scholarly journals Hypothalamus-Pituitary Dysfunction as an Independent Risk Factor for Postoperative Central Nervous System Infections in Patients With Sellar Region Tumors

2021 ◽  
Vol 12 ◽  
Author(s):  
Junxian Wen ◽  
Rui Yin ◽  
Yihao Chen ◽  
Jianbo Chang ◽  
Baitao Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Adrenal Insufficiency ◽  
Sellar Region ◽  
Central Nervous System Infections ◽  
College Hospital ◽  
Medical College ◽  
Pituitary Dysfunction ◽  
Csf Leakage

ObjectiveThe purpose of this study was to verify that hypothalamus-pituitary dysfunction is one of the risk factors for postoperative central nervous system infections (PCNSIs).MethodWe performed a retrospective analysis of all patients with sellar region lesions who underwent surgery between January 2016 and November 2019 at Peking Union Medical College Hospital. In total, 44 age− and sex-matched controls were enrolled. Univariate and multivariate analyses were performed to identify risk factors for PCNSIs.ResultWe enrolled 88 patients, 44 of whom had PCNSIs. Surgical approach (TCS) (P<0.001), previous surgery on the same site (P=0.001), intraoperative cerebral spinal fluid (CSF) leakage (P<0.001), postoperative adrenal insufficiency (P=0.017), postoperative DI (P=0.004) and the maximum Na+ levels(<0.001) correlated significantly with PCNSIs. Multivariate analysis showed that Surgery approach (TCS)(OR: 77.588; 95%CI: 7.981-754.263; P<0.001), intraoperative CSF leakage (OR: 12.906; 95%CI: 3.499-47.602; P<0.001), postoperative DI (OR: 6.999; 95%CI:1.371-35.723; P=0.019) and postoperative adrenal insufficiency (OR: 6.115; 95%CI: 1.025-36.469; P=0.047) were independent influencing factors for PCNSIs.ConclusionTCS, intraoperative CSF leakage, postoperative DI and postoperative adrenal insufficiency are risk factors for PCNSIs in patients with sellar region tumors.

scholarly journals Hypothalamus-pituitary Dysfunction as an Independent Risk Factor for Postoperative Central Nervous System Infections in Patients with Sellar Region Tumors

2021 ◽  
Author(s):  
Junxian Wen ◽  
Rui Yin ◽  
Yihao Chen ◽  
Jianbo Chang ◽  
Baitao Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Adrenal Insufficiency ◽  
Sellar Region ◽  
Central Nervous System Infections ◽  
College Hospital ◽  
Medical College ◽  
Pituitary Dysfunction ◽  
Csf Leakage

Abstract Objective: The purpose of this study was to verify that hypothalamus-pituitary dysfunction is one of the risk factors for postoperative central nervous system infections (PCNSIs).Method: We performed a retrospective analysis of all patients with sellar region lesions who underwent surgery between January 2016 and November 2019 at Peking Union Medical College Hospital. In total, 44 age‑ and sex-matched controls were enrolled. Univariate and multivariate analyses were performed to identify risk factors for PCNSIs.Result: We enrolled 88 patients, 44 of whom had PCNSIs. Surgical approach (TCS) (P<0.001), previous surgery on the same site (P=0.001), intraoperative cerebral spinal fluid (CSF) leakage (P<0.001), postoperative adrenal insufficiency (P=0.017), and postoperative DI (P=0.004) correlated significantly with PCNSIs. Multivariate analysis showed that intraoperative CSF leakage (OR:13.754; 95%CI: 3.482-54.328; P<0.001), postoperative diabetes insipidus (DI) (OR: 6.261; 95%CI: 1.114-35.189; P=0.037) and postoperative adrenal insufficiency (OR: 7.153; 95%CI: 1.071-47.764; P=0.042) were independent influencing factors for PCNSIs.Conclusion: Intraoperative CSF leakage, postoperative DI and postoperative adrenal insufficiency are risk factors for PCNSIs in patients with sellar region tumors.

scholarly journals Nosocomial infections in patients with acute central nervous system infections

2007 ◽  
Vol 60 (1-2) ◽  
pp. 12-18
Author(s):  
Olgica Gajovic ◽  
Predrag Canovic ◽  
Zeljko Mijailovic ◽  
Zorica Lazic
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Nosocomial Infections ◽  
Clinical Manifestations ◽  
Central Nervous System Infections ◽  
Current Increase ◽  
Urinary Infections ◽  
Clinical Center ◽  
Clinical Presentations

Due to current increase in the rate of nosocomial infections, our objective was to examine the frequency, risk factors, clinical presentation and etiology of nosocomial infections in patients with central nervous system infections. 2246 patients with central nervous system infections, treated in the intensive care units of the Institute of Infectious and Tropical Diseases, Clinical Center of Serbia in Belgrade and at the Department of Infectious Diseases of the Clinical Hospital Center Kragujevac, were included in this retrospective and prospective study. Clinical manifestations of nosocomial infections were registered in 180 (12.7%) patients. Direct risk factors for nosocomial infections were: venous lines, urinary catheter, length of stay over 20 days, inhibitors of gastric secretion, consciousness disorders and coma, endotracheal intubation, tracheotomy and controlled ventilation for 5 days or more. The most frequent clinical presentations of nosocomial infections were: tract urinary infections, bacteriemia/sepsis and nosocomial pneumonia. Significantly higher frequency of death outcomes was registered in patients with nosocomial infections.

scholarly journals Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections

2011 ◽  
Vol 139 (7-8) ◽  
pp. 476-480 ◽  
Author(s):  
Olgica Gajovic ◽  
Zoran Todorovic ◽  
Zeljko Mijailovic ◽  
Predrag Canovic ◽  
Ljiljana Nesic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Mechanical Ventilation ◽  
Nervous System ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nosocomial Pneumonia ◽  
Central Nervous System Infections ◽  
Mechanical Ventilation Duration ◽  
Gcs Score

Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30%) patients developed nosocomial pneumonia. The time to develop pneumonia was 10?6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS) score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%), Pseudomonas aeruginosa (24.1%), Acinetobacter spp. (16.6%) and Staphylococcus aureus (25.9%). Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.

scholarly journals Comparison of relapsing polychondritis patients with and without central nervous system involvement: A retrospective study of 181 patients

2021 ◽  
Vol 35 ◽  
pp. 205873842110005
Author(s):  
Xiaoyu Cao ◽  
Lixiu Zhu ◽  
Huijuan Li ◽  
Li Jiang ◽  
Dong Xu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Odds Ratio ◽  
Pulmonary Infection ◽  
Central Nervous System Involvement ◽  
Relapsing Polychondritis ◽  
Cns Involvement ◽  
College Hospital ◽  
Medical College ◽  
Manubriosternal Joint

The relapsing polychondritis (RP) patients with central nervous system (CNS) involvement were rare. We aimed to determine the clinical characteristics of RP patients with CNS involvement. The clinical data of 181 RP patients, hospitalized at Peking Union Medical College Hospital between December 2005 and February 2019, were collected. The patients were categorized into two subgroups: 25 RP patients with CNS involvement, and 156 RP patients without CNS involvement. The involvement of the ear was more frequent in RP patients with CNS involvement, compared with those of RP patients without CNS involvement ( P < 0.01). After controlling sex and the admission age, logistic regression analysis revealed hypertension (odds ratio = 4.308, P = 0.006) and involvement of eye (odds ratio = 5.158, P = 0.001) and heart (odds ratio = 3.216, P = 0.025) were correlated with RP patients with CNS involvement, respectively. In addition, pulmonary infection (odds ratio = 0.170, P = 0.020), tracheal involvement (odds ratio = 0.073, P < 0.01), and involvement of laryngeal (odds ratio = 0.034, P = 0.001), costochondral joint (odds ratio = 0.311, P = 0.013), sternoclavicular joint (odds ratio = 0.163, P = 0.017) and manubriosternal joint (odds ratio = 0.171, P = 0.021) were associated with RP patients without CNS involvement, respectively. In contrast to RP patients without CNS involvement, the incidence of ear involvement was higher in RP patients with CNS involvement. After controlling the potential confounding factor sex and the admission age, hypertension and involvement of eye and heart were related with RP patients with CNS involvement, respectively.

scholarly journals Incidence and risk factors for seizures in central nervous system infections in childhood

2009 ◽  
Vol 15 (2) ◽  
pp. 83-88
Author(s):  
Paulo Breno Noronha Liberalesso ◽  
Izabella Celidônio Bertoldo da Silva ◽  
Karlin Fabianne Klagenberg ◽  
Ari Leon Jurkiewicz ◽  
Bianca Simone Zeigelboim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Viral Encephalitis ◽  
Viral Meningitis ◽  
Central Nervous System Infections ◽  
Stiff Neck ◽  
The Central Nervous System ◽  
Group 2 ◽  
Group 1

INTRODUCTION: The infections of the central nervous system remain as a public health problem in several countries and there is a direct relation between poverty and underdevelopment with high mortality and morbidity rates. Seizures represents a complication related to infections of the central nervous system, are considered a clinical emergency and requiring neurological investigation. OBJECTIVE: In this article, we propose to describe the incidence and risk factors for seizures in central nervous system infections in childhood. METHODS: a retrospective study was performed between October 2007 and October 2008 and all patients who were hospitalized with the diagnosis of infections of the central nervous system were analyzed. Newborns were excluded. The patients were divided into GROUP 1 (without seizures) and GROUP 2 (with seizures). RESULTS: 731 patients were included, 47.75% males, with average age of 15.7 years. GROUP 1 - with fever (652/92.35%), headache (580/82.15%), vomits (550/77.9%), and viral meningitis predominance (652/93.06%). GROUP 2 - with fever (25/100%), vomits (12/48), headache (6/24%), and viral encephalitis predominance (14/56%). Ten (40%) patients from the GROUP 2 presented EEG alterations. The incidence of seizures was 3.42% and a significant statistical difference was noticed related to mean age (p<0.000069), presence of headache (p<0.0000), vomits (p<0.0005), stiff neck (p<0.0105) and drowsiness (p<0.0265). CONCLUSIONS: the occurrence of seizures during the hospitalization is significantly more frequent in cases of viral encephalitis and bacterial meningitis compared to viral meningitis. The risk of seizures increases in early ages. Headache, vomits, stiff neck and drowsiness are more frequent symptoms in children with infection of the central nervous system who presented seizures during the hospitalization.

Central Nervous System Infections

2016 ◽  
pp. 453-460
Author(s):  
Pritish K. Tosh ◽  
M. Rizwan Sohail
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Venous Thromboembolism ◽  
Antiphospholipid Antibodies ◽  
Arterial Thrombosis ◽  
Lupus Anticoagulant ◽  
Anticardiolipin Antibodies ◽  
Central Nervous System Infections ◽  
Glycoprotein I

Thrombophilia refers to the tendency for thromboembolism (ie, having risk factors for thromboembolism), which may be inherited or acquired. The presence of increasing numbers of risk factors further increases the risk of venous thromboembolism (VTE). Antiphospholipid antibodies (lupus anticoagulant, anticardiolipin antibodies, and anti–β‎2-glycoprotein I antibodies) and hyperhomocysteinemia are risk factors not only for VTE but also for arterial thrombosis.

Causes of Infections in Penetrating Head Wounds in the Iran-Iraq War

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 923-926 ◽  
Author(s):  
Bizhan Aarabi
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Mortality Rate ◽  
Infection Rate ◽  
Iraq War ◽  
Wound Age ◽  
Central Nervous System Infections ◽  
Predisposing Factor ◽  
Csf Leakage ◽  
Shell Fragments

Abstract Factors seemingly influential in postoperative central nervous system infections were evaluated in 379 patients who sustained missile wounds to the head during the Iran-Iraq War. The mean wound age was 49 hours. The site of injury and presence of retained bone and/or shell fragments did not have a significant effect on infection rate. Thirty-three of 379 patients developed cerebrospinal fluid (CSF) fistulas of which 12 (36%) were associated with infection. The infection rate was 6 of 346 (1.7%) in the absence of CSF leaks. There was a statistically significant association between CSF fistula and infection. All 6 positive cultures in patients with CSF fistulas were gram-negative. Thirty-two patients died during the study, a mortality rate of 8.4%. The mortality rate from infection was 1.8%. Two hundred seventy-seven of 347 patients were followed for a mean of 22 ± 17 months during which time 2 patients were readmitted with central nervous system infections, both due to CSF leakage. CSF fistulas were the main predisposing factor in postdebridement central nervous system infections in this study.

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