Cardiac Implantable Electronic Device Infections; Long-Term Outcome after Extraction and Antibiotic Treatment

Background: The aim of the study was to examine the treatment outcome for patients with cardiovascular implantable electronic device (CIED) infections after extraction. Methods: Patients who underwent CIED extractions due to an infection at Karolinska University Hospital 2006–2015 were analyzed. Results: In total, 165 patients were reviewed, 104 (63%) with pocket infection and 61 (37%) with systemic infection. Of the patients with systemic infection, 34 and 25 patients fulfilled the criteria for definite and possible endocarditis, respectively. Complications after extraction occurred only in one patient. Reimplantation was made after a mean of 9.5 days and performed in 81% of those with pocket infection and 44.3% in systemic infection. Infection with the new device occurred in 4.6%. The mean length of hospital stay for patients with pocket infection was 5.7 days, compared to 38.6 days in systemic infection. One-year mortality was 7.7% and 22.2% in pocket infection and systemic infection, respectively. Patients with Staphylococcus aureus infection had a higher mortality. Conclusions: In this study, the majority of the patients had a pocket CIED infection, with a short hospital stay. Patients with a systemic infection, and S. aureus etiology, had a prolonged hospital stay and a higher mortality.

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Pump Removal in Infected Patients with Hepatic Chemotherapy Pumps: When is it Necessary?

The American Surgeon ◽

10.1177/000313480607201008 ◽

2006 ◽

Vol 72 (10) ◽

pp. 880-884

Author(s):

Jonathan J. Roybal ◽

Eric C. Feliberti ◽

Layla Rouse ◽

Lawrence D. Wagman

Keyword(s):

Colorectal Liver Metastases ◽

Chart Review ◽

Systemic Infection ◽

Clinical Scenario ◽

Wound Infections ◽

Term Outcome ◽

Long Term Outcome ◽

Pocket Infection ◽

Premature Removal

Hepatic chemotherapy pumps have been shown to be an effective and well-tolerated treatment for metastatic colorectal cancer confined to the liver. The importance of completing chemotherapy in long-term outcome makes it desirable to salvage hepatic pumps where possible. Concerns of persistent and systemic infection have resulted in premature removal of pumps in patients with infection. We report our experience in this clinical scenario. We placed 75 hepatic chemotherapy pumps from January 1998 to August 2005 for treatment of colorectal liver metastases. Information was collected on the patients’ courses of treatment, complications, and demographics via chart review. The rate of infection was 22.7% (n = 17), including eight infections localized to the abdomen (entailing five wound infections, three hepatic abscesses, and two pump pocket infections). Of these, two pumps had to be removed because of pump pocket infection, and these patients received more cycles of chemotherapy compared with the four removed for noninfectious complications (12.3 vs 3.2, P = 0.0349). Time to infection was found to be significantly higher in these patients (12.5 months) than in the patients with infections overall (4.87 months, P = 0.029), and age was found to be lower (42.5 vs 57.6 years, P = 0.0068).

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Day-Case Limberg Flap for Recurrent Pilonidal Sinus: Does Obesity Complicate the Issue?

The American Surgeon ◽

10.1177/000313481007600936 ◽

2010 ◽

Vol 76 (9) ◽

pp. 995-999 ◽

Cited By ~ 5

Author(s):

Khaled M. Madbouly

Keyword(s):

Hospital Stay ◽

Pilonidal Sinus ◽

Operative Time ◽

Day Surgery ◽

Complete Healing ◽

Limberg Flap ◽

Term Outcome ◽

Long Term Outcome ◽

Rhomboid Excision

The purpose of this study was to analyze the long-term outcome of rhomboid excision with Limberg flap reconstruction (LF) as one-day surgery in treatment of recurrent pilonidal sinus (RPS). The effect of obesity on outcome will be addressed. Forty-nine patients with RPS were treated by rhomboid excision and LF as one-day surgery. Data collected included demographics, body mass index, operative time, flap ischemia, wound infection, length of hospital stay, time of complete healing, and recurrence. Patients’ mean age was 33.4 years and mean number of previous operations was 3.4. Operative time ranged from 40 to 70 minutes. Two patients developed sterile seroma (4.1%) and two patients (4.1%) had wound infections. No wound dehiscence or flap ischemia was reported. All patients returned to normal activity within 7 days. No recurrences were reported after a mean follow-up of 32.1 months. Obesity significantly increased the operative time, however, it affected neither the postoperative outcome nor the long-term recurrence. Rhomboid excision and LF as one-day surgery is a safe and reliable method for treatment of RPS. It guarantees low morbidity, short hospital stay, short time off work, and carries low risk of recurrence, even in obese patients.

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Locked intramedullary nailing technique of the femur without brilliance amplifier at the trauma and orthopedics department of the university hospital of peace series on 35 cases during 1 year

MOJ Orthopedics & Rheumatology ◽

10.15406/mojor.2021.13.00556 ◽

2021 ◽

Vol 13 (5) ◽

pp. 95-97

Author(s):

Augustin Delange Hendrick ◽

Almenord Pharol ◽

Khawly Clifford PG ◽

Augustin Delange ◽

Pierre Marie Woolley

Keyword(s):

Hospital Stay ◽

Intramedullary Nailing ◽

Femoral Fractures ◽

Length Of Hospital Stay ◽

University Hospital ◽

Patient Morbidity ◽

Duration Of Hospitalization ◽

The Cost ◽

The University

Femoral fractures increase the length of hospital stay for our patients for several reasons such as lack of blood, economic resources, and lack of infrastructure. The use of a C-arm has been shown to reduce patient morbidity due to early functional recovery and reduced hospital stay. Objective: To develop an intramedullary nailing technique without c-arm with a closed focus to reduce the duration of hospitalization of its patients as well as the cost related to the equipment used for follow-up. Methodology: prospective study on 35 patients for 1 year August 2020 to August 2021 Results: We followed 35 patients in which the mean age was 37.83 years with extremes of 18 and 78 years. The male sex predominates 21 against 14 women or 60% against 40% respectively. The sex ratio is 1.5. A total of 19 diaphyseal fractures (54.3%) were nailed, 9 supracondylar (25.7%) and 7 subtrochanteric (20%). Twenty-seven were closed fractures (71.1%), and 8 were open fractures (22.9%). The length of hospitalization was less than 3 days for 30 patients (85.7%), and more than 3 days for 5 patients (14.3%). Conclusion: We recommend that we promote this closed-hearth technique because it improves the postoperative follow-up of patients. Additionally, it would reduce exposure to radiation from c-arm in hospitals that have this equipment.

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Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

Scandinavian Journal of Surgery ◽

10.1177/1457496920938605 ◽

2020 ◽

pp. 145749692093860

Author(s):

T. Mönttinen ◽

H. Kangaspunta ◽

J. Laukkarinen ◽

M. Ukkonen

Keyword(s):

Acute Appendicitis ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Operation Time ◽

Time Of Day ◽

University Hospital ◽

Patient Comfort ◽

Intraoperative Bleeding ◽

Significant Difference ◽

Clinically Significant

Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

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Clinicopathologic Characteristics and Long-Term Outcome of Gastric Cancer Patients with Family History: Seven-Year Follow-Up Study for Korean Health Check-Up Subjects

Gastroenterology Research and Practice ◽

10.1155/2020/4028136 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Jooyoung Lee ◽

Su Jin Chung ◽

Ji Min Choi ◽

Yoo Min Han ◽

Joo Sung Kim

Keyword(s):

Gastric Cancer ◽

Family History ◽

University Hospital ◽

Upper Gastrointestinal Endoscopy ◽

Clinicopathologic Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

National University ◽

Gastric Cancer Patients

Background/Aims. Family history (FHx) has been reported to be a risk factor for gastric cancer (GC). However, the long-term prognosis of GC with FHx remains controversial. We aimed to investigate the clinicopathologic characteristics and long-term outcomes of GC according to the presence or absence of GC FHx. Methods. This study was conducted on asymptomatic healthy individuals who underwent upper gastrointestinal endoscopy for the purpose of GC screening. Patients who were diagnosed with GC between October 2003 and December 2013 at Seoul National University Hospital Healthcare System Gangnam Center were identified. Demographic and clinicopathologic characteristics were compared between the groups with and without FHx of GC. Overall survival (OS) and recurrence-free survival (RFS) were assessed as primary outcomes. Results. There were no significant differences in tumor characteristics according to FHx of GC. However, preexisting adenoma was more frequent in patients with FHx than in those without FHx (14.5% vs. 6.3%, p = 0.035 ). The proportion of patients with microsatellite instability (MSI) was also higher in groups with FHx of GC (43.2% vs. 13.2%, p = 0.006 ). Helicobacter pylori infection rates of patients with FHx of GC tended to be higher although not significant (70.5% vs. 61.3%, p = 0.188 ). However, OS and RFS at 5 years of the GC patients with FHx were not significantly different from those of patients without FHx. Conclusion. Preexisting adenoma and GC with MSI are more common in patients with FHx of GC than in those without. There were no significant differences in the survival rate according to FHx.

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Very long-term follow-up of aplastic anemia treated with immunosuppressive therapy or allogeneic hematopoietic cell transplantation

Annals of Hematology ◽

10.1007/s00277-020-04271-4 ◽

2020 ◽

Vol 99 (11) ◽

pp. 2529-2538

Author(s):

Beatrice Drexler ◽

Felicitas Zurbriggen ◽

Tamara Diesch ◽

Romaine Viollier ◽

Joerg P. Halter ◽

...

Keyword(s):

Aplastic Anemia ◽

Immunosuppressive Therapy ◽

Hematopoietic Cell Transplantation ◽

Clonal Evolution ◽

University Hospital ◽

Term Outcome ◽

Long Term Outcome ◽

Long Term Survivors

Abstract Introduction Since the 1970s outcome of aplastic anemia (AA) patients has improved significantly due to the introduction of immunosuppressive therapy (IST) and allogeneic hematopoietic transplantation (HCT). However, patients may suffer from persistent disease, relapse, clonal evolution, graft-versus-host disease and other late effects. Here, we analyse very long-term outcome of all AA patients at our institution comparing not only survival, but also response status and complications. Methods Patient charts of all 302 AA patients treated between 1973 and 2017 at the University Hospital Basel, Switzerland, were retrospectively analysed. Results First line treatment was IST in 226 (75%) and HCT in 76 (25%) patients. Overall survival at 30 years was similar in patients treated initially by HCT and IST (44% (±14%), and 40% (± 9%) respectively, with better results in more recent years. Partial and no response occurred more frequently after IST, relapse incidence after IST was 24 %, whereas non-engraftment and graft failure was documented in 15 patients (19 %) after HCT. Clonal evolution to myelodysplastic syndrome / acute myeloid leukemia was 16 % at 25 years in IST patients, 1.3 % in HCT patients, iron overload (18 versus 4 %, p = 0.002) and cardiovascular events (11 versus 1 %, p=0.011) occured significantly more often in IST than HCT treated patients. The majority of long-term survivors, 96% of those alive at 25 years, were in complete remission at last follow up, irrespective of the initial treatment modality. Conclusion Very long term survivors after AA are those with stable hematopoietic recovery.

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Ear injuries caused by lightning: report of 18 cases

The Journal of Laryngology & Otology ◽

10.1258/0022215011906858 ◽

2001 ◽

Vol 115 (1) ◽

pp. 4-8 ◽

Cited By ~ 33

Author(s):

Ivo Glunčić ◽

Željka Roje ◽

Vicko Glunčić ◽

Kolja Poljak

Keyword(s):

Clinical Management ◽

Neuropsychological Testing ◽

University Hospital ◽

Psychotherapeutic Treatment ◽

Term Outcome ◽

Long Term Outcome ◽

Membrane Rupture ◽

Hearing Function

The clinical management and long-term outcome in lightning survivors with subsctantial ear damage treated at the Department of Otorhinolaryngology, University Hospital Split during the 1984–1999 period are reviewed. Results of clinical management and outcomes of lightning ear damage in 18 patients (mean age 35.3 ± 5 years) were retrospectively analyzed. On admission, all patients complained of severe pain, tinnitus and hearing impairment. Otomicroscopy revealed tympanic membrane rupture in 12 patients. The active therapeutic approach included immediate otomicroscopy, aseptic aspiration toilet, and eversion of perforation edges. In all patients, the ruptures healed well, and restitution of the hearing function was achieved. Follow-up examination performed in 1999 (13.2 ± 2.9 years later) in 11 patients (mean age 52.3 ± 6.1 years) revealed an almost identical audiogram as on discharge from the hospital, however, neuropsychological testing revealed numerous sequelae. Tympanic injury caused by lightning should be actively treated. Lightning survivors require additional psychotherapeutic treatment.

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CIED infection with either pocket or systemic infection presentation – complete device removal and long-term antibiotic treatment; long-term outcome

Scandinavian Cardiovascular Journal ◽

10.3109/14017431.2015.1091089 ◽

2015 ◽

Vol 50 (1) ◽

pp. 52-57 ◽

Cited By ~ 2

Author(s):

Nikolaj Ihlemann ◽

Michael Møller-Hansen ◽

Kirsten Salado-Rasmussen ◽

Regitze Videbæk ◽

Claus Moser ◽

...

Keyword(s):

Antibiotic Treatment ◽

Systemic Infection ◽

Device Removal ◽

Term Outcome ◽

Long Term Outcome

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Subacute Thyroiditis: Clinical Presentation and Long Term Outcome

International Journal of Endocrinology ◽

10.1155/2014/794943 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 16

Author(s):

Assim A. Alfadda ◽

Reem M. Sallam ◽

Ghadi E. Elawad ◽

Hisham AlDhukair ◽

Mossaed M. Alyahya

Keyword(s):

Clinical Presentation ◽

Thyroid Stimulating Hormone ◽

Subacute Thyroiditis ◽

University Hospital ◽

Term Outcome ◽

Long Term Outcome ◽

Thyroid Uptake ◽

Inflammatory Drugs ◽

And Gender

Few studies have been reported from the Kingdom of Saudi Arabia (SA) to describe the clinical presentation and long term outcomes of subacute thyroiditis (SAT). Our aim was to review the demographic, anthropometric, clinical presentation, laboratory results, treatment, and disease outcome in Riyadh region and to compare those with results from different regions of the Kingdom and different parts of the world. We reviewed the medical files of patients who underwent thyroid uptake scan during an 8-year period in King Khalid University Hospital. Only 25 patients had confirmed diagnosis of thyroiditis. Age and gender distribution were similar to other studies. Most patients presented with palpitation, goiter, and weight change. Elevated thyroid hormones, suppressed thyroid-stimulating hormone, and elevated ESR were reported. Among those, 7 cases of SAT were recorded.β-Blockers were prescribed to 57% and nonsteroidal anti-inflammatory drugs to 29% of SAT. Long follow-up demonstrated that 85.7% of SAT cases recovered, while 14.3% developed permanent hypothyroidism. In conclusion, SAT is uncommon in the central region of SA. Compared to the western region, corticosteroid is not commonly prescribed, and permanent hypothyroidism is not uncommon. A nation-wide epidemiological study to explain these interprovincial differences is warranted.

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