scholarly journals Comparison of three different antibiotic protocols in transurethral resection of bladder tumour and the possible infectious risk factors: A non-randomized, prospective study

2018 ◽  
Vol 12 (11) ◽  
Author(s):  
Jorge Panach-Navarrete ◽  
Lorena Valls-González ◽  
Eduardo Sánchez-Cano ◽  
María Medina-González ◽  
Ana Castelló-Porcar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Transurethral Resection ◽  
Urinary Catheter ◽  
Bladder Tumour ◽  
Infectious Complications ◽  
Infectious Risk ◽  
Increased Risk ◽  
Group A ◽  
Long Protocol

Introduction: We sought to investigate three different antibiotic protocols in transurethral resection of a bladder tumour (TURBT), and the possible infectious risk factors of this surgery.Methods: We conducted a non-randomized, prospective study, gathering cases of patients in whom TURBT had been performed. The sample was divided into three groups based on those who received antibiotics as: a single preoperative dose (Group A); a preoperative dose, plus a long protocol during the hospitalization (Group B); a preoperative dose, plus a long protocol during the hospitalization, plus five days at home (Group C). Intra- and postoperative data that could be relevant to infections was gathered.Results: A total of 219 patients were included. In the multivariate analysis, it was observed that the patients in Group A were more prone to re-hospitalization due to fever than were those from Group C (odds ratio [OR] 11.13; p=0.03). Furthermore, the cases with tumour necrosis and those who entered surgery with a urinary catheter were more prone to have a temperature above 37.5ºC (OR6.74; p=0.02 and OR6.4; p=0.04, respectively), as well as have an increased risk per every additional tumour in the cystoscopy (OR 1.32; p=0.01). Those who received mitomycin had a lower chance of a positive urine culture (OR 0.29; p=0.01), contrary to those patients with over two days of hospitalization (OR 4.11; p<0.01) and those who entered surgery with a urinary catheter (OR 12.35; p=0.02).Conclusions: Those patients that only received a single dose of antibiotic before TURBT may have an increased risk of re-hospitalization due to fever in comparison to those who received prolonged antibiotic protocols. In addition, there are perioperative factors in this surgery that predict the risk of infectious complications.

scholarly journals A prospective observational study to evaluate the role of restaging transurethral resection of bladder tumour in patients with non-muscle invasive bladder cancer

2019 ◽  
Vol 7 (11) ◽  
pp. 4134
Author(s):  
Kishan K. Raj ◽  
Yogesh Taneja ◽  
Prateek Ramdev ◽  
Santosh K. Dhaked ◽  
Charan K. Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transurethral Resection ◽  
Prospective Observational Study ◽  
Residual Disease ◽  
Bladder Tumour ◽  
Detrusor Muscle ◽  
Residual Tumour ◽  
Muscle Invasive Bladder Cancer ◽  
T1 Stage ◽  
Muscle Invasive

Background: Transurethral resection of bladder tumour (TURBT) is the primary treatment modality for Non-muscle invasive bladder cancer (NMIBC). Restaging transurethral resection of bladder tumour (RETURBT) is indicated to reduce risk of residual disease and correct staging errors after primary TURBT. The aim of the study is to evaluate the risk of residual tumour and upstaging in NMIBC after TURBT and to investigate the risk factors for the same.Methods: A prospective observational study was carried out over 4 years and 87 patients were included in the study. Patients with NMIBC underwent RETURBT after 2-6 weeks of primary TURBT. The incidence of residual tumour and upstaging in RETUBRT was correlated with various histopathological and morphological parameters in primary TURBT.Results: Out of 87 patients, who underwent RETURBT, residual disease was present in 51 patients (58.6%) and upstaging occurred in 22 patients (25.2%).On univariate analysis, T1 stage (p=0.01), high grade (p=0.01), Carcinoma in situ(CIS) (p=0.01) and multifocality (p=0.05) were predictive for residual disease in RETURBT. High grade (p=0.01), CIS (p=0.01) and absence of detrusor muscle in specimen (p=0.03) were risk factors for upstaging in RETURBT.Conclusions: NMIBC have high incidence of residual disease and upstaging after primary TURBT. T1 stage, high tumour grade, CIS, and multifocality are risk factors for residual disease after primary TURBT. High tumour grade, CIS and absence of detrusor muscle are strongly associated with upstaging during RETURBT.

scholarly journals Epidemiology, risk factors and outcomes of Candida albicans vs. non-albicans candidaemia in adult patients in Northeast China

2019 ◽  
Vol 147 ◽  
Author(s):  
Wei Zhang ◽  
Xingpeng Song ◽  
Hao Wu ◽  
Rui Zheng
Keyword(s):  
Risk Factors ◽  
Antifungal Agents ◽  
Multivariate Analyses ◽  
Urinary Catheter ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Adult Patients ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Isolated Species

Abstract This study aimed to evaluate the clinical characteristics, risk factors and outcomes of adult patients with candidaemia caused by C. albicans vs. non-albicans Candida spp. (NAC). All adult hospitalised cases of candidaemia (2012–2017) at a tertiary hospital in Shenyang were included in the retrospective study, and a total of 180 episodes were analysed. C. parapsilosis was the most frequently isolated species (38.3%), followed by C. albicans (35.6%), C. glabrata (13.9%), C. tropicalis (10%) and others (2.2%). As initial antifungal therapy, 75.0%, 3.9%, 5.6% and 2.2% of patients received fluconazole, caspofungin, micafungin and voriconazole, respectively. Multivariate analyses revealed that total parenteral nutrition was associated with an increased risk of NAC bloodstream infections (BSI) (OR 2.535, 95% CI (1.066–6.026)) vs. C. albicans BSI. Additionally, the presence of a urinary catheter was associated with an increased risk of C. albicans BSI (OR 2.295 (1.129–4.666)) vs. NAC BSI. Moreover, ICU stay (OR 4.013 (1.476–10.906)), renal failure (OR 3.24 (1.084–9.683)), thrombocytopaenia (OR 7.171 (2.152–23.892)) and C. albicans (OR 3.629 (1.352–9.743)) were independent risk factors for candidaemia-related 30-day mortality, while recent cancer surgery was associated with reduced mortality risk (OR 26.479 (2.550–274.918)). All these factors may provide useful information to select initial empirical antifungal agents.

Biologic-Induced Infections in Inflammatory Bowel Disease: The TNF-α Antagonists

2018 ◽  
Vol 52 (6) ◽  
pp. 571-579 ◽  
Author(s):  
Sean M. McConachie ◽  
Sheila M. Wilhelm ◽  
Ashish Bhargava ◽  
Pramodini B. Kale-Pradhan
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Opportunistic Infections ◽  
Case Series ◽  
Infectious Risk ◽  
Increased Risk ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Meta Analyses

Objective: To review the mechanism and association of infectious risk among the tumor-necrosis factor α (TNF-α) antagonists used in inflammatory bowel disease. Data Sources: A PubMed literature search was performed using the following search terms: infliximab, adalimumab, certolizumab, golimumab, inflammatory bowel disease, crohn’s, ulcerative colitis, adverse effects, adverse events, safety, and infection. Study Selection and Data Extraction: Meta-analyses and cohort studies with outcomes pertaining to quantitative infectious risk were reviewed. Case reports and case series describing association between TNF-α inhibitors and infection were also reviewed. Data Synthesis: A total of 7 recent meta-analyses of randomized trials demonstrate inconclusive association of infection with TNF-α antagonists. Registry data suggest that medications carry an independent risk of opportunistic infections. Risk factors for infection include older age, malnutrition, diabetes, and possibly combination therapy. Reported infections vary widely but include intracellular and granulomatous bacteria, viruses, and fungi. Conclusion: TNF-α antagonists are associated with an increased risk of opportunistic infection, although this risk has not been demonstrated conclusively in randomized controlled trials. Knowledge of concomitant risk factors, mechanism of infectious risk, and available treatment options can improve patient care in the clinical setting.

Urethral Stenosis following Transurethral Resection

1992 ◽  
Vol 59 (1) ◽  
pp. 50-52
Author(s):  
P.P. Graziotti ◽  
A. Piccinelli ◽  
L Faggiano ◽  
M. Scanzi ◽  
A. Calabrò
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Transurethral Resection ◽  
Statistical Correlation ◽  
Urethral Stenosis ◽  
Final Data

The authors report the results of a multicentric prospective study on risk factors related to post-TURP stenosis. 47 different parameters were considered and 21 urethral stenoses (9% of 234 patients) are reported. Meatal stenoses are included, but were not considered for statistical correlation with other sites. Final data, statistically examined, show that electrotomes (Martin/Danieli), urethral lubricant and rubber catheters, singly or jointly, are possibly related to post-TURP urethral stenosis.

Routine preoperative group and save for TURP and TURBT – need and cost effectiveness

2017 ◽  
Vol 11 (1) ◽  
pp. 33-37
Author(s):  
Hazel Smith ◽  
Rachel Falconer ◽  
Justyna Szczachor ◽  
Sarfraz Ahmad
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
Blood Transfusion ◽  
Transurethral Resection ◽  
Bladder Tumour ◽  
Transurethral Resection Of Prostate ◽  
Junior Doctors ◽  
Two Samples ◽  
Muscle Invasive ◽  
One Year

Introduction: Standard practice in our unit is to take a group and save (G+S) blood sample for all patients undergoing a transurethral resection of prostate (TURP) and transurethral resection of bladder tumour (TURBT). Modern studies show the transfusion rates for TURP are 2%–7% and for TURBT 2%. Aims: We will determine how many patients undergoing TURP and TURBT required blood transfusion, analyse the indication, timing and risk factors. Additionally we will assess the cost effectiveness of routine G+S. Methods: A retrospective analysis was conducted between 1 March 2015 and 29 February 2016 (one year). Patients were identified from OPERA database and cross-referenced with blood transfusion records. Electronic case notes for patients receiving transfusions were reviewed. Results: A total of 167 patients underwent TURP. Of these, 0.6% (1/167) received transfusion on day 4 post-op. A total of 160 patients underwent TURBT. Overall 3.8% (6/160) received transfusion: three patients on days 0–1 and three patients on days 2–30. All patients had pre-op Hb <100 g/l. All had large muscle-invasive tumours. Cost in our lab of a G+S sample is £23.52. Two samples are now required before blood can be issued. Discussion: Our study shows that risk factors for transfusion are large prostates, likely muscle-invasive bladder tumours and pre-op Hb <100 g/l. Other risks include coagulopathy. These will usually be identified by the surgeon or pre-assessment clinic prior to the procedure. Change in policy would save money and time of phlebotomists and junior doctors. Conclusions: Routine G+S is not necessary for all patients. Patients with risk factors can be identified preoperatively. This would give a potential saving of over £15,000 per year. This can be implemented without adversely affecting patient safety.

scholarly journals A study of infectious intestinal disease in England: risk factors associated with group A rotavirus in children

2001 ◽  
Vol 126 (1) ◽  
pp. 63-70 ◽  
Author(s):  
D. SETHI ◽  
P. CUMBERLAND ◽  
M. J. HUDSON ◽  
L. C. RODRIGUES ◽  
J. G. WHEELER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Breast Feeding ◽  
Significant Risk ◽  
Bottle Feeding ◽  
Intestinal Disease ◽  
Infectious Intestinal Disease ◽  
Increased Risk ◽  
Group A ◽  
Control Study ◽  
Council Housing

Objective: To identify risk factors for infectious intestinal disease (IID) due to rotavirus group A in children aged under 16 years.Methods: Case-control study of cases of IID with rotavirus infection presenting to general practitioners (GPs) or occurring in community cohorts, and matched controls.Results: There were 139 matched pairs. In children under 16 years the following risk factors were significantly associated with rotavirus IID: living in rented council housing (adjusted OR=3·78, P=0·022), accommodation with more than five rooms (OR=0·72, P=0·002), contact with someone ill with IID (OR=3·45, P<0·001). Some foods were associated with decreased risk. In infants, bottle feeding with or without breast feeding was associated with increased risk (OR=9·06, P<0·05).Conclusions: Contact with persons with IID, living in rented council housing and accommodation with fewer rooms, were significant risk factors for sporadic rotavirus IID in children whereas breast feeding is protective in infants.

scholarly journals Predictive Risk Factors of Urinary Tract Infection Following Semirigid Ureteroscopic Lithotripsy

2020 ◽  
Author(s):  
Mehmet Çağlar Çakıcı ◽  
Özgür Kazan ◽  
Ayberk İplikçi ◽  
Muhammet Çiçek ◽  
Özgür Efiloğlu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Infectious Complications ◽  
Ureteral Stones ◽  
P Value ◽  
Ureteroscopic Lithotripsy ◽  
Increased Risk ◽  
Predictive Risk ◽  
Tract Infections ◽  
Residual Fragments

INTRODUCTION: The aim of this study is to determine the frequency and predictive factors of postoperative UTI in patients who underwent URS regarding ureteral stones. METHODS: Data from 425 patients undergoing semi-rigid ureteroscopic lithotripsy between December 2015 and December 2019 at a single center were reviewed to detect factors predicting postoperative urinary tract infections. RESULTS: Of the 425 patients, 35 were infective (8.2%). Proximal ureteral stones were the majority in infective group (48.5%); distal ureteral stones were the majority in non-infective group (42.6%)(p=0.026). Stone number and stone size were also higher in the postoperative infective group (p<0.05). UTI history and preoperative DJS insertion were higher in Group 1 (p <0.001, p = 0.001, respectively). Multivariate regression analyses revealed that history of UTI (OR=5.513, 95% CI; 2.622–11.591, p value <0.001) and presence of residual fragments (OR=4.274, 95% CI; 1.892–9.657, p value <0.001) were independent risk factors for infectious complications after URS. DISCUSSION AND CONCLUSION: Even if URS is considered an innocuous procedure, the probability of postoperative infectious complications is far from negligible. Our results showed that the presence of UTI history and residual fragments were associated with an increased risk of subsequent UTI after URS. These infectious complications also have significant morbidity, mortality and expenditure if not treated timely. Therefore, to avoid this preventable complication, all variables should be reviewed and more careful.

scholarly journals Risk of Complications in Spine Surgery: A Prospective Study

2015 ◽  
Vol 9 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Rodolfo Casimiro Reis ◽  
Matheus Fernandes de Oliveira ◽  
José Marcus Rotta ◽  
Ricardo Vieira Botelho
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Spine Surgery ◽  
Absolute Risk ◽  
Surgical Site Infections ◽  
Spine Instrumentation ◽  
Increased Risk ◽  
The Mean ◽  
A Prospective Study ◽  
Epidemiological Characteristics

Purpose : Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence. Methods : Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014. Epidemiological characteristics and complications during the surgical hospitalization were recorded and analyzed. Results : The sample comprised 95 patients (mean age, 59 years). Overall, 23% of patients were obese (BMI =30). The mean BMI was 25.9. Approximately 53% of patients had comorbidities. Complications occurred in 23% of cases; surgical site infections were the most common (9%). There were no significant differences between patients who did and did not develop complications in terms of age (60.6 vs 59.9 years, p = 0.71), sex (56% female vs 54% female, p = 0.59), BMI (26.6 vs 27.2, p = 0.40), or presence of comorbidities (52% vs 52.8%, p = 0.87). The risk of complications was higher among patients submitted to spine instrumentation than those submitted to non-instrumented surgery (33% vs 22%), p=0.8. Conclusion : Just over one-quarter of patients in the sample developed complications. In this study, age, BMI, comorbidities were not associated with increased risk of complications after spine surgery. The use of instrumentation increased the absolute risk of complications.

Risk Factors for Infectious Complications with Angio-Seal Percutaneous Vascular Closure Devices

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 218-221 ◽  
Author(s):  
Johnny Franco ◽  
Raghunandan Motaganahalli ◽  
Murtz Habeeb ◽  
Catherine Wittgen ◽  
Gary Peterson
Keyword(s):  
Risk Factors ◽  
Cardiac Catheterization ◽  
Femoral Artery ◽  
Infectious Complications ◽  
High Morbidity ◽  
Peripheral Vascular ◽  
Vascular Intervention ◽  
Vascular Closure Devices ◽  
Increased Risk ◽  
Peripheral Vascular Intervention

Percutaneous vascular closure devices have become increasingly common in their use in both cardiac and peripheral vascular intervention. Our cases present the risk factors of repeat percutaneous vascular closure devices for subsequent infectious complications. A 43-year-old male underwent cardiac catheterization and closure with an Angio-Seal (St. Judes Medical, Inc., St. Paul, MN) device. He required a second cardiac catheterization with access gained on the same side as the previous intervention. He developed bacteremia and an infected hematoma with erosion of the femoral artery. The second case involves a 57-year-old male who underwent cardiac catheterization and closure with an Angio-Seal device. He developed a localized infection over the accessed groin site. The overall complication rate of closure devices is 2%, and 0.3% of patients have infectious complications. The high morbidity associated with these complications indicates the need to be able to identify patients who are at increased risk for these complications.

Persistence of conduct disorders and their relation to early initiation of smoking and alcohol drinking in a prospective ELSPAC Study

Open Medicine ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. 628-634
Author(s):  
Drahoslava Hrubá ◽  
Lubomír Kukla ◽  
Petr Okrajek ◽  
Aleš Peřina
Keyword(s):  
Risk Factors ◽  
Conduct Disorder ◽  
Prospective Study ◽  
Alcohol Drinking ◽  
Conduct Disorders ◽  
Early Initiation ◽  
Statistic Analysis ◽  
Poor Academic Performance ◽  
Group A ◽  
Group B

AbstractThe important risk factors of early initiation of smoking and alcohol drinking are: prosmoking family and peers, conduct disorders and delinquency, poor academic performance. The data obtained by physicians, teachers and children were collected at the age of 11 years. Children were divided into group A (without symptoms), Group B (with one or more symptoms). For statistic analysis, the programme EPI INFO was used.During the period between 7 and 11 years, new children with problematic behaviour (178=3.9%) were diagnosed in Group A, while substantial decreasing of children previously included in Group B was seen (by 59.1%). Together 7.05% of 11 years old children visited specialists (psychologists) due to their conduct disorders: 6.8% from Group A and 12.3% from Group B. Children more often than their teachers reported the frequent occurrence of conduct disorder. About 20% of children smoked, and more than 40% had tasted alcohol. However, the differences between Groups A and B were not significant. Our prospective study has demonstrated the possibility of misinterpretation of behavioural outputs. Children with previous behavioural problems had not a higher risk for early smoking and alcohol use.

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