septic complications
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2022 ◽  
Vol 270 ◽  
pp. 94-103
Author(s):  
Martin Mauser ◽  
Deirdré Kruger ◽  
Sugeshnee Pather ◽  
Frank Plani

2022 ◽  
pp. 143-151
Author(s):  
I. I. Litvinov ◽  
I. V. Lokhovinin ◽  
V. V. Savgachev

Introduction. Chronic back pain syndrome, which significantly restricts a person’s daily activity, can cause the formation of depressive states and is a significantly more difficult task for treatment compared to acute pain.Aim. To evaluate the efficacy and safety of caudal epidural catheterization (CEC) and local therapy with anesthetics and glucocorticoids for chronic nonspecific discogenic and chronic radicular low back pain (LBP) in young and middle-aged patients.Materials and methods. 42 patients aged from 29 to 59 years, who in the neurosurgical department of the Vologda City Hospital No. 1 in 2017–2019 underwent an operation to install a caudal epidural catheter and prolonged injection therapy of local anesthetics and glucocorticosteroids for chronic nonspecific discogenic and chronic radicular LBP.Results. There were no purulent-septic complications, hematomas of the spinal canal. In the group of patients with radicular syndrome the average values of LBP according to VAS were as follows: before CEC – 78.5 mm; 5 days after CEC – 24.1 mm; 6 months after CEC – 19.6 mm; after 12 months – 17.9 mm. In the group of patients with nonspecific discogenic LBP the average pain estimates for VAS were as follows: before CEC – 78.1 mm; 5 days after CEC – 21.7 mm; 6 months after CEC – 20.9 mm; after 12 months – 23.4 mm.Сonclusion. Our experience indicates a high long-term efficacy and safety of treatment with caudal epidural catheterization and local prolonged therapy with anesthetics and glucocorticoids for chronic radicular and chronic nonspecific discogenic pain in the lower back in young and middle-aged patients selected on the basis of a special system of criteria.


Antibiotics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 43
Author(s):  
Carlo Vallicelli ◽  
Federico Coccolini ◽  
Massimo Sartelli ◽  
Luca Ansaloni ◽  
Simona Bui ◽  
...  

The procedure of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a combined surgical and oncological treatment for peritoneal carcinomatosis of various origins. Antibiotic prophylaxis is usually center-related and should be discussed together with the infectious disease specialist, taking into account the advanced oncologic condition of the patient, the complexity of surgery—often requiring multiorgan resections—and the risk of post-HIPEC neutropenia. The incidence of surgical site infection (SSI) after CRS and HIPEC ranges between 11 and 46%. These patients are also at high risk of postoperative abdominal infections and septic complications, and a bacterial translocation during HIPEC has been hypothesized. Many authors have proposed aggressive screening protocols and a high intra and postoperative alert, in order to minimize and promptly identify all possible infectious complications following CRS and HIPEC.


2021 ◽  
pp. 60-64
Author(s):  
A. V. Omelchenko-Seliukova ◽  
S. S. Dubivska ◽  
Y. V. Volkova

Purpose. Identify patterns of traumatic disease and characterize complications in patients with polytrauma (PT) and chronic alcohol intoxication (CAI). Materials and methods. Case histories of 39 victims with PT and alcohol history at age 19-60 years who were undergoing treatment at the Prof. Meshchaninov Kharkov City Clinical Emergency Hospital in 2016. Patient inclusion criteria: age 19-60, damage of two or more anatomical functional areas, severity of traumatic injury on the ISS scale 9-25 points, Glasgow coma scores ≥14 at the time of admission, absence of craniocerebral trauma, the absence of general anesthesia. Results. The average age of patients was 37.4 ± 9.4 years. Among these groups of patients were 29 men (74%), which is 2.9 times the number of women 10 (26%). Attention is drawn to the fact that the most important part of the victims (28.2%) was precisely the patients of the young able-bodied age. Infectious complications that developed in the early and late period of traumatic disease in victims with CAI are the main causes of death in PT - patients and induce a negative prognosis for survival. During analyzing the timing of the development of purulent-septic complications in this group of patients, we came to the conclusion that they occur on average at 7.2 ± 2.4 days. Among the infectious complications of PT in patients with CAI were pneumonia (28.2%), sepsis (7.6%), peritonitis (7.6%), pleural empyema (5.1%), osteomyelitis (5.1%). Non-infectious complications, in contrast to infectious, manifested from the first hours of injury and reached maximum development during the period by 2.3 ± 0.8 days, they were the main trigger for the development of severe infectious complications in the early period of traumatic disease. Noninfectious complications were consisted by delirium - in 29 patients, which increased the patients duration at intensive care unit on 39,6 ± 5 3 hours. These complications significantly increased the severity of the PT patients with CAI. With a higher incidence, it occurred in hyperactive, (62%) patients with delirium, and mixed (38%) form. Attention is drawn to the fact that patients with fatal outcome (29 cases), delirium was observed significantly more frequently (χ2 to include Yeats = 3.641, p <0.05) was found in 25 patients. Less frequently in patients occurred thrombosis 5(12.8%) and fat embolism syndrom 2 (5.1%). Conclusions. Most often, multiple injuries with history of alcohol use are obtained by young working aged men. The cause of injury in more than 60% of cases is accidents. 82% of the victims were in the state of alcohol intoxication during their hospitalization. On average, the terms of stay of patients with ICU are 64.9 ± 23.7 hours, although with the development of complications, these terms increase to 103.2 ± 14.2 hours. In patients with CAI there is a complicated course of traumatic disease. Among the infectious complications that develop at 7.2 ± 2.4 days, pneumonia, sepsis and peritonitis predominate. The most common non-infectious complications were delirium, thrombophlebitis thrombosis, fat embolism. Risk of fatal outcome in patients with delirium in 6.25 times higher than in patients without acute encephalopathy. Thus, the treatment of patients with a history of with polytrauma and chronic alcohol intoxication is an extremely important medical problem that needs further study and improvement.


2021 ◽  
Vol 1 (1) ◽  
pp. 03-06
Author(s):  
Abdulla Al-Ansari ◽  
Maged Alrayashi ◽  
Hatem Kamkoum ◽  
Hossameldin Alnawsara ◽  
Bela Tallai ◽  
...  

Flexible Ureteroscopy (FURS) has become an integral aspect of the surgical armamentarium to treat intra-renal stones that are less than 2 cm in diameter. Despite the progress made with regards to the design of the flexible ureteroscopes, surgeons still need to work with suboptimal ergonomics, which may result in orthopedic complaints, which as a result lead to imperfect performance. Robotic- Assisted FURS with Avicenna Roboflex has provided significant improvement of ergonomics. The Super Pulse Thulium Fiber Laser (SPTFL) may be considered as a viable alternative to holmium laser in stone management. Coronavirus Disease- 19 (Covid-19) has been declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. As a result, many hospitals have been converted to dedicated facilities to manage the Covid-19 patients. Urinary stone disease represents a benign condition, but in non-negligible number of cases, it can lead to potential severe septic complications that could increase the burden on emergency services. Many surgical specialties including urology has made short pathways for patient flow to decrease the contact with the patients which in turn will decrease the possibility of transmission of Covid-19. The use of new technologies such as Avicenna Roboflex and thulium fiber laser in Covid-19 positive patients when performing flexible ureteroscopy can minimize direct contact with the patient, expedite the procedure, while protecting the staff from getting Covid-19 infection.


2021 ◽  
Vol 11 (12) ◽  
pp. 235-240
Author(s):  
Julia Fuss ◽  
Anna Voloboyeva ◽  
Victor Polovyj ◽  
Roksolana Yaremkevych

Over the past few decades, surgeons have made many attempts to reduce the incidence of surgical site infections (SSI) after elective colorectal surgery. Routine faecal diversion is no longer practiced in elective colonic surgery and mechanical bowel preparation is on the verge of being eliminated altogether. Intravenous antibiotics have become the standard of care as prophylaxis against SSI for elective colorectal operations. However, the role of antibiotics is still being debated.   The aim of the study was to reduce the proportion of antibiotic-resistant strains of pathogens of infectious complications in colorectal surgery by optimizing the use of antimicrobial drugs. Method: We analyzed data of 135 patients who were operated for colorectal cancer in our general surgery department in between 2019 and 2021. Age, gender, body mass index, presence of chronic pulmonary disease, surgery duration, disease location (colon or rectum), and surgeon volume were evaluated for associations with the development of superficial or deep surgical site infection. Results: All parameters were found to be significant for the development surgical site infection except sex. Cut-off values were 63.5 years for age, 167.5 minutes for surgery duration. Conclusion. The introduction of strict monitoring of compliance with the protocols of antibiotic prophylaxis and antibiotic therapy at the level of a separate surgical unit in a multidisciplinary hospital improves conditions for the rational use of antimicrobial drugs.


2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Fatima Hemani ◽  
Anjum Naveed ◽  
Shakil Akhtar ◽  
Saba Shahid

Lemierre’s Syndrome (LS) is a rare syndrome most frequently due to an anaerobic organism, Fusobacterium Necrophorum. It is commonly a complication of an acute oropharyngeal infection, but there are exceptions to its presentations. In our case the cause of LS was otitis media caused by Streptococcus species. This is a rather unusual presentation of LS. LS is caused due to septic complications of oropharyngeal infections, which lead to thrombophlebitis of internal jugular vein leading to thrombosis formation. In this case report, we present a case of Lemierre’s syndrome in a seven-year-old male child. The patient presented with high grade fever spikes and earache, which were unresponsive to oral antibiotics. LS was diagnosed in this patient on the basis of clinical, microbiological and radiological findings. After the diagnosis, treatment involved using broad spectrum antibiotics and anticoagulants, followed by surgery. Though role of anticoagulants is controversial in LS, but there is no specific guideline contraindicating the use of anti-coagulants. In our case, timely diagnosis and management enabled us to discharge the patient without any symptoms. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773 How to cite this:Hemani F, Naveed A, Akhtar S, Shahid S. Lemierre’s syndrome in a child. Pak J Med Sci. 2022;38(2):433-435.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Abdelmoughit Hosni ◽  
Siham EL HADDAD ◽  
Nazik ALLALI ◽  
Latifa CHAT

To highlight the risk of septic complications following a pulmonary embolism (PE), we report the case of an elderly patient, that was hospitalized for a PE, an had progressively worsen his respiratory and septic state. Chest CT slices showed a gangrenous lung segment with an associated pleuropulmonary abscess.


2021 ◽  
Vol 8 (12) ◽  
pp. 3569
Author(s):  
Sai P. Krishna ◽  
R. D. R. Somasekar ◽  
Sivasankar A. ◽  
Kesavan B. ◽  
Pon M. Chidambaram ◽  
...  

Background: The role of bacteria in pathogenesis of chronic pancreatitis is poorly understood. Our aim was to analyse pancreatic duct fluid culture in patients undergoing operative intervention for chronic pancreatitis and its implications in post operative outcomes.Methods: Among 35 patients, 17 underwent Freys, 13 underwent longitudinal pancreatico-jejunostomy, 5 underwent cystojejunostomy. Duct fluid culture was obtained intraoperatively and analysed and compared with preoperative parameters and post operative outcomes.Results: 20 patients had positive duct fluid culture. Most common pathogen isolated was Klebsiella (8 patients). The only preoperative parameter which showed significant association was fasting blood glucose level. Wound infections were seen in 11 of which 10 had positive duct culture, out of which 9 had the same organism of that in duct culture. Mean hospital stay was 9±1.07 and 10±1.13 days in patients without and with infectious complications respectively.Conclusions: Older concept of sterile PD fluid in patients with CP may no longer hold true. In our study upto 60% of patients showed positive PD culture. By starting appropriate antibiotic we can reduce the length of hospital stay in patients who have septic complications. However large centre studies may guide us further into the importance of this concept and the role of bacteria in the pathogenesis of CP.


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