua-Peng Yu ◽

...

Keyword(s):

Risk Factors ◽

Foreign Body ◽

Neck Pain ◽

Foreign Body Sensation ◽

Missing Teeth ◽

Body Sensation ◽

Independent Risk Factors ◽

Male Patients ◽

A Prospective Study ◽

Nose And Throat

Objective: Accidental pharyngeal fishbone ingestion is a common complaint in ear, nose, and throat clinics. Approximately two-thirds of the accidentally ingested fishbones can be removed using tongue depressors and indirect laryngoscopy. However, the remaining third is challenging to identify and remove using these methods. These difficult fishbones require identification and removal via more advanced approaches. Video-guided laryngoscope is used to deal with difficult fishbones in our center. This study aimed to explore the risk factors for difficult fishbones. Methods: A prospective study was performed at a teaching hospital on 2080 patients. Univariate and multivariate analyses were performed to identify the risk factors. Results: The common fishbone locations were the tonsils (39.8%; defined as STEP-I), tongue base (37.1%), vallecula (13.3%; STEP-II), and hypopharynx (9.8%; STEP-III). With increasing STEP level, the ratio of difficult fishbones correspondingly increased (Z = 13.919, P < .001), and the proportions were 21.1%, 41.9%, and 70% in STEP-I, II, and III, respectively. In particular, fishbones in STEP-III (vs STEP-I) had a higher risk of difficult fishbones (odds ratio [OR]: 11.573, 95% CI: 7.987-16.769). Complaints of neck pain (yes vs no), foreign body sensation (yes vs no), and shorter length of fishbones always had a lower risk of difficult fishbones (OR: 0.455, 95% CI: 0.367-0.564; OR: 0.284, 95% CI: 0.191-0.422; OR: 0.727, 95% CI: 0.622-0.85). Missing teeth (yes vs no), swallowing behavior after fishbone ingestion (yes vs no), and male patients (vs female) had a higher risk of difficult fishbones (OR: 1.9, 95% CI: 1.47-2.456; OR: 1.631, 95% CI: 1.293-2.059; OR: 1.278, 95% CI: 1.047-1.56). Conclusions: Neck pain, foreign body sensation, fishbone length, patient age and sex, tooth status, and swallowing behavior after fishbone ingestion are independent risk factors for difficult fishbones.

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1382. A Prospective Epidemiological Study BK Polyomavirus DNAuria and DNAemia within the First Year after Kidney Transplantation

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1574 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S777-S777

Author(s):

Pannawat Mongkolrattanakul ◽

Jackrapong Bruminhent ◽

Tanaya Siripoon ◽

Punlop Wiwattanathum ◽

Suchin Worawichawong ◽

...

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

Chi Square ◽

Low Level ◽

Resource Limited ◽

Kaplan Meier ◽

Bk Polyomavirus ◽

Student’S T ◽

High Level ◽

A Prospective Study

Abstract Background Screening and early detection for the preceding BK polyomavirus (BKV) DNAuria and DNAemia to prevent the occurrence of BK polyomavirus BKV-associated nephropathy (BKPyVAN) among kidney transplant (KT) recipients has not been universally utilized and never assessed in a setting where the resource is limited. Therefore, we aimed to investigate this entity’s incidence, risk factors, and outcome with this intervention at our institution. Methods A prospective study of KT recipients at a tertiary care transplant center in Bangkok, Thailand, was conducted between January 2019 and March 2020. All patients underwent preemptive monitoring of urine and plasma BKV DNA load, measured by quantitative real-time PCR at 1, 2, 3, 6, 9, and 12 months post-KT. Low- and high-level BKV DNAuria was defined as urine BKV DNA load of < and > 7log10 copies/mL, respectively. Low- and high-level BKV DNAemia was defined as plasma BKV DNA load of < and > 4log10 copies/mL, respectively. The incidences were calculated by Kaplan-Meier analysis. The chi-square or student’s T-test compared clinical characteristics between those with and without high-level BKV DNAuria as appropriate. Risk factors of high-level BKV DNAuria were analyzed using Cox proportional hazard model. Results Among 99 evaluable KT recipients, a mean (SD) age was 42 (11) years, 64.6% were male, and 69.6% received an induction immunosuppressive therapy. Within 12 months post-KT, the incidences of low-level BKV DNAuria, high-level BKV DNAuria, low-level BKV DNAemia, and high-level BKV DNAemia were 22.63%, 13.14%, 9.49%, and 5.11%, respectively. High panel reactive antibody (PRA) was associated with high-level BKV DNAuria at 6 and 12 months, (HR 1.02 [95% CI (1.00-1.04)], P=0.019) and (HR 1.02 [95% CI (1.00-1.04)], P=0.023), respectively. Underlying diabetes mellitus was associated with high-level BKV DNAuria (HR 3.49 [95% CI (1.28-9.51)], P=0.015) at six months; however, not at 12 months. There was no allograft rejection directly related to a reduction of immunosuppression for BKV infection observed. Conclusion BKPyV infection is also prevalent among KT recipients in a resource-limited setting, however, without unfavorable consequence. Those with high-level PRA and underlying diabetes could be at risk of high-level BKV DNAuria after KT. Disclosures All Authors: No reported disclosures

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Incidence and perioperative risk factors for surgical site infections in neurosurgery: prospective observational study

Egyptian Journal of Neurosurgery ◽

10.1186/s41984-021-00142-w ◽

2022 ◽

Vol 37 (1) ◽

Author(s):

Assem Mouneir Abdel-Latif ◽

Amira A. Moharram ◽

Ahmed Higazy ◽

Nehal I. Ghoneim ◽

Omnia Shafei ◽

...

Keyword(s):

Risk Factors ◽

Antimicrobial Prophylaxis ◽

Significant Risk ◽

Surgical Site Infections ◽

Significant Risk Factor ◽

Patient Characteristics ◽

Csf Leak ◽

Neurosurgical Procedures ◽

Trauma Patients ◽

Contributing Factors

Abstract Background Surgical site infections (SSI) represent a burden on the health care system especially in developing countries with significant morbidity and mortality. In Egypt, especially in our institution, there is no registry for the SSI rate or the contributing factors with no clear guidelines regarding the regimen of perioperative antibiotic prophylaxis. Our study was conducted to assess the local practice and to calculate the rate and risk factors of SSI. Patients and methods A prospective registry was established at the Neurosurgery Department, Demerdash teaching hospital Ain Shams University, Cairo, Egypt. All patients who underwent elective neurosurgical procedures were included in this study. Trauma patients were excluded. Patients were followed-up for incident SSI for 1 month postoperatively. SSIs were identified based on CDC criteria and a standardized data collection form predictor variables including patient characteristics, preoperative, intraoperative, and postoperative factors along with the pattern of antimicrobial prophylaxis. Results The study included 248 patients with 1-month postoperative follow-up. An SSI rate of 19% was recorded being mainly in patients below 10 years of age. Postoperative CSF leak was noticed to be the most significant risk factor of SSI in our study (p value < 0.01). Sixty five percent of culture results showed infection with gram-negative bacilli with the predominance of Acinetobacter. Conclusion Prolonged use of perioperative antibiotics does not seem to have an added benefit in SSI prevention. Tailoring of the used antibiotic regimen is highly recommended according to the latest antimicrobial prophylaxis guidelines and the local culture and sensitivity results.

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Melioidosis: distinctive clinico-epidemiological characteristics in southern India

Tropical Doctor ◽

10.1177/0049475520943698 ◽

2020 ◽

pp. 004947552094369

Author(s):

Aneesh Basheer ◽

Nayyar Iqbal ◽

Sheeladevi C ◽

Reba Kanungo ◽

Ravichandran Kandasamy

Keyword(s):

Risk Factors ◽

Soft Tissue ◽

Clinical Laboratory ◽

Epidemiological Data ◽

Neurological Involvement ◽

Intensive Phase ◽

Continuation Treatment ◽

Common Risk Factors ◽

A Prospective Study ◽

Epidemiological Characteristics

As it is increasingly being reported from India, we carried out a prospective study of patients with culture-proven melioidosis from south India, examining clinical, laboratory features, epidemiological data, risk factors, treatments, outcomes at three and six months, and factors associated with mortality. Between 2014 and 2018, 31 cases were identified. Diabetes (83.9%) and alcohol abuse (58.1%) were common risk factors. Musculoskeletal, skin and soft tissue manifestations together constituted 48.4% of presentations, while 29% had pneumonia. During the intensive phase, 74.2% received one of three recommended antibiotic regimes, but 51.6% did not receive continuation treatment. Pneumonia and lack of continuation treatment were independently associated with a high mortality of 25.8%. Hot spots for melioidosis exist in India, and there is considerable diversity of presentation, including skin, soft tissue, musculoskeletal and neurological involvement. High rates of bacteraemia are shown.

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A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non-modifiable risk factors

BMC Research Notes ◽

10.1186/s13104-019-4839-2 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

S. Artemi ◽

P. Vassiliu ◽

N. Arkadopoulos ◽

Maria-Eleni Smyrnioti ◽

P. Sarafis ◽

...

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Prospective Study ◽

Erectile Function ◽

Pelvic Surgery ◽

Control Group ◽

Modifiable Risk Factors ◽

Analysis Model ◽

Male Patients ◽

A Prospective Study

Abstract Objective A pelvic surgery can cause erectile dysfunction. The purpose of this study was to evaluate erectile function at various times after pelvic surgery in male patients; to search the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. This prospective study used the erectile dysfunction IIEF scale. Results The study population comprised of 106 male patients who had undergone minor pelvic surgery at least 9 months before and during the 2010–2016 period in the 4th Surgical Clinic. A control group of healthy males (N = 106) who underwent no pelvic surgery matched for age was also used for reference values. The main age of the participants was 66.16 ± 13.07 years old. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p < 0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function (p < 0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.

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Characteristics of Nephrolithiasis Patients at Ulin General Hospital Banjarmasin 2017-2018 Period

Berkala Kedokteran ◽

10.20527/jbk.v17i1.10247 ◽

2021 ◽

Vol 17 (1) ◽

pp. 31

Author(s):

Nazmyatus Sa’idah ◽

Eka Yudha Rahman ◽

Dewi Indah Noviana Pratiwi ◽

Heru Prasetya ◽

Siti Kaidah

Keyword(s):

Risk Factors ◽

General Hospital ◽

Patient Characteristics ◽

Exclusion Criteria ◽

Female Patients ◽

Male Patients ◽

Descriptive Method

Abstract: The purpose of this study was to determine the characteristics of nephrolithiasis patients at Ulin General Hospital Banjarmasin based on sex, age, and residence place of patients. This study was conducted at Ulin General Hospital Banjarmasin, using a descriptive method with a retrospective approach. A total of 100 nephrolithiasis patients were obtained by total sampling according to inclusion and exclusion criteria. The results of this study showed that all nephrolithiasis patients in the 2017-2018 period were recorded, there were 58 male patients (58%), while there were 42 female patients (42%). The results showed that nephrolithiasis patients at Ulin General Hospital Banjarmasin were more than 55-64 years old (31%) and Banjarmasin was the area where most nephrolithiasis patients with a number of 35 patients (35%). This study showed the characteristics of age, sex, and residence place of patients were the risk factors that influence the incidence of nephrolithiasis at Ulin General Hospital Banjarmasin. Keywords: Patient Characteristics, Nephrolithiasis, Ulin General Hospital Banjarmasin.

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