scholarly journals Low Body Mass Index as a Predictive Factor for Postoperative Infectious Complications after Ureterorenoscopic Lithotripsy

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1100
Author(s):  
Kensaku Seike ◽  
Takashi Ishida ◽  
Tomoki Taniguchi ◽  
Shota Fujimoto ◽  
Daiki Kato ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Urinary Stone ◽  
Infectious Complications ◽  
Ureteral Stent ◽  
Stent Insertion ◽  
Antibiotic Administration ◽  
Related Complication ◽  
Postoperative Fever ◽  
Basket Catheter

Background and Objectives: In this study, we aimed to evaluate predictive factors of postoperative fever (POF) after ureterorenoscopic lithotripsy (URSL). Materials and Methods: A total of 594 consecutive patients who underwent URSL for urinary stone disease at Gifu Municipal Hospital and Chuno Kosei Hospital between April 2016 and January 2021 were enrolled in this study. In all patients, antibiotics were routinely administered intraoperatively and the next day after surgery. We used rigid and/or flexible ureterorenoscopes depending on the stone location for URSL. Stones were fragmented using a holmium: YAG laser. The fragments of the stone were manually removed as much as possible using a stone basket catheter. A ureteral stent was placed at the end of the surgery in all cases. Results: The median age and body mass index (BMI) in all patients were 62 years and 23.8 kg/m2, respectively. The median operation duration was 52 min. The most common URSL-related complication was POF in 28 (4.7%) patients. In these patients, the rates of antibiotic administration and ureteral stent insertion before surgery were significantly higher than in those without POF. In multivariate analysis, BMI was associated with POF after URSL. There were no significant differences in predicting POF after surgery in patients who had bacteriuria or received antibiotics before surgery. Conclusions: A low BMI was significantly associated with POF after URS or URSL.

Intra-Abdominal Placement of Antimicrobial-Impregnated Mesh is Associated with Noninfectious Fever

2006 ◽  
Vol 72 (12) ◽  
pp. 1205-1209 ◽  
Author(s):  
William S. Cobb ◽  
B. Lauren Paton ◽  
Yuri W. Novitsky ◽  
Michael J. Rosen ◽  
Kent W. Kercher ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
In Vivo Models ◽  
Postoperative Fever ◽  
Dual Mesh

The antimicrobial, silver/chlorhexidine, when impregnated on mesh has been demonstrated to resist mesh infection in in vitro and in vivo models. The clinical, human systemic response to intraperitoneal placement of silver/chlorhexidine-impregnated mesh has not been investigated to date. Between October 2002 and November 2004, all in-patients undergoing laparoscopic ventral hernia repair were retrospectively analyzed. All repairs used expanded polytetraflouroethylene (ePTFE) Dual Mesh (DM) or ePTFE impregnated with silver/chlorhexidine, Dual Mesh Plus (DM+). Patient demographics, hernia characteristics, mesh type, operative details, and hospital course data were collected. Noninfectious fevers were defined as a temperature greater than 100.4 F without an identified source. Standard statistical methods were used. During the 2-year study period, 120 patients underwent laparoscopic ventral hernia repair (DM = 55, DM+ = 65). The two groups were similarly matched in terms of age, body mass index, American Society of Anesthesiologists score, defect size, and mesh size. Postoperative fever without an identified source occurred in 10 (18.2%) patients with DM and in 25 (38.5%) patients using DM+ (P = 0.015). A multivariant analysis revealed that only mesh type and body mass index predicted postoperative fever. All fevers resolved within the first 72 hours in the DM patients; however, 16 per cent of the DM+ group had persistent fevers of unknown origin after 72 hours. Within the DM+ group, patients with postoperative fevers had significantly longer postoperative stays (4.8 days vs 3.0 days; P = 0.009). The use of antimicrobial-impregnated ePTFE mesh with silver/chlorhexidine in laparoscopic ventral hernia repair is associated with noninfectious postoperative fever. In our patients, the evaluation and management of these fevers resulted in a significantly longer hospital stay.

scholarly journals Recipient body mass index and infectious complications following liver transplantation

HPB ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1032-1038 ◽  
Author(s):  
Rafael Diaz-Nieto ◽  
Panagis M. Lykoudis ◽  
Brian R. Davidson
Keyword(s):  
Body Mass Index ◽  
Liver Transplantation ◽  
Body Mass ◽  
Infectious Complications

scholarly journals Metal stent for the ureteral stricture after surgery and/or radiation treatment for malignancy

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Wang ◽  
Xiaoshuai Gao ◽  
Jixiang Chen ◽  
Zhenghuan Liu ◽  
Liao Peng ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Treatment ◽  
Ureteral Stent ◽  
Stent Insertion ◽  
Rectal Cancer Surgery ◽  
Ureteral Stricture ◽  
Metallic Stent ◽  
Stent Patency ◽  
Postoperative Fever

Abstract Background To assess the efficacy and safety of self-expanding metal ureteral stent for the stricture following surgery and/or radiation for malignancy. Methods We performed 36 metal ureteral stent insertion procedures (32 patients) between May 2019 and June 2020. The main inclusion criterion was the patients with ureteral stricture due to surgery and/or radiation treatment for malignancy. The diagnosis of stricture was ascertained by history and radiographic imaging. The etiologies underlying the strictures were: surgery and/or radiation therapy for cervical and rectal cancer, surgery for ovarian cancer. The primary outcome was the stent patency rate, and the secondary outcomes were the postoperative complications and glomerular filtration rate (GFR). Stent patency was defined as stent in situ without evident migration, unanticipated stent exchange or recurrent ureteral obstruction. Cost analysis was calculated from stent cost, anesthesia cost and operating room fee. Results The pre-metallic stent GFR was 22.53 ± 6.55 mL/min/1.73 m2. Eight patients were on double-J stents before insertion of metallic stents. The total annual cost of per patient in our study was $10,600.2 US dollars (range $9394.4–$33,527.4 US dollars). During a median follow-up time of 16 months (range 8–21 months), 27 cases (31 sides, 84%) remained stent patency. Twelve patients died from their primary malignancy carrying a patency stent. Stent migration was observed in 4 patients within 10 months after insertion. Ectopic stents were endoscopically removed and replaced successfully. Three stents were occluded, and no encrustation was seen in our study. Three and four patients had postoperative fever and gross hematuria, respectively. Infection was observed in 2 cases, mandating antibiotics therapy. In addition, postoperative volume of hydronephrosis postoperatively was significantly reduced compared with preoperation (54.18 ± 15.42 vs 23.92 ± 8.3, P = 0.019). However, no statistically significant differences regarding GFR, creatinine levels, blood urea nitrogen and hemoglobin existed between preoperation and last follow-up. Conclusions The current study demonstrated that metal ureteral stent is effective and safe in the treatment of stricture following surgery and/or radiation therapy for malignant cancer. Patients hydronephrosis could be improved by the stent placement.

scholarly journals Latency and infectious complications after preterm premature rupture of membranes: impact of body mass index

2009 ◽  
Vol 201 (6) ◽  
pp. 600.e1-600.e5 ◽  
Author(s):  
Saju D. Joy ◽  
Yuan Zhao ◽  
Brian M. Mercer ◽  
Menachem Miodovnik ◽  
Robert L. Goldenberg ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Infectious Complications ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

The Impact of BMI on Postpartum Infectious Morbidities and Wound Complications: A Study of Extremes

2021 ◽  
Author(s):  
Iqra Sheikh ◽  
Kylie A Fuller ◽  
Kateena Addae-Konadu ◽  
Sarah Dotters-Katz ◽  
Megan Varvoutis
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Secondary Analysis ◽  
Wound Complication ◽  
Infectious Complications ◽  
Wound Complications ◽  
Maternal Fetal Medicine ◽  
Infectious Morbidity ◽  
Increased Risk ◽  
The Impact

Background As body mass index increases, the risk of postpartum infections has been shown to increase. However, most studies lump women with a body mass index (BMI) of above 40kg/m2 together, making risk assessment for women in higher BMI categories challenging. The objective of this study was to evaluate the impact of extreme obesity on postpartum infectious morbidity and wound complications during the postpartum period. Study Design The present study is a secondary analysis of women who underwent cesarean delivery and had BMI > 40 kg/m2 in the Maternal Fetal Medicine Units Cesarean Registry. The primary outcome was a composite of postpartum infectious morbidity including endometritis, wound infection, inpatient wound complication prior to discharge, and readmission due to wound complications. Appropriate statistics used to compare baseline demographics, pregnancy complications, and primary outcomes among women by increasing BMI groups (40-49.9kg/m2, 50-59.9kg/m2, 60-69.9kg/m2, and >70kg/m2). Results Rates of postpartum infectious morbidity increased with BMI category (11.7% body mass index 50-59.9 kg/m2; 13.7% BMI 60-69.9 kg/m2, 21.9%; and BMI >70+ kg/m2; p=0.001). Readmission for wound complications also increased with BMI (3.1% for BMI 50-59.9 kg/m2; 6.2% for BMI 60-69.9 kg/m2; and 9.4% for BMI >70+kg/m2; p=0.001). After adjusting for confounders, increased BMI 70+ kg/m2 category remained the most significant predictor of postpartum infectious complications compared to women with BMI 40-49.9 kg/m2 (aOR 6.38; 95% CI 1.37-29.7). The adjusted odds of readmission also increased with BMI (aOR 2.33 (95%CI 1.35-4.02) BMI 50-59.9kg/m2, aOR 4.91 (95% CI 2.07-11.7) BMI 60-69.9kg/m2, aOR 36.2 (7.45-176) for BMI >70kg/m2). Conclusion Women with BMI 50-70+kg/m2 are at an increased risk of postpartum wound infections and complications compared to women with BMI 40-49.9kg/m2. These data provide increased guidance for counseling women with an extremely elevated body mass index and highlight the importance of postpartum wound prevention bundles.

scholarly journals Characterization and Outcomes in Patients with SARS-CoV-2 Infection According to Body Mass Index, Fundación Valle Del Lili, Cali, Colombia 2020-2021

2021 ◽  
Author(s):  
Karen Milena Feriz ◽  
Veline Martínez ◽  
Guillermo Edinson Guzman
Keyword(s):  
Body Mass Index ◽  
Mechanical Ventilation ◽  
Body Mass ◽  
Association Studies ◽  
Invasive Mechanical Ventilation ◽  
Infectious Complications ◽  
University Hospital ◽  
Accelerated Expansion ◽  
Obese Patients ◽  
Prospective Longitudinal

Abstract Introduction: SARS-CoV-2 has undergone an accelerated expansion and was declared a pandemic in 2020. It has been responsible of millions of deaths around the world. Several factors related to severity and mortality have been described, including obesity(1,2). In United States and in Latin America, obesity has grown rapidly (3). In Colombia, 56% of the population is overweight/obese. However, in the region, association studies of SARS-CoV-2 and obesity are scarce. We sought to investigate the characterization and outcomes of patients according to body mass index in a highly complex center in Colombia.Material and Methods: The study was a prospective longitudinal observational descriptive study in patients older than 18 years treated at the Fundación Valle del Lili University Hospital in Cali, Colombia in 2020-2021, with a diagnosis of SARS-CoV-2 infection. Sociodemographic characteristics, medical history, clinical presentation, paraclinical characteristics and outcomes were described. Results: The average age was 48 years, 53% were men, and 66.5% were overweight or obese. Dyspnea (p = 0.003) was the most representative symptom in overweight/obesity. The severity of the disease (p = 0.02), days of stay in the ICU (p = 0.045), overall stay (p = 0.0037), and mechanical ventilation (p = 0) had relationships directly proportional to the increase in BMI (p = 0.022). Obese patients had a higher frequency of sepsis (P 0.003), need for vasopressor (P = 0.001), infectious complications (P = 0.011) and myocarditis (P = 0.03). There was no relationship with thrombotic complications.Conclusion. Overweight and obese patients have more severe symptoms of SARS-CoV-2, infectious complications, and requirements for invasive mechanical ventilation, general hospitalization and ICU stay than the normal weight population.

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