Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery

2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.

2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.


Author(s):  
Elif Karatoprak ◽  
Samet Paksoy

AbstractThe aim of this study was to investigate the thyroid functions in children receiving levetiracetam or valproate monotherapy. We retrospectively reviewed the records of children with controlled epilepsy receiving valproic acid (VPA group) or levetiracetam monotherapy (LEV group) for at least 6 months. Free thyroxine 4 levels (fT4) and thyroid stimulating hormone (TSH) levels were compared between VPA group, LEV group, and age- and gender-matched healthy children (control group). A total of 190 children were included in the study: 63 were in the VPA, 60 in the LEV, and 67 in the control group. Although there was no significant difference regarding average fT4 levels, higher TSH levels were found in the VPA group when compared with the LEV and control groups (p < 0.001 and p < 0.001, respectively). There was no significant difference in terms of fT4 and TSH values in the LEV group when compared with the control group (p = 0.56 and p = 0.61, respectively). Subclinical hypothyroidism (defined as a TSH level above 5 uIU/mL with a normal fT4 level was detected in 16% of patients in the VPA group, none in the LEV and control groups. Our study found that VPA therapy is associated with an increased risk of subclinical hypothyroidism while LEV had no effect on thyroid function tests.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2604
Author(s):  
Jin-Young Park ◽  
Kyung-A Ko ◽  
Ji-Yeong Lee ◽  
Jae-Woon Oh ◽  
Hyun-Chang Lim ◽  
...  

Background: Mangosteen and propolis extracts (MAEC) have been potential therapeutic agents known to exhibit powerful antioxidant and anti-inflammatory properties. The aim of the current study was to evaluate the clinical and immunological efficacy of MAEC as well as safety and patient-reported outcomes (PROMs) on gingivitis and incipient periodontitis. Methods: This study was performed on 104 patients diagnosed with gingivitis or incipient periodontitis. At baseline, the participants were randomly allocated to either the test group, with daily intake of a single capsule containing 194 mg of MAEC for eight weeks, or control group, with placebo. Clinical periodontal evaluation and immunological parameters from saliva and gingival sulcular fluid were assessed at baseline, four, and eight weeks. Individual PROMs were assessed by OHIP-14 questionnaires. Results: There was a significant difference of modified gingival index at four and eight weeks between the test and control groups. In the test group, crevicular interleukin (IL)-6 was reduced, and the salivary matrix metalloproteinase (MMP)-9 was increased after eight weeks. PROMs were improved up to four weeks compared to placebo. Conclusion: Oral administration of MAEC would have a potential to reduce gingival inflammation clinically and immunologically in the patients with gingivitis and incipient periodontitis.


2020 ◽  
pp. bmjstel-2020-000657
Author(s):  
Rebecca Singer ◽  
Grace Leo ◽  
Tessa Davis ◽  
Ben Lawton ◽  
Henry Goldstein ◽  
...  

Previous research has examined the utilisation of musical cues to improve the performance of cardiopulmonary resuscitation (CPR) delivered in training environments. We postulated a musical cue that is both contemporary and transcends cultures may improve CPR performance. Our aim was to establish whether chest compressions are performed with improved rate and depth if a song of a fixed beat (PinkFong’s ‘Baby Shark’ with a tempo of 115 beats per minute (bpm) and 15 beats in each verse) is played to a healthcare professional immediately before undertaking CPR compared to whale noises (a non-metronomic rhythm). 58 Participants of a paediatric conference (majority doctors) were randomly assigned to listen to a minute of Baby Shark (28) or whale song (30) and then undertake a minute of CPR. There was no significant difference in the mean compression rate between the Baby Shark and control groups, with the groups achieving 121 and 125 bpm, respectively (p=0.18). In relation to compression depth within the target zone, the Baby Shark group had more compressions completed within the target zone (55%) than the control group (39%) although this difference was not significant (p=0.08). Listening to Baby Shark prior to undertaking simulated CPR does not improve overall performance, but there is a potential tendency to improve adequate compression depth which may be beneficial in training exercises.


2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Qiang Chen ◽  
Manman Wang ◽  
Shuai Shao ◽  
Hongze Liu ◽  
Xiaodong Xia ◽  
...  

Objectives. Percutaneous coronary intervention (PCI) is the mainstay treatment for coronary artery disease but complications such as in-stent restenosis and thrombosis remain problematic. Radiofrequency balloon angioplasty (RBA) can improve lumen dimension, fusing intimal tears, and artery dissection but is associated with higher restenosis rate. Methods. After establishing an atherosclerosis model based on endothelial abrasion and high cholesterol diet, forty-five rabbits were randomly divided into three groups: RBA (n=20), percutaneous transluminal angioplasty (PTA) (n=20), and control groups (n=5). The RBA and PTA groups were subdivided according to harvested time posttreatment, respectively (1 hour, 7 days, 14 days, and 28 days). Aorta segments were then isolated for hematoxylin and eosin staining, Masson trichrome staining, immunohistochemistry, and Western blot for TLR-4, NF-κB, MCP-1, and VCAM-1expression. Results. At 28 days, intimal area was significantly lower in the RBA group compared to the PTA and control groups, whilst luminal and medial area were comparable in the RBA and PTA group but higher and lower than the control group, respectively. Expression of TLR-4, NF-κB, MCP-1, and VCAM-1 showed no significant difference between RBA and PTA groups. Conclusions. RBA can depress the intimal hyperplasia and promote dilatation of the artery to greater extents than PTA at 28 days. However, this did not involve TLR-4 signaling pathway, which likely plays a negligible role in mediating restenosis. Reduction of intimal hyperplasia may be due to injury of ablation to the tunica media and inhibition of VSMC proliferation and migration.


1990 ◽  
Vol 157 (6) ◽  
pp. 881-887 ◽  
Author(s):  
Paul Furlong ◽  
Paul Barczak ◽  
Gwilym Hayes ◽  
Graham Harding

The SSEPs obtained from 19 schizophrenics defined by RDC, DSM–III and PSE criteria Were compared with those from a control group of healthy volunteers. Previous findings of an abnormal lack of lateralising response in schizophrenic patients were not replicated. No significant difference in either amplitude or morphology between the traces obtained from the two groups were recorded. Ipsilateral and contralateral latencies for stimulation of the left and right index finger showed no significant difference in peak latency for any component between patient and control group. When mean peak-to-peak amplitudes were plotted the contralateral component was always greater in amplitude than the ipsilateral one. An objective measure of the degree of lateralisation, the percentage lateralisation quotient, showed no lateralisation differences between the patient and control groups. A case of myogenic contamination of ipsilateral components was observed calling into doubt findings where no temporal region monitoring has been performed.


2019 ◽  
Vol 2 (2) ◽  
pp. 269
Author(s):  
Yoga Pratama

The objectives of this study were to find out whether or not there was significant improvement in writing and speaking achievements of the eighth grade students of SMPN1 Jarai after they were taught by using Sociogram, to find out whether or not there was significant improvement in each aspect of writing and speaking achievements of the eighth grade students of SMPN1 Jarai after they were taught by using Sociogram, to find out whether or not there was significant difference in writing and speaking achievements between the eighth grade students of SMP 1 Jarai who were taught by using Sociogram and those who were not, and to find out the perception of the eighth grade students of SMPN 1 Jarai after they were taught by using Socoiogram. In this paper, an experimental research method with pre and post test control group design was used with 70 students as the sample divided into two groups, experimental and control group. However, only the students of the experimental group were taught by using Sociogram. The obtained data were analyzed by using t-test. The students were given questionnaire to know their perceptions. The result showed that there was a significant difference in both students? writing and speaking achievements after they were tought by using Sociogram. Furthermore, it was found that there was a significant difference in students? writing and speaking achievement between the experimental and control groups. In conclusion, Sociogram improves the students? writing and speaking achievements.


Author(s):  
Salim Ahmed Saif Al-rashdi

    The present study aimed at uncovering the effectiveness of employing the enrichment activities for mental thinking on the development of mathematical thinking and achievement among Grade 7 students. To achieve the research objectives, the researcher used the semi experimental design known as the design of the control group with the tribal and remote tests. In light of the experimental design, the average Grade 7 students tested the sample of the study in the second semester of 30 students who were divided into 15 students for the experimental group and 15 students for the control group after checking the validity and stability of the tools. The results showed that there was a statistically significant difference at (0.05) between the mean scores of the experimental and control groups in the cognitive achievement test related to the unit of Engineering in the second semester and the mathematical thinking test for the average of the experimental group. The results also showed a statistically significant difference) between the average scores of the experimental group students in the tribal and remote applications in the cognitive achievement test and the mathematical thinking test, and in favor of the average post-implementation. In the light of these results, the study presented a number of recommendations and suggestions.   ، ، ، ،


2019 ◽  
Vol 3 (2) ◽  

Objective: To search for a dental pulp preservative method in experimental pulpitis. Methods: 20 rabbits with experimental pulpitis were selected for this study; Teeth were randomly assigned to 2 groups (experimental and control groups) based on the final irrigation methods. In experimental group (double-pinhole drainage), the two pinholes were drilled in middle 1/3 dental cervix of buccal labial surface of tooth; the pinholes were inserted into infant transfusion needles then the two syringes were contacted with them, one for suck, another for irrigation. In control group, pinhole was sealed. Rabbits were executed in 1, 3, 5, 7 day. The inflammation in pulp chamber was assessed after 1, 3, 5, and 7 days. Results: At the 1, 5 day time intervals, control group reported more inflammation than experimental group (P < .05). There was no significant difference between two groups at the other time intervals (P > .05), and in all groups the inflammation decreased over time. Conclusion: Dental pulp can be preserved by double-pinhole drainage efficiently.


2017 ◽  
Vol 5 (4) ◽  
pp. 74
Author(s):  
Nevzat Demirci ◽  
Mehmet Akif Ziyagil

The metabolic fitness (MF) is a component of athletes’ physical conditioning. This study aims to investigate the effects of quercetin supplementation on Turkish Junior athletes’ lipid and protein metabolism relating to MF after one month classic boxing training. Totally 20 voluntary junior male athletes were separated into two equal groups as the experimental group (EG) and control group (CG). The participants were supplemented with 500 mg quercetin fifteen minutes before each workout in one month boxing training program. Blood samples during pre and post training were taken from athletes in order to determine metabolic fitness related parameters. Lipid profile contains low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), trigliserid (TG), total cholesterol (TC) variables while protein metabolism includes the albumin, total protein, direct bilirubin and total bilirubin parameters. The Mann Whitney U analyzes were used for comparison of the means between experimental and control groups during pre and posttest and between pre and post test results in experimental and control groups. This study showed that EG had a similar physical characteristic with CG. There were significant decrease in TC and LDL-C and an increase in HDL-C in EG while there was only significant increase in HDL-C of in controls. A significant difference of HDL-C was observed between EG and CG during pretest. In other side, TC and LDL-C and HDL-C were significantly differentiated between EG and CG during posttest. Conclusion: it can be concluded that quercetin plays an important role on lipid metabolism not protein.


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