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Sample records for infection complicating alefacept

  1. Complicated infective endocarditis: a case series.

    Science.gov (United States)

    Kim, Joo Seop; Kang, Min-Kyung; Cho, A Jin; Seo, Yu Bin; Kim, Kun Il

    2017-05-08

    Infective endocarditis is associated with not only cardiac complications but also neurologic, renal, musculoskeletal, and systemic complications related to the infection, such as embolization, metastatic infection, and mycotic aneurysm. We report three cases (the first patient is Chinese and the other two are Koreans) of complicated infective endocarditis; two of the cases were associated with a mycotic aneurysm, and one case was associated with a splenic abscess. One case of a patient with prosthetic valve endocarditis was complicated by intracerebral hemorrhage caused by mycotic aneurysm rupture. A second case of a patient with right-sided valve endocarditis associated with a central catheter was complicated by an abdominal aortic mycotic aneurysm. The third patient had a splenic infarction and abscess associated with infected cardiac thrombi. Complicated infective endocarditis is rare and is associated with cardiac, neurologic, renal, musculoskeletal, and systemic complications related to infection, such as embolization, metastatic infection, and mycotic aneurysm. Infective endocarditis caused by Staphylococcus aureus is more frequently associated with complications. Because the mortality rate increases when complications develop, aggressive antibiotic therapy and surgery, combined with specific treatments for the complications, are necessary.

  2. Neurological complications of Zika virus infection.

    Science.gov (United States)

    Carod-Artal, Francisco Javier

    2018-04-26

    Zika virus (ZIKV) disease is a vector-borne infectious disease transmitted by Aedes mosquitoes. Recently, ZIKV has caused outbreaks in most American countries. Areas covered: Publications about neurological complications of ZIKV infection retrieved from pubmed searchers were reviewed, and reference lists and relevant articles from review articles were also examined. Vertical/intrauterine transmission leads to congenital infection and causes microcephaly and congenital ZIKV syndrome. ZIKV preferentially infects human neural progenitor cells and triggers cell apoptosis. ZIKV RNA has been identified in foetal brain tissue and brains of microcephalic infants who died; amniotic fluid and placentas of pregnant mothers; and umbilical cord, cerebro-spinal fluid and meninges of newborns. The increase in the number of Guillain-Barre syndrome (GBS) cases during the ZIKV outbreak in the Americas provides epidemiological evidence for the link between ZIKV infection and GBS. Less frequently reported ZIKV neurological complications include encephalitis/meningoencephalitis, acute disseminated encephalomyelitis, myelitis, cerebrovascular complications (ischemic infarction; vasculopathy), seizures and encephalopathy, sensory polyneuropathy and sensory neuronopathy. Analysis of GBS incidence could serve as an epidemiological 'marker' or sentinel for ZIKV disease and other neurological complications associated to ZIKV. Expert commentary: An expanding spectrum of neurological complications associated with ZIKV infection is being recognised.

  3. Complicated Intra-Abdominal Infections Observational European study (CIAO Study

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    Sartelli Massimo

    2011-12-01

    Full Text Available Abstract Complicated intra-abdominal infections are frequently associated with poor prognoses and high morbidity and mortality rates. Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. In order to describe the clinical, microbiological, and management-related profiles of both community-acquired and healthcare-acquired complicated intra-abdominal infections (IAIs, the World Society of Emergency Surgery (WSES, in collaboration with the Surgical Infections Society of Europe (SIS-E and other prominent European surgical societies, has designed the CIAO study. The CIAO study is a multicenter, observational study and will be carried out in various surgical departments throughout Europe. The study will include patients undergoing surgery or interventional drainage for complicated IAI.

  4. [COMPLICATED URINARY TRACT INFECTIONS IN THE ELDERLY].

    Science.gov (United States)

    Ćosić, I; Ćosić, V

    2016-12-01

    Urinary tract infections (UTI) are the most common bacterial infections involving lower (cystitis, prostatitis) or upper (pyelonephritis, renal abscess, perinephric abscess) urinary tract. Differentiation of complicated and uncomplicated UTI is usually based on the presence of structural or functional urinary tract abnormalities, which can increase the risk of treatment failure and development of serious complications. Factors that increase the risk are foreign bodies, stones, obstruction, neurogenic bladder, kidney transplantation, immunosuppression, and pregnancy. Complicated UTI includes a spectrum of conditions that increase the risk of treatment failure, as well as of serious complications such as bacteremia and sepsis, perinephric abscess, renal impairment and emphysematous pyelonephritis. To avoid the potentially devastating outcomes, appropriate diagnostic procedures, antibiotic and surgical treatment, and appropriate follow-up are required. The incidence of complicated UTI will grow in the future due to general aging of the population, increasing incidence of diabetes, and ever growing number of immunocompromised and immunosuppressed patients. It is of key importance to recognize complicated UTI on time, and treat it wisely and aggressively to reduce duration of the disease and the risk of antibiotic resistance.

  5. Antibiotic Resistance in Children with Recurrent or Complicated Urinary Tract Infection

    OpenAIRE

    Nidal S Younish; K Qual; T Al-Awaisheh; F Al-Awaisheh; D Al-Kayed

    2009-01-01

    INTRODUCTION: Urinary tract infection is certainly one of the most common childhood infections. Emerging resistance to the antibiotics is not unusual. Current hospitalization for children with urinary tract infection is reserved for severe or complicated cases. The aim of the present study was to determine the antibiotic resistance pattern among children with recurrent or complicated urinary tract infection. METHODS: A retrospective study carried out at Prince Hashem hospital, Zarqa ...

  6. Timing of surgical site infection and pulmonary complications after laparotomy

    DEFF Research Database (Denmark)

    Gundel, Ossian; Gundersen, Sofie Kirchhoff; Dahl, Rikke Maria

    2018-01-01

    BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur....... The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy. MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent...... laparotomy. Patients were randomly allocated to either 80% or 30% perioperative inspiratory oxygen fraction. RESULTS: SSI or pulmonary complications were diagnosed in 24.2% (95% CI: 22.0%-26.5%) of the patients at a median of 9 days [IQR: 5-15] after surgery. Most common was surgical site infection (19...

  7. Pylephlebitis: An Uncommon Complication of Intra-Abdominal Infection

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    Salim R Surani

    2011-05-01

    Full Text Available We herein present a case of pylephlebitis, which is an infective suppurative thrombosis of the portal vein. Pylephlebitis is an uncommon complication of intra-abdominal infections and carries with it significant morbidity and mortality. [West J Emerg Med. 2011;12(4:575–576.

  8. Neurological complications of infective endocarditis

    International Nuclear Information System (INIS)

    Khan, Sonia A.A.; Yaqub, Basim A.; Al-Deeb, Saleh M.

    1996-01-01

    We reviewed the files of 80 successive patients with native and prosthetic valve endocarditis admitted to Riyadh Armed Forces Hospital. Neurolological complications (NC) occurred in 28 (35%) patients. The valves involved were mitral in 12 (43%), aortic in eight (29%), combined mitral and aortic lesions in six (21%) and others in two (7%). The common causative organisms were Streptococci in 12 (43%), Staphylococcus aureus and Staphylococcus epidermides, both occurring in four (14%). Compared to the 52 infective endocarditis patients with no neurological complications (NNC), the NC occurred more frequently in male patients, those with aortic valve lesion, those with atrial fibrillation, those with delayed therapy and those with causative organisms being Streptococci or Staphylococci. Eleven patients died (39%), 12 (43%) recovered with motor sequelae, six (21%) had seizure disorder and five (18%) had full recovery. The frequency of neurological complications and mortality is comparable to those reported in the literature: however, the frequency was higher in our patients. (author)

  9. Complications of cesarean deliveries among HIV-infected women in the United States

    Science.gov (United States)

    Kourtis, Athena P.; Ellington, Sascha; Pazol, Karen; Flowers, Lisa; Haddad, Lisa; Jamieson, Denise J.

    2015-01-01

    Objective To compare rates of complications associated with cesarean delivery in HIV-infected and HIV-uninfected women in the United States and to investigate trends in such complications across four study cycles spanning the implementation of HAART in the United States (1995–1996, 2000–2001, 2005–2006, 2010–2011). Design The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project is the largest all-payer hospital inpatient care database in the United States; when weighted to account for the complex sampling design, nationally representative estimates are derived. After restricting the study sample to women aged 15–49 years, our study sample consisted of approximately 1 090 000 cesarean delivery hospitalizations annually. Methods Complications associated with cesarean deliveries were categorized as infection, hemorrhage, or surgical trauma, based on groups of specific International Classification of Diseases 9th revision codes. Length of hospitalization, hospital charges, and in-hospital deaths were also examined. Results The rate of complications significantly decreased during the study periods for HIV-infected and HIV-uninfected women. However, rates of infectious complications and surgical trauma associated with cesarean deliveries remained higher among HIV-infected, compared with HIV-uninfected women in 2010–2011, as did prolonged hospital stay and in-hospital deaths. Length of hospitalization decreased over time for cesarean deliveries of HIV-infected women to a greater extent compared with HIV-uninfected women. Conclusion In the United States, rates of cesarean delivery complications decreased from 1995 to 2011. However, rates of infection, surgical trauma, hospital deaths, and prolonged hospitalization are still higher among HIV-infected women. Clinicians should remain alert to this persistently increased risk of cesarean delivery complications among HIV-infected women. PMID:25574961

  10. Mandible Fracture Complications and Infection: The Influence of Demographics and Modifiable Factors.

    Science.gov (United States)

    Odom, Elizabeth B; Snyder-Warwick, Alison K

    2016-08-01

    Mandible fractures account for 36 to 70 percent of all facial fractures. Despite their high prevalence, the literature lacks a comprehensive review of demographics, fracture patterns, timing of management, antibiotic selection, and outcomes, particularly when evaluating pediatric versus adult patients. The authors aim to determine the complication and infection rates after surgical treatment of mandibular fractures and the bacterial isolates and antibiotic sensitivities from mandible infections after open reduction and internal fixation at their institution. Data were collected retrospectively for all mandible fractures treated at the authors' institution between 2003 and 2013. Patients were divided into pediatric (younger than 16 years) and adult (16 years or older) subgroups. Demographics, fracture location, fracture cause, comorbidities, antibiotic choice, and subsequent complications and infections were analyzed. Data were evaluated using appropriate statistical tests for each variable. Three hundred ninety-five patients were evaluated. Demographics and fracture cause were similar to those reported in current literature. Of the 56 pediatric patients, complications occurred in 5.6 percent. Time from injury to operative intervention did not affect outcome. The complication rate was 17.5 percent and the infection rate was 9.4 percent in the adult subgroup. Time from injury to operative intervention, sex, and edentulism were not significant predictors of complication or infection. Tobacco use, number of fractures, number of fractures fixated, and surgical approach were predictors of complication and infection. Perioperative ampicillin-sulbactam had a significantly lower risk of infection. Certain demographic and operative factors lead to significantly higher risks of complications after surgical management of mandibular fractures. Ampicillin-sulbactam provides effective antibiotic prophylaxis. Risk factor modification may improve outcomes. Risk, IV.

  11. Acute Kidney Injury Complicated Epstein-Barr Virus Infection in Infancy

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    Gamze Ozgurhan

    2015-01-01

    Full Text Available Infectious mononucleosis is an acute lymphoproliferative disorder caused by the Epstein-Barr virus (EBV and seen most commonly in children and young adults. Clinical presentation of the disease is characterized by fever, tonsillopharyngitis, lymphadenopathy, and hepatosplenomegaly, whereas serological findings of this benign disorder include positive heterophilic antibody formation (transient increase in heterophilic antibodies and prominence of hematological lymphocytosis of more than 10% of atypical lymphocytes. An EBV infection is usually asymptomatic in childhood, but acute kidney injury can be a rare complication during its course. Most cases recover from the disease completely. Early recognition of EBV infection and estimation of its complication are important for its prognosis. In light of previous literature, we discuss the case evaluated as an EBV infection complicated by acute kidney injury in early childhood and results of tubulointerstitial nephritis shown on a renal biopsy that was later diagnosed as an EBV infection by serological examination.

  12. Management of non-catheter-associated complicated urinary tract infection.

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    Dielubanza, Elodi J; Mazur, Daniel J; Schaeffer, Anthony J

    2014-03-01

    This article presents an overview of non-catheter-associated complicated urinary tract infection (UTI) from a urologic point of view. Discussion includes the evaluation and workup a complicated UTI through history, physical examination, laboratory analysis, and radiographic studies. Specific types of complicated UTI, such as urinary obstruction and renal abscess, are reviewed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Antibiotic resistance in children with recurrent or complicated urinary tract infection.

    Science.gov (United States)

    Younis, N; Quol, K; Al-Momani, T; Al-Awaisheh, F; Al-Kayed, D

    2009-01-01

    Urinary tract infection is certainly one of the most common childhood infections. Emerging resistance to the antibiotics is not unusual. Current hospitalization for children with urinary tract infection is reserved for severe or complicated cases. The aim of the present study was to determine the antibiotic resistance pattern among children with recurrent or complicated urinary tract infection. A retrospective study carried out at Prince Hashem hospital, Zarqa city, eastern Jordan and involved 336 episodes of culture proved urinary tract infection obtained from 121 patients with recurrent UTI, who used prophylactic antibiotics during the period from April 1, 2004 to December 31, 2006. The isolated microorganisms and there antibiotics susceptibility were studied. Seventy three patients (60.3%) were found to have some forms of urinary tract anomaly, significantly more prevalent among male children Purinary tract infection (64.3% vs. 16.6%, Purinary tract infection. Proteus, Pseudomonas and Candida spp. were more prevalent in patients with complicated (Presistant to most antibiotics tested. Pediatric urine culture isolates are becoming increasingly resistant to commonly used antibiotics. Empirical treatment with Trimethoprim-Sulfamethoxazole (TMP-SMX) or Cephalexin as the initial drug is ineffective. Nitrofurantoin and Nalidixic acid can be considered as the first line antibiotics for prophylaxis and or treatment of patients with recurrent UTI, while Meropenam and Ciprofloxacin can be used empirically in treating patients with complicated UTI.

  14. Sacral myeloradiculitis complicating genital herpes in a HIV-infected patient.

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    Corral, I; Quereda, C; Navas, E; Pérez-Elias, M J; Jover, F; Moreno, S

    2005-02-01

    Myeloradiculitis is a rare neurological complication of herpes simplex type 2 (HSV-2) infection, frequently associated with a fatal outcome. Among patients with HIV infection, HSV-2 myeloradiculitis has occasionally been reported, always associated with advanced immunosuppression and AIDS. We report a patient with HIV infection but no history of previous opportunistic infections, who developed sacral myeloradiculitis immediately after an episode of genital herpes. Magnetic resonance imaging with gadolinium showed necrotizing myelitis in the conus medullaris and enhancement of sacral roots. CD4 lymphocyte count was 530/mm3. Other possible causes of myeloradiculitis in HIV-infected patients were appropriately excluded. Acyclovir therapy resulted in partial clinical improvement. This report shows that myeloradiculitis as a complication of genital herpes may occur in the early stages of HIV infection and may have a favourable outcome with antiviral treatment.

  15. Brain magnetic resonance findings in infective endocarditis with neurological complications

    International Nuclear Information System (INIS)

    Azuma, Asako; O'uchi, Toshihiro; Toyoda, Keiko

    2009-01-01

    Diagnosing infective endocarditis and its complications can be difficult because of the nonspecific symptoms. We reviewed findings of intracranial abnormalities on magnetic resonance imaging (MRI) in 14 patients with neurological complications and herein discuss the overall intracranial MRI findings. We retrospectively reviewed patients with infective endocarditis from August 2004 to August 2006. Brain MRI, the causative bacteria, and abnormal neurological symptoms were reviewed for 14 patients with neurological complications. Of the 14 patients, 13 showed intracranial abnormalities on MRI. Embolization was seen in 10 patients, hemorrhage in 3, abscess formation in 3, and encephalitis in 2. Hyperintense lesions with a central hypointense area on T2-weighted and/or T2*-weighted imaging (Bull's-eye-like lesion) were seen in four patients. A combination of these intracranial abnormalities was observed in 6 patients. The MRI findings associated with infective endocarditis are wide-ranging: embolization, hemorrhage, meningitis, cerebritis, abscess, the bull's-eye-like lesion. Clinicians should consider the possibility of infective endocarditis in patients with unknown fever and neurological abnormality. Brain MRI should be promptly performed for those patients, and T2*-weighted imaging is recommended for an early diagnosis of infective endocarditis. (author)

  16. Cushing's syndrome complicated by multiple opportunistic infections

    NARCIS (Netherlands)

    Bakker, R. C.; Gallas, P. R.; Romijn, J. A.; Wiersinga, W. M.

    1998-01-01

    The case history of a 56-year-old man is described who suffered from severe adrenocorticotrophic hormone (ACTH)-dependent Cushing's syndrome. The clinical course was complicated by simultaneous infections with Pneumocystis carinii, Staphylococcus aureus, Candida albicans, Aspergillus fumigatus and

  17. Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger

    Science.gov (United States)

    Page, Anne-Laure; de Rekeneire, Nathalie; Sayadi, Sani; Aberrane, Said; Janssens, Ann-Carole; Rieux, Claire; Djibo, Ali; Manuguerra, Jean-Claude; Ducou-le-Pointe, Hubert; Grais, Rebecca F.; Schaefer, Myrto; Guerin, Philippe J.; Baron, Emmanuel

    2013-01-01

    Background Although malnutrition affects thousands of children throughout the Sahel each year and predisposes them to infections, there is little data on the etiology of infections in these populations. We present a clinical and biological characterization of infections in hospitalized children with complicated severe acute malnutrition (SAM) in Maradi, Niger. Methods Children with complicated SAM hospitalized in the intensive care unit of a therapeutic feeding center, with no antibiotics in the previous 7 days, were included. A clinical examination, blood, urine and stool cultures, and chest radiography were performed systematically on admission. Results Among the 311 children included in the study, gastroenteritis was the most frequent clinical diagnosis on admission, followed by respiratory tract infections and malaria. Blood or urine culture was positive in 17% and 16% of cases, respectively, and 36% had abnormal chest radiography. Enterobacteria were sensitive to most antibiotics, except amoxicillin and cotrimoxazole. Twenty-nine (9%) children died, most frequently from sepsis. Clinical signs were poor indicators of infection and initial diagnoses correlated poorly with biologically or radiography-confirmed diagnoses. Conclusions These data confirm the high level of infections and poor correlation with clinical signs in children with complicated SAM, and provide antibiotic resistance profiles from an area with limited microbiological data. These results contribute unique data to the ongoing debate on the use and choice of broad-spectrum antibiotics as first-line treatment in children with complicated SAM and reinforce the call for an update of international guidelines on management of complicated SAM based on more recent data. PMID:23874731

  18. Intracranial complications of Serratia marcescens infection in neonates.

    Science.gov (United States)

    Madide, Ayanda; Smith, Johan

    2016-03-15

    Even though Serratia marcescens is not one of the most common causes of infection in neonates, it is associated with grave morbidity and mortality. We describe the evolution of brain parenchymal affectation observed in association with S. marcescens infection in neonates. This retrospective case series details brain ultrasound findings of five neonates with hospital-acquired S. marcescens infection. Neonatal S. marcescens infection with or without associated meningitis can be complicated by brain parenchymal affectation, leading to cerebral abscess formation. It is recommended that all neonates with this infection should undergo neuro-imaging more than once before discharge from hospital; this can be achieved using bedside ultrasonography.

  19. Fetal stroke and congenital parvovirus B19 infection complicated by activated protein C resistance

    NARCIS (Netherlands)

    de Haan, Timo R.; van Wezel-Meijler, Gerda; Beersma, Matthias F. C.; Von Lindern, Jeanette S.; van Duinen, Sjoerd G.; Walther, Frans J.

    2006-01-01

    Parvovirus B19 infection in gestation has been associated with severe fetal complications such as anaemia, hydrops and fetal demise. Fetal infection in the first trimester poses the greatest risk for these complications, but infection during the third trimester is more common than previously

  20. Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

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    Ichiro Hashimoto

    2014-05-01

    Full Text Available Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI, comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1±3.74 kg/m2. Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041. A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus and coagulase-negative Staphylococci (P=0.011. There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048. The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.

  1. [Clinical trials of flomoxef in complicated urinary tract infections].

    Science.gov (United States)

    Ohta, N; Sudoko, H; Fukuta, K; Nakano, M; Ushiyama, T; Tajima, A; Aso, Y; Masuda, H; Suzuki, A; Suzuki, K

    1987-10-01

    Flomoxef (6315-S, FMOX), a new oxacephem antibiotic was studied clinically in 27 patients with complicated urinary tract infections. FMOX was intravenously administered at a dose of 1.0 g twice daily for 5 days. Clinical effect of FMOX on patients with complicated urinary tract infections were excellent in 11.5%, moderate in 57.7% and overall clinical efficacy rate was 69.2%. During the treatment with FMOX, urticaria was observed in 1 case. In laboratory tests, a decrease of RBC, Hb and Ht in 1 case, a decrease of WBC in 1 case and an elevation of GPT in another case were observed. But these abnormal values were slight and transient.

  2. Pharmacokinetic/pharmacodynamic based dosing of ciprofloxacin in complicated urinary tract infections

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    Ana Sabo

    2015-08-01

    Full Text Available Ciprofloxacin is often used in treatment of complicated urinary tract infections in areas with high rates of resistance to first line agents. The aim of this study was to evaluate efficacy of ciprofloxacin in standard dosing regimens in treatment of complicated urinary tract infections. Plasma concentration curves were simulated and minimum inhibitory concentration (MIC and post-antibiotic effect were determined. Ciprofloxacin MIC ranged from 0.0156 for Gram-negative and to 0.125-0.5 µg/mL for Gram-positive bacteria. Both dosing regimens were suitable for eradication of Gram-negative bacteria, with slight supremacy of 750 mg/12 hours over 500 mg/12 hours dosing regimen. Even though all strains were fully susceptible to ciprofloxacin, pharmaco-kinetic/pharmacodynamic parameters did not meet target thresholds for pathogens with MIC over 0.1-0.2 µg/mL regardless of the administered dose. Ciprofloxacin remains an excellent choice for treatment of complicated urinary tract infections caused by Gram-negative bacteria, but in infection caused by Gram-positive strains, deeper analysis is necessary in order to achieve optimal results.

  3. Improving antibiotic use for complicated urinary tract infections

    NARCIS (Netherlands)

    Spoorenberg, V.

    2014-01-01

    Guidelines for antimicrobial treatment are important in the process of improving antibiotic use, because they describe appropriate antibiotic use. In this thesis, we demonstrated the value of appropriate antibiotic use (i.e. guideline adherence) in patients with a complicated urinary tract infection

  4. Primary Epstein-Barr virus infection with neurological complications

    NARCIS (Netherlands)

    Bathoorn, Erik; Vlaminckx, Bart J. M.; Schoondermark-Stolk, Sung; Donders, Richard; Van Der Meulen, Marjon; Thijsen, Steven F. T.

    Several case studies have reported on neurological complications caused by a primary Epstein-Barr virus (EBV) infection. We aimed to investigate the viral loads and the clinical and inflammatory characteristics of this disease entity. We evaluated all 84 cases in which the EBV polymerase chain

  5. Primary Epstein-Barr virus infection with neurological complications

    NARCIS (Netherlands)

    Bathoorn, E.; Vlaminckx, B.J.; Schoondermark-Stolk, S.; Donders, R.; Meulen, M. van der; Thijsen, S.F.

    2011-01-01

    Several case studies have reported on neurological complications caused by a primary Epstein-Barr virus (EBV) infection. We aimed to investigate the viral loads and the clinical and inflammatory characteristics of this disease entity. We evaluated all 84 cases in which the EBV polymerase chain

  6. 77 FR 11133 - Draft Guidance for Industry on Complicated Urinary Tract Infections: Developing Drugs for...

    Science.gov (United States)

    2012-02-24

    ...] Draft Guidance for Industry on Complicated Urinary Tract Infections: Developing Drugs for Treatment... Urinary Tract Infections: Developing Drugs for Treatment.'' The purpose of this guidance is to assist sponsors in the clinical development of drugs for the treatment of complicated urinary tract infections (c...

  7. Zika virus infection in pregnancy: a systematic review of disease course and complications.

    Science.gov (United States)

    Chibueze, Ezinne C; Tirado, Veronika; Lopes, Katharina da Silva; Balogun, Olukunmi O; Takemoto, Yo; Swa, Toshiyuki; Dagvadorj, Amarjargal; Nagata, Chie; Morisaki, Naho; Menendez, Clara; Ota, Erika; Mori, Rintaro; Oladapo, Olufemi T

    2017-02-28

    To characterize maternal Zika virus (ZIKV) infection and complement the evidence base for the WHO interim guidance on pregnancy management in the context of ZIKV infection. We searched the relevant database from inception until March 2016. Two review authors independently screened and assessed full texts of eligible reports and extracted data from relevant studies. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) and the National Institute of Health (NIH) tool for observational studies and case series/reports, respectively. Among 142 eligible full-text articles, 18 met the inclusion criteria (13 case series/reports and five cohort studies). Common symptoms among pregnant women with suspected/confirmed ZIKV infection were fever, rash, and arthralgia. One case of Guillain-Barré syndrome was reported among ZIKV-infected mothers, no other case of severe maternal morbidity or mortality reported. Complications reported in association with maternal ZIKV infection included a broad range of fetal and newborn neurological and ocular abnormalities; fetal growth restriction, stillbirth, and perinatal death. Microcephaly was the primary neurological complication reported in eight studies, with an incidence of about 1% among newborns of ZIKV infected women in one study. Given the extensive and variable fetal and newborn presentations/complications associated with prenatal ZIKV infection, and the dearth of information provided, knowledge gaps are evident. Further research and comprehensive reporting may provide a better understanding of ZIKV infection in pregnancy and attendant maternal/fetal complications. This knowledge could inform the creation of effective and evidence-based strategies, guidelines and recommendations aimed at the management of maternal ZIKV infection. Adherence to current best practice guidelines for prenatal care among health providers is encouraged, in the context of maternal ZIKV infection.

  8. Nocardia brasiliensis Infection Complicating Cryptogenic Organizing Pneumonia.

    Science.gov (United States)

    Fernandes, Alison M; Sluzevich, Jason C; Mira-Avendano, Isabel

    2017-01-01

    Pulmonary nocardiosis is a severe and uncommon opportunistic infection caused by Nocardia species. We present a patient with cryptogenic organizing pneumonia who was receiving long-term immunosuppressive therapy, whose treatment course was complicated by cutaneous and pulmonary nocardiosis. Tissue cultures confirmed Nocardia brasiliensis . Nocardiosis should be a diagnostic consideration for patients treated with long-term immunosuppression who have worsening pulmonary symptoms and relapsing pustular skin lesions.

  9. Nocardia brasiliensis Infection Complicating Cryptogenic Organizing Pneumonia

    OpenAIRE

    Fernandes, Alison M.; Sluzevich, Jason C.; Mira-Avendano, Isabel

    2017-01-01

    Pulmonary nocardiosis is a severe and uncommon opportunistic infection caused by Nocardia species. We present a patient with cryptogenic organizing pneumonia who was receiving long-term immunosuppressive therapy, whose treatment course was complicated by cutaneous and pulmonary nocardiosis. Tissue cultures confirmed Nocardia brasiliensis. Nocardiosis should be a diagnostic consideration for patients treated with long-term immunosuppression who have worsening pulmonary symptoms and relapsing p...

  10. Early rise in C-reactive protein is a marker for infective complications in laparoscopic colorectal surgery.

    LENUS (Irish Health Repository)

    Nason, Gregory J

    2014-02-01

    Infective complications are the most significant cause of morbidity associated with elective colorectal surgery. It can sometimes be difficult to differentiate complications from the normal postoperative course. C-reactive protein (CRP) is an acute phase reactant which has been reported to be predictive of postoperative infective complications.

  11. Nocardia brasiliensis Infection Complicating Cryptogenic Organizing Pneumonia

    Directory of Open Access Journals (Sweden)

    Alison M. Fernandes

    2017-01-01

    Full Text Available Pulmonary nocardiosis is a severe and uncommon opportunistic infection caused by Nocardia species. We present a patient with cryptogenic organizing pneumonia who was receiving long-term immunosuppressive therapy, whose treatment course was complicated by cutaneous and pulmonary nocardiosis. Tissue cultures confirmed Nocardia brasiliensis. Nocardiosis should be a diagnostic consideration for patients treated with long-term immunosuppression who have worsening pulmonary symptoms and relapsing pustular skin lesions.

  12. Omental Herniation: A Rare Complication of Vacuum-Assisted Closure of Infected Sternotomy Wound

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    Philemon Gukop

    2012-01-01

    Full Text Available Vacuum-assisted closure (VAC has recently been adopted as an acceptable modality for management of sternotomy wound infections. Although generally efficacious, the use of negative pressure devices has been associated with complications such as bleeding, retention of sponge, and empyema. We report the first case of greater omental hernia as a rare complication of vacuum-assisted closure of sternal wound infection following coronary artery bypass grafting.

  13. Surgical Complications of Bacille Calmette-Guérin (BCG) Infection in ...

    African Journals Online (AJOL)

    Surgical Complications of Bacille Calmette-Guérin (BCG) Infection in HIV infected children. J Karpelowsky, A Alexander, SD Peek, A Millar, H Rode. Abstract. Aim. Bacille Calmette-Guérin (BCG) immunisation is well established as part of the South African national expanded programme for immunisation (EPI). The World ...

  14. Doripenem in hospital infections: a focus on nosocomial pneumonia, complicated intra-abdominal infections, and complicated urinary tract infections

    Directory of Open Access Journals (Sweden)

    Tze Shien Lo

    2009-06-01

    Full Text Available Tze Shien Lo,1 Stephanie M Borchardt,2 Justin M Welch,3 Melissa A Rohrich,3 Augusto M Alonto,4 Anne V Alonto51Infectious Diseases Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 2Research Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 3Pharmacy Service, Veterans Administration Medical Center, Fargo, North Dakota, USA; 4Infectious Diseases Department, MeritCare Medical Center, Fargo, North Dakota, USA; 5Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USAAbstract: Doripenem is the latest carbapenem on the market to date. Although not an antibiotic in a new class, it offers a glimmer of hope in combating serious infections secondary to multidrug-resistant Gram-negative bacteria when we have not seen a new class of antibacterial, particularly for Gram-negative bacteria, for more than 10 years. In vitro, doripenem exhibits a broad spectrum of activity against Gram-positive and Gram-negative bacteria, including extended-spectrum β-lactamase (ESBL and Amp-C β-lactamase producing Enterobacteriaceae and anaerobes. Doripenem also exhibits better in vitro activity against Pseudomonas aeruginosa compared to other anti-pseudomonal carbapenems. It combines the desirable activities of both imipenem and meropenem. It has similar activity to imipenem against Gram-positive pathogens and has the antimicrobial spectrum of meropenem against Gram-negative organisms. Several randomized clinical trials have demonstrated that doripenem is non-inferior to meropenem, imipenem, piperacillin/tazobactam, or levofloxacin in its efficacy and safety profile in treating a wide range of serious bacterial infections including intra-abdominal infection, complicated urinary tract infection, and nosocomial pneumonia. Due to its wide spectrum of activity and good safety profile it is susceptible to misuse leading to increasing rates of resistance

  15. Genital herpes simplex virus infections: clinical manifestations, course, and complications.

    Science.gov (United States)

    Corey, L; Adams, H G; Brown, Z A; Holmes, K K

    1983-06-01

    The clinical course and complications of 268 patients with first episodes and 362 with recurrent episodes of genital herpes infection were reviewed. Symptoms of genital herpes were more severe in women than in men. Primary first-episode genital herpes was accompanied by systemic symptoms (67%), local pain and itching (98%), dysuria (63%), and tender adenopathy (80%). Patients presented with several bilaterally distributed postular ulcerative lesions that lasted a mean of 19.0 days. Herpes simplex virus was isolated from the urethra, cervix, and pharynx of 82%, 88%, and 13% of women with first-episode primary genital herpes, and the urethra and pharynx of 28% and 7% of men. Complications included aseptic meningitis (8%), sacral autonomic nervous system dysfunction (2%), development of extragenital lesions (20%), and secondary yeast infections (11%). Recurrent episodes were characterized by small vesicular or ulcerative unilaterally distributed lesions that lasted a mean of 10.1 days. Systemic symptoms were uncommon and 25% of recurrent episodes were asymptomatic. The major concerns of patients were the frequency of recurrences and fear of transmitting infection to partners or infants.

  16. Refractory ulcerative colitis complicated by cytomegalovirus infection successfully treated with valganciclovir

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    Tiziana Larussa

    2012-11-01

    Full Text Available Cytomegalovirus (CMV infection is widespread in the general population. In patients with severe and/or steroid-refractory ulcerative colitis (UC, local reactivation of CMV can be detected in actively inflamed colonic tissue in approximately 30% of cases. However, the role of CMV in patients with UC is not clearly understood. There is evidence to show a possible role in exacerbating a colitis flare, whereas other studies describe CMV as an innocent bystander. We report the case of a patient with severe UC complicated by CMV infection who did not respond to conventional therapy. A complete diagnostic panel for CMV diagnosis, including tissue polymerase chain reaction and immunohistochemistry, was carried out. Three-week therapy with oral valganciclovir resulted in dramatic clinical and endoscopic improvement. Timing of diagnosis and treatment of CMV infection complicating UC is crucial in order to recognize the organ-disease and plan appropriate treatment.

  17. Prosthetic joint infection-a devastating complication of hemiarthroplasty for hip fracture.

    Science.gov (United States)

    Guren, Ellen; Figved, Wender; Frihagen, Frede; Watne, Leiv Otto; Westberg, Marianne

    2017-08-01

    Background and purpose - Hemiarthroplasty is the most common treatment in elderly patients with displaced femoral neck fracture. Prosthetic joint infection (PJI) is a feared complication. The infection rate varies in the literature, and there are limited descriptive data available. We investigated the characteristics and outcome of PJI following hemiarthroplasty over a 15-year period. Patients and methods - Patients with PJI were identified among 519 patients treated with hemiarthroplasty for a femoral neck fracture at Oslo University Hospital between 1998 and 2012. We used prospectively registered data from previous studies, and recorded additional data from the patients' charts when needed. Results - Of the 519 patients, we identified 37 patients (6%) with early PJI. 20 of these 37 patients became free of infection. Soft tissue debridement and retention of implant was performed in 35 patients, 15 of whom became free of infection with an intact arthroplasty. The 1-year mortality rate was 15/37. We found an association between 1-year mortality and treatment failure (p = 0.001). Staphylococcus aureus and polymicrobial infection were the most common microbiological findings, each accounting for 14 of the 37 infections. Enterococcus spp. was found in 9 infections, 8 of which were polymicrobial. There was an association between polymicrobial infection and treatment failure, and between polymicrobial infection and 1-year mortality. Interpretation - PJI following hemiarthroplasty due to femoral neck fracture is a devastating complication in the elderly. We found a high rate of polymicrobial PJIs frequently including Enterococcus spp, which is different from what is common in PJI after elective total hip arthroplasty.

  18. State infants after perinatal complications prevention by mother with the association of HIV and herpes virus infection

    OpenAIRE

    Zhdanovich O.I.; Anoshyna T.M.; Kolomiichenko T.V.

    2016-01-01

    Relevance. Complicated and little studied issue is the perinatal complications prevention in pregnant women with HIV and herpes virus infections (GI) The goal — to evaluate the effectiveness of the system of perinatal complications prevention during the association of HIV and herpes infection. Materials and methods. Selected 60 HIV-infected pregnant women with the GI, which divided into 2 groups: primary — 30 pregnant women with the use of recommended prophylaxis complex (specific immunogl...

  19. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

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    Sartelli Massimo

    2012-11-01

    Full Text Available Abstract The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152. According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation, a delayed initial intervention (a delay exceeding 24 hours, sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs throughout Europe.

  20. Cross-sectional imaging of complicated urinary infections affecting the lower tract and male genital organs

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    Massimo Tonolini

    2016-06-01

    Full Text Available Abstract Complicated urinary tract infections (C-UTIs are those associated with structural or functional genitourinary abnormalities or with conditions that impair the host defence mechanisms, leading to an increased risk of acquiring infection or failing therapy. C-UTIs occur in patients with risk factors such as neurogenic dysfunction, bladder outlet obstruction, obstructive uropathy, bladder catheterisation, urologic instrumentation or indwelling stent, urinary tract post-surgical modifications, chemotherapy- or radiation-induced damage, renal impairment, diabetes and immunodeficiency. Multidetector CT and MRI allow comprehensive investigation of C-UTIs and systemic infection from an unknown source. Based upon personal experience at a tertiary care hospital focused on the treatment of infectious illnesses, this pictorial essay reviews with examples the clinical features and cross-sectional imaging findings of C-UTIs affecting the lower urinary tract and male genital organs. The disorders presented include acute infectious cystitis, bladder mural abscesses, infections of the prostate and seminal vesicles, acute urethritis and related perineal abscesses, funiculitis, epididymo-orchitis and scrotal abscesses. Emphasis is placed on the possible differential diagnoses of lower C-UTIs. The aim is to provide radiologists greater familiarity with these potentially severe disorders which frequently require intensive in-hospital antibiotic therapy, percutaneous drainage or surgery. Teaching Points • Complicated urinary tract infections occur in patients with structural or functional risk factors. • CT and MRI comprehensively investigate complicated urinary infections and sepsis from unknown sources. • Infections of the urinary bladder, prostate, seminal vesicles, urethra and scrotum are presented. • Emphasis is placed on differential diagnoses of complicated lower urogenital infections. • Unsuspected urinary infections may be detected on CT

  1. Research Progress on Systemic Lupus Erythematosus Complicated with Infection

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    Zhang Weisan

    2015-06-01

    Full Text Available In recent years, in treatment standardization of systemic lupus erythematosus (SLE, infections and serious complications became the leading cause of death related to this disease, exceeding those of renal involvement and lupus encephalopathy. SLE coinfection is mainly related to defects in humoral immunity and cellular immunity, SLE disease activity, and doses of hormone and immune inhibitors.

  2. Contemporary management of infected necrosis complicating severe acute pancreatitis

    Science.gov (United States)

    Jamdar, Saurabh; Siriwardena, Ajith K

    2006-01-01

    Pancreatic necrosis complicating severe acute pancreatitis is a challenging scenario in contemporary critical care practice; it requires multidisciplinary care in a setting where there is a relatively limited evidence base to support decision making. This commentary provides a concise overview of current management of patients with infected necrosis, focusing on detection, the role of pharmacologic intervention, and the timing and nature of surgical interventions. Fine-needle aspiration of necrosis remains the mainstay for establishment of infection. Pharmacological intervention includes antibiotic therapy as an adjunct to surgical debridement/drainage and, more recently, drotrecogin alfa. Specific concerns remain regarding the suitability of drotrecogin alfa in this setting. Early surgical intervention is unhelpful; surgery is indicated when there is strong evidence for infection of necrotic tissue, with the current trend being toward 'less drastic' surgical interventions. PMID:16356213

  3. Antibiotic Resistance in Children with Recurrent or Complicated Urinary Tract Infection

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    Nidal S Younish

    2009-01-01

    Pediatric urine culture isolates are becoming increasingly resistant to commonly used antibiotics. Empirical treatment with Trimethoprim-Sulfamethoxazole (TMP-SMX or Cephalexin as the initial drug is ineffective. Nitrofurantoin and Nalidixic acid can be considered as the first line antibiotics for prophylaxis and or treatment of patients with recurrent UTI, while Meropenam and Ciprofloxacin can be used empirically in treating patients with complicated UTI. Key words: Antibiotic resistance, Complicated, Recurrent, Urinary tract infection

  4. [Neurological complications of infective endocarditis in Burkina Faso. Clinical features, management and evolutionary profile].

    Science.gov (United States)

    Yaméogo, N V; Seghda, A; Kagambèga, L J; Diallo, O; Millogo, G R C; Toguyéni, B J Y; Samadoulougou, A K; Niakara, A; Simporé, J; Zabsonré, P

    2015-04-01

    Neurological complications are the most frequent extracardiac complications of infective endocarditis (IE). This study aimed to describe the epidemiological, clinical and paraclinical aspects, and outcome of neurological complications of infective endocarditis in three hospitals in the city of Ouagadougou in Burkina Faso. From 1 January 2009 to 31 December 2012, we included all patients suffering from IE and selected those in whom a neurological complication was objectified. Neurological involvement was sought on clinical examination but especially CT brain (ischemic infarcts, hemorrhages, aneurysms and abscesses). Blood cultures were systematic. Echocardiography was done for vegetations and characteristics. Among 63 cases of IE, neurological complications were found in 14 patients (22.2%). The average age of patients with neurological complications was 37.4 ± 5.8 years. The sex ratio was 1.3 for women. Neurological damage consisted of nine cases of stroke (64.3%), three cases of hemorrhagic stroke (21.4%) and two cases of brain abscess (14.3%). Neurological complications had already occurred before hospitalization in 4 cases. Blood cultures were positive in 8 cases. Germs found were predominantly Staphylococcus aureus (5 cases) and Streptococcus a- viridans (2 cases). All cases of S. aureus were complicated by stroke. At echocardiography, vegetation was found in all cases. It was found on the mitral in 7 cases, the aorta in 3 cases, the mitral and aortic in 2 cases and the mitral and tricuspid in 2 cases also. The EI had occurred on a native valve in 11 cases, prosthesis in 4 cases (2 mitral and 2 aortic). The vegetations average diameter was 11.2 ± 2.1 mm (6.4 and 1 7.7 mm). Vegetations were mobile in 12 cases. The treatment consisted of antibiotics adapted to the antibiogram, neurological and cardiovascular monitoring. The evolution was marked by seven deaths (50%), including 5 deaths related to cerebral complication (71.4% of deaths). This study shows that

  5. Immunopathogenesis of Hepatitis B Virus Infection and Related Complications

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    Mankgopo M. Kgatle

    2016-05-01

    Full Text Available Chronic hepatitis B (CHB is a serious consequence of hepatitis B virus (HBV, which infects and replicates in the liver. It is characterised by prolonged hepatitis B surface antigen seropositivity; this can lead to both cirrhosis and hepatocellular carcinoma (HCC. The infection begins when HBV binds its only known functional receptor, sodium taurocholate cotransporting polypeptide (NTCP, which was identified recently. The discovery of NTCP was a significant breakthrough in the field of HBV research, and has facilitated the establishment of a susceptible hepatoma cell line model for studying the mechanisms underlying HBV pathogenesis. Following productive HBV infection, both cellular and humoral immune cells and molecules, such as T cells and chemokines, are activated to resolve infection by destroying HBV-infected hepatocytes. However, host immunity to HBV is not always protective, most likely due to immune evasion mechanisms employed by HBV. These mechanisms may result in viral persistence, accumulation of mutations, and aberrant epigenetic alterations that lead to HCC. Here we highlight our current understanding of the HBV replication cycle, immunopathogenesis, and related mechanisms underlying the progression of CHB to advanced liver disease, along with the attendant complications.

  6. Myocardial abscess as a complication of an infected arteriovenous fistula: autopsy report

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    Cristiane Rúbia Ferreira

    2011-09-01

    Full Text Available Myocardial abscess is a severe and life-threatening infectious complication thatis commonly but not exclusively associated with infective endocarditis. It mayalso be developed in necrotic myocardial tissue, post trauma, in septic burnpatients, in transplanted heart, in ventricular aneurysm and post angioplasty.Patients on hemodialysis are prone to bacteremia, and infectious complicationsoccur in 48-73% of cases. Myocardial abscess is a rare complication of aninfected arteriovenous fistula. We present an autopsy report of a hemodialysispatient who had an arteriovenous fistula with a polytetrafluoroethylene graftwhere a local infection developed. The patient presented with fever and toxemia.On post-admission day 2, he unexpectedly suffered sudden cardiopulmonaryarrest and died. The autopsy revealed a myocardial abscess, near a branch ofthe left coronary artery, with septic embolism.

  7. Placental vascular complications in HIV-infected pregnant women: a case-control study

    OpenAIRE

    CANLORBE, Geoffroy

    2012-01-01

    Background: Data from international literature suggest a link between HIV infection and placental vascular complications during pregnancy. Current studies on the subject are conflicting.Objective: The aim of the study was to evaluate the incidence of placental vascular complications during pregnancy among HIV+ and HIV- patients.Study Design: It is a single-center case-control study comparing the rates of gestational hypertension, preeclampsia, eclampsia and vascular intrauterine growth retard...

  8. Cholecystitis and nephrotic syndrome complicating Epstein-Barr virus primary infection.

    Science.gov (United States)

    Rodà, Diana; Huici, Malka; Ricart, Sílvia; Vila, Jordi; Fortuny, Clàudia; Alsina, Laia

    2017-02-01

    Epstein-Barr virus (EBV) infection results in a spectrum of clinical manifestations. The host immune response to EBV plays a key role in the extent and degree of clinical features, which in children under 4 years of age are usually mild, non-specific and self-limiting. A 2-year-old boy in whom no known immune disorder could be found presented with acute acalculous cholecystitis, renal dysfunction with massive proteinuria, ascites, pleural effusion, minimal peripheral oedema and a severe systemic inflammatory response. Improvement occurred after initiation of corticosteroids and antiviral treatment with gancyclovir. In severely symptomatic or complicated EBV infection, a primary immunodeficiency must be suspected. If a primary immunodeficiency has been ruled out, the correct management of severe EBV infection in the immunocompetent host remains controversial.

  9. Opportunistic Infections and Complications in Human Immunodeficiency Virus-1-Infected Children: Correlation with immune status

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    Jaivinder Yadav

    2014-10-01

    Full Text Available Objectives: The aim of this study was to ascertain the correlation between various opportunistic infections and complications in human immunodeficiency virus (HIV-1-infected children and the immune status of these patients, evaluated by absolute cluster of differentiation 4 (CD4 count and CD4 percentage. Methods: This study was conducted from January 2009 to June 2010 at the Antiretroviral Treatment Centre of the Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, a tertiary care hospital in Rohtak, Haryana, in northern India. A total of 20 HIV-1-infected children aged 4–57 months were studied. Demographic and baseline investigations were performed prior to the start of highly active antiretroviral therapy (HAART. A fixed-dose combination of HAART was given based on the patient’s weight. Baseline investigations were repeated after six months of HAART. Results: There was a significant increase in the patients’ haemoglobin, weight, height and CD4 count after six months of HAART. Significant improvements (P <0.05 were also noted in the patients’ immune status, graded according to the World Health Organization. Conclusion: This study observed that the severity and frequency of opportunistic complications in paediatric patients with HIV-1 increased with a fall in the CD4 count. The treatment of opportunistic infections, along with antiretroviral therapy, may lead to both clinical and immunological recovery as well as a decreased incidence of future opportunistic infections. The CD4 count may give treating physicians an initial idea about the immune status of each child and could also be used as a biological marker of HAART efficacy. Patient compliance must be ensured during HAART as this is a key factor in improving outcomes.

  10. The Role of Chronic Mesh Infection in Delayed-Onset Vaginal Mesh Complications or Recurrent Urinary Tract Infections: Results From Explanted Mesh Cultures.

    Science.gov (United States)

    Mellano, Erin M; Nakamura, Leah Y; Choi, Judy M; Kang, Diana C; Grisales, Tamara; Raz, Shlomo; Rodriguez, Larissa V

    2016-01-01

    Vaginal mesh complications necessitating excision are increasingly prevalent. We aim to study whether subclinical chronically infected mesh contributes to the development of delayed-onset mesh complications or recurrent urinary tract infections (UTIs). Women undergoing mesh removal from August 2013 through May 2014 were identified by surgical code for vaginal mesh removal. Only women undergoing removal of anti-incontinence mesh were included. Exclusion criteria included any women undergoing simultaneous prolapse mesh removal. We abstracted preoperative and postoperative information from the medical record and compared mesh culture results from patients with and without mesh extrusion, de novo recurrent UTIs, and delayed-onset pain. One hundred seven women with only anti-incontinence mesh removed were included in the analysis. Onset of complications after mesh placement was within the first 6 months in 70 (65%) of 107 and delayed (≥6 months) in 37 (35%) of 107. A positive culture from the explanted mesh was obtained from 82 (77%) of 107 patients, and 40 (37%) of 107 were positive with potential pathogens. There were no significant differences in culture results when comparing patients with delayed-onset versus immediate pain, extrusion with no extrusion, and de novo recurrent UTIs with no infections. In this large cohort of patients with mesh removed for a diverse array of complications, cultures of the explanted vaginal mesh demonstrate frequent low-density bacterial colonization. We found no differences in culture results from women with delayed-onset pain versus acute pain, vaginal mesh extrusions versus no extrusions, or recurrent UTIs using standard culture methods. Chronic prosthetic infections in other areas of medicine are associated with bacterial biofilms, which are resistant to typical culture techniques. Further studies using culture-independent methods are needed to investigate the potential role of chronic bacterial infections in delayed vaginal mesh

  11. The Netherlands Chlamydia cohort study (NECCST) protocol to assess the risk of late complications following Chlamydia trachomatis infection in women.

    Science.gov (United States)

    Hoenderboom, B M; van Oeffelen, A A M; van Benthem, B H B; van Bergen, J E A M; Dukers-Muijrers, N H T M; Götz, H M; Hoebe, C J P A; Hogewoning, A A; van der Klis, F R M; van Baarle, D; Land, J A; van der Sande, M A B; van Veen, M G; de Vries, F; Morré, S A; van den Broek, I V F

    2017-04-11

    Chlamydia trachomatis (CT), the most common bacterial sexually transmitted infection (STI) among young women, can result in serious sequelae. Although the course of infection is often asymptomatic, CT may cause pelvic inflammatory disease (PID), leading to severe complications, such as prolonged time to pregnancy, ectopic pregnancy, and tubal factor subfertility. The risk of and risk factors for complications following CT-infection have not been assessed in a long-term prospective cohort study, the preferred design to define infections and complications adequately. In the Netherlands Chlamydia Cohort Study (NECCST), a cohort of women of reproductive age with and without a history of CT-infection is followed over a minimum of ten years to investigate (CT-related) reproductive tract complications. This study is a follow-up of the Chlamydia Screening Implementation (CSI) study, executed between 2008 and 2011 in the Netherlands. For NECCST, female CSI participants who consented to be approached for follow-up studies (n = 14,685) are invited, and prospectively followed until 2022. Four data collection moments are foreseen every two consecutive years. Questionnaire data and blood samples for CT-Immunoglobulin G (IgG) measurement are obtained as well as host DNA to determine specific genetic biomarkers related to susceptibility and severity of infection. CT-history will be based on CSI test outcomes, self-reported infections and CT-IgG presence. Information on (time to) pregnancies and the potential long-term complications (i.e. PID, ectopic pregnancy and (tubal factor) subfertility), will be acquired by questionnaires. Reported subfertility will be verified in medical registers. Occurrence of these late complications and prolonged time to pregnancy, as a proxy for reduced fertility due to a previous CT-infection, or other risk factors, will be investigated using longitudinal statistical procedures. In the proposed study, the occurrence of late complications following

  12. Saving the limb in diabetic patients with ischemic foot lesions complicated by acute infection.

    Science.gov (United States)

    Clerici, Giacomo; Faglia, Ezio

    2014-12-01

    Ischemia and infection are the most important factors affecting the prognosis of foot ulcerations in diabetic patients. To improve the outcome of these patients, it is necessary to aggressively treat 2 important pathologies--namely, occlusive arterial disease affecting the tibial and femoral arteries and infection of the ischemic diabetic foot. Each of these 2 conditions may lead to major limb amputation, and the presence of both critical limb ischemia (CLI) and acute deep infection is a major risk factor for lower-extremity amputation. Thus, the management of diabetic foot ulcers requires specific therapeutic approaches that vary significantly depending on whether foot lesions are complicated by infection and/or ischemia. A multidisciplinary team approach is the key to successful treatment of a diabetic foot ulcer: ischemic diabetic foot ulcers complicated by acute deep infection pose serious treatment challenges because high levels of skill, organization, accuracy, and timing of intervention are required to maximize the chances of limb salvage: these complex issues are better managed by a multidisciplinary clinical group. © The Author(s) 2014.

  13. Combined diabetic foot infections treatment, complicated by foot phlegmon

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    Yavruyan O.A.

    2017-01-01

    Full Text Available the article shows the analysis of treatment results of 163 patients with diabetic foot infections, complicated by foot phlegmon. Patients were divided into 2 groups. The control group received traditional treatment and had an autopsy deep plantar space done and then, during the second phase, cytokine-rich autoplatelet concentrate had been applied. The research results confirmed a significant decrease in the duration of treatment and hospitalization of patients in the hospital.

  14. Anterior Cervical Infection: Presentation and Incidence of an Uncommon Postoperative Complication.

    Science.gov (United States)

    Ghobrial, George M; Harrop, James S; Sasso, Rick C; Tannoury, Chadi A; Tannoury, Tony; Smith, Zachary A; Hsu, Wellington K; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; De Giacomo, Anthony F; Jobse, Bruce C; Rahman, Ra'Kerry K; Thompson, Sara E; Riew, K Daniel

    2017-04-01

    Retrospective multi-institutional case series. The anterior cervical discectomy and fusion (ACDF) affords the surgeon the flexibility to treat a variety of cervical pathologies, with the majority being for degenerative and traumatic indications. Limited data in the literature describe the presentation and true incidence of postoperative surgical site infections. A retrospective multicenter case series study was conducted involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network, selected for their excellence in spine care and clinical research infrastructure and experience. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, inclusive, were reviewed to identify the occurrence of 21 predefined treatment complications. Patients who underwent an ACDF were identified in the database and reviewed for the occurrence of postoperative anterior cervical infections. A total of 8887 patients were identified from a retrospective database analysis of 21 centers providing data for postoperative anterior cervical infections (17/21, 81% response rate). A total of 6 postoperative infections after ACDF were identified for a mean rate of 0.07% (range 0% to 0.39%). The mean age of patients identified was 57.5 (SD = 11.6, 66.7% female). The mean body mass index was 22.02. Of the total infections, half were smokers (n = 3). Two patients presented with myelopathy, and 3 patients presented with radiculopathic-type complaints. The mean length of stay was 4.7 days. All patients were treated aggressively with surgery for management of this complication, with improvement in all patients. There were no mortalities. The incidence of postoperative infection in ACDF is exceedingly low. The management has historically been urgent irrigation and debridement of the surgical site. However, due to the rarity of this occurrence, guidance for management is limited to

  15. Predicting a complicated course of Clostridium difficile infection at the bedside

    NARCIS (Netherlands)

    Hensgens, M. P. M.; Dekkers, O. M.; Goorhuis, A.; LeCessie, S.; Kuijper, E. J.

    2014-01-01

    Clostridium difficile infections (CDIs) are a common cause of antibiotic-associated diarrhoea and associated with CDI-related mortality in c. 10%. To date, there is no prediction model in use that guides clinicians to identify patients at high risk for complicated CDI. From 2006 to 2009, nine Dutch

  16. [Pylephlebitis: a rare but possible complication of intra-abdominal infections].

    Science.gov (United States)

    Pérez-Bru, Susana; Nofuentes-Riera, Carmen; García-Marín, Andrés; Luri-Prieto, Paloma; Morales-Calderón, Miguel; García-García, Salvador

    2015-01-01

    Pylephlebitis or septic thrombophlebitis of the portal venous system is a rare but serious complication of intra-abdominal infections which drain into the portal venous system. Its diagnosis is based on clinical suspicion and imaging tests, mainly a computed tomography scan, given the lack of specificity of the signs and symptoms. Spread of septic emboli is the major cause of morbidity and mortality. The aim of the study was to analyse patients diagnosed in our hospital. Retrospective descriptive study of patients diagnosed with pylephlebitis in our hospital. Four patients were included, 3 men and one woman. In 3 cases it was acute cholecystitis that led to the diagnosis of pylephlebitis at the same time as the intra-abdominal infection. Emergency surgery was performed in one case, whilst the other 2 were treated conservatively. Blood cultures were performed in all cases, and empirical antibiotic treatment was used. In the only case of acute appendicitis, diagnosis of pylephlebitis was achieved during the study of postoperative fever, with empirical antibiotic treatment also being started. The haematologist was requested to start the required anticoagulation therapy in all cases. Pylephlebitis is a rare complication of intra-abdominal infections that may make lead to a worse outcome. A high level of suspicion is required as well as imaging tests to make an early diagnosis and appropriate treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  17. Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

    Directory of Open Access Journals (Sweden)

    Afessa Bekele

    2001-09-01

    Full Text Available Abstract Background A prospective observational study was done to describe nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus (HIV infection. Methods The study included 1,225 consecutive hospital admissions of 599 HIV-infected patients treated from April 1995 through March 1998. Data included demographics, risk factors for HIV infection, Acute Physiology and Chronic Health Evaluation (APACHE II score, pulmonary complications, CD4+ lymphocyte count, hospital stay and case-fatality rate. Results Patient age (mean ± SD was 38.2 ± 8.9 years, 62% were men, and 84% were African American. The median APACHE II score was 14, and median CD4+ lymphocyte count was 60/μL. Pulmonary complications were Pneumocystis carinii pneumonia (85 in 78 patients, Mycobacterium avium complex (51 in 38, Mycobacterium tuberculosis (40 in 35, Mycobacterium gordonae (11 in 11, Mycobacterium kansasii (10 in 9, Cytomegalovirus (10 in 10, Nocardia asteroides (3 in 3, fungus ball (2 in 2, respiratory syncytial virus (1, herpes simplex virus (1, Histoplasma capsulatum (1, lymphoma (3 in 3, bronchogenic carcinoma (2 in 2, and Kaposi sarcoma (1. The case-fatality rate of patients was 11% with Pneumocystis carinii pneumonia; 5%, Mycobacterium tuberculosis; 6%, Mycobacterium avium complex; and 7%, noninfectious pulmonary complications. Conclusion Most pulmonary complications in hospitalized patients with HIV are from Pneumocystis and mycobacterial infection.

  18. Sinonasal Fungal Infections and Complications: A Pictorial Review

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    Jose Gavito-Higuera

    2016-01-01

    Full Text Available Fungal infections of the nose and paranasal sinuses can be categorized into invasive and non-invasive forms. The clinical presentation and course of the disease is primarily determined by the immune status of the host and can range from harmless or subtle presentations to life threatening complications. Invasive fungal infections are categorized into acute, chronic or chronic granulomatous entities. Immunocompromised patients with poorly controlled diabetes mellitus, HIV and patients receiving chemotherapy or chronic oral corticosteroids are mostly affected. Mycetoma and Allergic Fungal Rhinosinusitis are considered non-invasive forms. Computer tomography is the gold-standard in sinonasal imaging and is complimented by Magnetic resonance imaging (MRI as it is superior in the evaluation of intraorbital and intracranial extensions. The knowledge and identification of the characteristic imaging patterns in invasive - and non- invasive fungal rhinosinusitis is crucial and the radiologist plays an important role in refining the diagnosis to prevent a possible fatal outcome.

  19. State infants after perinatal complications prevention by mother with the association of HIV and herpes virus infection

    Directory of Open Access Journals (Sweden)

    Zhdanovich O.I.

    2016-12-01

    Full Text Available Relevance. Complicated and little studied issue is the perinatal complications prevention in pregnant women with HIV and herpes virus infections (GI The goal — to evaluate the effectiveness of the system of perinatal complications prevention during the association of HIV and herpes infection. Materials and methods. Selected 60 HIV-infected pregnant women with the GI, which divided into 2 groups: primary — 30 pregnant women with the use of recommended prophylaxis complex (specific immunoglobulins, interferon α-2β, flavonoids, probiotics, arginine glutamat, the comparison group — 30 pregnant women with the knowledge of the pregnancy according to the Ministry of Health reports. Results. After recommended treatment course significantly improving the condition of children at birth: in satisfactory condition (without asphyxia was born 60.0 against 37.9% of children (p<0.05. Relatively better and during the period of early neonatal adaptation: 1.5–2 times lower than the frequency of jaundice, hemorrhagic syndrome, and gastrointestinal. Significantly reduces the incidence of life-threatening syndromes and further development of the child as neurological (up 23.3% vs. 44.8%, p<0.05 and RDS (up 16.7% vs. 37.9%, p<0.05. Conclusions. Security and high efficiency of the proposed complex of perinatal complications prevention for HIV-infected pregnant women with herpes infection can be recommended for implementation in antenatal clinics and maternity homes.

  20. [Effectiveness of imipenem/cilastatin (Tienam, MSD) in treating complicated infections in urology].

    Science.gov (United States)

    Derevianko, I I; Nefedova, L A; Lavrinova, L N

    2002-01-01

    Complicated urinary infections tend to eventuate in severe pyoseptic complications--bacteriuria, sepsis. The search for methods of fighting agents of urinary infections goes in the direction of perfection of already existing methods and in the direction of design of novel antibacterial drugs. In the middle 1980s the first carbapenem drug-imipenem--was proposed for urological clinical practice. Mechanism of its action as that of the other beta-lactam antibiotics consists in impairment of synthesis of bacterial cell wall as a result of the drug penetration through the surface membrane and irreversible binding with penicillin-binding proteins. Imipenem is active against most gram-positive and gram-negative aerobic and anaerobic microorganisms which cause severe urological infections. The article presents the results of treatment of 45 patients with severe urological infections with multiple resistance of the causing agent and failure of previous treatment. Imipenem was given in a daily dose 1.5-2.0 g. Sometimes a stepwise regimen was used: 500 mg 4 times a day intravenously for the first 3-4 days, then 500 mg twice a day intramuscularly for the following 3-4 days. In detection of highly sensitive bacteria (E. coli, Proteus mirabilis) daily doses were reduced to 1 g. In long standing infection caused by Pseudomonas aeruginosa imipenem was combined with amicacin. In high surgical risk of postoperative period imipenem was given prior to surgery and continued after it for 5 to 14 days. Good therapeutic results were achieved: clinical effect reached 95.5%, antibacterial efficiency was 87.8%. Thus, imipenem is antibiotic of the first line in empirical therapy of severe bacterial infections in urology as it has a wide spectrum of antibacterial action. We believe that this drug should not be left as a reserve but used for a starting empirical therapy of severe infections in urological hospital.

  1. Post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist complicated by a paradoxical reaction during treatment

    Directory of Open Access Journals (Sweden)

    Siong H. Hui

    2015-12-01

    Full Text Available Rapidly growing mycobacterial skin and soft tissue infections are known to complicate cosmetic surgical procedures. Treatment consists of more surgery and prolonged antibiotic therapy guided by drug susceptibility testing. Paradoxical reactions occurring during antibiotic therapy can further complicate treatment of non-tuberculous mycobacterial infections. We report a case of post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist and occurrence of paradox during treatment.

  2. The Relationship Between Osteomyelitis Complication and Drug-Resistant Infection Risk in Diabetic Foot Ulcer: A Meta-analysis.

    Science.gov (United States)

    Chen, Yin; Ding, Hui; Wu, Hua; Chen, Hong-Lin

    2017-09-01

    In this study, we aimed to investigate the relationship between osteomyelitis complications and drug-resistant infection risk in diabetic foot ulcer. Searches of MEDLINE and ISI databases were performed for the studies. Odds ratios (ORs) for drug-resistant infection incidence were calculated for diabetic foot ulcer patients with or without osteomyelitis complications. Eleven studies (12 cohorts) with 1526 patients were included in this study. Meta-analysis showed that the summary OR was 3.343 (95% CI = 2.355-4.745; Z = 6.75, P analysis by only pooled the adjusted ORs showed that the result was robust (the summary OR = 4.081, 95% CI = 2.471-6.739). Subgroup analysis by drug-resistant type showed that the summary OR was 4.391 (95% CI = 2.287-8.394) for methicillin-resistant infection subgroup, and 2.693 (95% CI = 1.882-3.851) for multidrug-resistant infection subgroup. The meta-regression showed that drug-resistant incidence ( t = -0.90, P = .389) and published year ( t = -0.11, P = .913) were not related with the OR changes. In conclusion, our meta-analysis indicates that osteomyelitis complications are related with drug-resistant infection risk in diabetic foot ulcer. We suggest bone culture-based narrow-spectrum antibiotic therapy for osteomyelitis for prevention drug-resistant infection in diabetic foot ulcer.

  3. Radiologic manifestations of extra-cardiac complications of infective endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Colen, Teran W.; Gunn, Martin; Cook, Erin; Dubinsky, Theodore [University of Washington Medical Center, Department of Radiology, 1959 NE Pacific Ave, Box 357115, Seattle, WA (United States)

    2008-11-15

    Infective endocarditis (IE) is a disease with high morbidity and a mortality rate of 9-30%, even with appropriate diagnosis and therapy. Septic emboli, caused by IE, can affect any organ or tissue in the body with an arterial supply and occur in 12-40% of IE cases. The most common extra-cardiac organ system involved in IE is the central nervous system. Other organs frequently involved are the lungs (especially in right-sided IE), spleen, kidneys, liver, and the musculoskeletal system. In addition, the arterial system itself is susceptible to the development of potentially fatal mycotic aneurysms. As extra-cardiac complications often antedate the clinical diagnosis of IE, it is important that the diagnosis is suggested when characteristic findings are encountered during imaging. In addition, imaging is often used to monitor the extent of complications in patients with a known diagnosis of IE. (orig.)

  4. Radiologic manifestations of extra-cardiac complications of infective endocarditis

    International Nuclear Information System (INIS)

    Colen, Teran W.; Gunn, Martin; Cook, Erin; Dubinsky, Theodore

    2008-01-01

    Infective endocarditis (IE) is a disease with high morbidity and a mortality rate of 9-30%, even with appropriate diagnosis and therapy. Septic emboli, caused by IE, can affect any organ or tissue in the body with an arterial supply and occur in 12-40% of IE cases. The most common extra-cardiac organ system involved in IE is the central nervous system. Other organs frequently involved are the lungs (especially in right-sided IE), spleen, kidneys, liver, and the musculoskeletal system. In addition, the arterial system itself is susceptible to the development of potentially fatal mycotic aneurysms. As extra-cardiac complications often antedate the clinical diagnosis of IE, it is important that the diagnosis is suggested when characteristic findings are encountered during imaging. In addition, imaging is often used to monitor the extent of complications in patients with a known diagnosis of IE. (orig.)

  5. Clinical experience of infective endocarditis complicated by acute cerebrovascular accidents.

    Science.gov (United States)

    Hsu, Chan-Yang; Chi, Nai-Hsin; Wang, Shoei-Shen; Chen, Yih-Sharng; Yu, Hsi-Yu

    2017-04-01

    To evaluate the clinical results of patients with infective endocarditis (IE) complicated by acute cerebrovascular accidents (CVAs). A total of 44 patients with IE complicated by CVA at admission were retrospectively analyzed in a single medical institute from 2005 to 2011. At the time of admission, 18 patients were diagnosed with hemorrhagic stroke, and 26 patients were diagnosed with ischemic stroke. Fifteen patients received surgical intervention during hospitalization. The hospital mortality rate was 38.9% for the hemorrhagic stroke group and 42.3% for the ischemic stroke group (p = 0.821). The mortality rate was 33.3% for the surgical group and 44.8% for the nonsurgical group (p = 0.531). At 30 days of hospitalization, 45.8% of the patients experienced an adverse event (defined as death due to organ failure, restroke, cardiogenic shock, or septic shock during the treatment period), and the attrition rate was 1.5% per day. Surgery performed after the adverse events increased mortality (80.0%) compared with surgery performed on patients with no adverse events (10.0%; p = 0.017). A Cox regression analysis revealed that creatinine > 2 mg/dL, diabetes, and staphylococcal infection were the risk factors of the adverse events. Early surgical intervention for IE with ischemic stroke may prevent adverse events, particularly in patients with impaired renal function, diabetes, or staphylococcal infection. A delay in operation of > 30 days is recommended after hemorrhagic stroke. Copyright © 2017. Published by Elsevier Taiwan.

  6. The diagnostic ability of echocardiography for infective endocarditis and its associated complications.

    Science.gov (United States)

    Vilacosta, Isidre; Olmos, Carmen; de Agustín, Alberto; López, Javier; Islas, Fabián; Sarriá, Cristina; Ferrera, Carlos; Ortiz-Bautista, Carlos; Sánchez-Enrique, Cristina; Vivas, David; San Román, Alberto

    2015-11-01

    Echocardiography, transthoracic and transoesophageal, plays a key role in the diagnosis and prognosis assessment of patients with infective endocarditis. It constitutes a major Duke criterion and is pivotal in treatment guiding. Seven echocardiographic findings are major criteria in the diagnosis of infective endocarditis (IE) (vegetation, abscess, pseudoaneurysm, fistulae, new dehiscence of a prosthetic valve, perforation and valve aneurysm). Echocardiography must be performed as soon as endocarditis is suspected. Transoesophageal echocardiography should be done in most cases of left-sided endocarditis to better define the anatomic lesions and to rule out local complications. Transoesophageal echocardiography is not necessary in isolated right-sided native valve IE with good quality transthoracic examination and unequivocal echocardiographic findings. Echocardiography is a very useful tool to assess the prognosis of patients with IE at any time during the course of the disease. Echocardiographic predictors of poor outcome include presence of periannular complications, prosthetic dysfunction, low left ventricular ejection fraction, pulmonary hypertension and very large vegetations.

  7. Cardiac complication after experimental human malaria infection: a case report

    Directory of Open Access Journals (Sweden)

    Druilhe Pierre

    2009-12-01

    Full Text Available Abstract A 20 year-old healthy female volunteer participated in a clinical Phase I and IIa safety and efficacy trial with candidate malaria vaccine PfLSA-3-rec adjuvanted with aluminium hydroxide. Eleven weeks after the third and last immunization she was experimentally infected by bites of Plasmodium falciparum-infected mosquitoes. When the thick blood smear became positive, at day 11, she was treated with artemether/lumefantrine according to protocol. On day 16 post-infection i.e. two days after completion of treatment, she woke up with retrosternal chest pain. She was diagnosed as acute coronary syndrome and treated accordingly. She recovered quickly and her follow-up was uneventful. Whether the event was related to the study procedures such as the preceding vaccinations, malaria infection or antimalarial drugs remains elusive. However, the relation in time with the experimental malaria infection and apparent absence of an underlying condition makes the infection the most probable trigger. This is in striking contrast, however, with the millions of malaria cases each year and the fact that such complication has never been reported in the literature. The rare occurrence of cardiac events with any of the preceding study procedures may even support a coincidental finding. Apart from acute coronary syndrome, myocarditis can be considered as a final diagnosis, but the true nature and patho-physiological explanation of the event remain unclear.

  8. Diagnosis of aetiology and complications of relapsing urinary tract infections via imaging methods

    International Nuclear Information System (INIS)

    Rieden, K.; Mende, U.

    1985-01-01

    The indication and efficiency of various radiological examination methods in relapsing infections of the urinary tract, as well as the complications of such infections, are described, and characteristic and pathognomical findings are demonstrated. The diagnostic accuracy of the individual imaging methods depends on the site, size, and density of the pathological process. Accurate diagnosis also requires the incorporation of clinical findings including those established by means of clinical pathology setups. (orig.) [de

  9. Late Streptococcus bovis infection of total knee replacement complicated by infective endocarditis and associated with colonic ulcers

    Science.gov (United States)

    Nagy, Mathias Thomas; Hla, Sann Minn; Keys, Graham Watson

    2013-01-01

    Streptococcus bovis is rare cause of late infections after total knee replacement (TKR). This report presents a case of confirmed late septic arthritis following TKR caused by S bovis that was further complicated with infective endocarditis resulting in aortic valve insufficiency in an immunecompetent patient. As an association between S bovis and gastrointestinal malignancies is suggested, a workup for such malignancies was performed that revealed non-malignant ulcers in patient's ascending colon. The patient is currently recovering from his aortic valve replacement surgery and is scheduled to have annual colonoscopies. His knee joint has improved; however, he developed constant pain because of underlying chronic infection in the affected joint and has difficulties mobilising. Therefore, a revision TKR is considered but postponed until he fully recovers from his heart valve surgery. PMID:23744853

  10. [Therapeutic effects of a combination treatment with flomoxef and tobramycin against infections complicated with hematological disorders].

    Science.gov (United States)

    Yamane, T; Tanaka, K; Hasuike, T; Hirai, M; Misu, K; Ota, K; Ohira, H; Nakao, Y; Yasui, Y; Inoue, T

    1992-08-01

    The efficacy and safety of a combination regimen using flomoxef (FMOX) and tobramycin (TOB) were evaluated in the treatment of infections complicated with hematological disorders. The primary diseases in 40 patients included acute leukemia, malignant lymphoma and others. Complicated infections included 35 cases with suspected septicemia, 4 cases with septicemia and 1 case with pleuritis. Clinical responses were excellent in 10 (25.0%), good in 14 (35.0%), fair in 2 (5.0%) and poor in 14 (35.0%). The efficacy rate was 73.1% in patients with neutrophil counts higher than 501/microliters after administration, but it was 35.7% in patients with counts less than 501/microliters; the difference was statistically significant. No side effects were observed in any of the 40 patients. Abnormal laboratory data in liver functions were identified in 1 patient (2.5%). Degree of this abnormality was very slight, and the continuation of treatment was not disturbed. In conclusion, this combination therapy of FMOX and TOB thus appears to be useful and safe in therapies for infections complicated with hematological disorders.

  11. [An analysis of clinical characteristic and related risk factors in 208 cirrhotic patients complicated with infections].

    Science.gov (United States)

    Zhang, G H; Wang, M; Wang, L; Wang, X M; Wang, Y; Ou, X J; Jia, J D

    2018-02-01

    Objective: To analyze the clinical features and risk factors of cirrhotic patients complicated with infections. Methods: The clinical and laboratory characteristics of cirrhotic patients complicated with infections hospitalized from April 2014 to June 2017 were retrospectively analyzed. Relevant risk factors for infection and mortality were explored. Results: The overall incidence of infections was 17.6% in 1 670 hospitalized cirrhotic patients. Among the recruited 208 patients in this study, alcoholic, viral hepatitis B or C and autoimmune liver diseases accounted for 29.8% (62/208), 26.0% (54/208), and 22.1% (46/208), respectively. The most common infection site was respiratory tract (70.2%), followed by urinary tract, intestinal and intra-abdomen. Forty-six pathogens were isolated from 32 patients, including 22 (47.8%) Gram negative bacteria, 16 (34.8%) Gram positive bacteria and 2(4.3%) mycobacterium tuberculosis, 5 (10.9%) fungi and 1 (2.2%) mycoplasma. The mortality in patients with nosocomial infections (16.7%,7/42) was higher than that in patients with community-acquired infections (6.0%,10/166, P =0.025). All 17 deaths occurred in decompensated cirrhosis. Multivariate analysis demonstrated that hepatic encephalopathy and prothrombin time were independent risk factors of mortality. Conclusions: Patients with decompensated cirrhosis are more susceptible to infections. Hepatic encephalopathy and prothrombin time are independent risk factors for death.

  12. Efficacy of tigecycline versus ceftriaxone plus metronidazole for the treatment of complicated intra-abdominal infections

    DEFF Research Database (Denmark)

    Qvist, Niels; Warren, Brian; Leister-Tebbe, Heidi

    2012-01-01

    This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone-metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections (cIAI)....

  13. Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.

    Directory of Open Access Journals (Sweden)

    Claire Nour Abou Chakra

    Full Text Available BACKGROUND: Clostridium difficile infection (CDI can lead to complications, recurrence, and death. Numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality. METHODS: A systematic review was completed according to PRISMA guidelines. An electronic search in five databases was performed. Studies published until October 2013 were included if risk factors for at least one CDI outcome were assessed with multivariate analyses. RESULTS: 68 studies were included: 24 assessed risk factors for recurrence, 18 for complicated CDI, 8 for treatment failure, and 30 for mortality. Most studies accounted for mortality in the definition of complicated CDI. Important variables were inconsistently reported, such as previous episodes and use of antibiotics. Substantial heterogeneity and methodological limitations were noted, mainly in the sample size, the definition of the outcomes and periods of follow-up, precluding a meta-analysis. Older age, use of antibiotics after diagnosis, use of proton pump inhibitors, and strain type were the most frequent risk factors for recurrence. Older age, leucocytosis, renal failure and co-morbidities were frequent risk factors for complicated CDI. When considered alone, mortality was associated with age, co-morbidities, hypo-albuminemia, leucocytosis, acute renal failure, and infection with ribotype 027. CONCLUSION: Laboratory parameters currently used in European and American guidelines to define patients at risk of a complicated CDI are adequate. Strategies for the management of CDI should be tailored according to the age of the patient, biological markers of severity, and underlying co-morbidities.

  14. Late-onset cytomegalovirus infection complicated by Guillain-Barre syndrome in a kidney transplant recipient: case report and review of the literature.

    Science.gov (United States)

    Shaban, E; Gohh, R; Knoll, B M

    2016-04-01

    Cytomegalovirus (CMV) infection remains a common infection after solid-organ transplantation. In the general population CMV disease is associated with Guillain-Barre syndrome (GBS), an autoimmune disease leading to an acute peripheral neuropathy, in 1 of 1000 cases. Interestingly, GBS is a rarely observed complication in solid-organ transplant recipients, possibly related to maintenance immunosuppression. We describe a case of CMV infection complicated by GBS in a kidney transplant recipient and review the literature.

  15. Post dengue neurological complication

    Directory of Open Access Journals (Sweden)

    Hizlinda Tohid

    2015-12-01

    Full Text Available Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE followed by an upper respiratory tract infection (URTI weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

  16. Impact of bicuspid aortic valve on complications and death in infective endocarditis of native aortic valves.

    Science.gov (United States)

    Kahveci, Gokhan; Bayrak, Fatih; Pala, Selcuk; Mutlu, Bulent

    2009-01-01

    We retrospectively investigated the impact of bicuspid aortic valve on the prognosis of patients who had definite infective endocarditis of the native aortic valve.Of 51 patients, a bicuspid aortic valve was present in 22 (43%); the other 29 had tricuspid aortic valves. On average, the patients who had bicuspid valves were younger than those who had tricuspid valves. Patients with a tricuspid valve had larger left atrial diameters and were more likely to have severe mitral regurgitation.Periannular complications, which we detected in 19 patients (37%), were much more common in the patients who had a bicuspid valve (64% vs 17%, P = 0.001). The presence of a bicuspid valve was the only significant independent predictor of periannular complications. The in-hospital mortality rate in the bicuspid group was lower than that in the tricuspid group; however, this figure did not reach statistical significance (9% vs 24%, P = 0.15). In multivariate analysis, left atrial diameter was the only independent predictor associated with an increased risk of death (hazard ratio, 2.19; 95% confidence interval, 1.1-4.5; P = 0.031).In our study, patients with infective endocarditis in a bicuspid aortic valve were younger and had a higher incidence of periannular complications. Although a worse prognosis has been reported previously, we found that infective endocarditis in a native bicuspid aortic valve is not likely to increase the risk of death in comparison with infective endocarditis in native tricuspid aortic valves.

  17. Clostridium perfringens infection complicating periprosthetic fracture fixation about the hip: successful treatment with early aggressive debridement.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-07-13

    Periprosthetic fracture and infection are both challenges following hip arthroplasty. We report the case of an 87 year old female who underwent open reduction and internal fixation of a periprosthetic femoral fracture. Her post-operative course was complicated by infection with Clostridium perfringens. Early aggressive antibiotic treatment and surgical debridement were successful, and allowed retention of the original components.

  18. Surgical-site infections and postoperative complications: agreement between the Danish Gynecological Cancer Database and a randomized clinical trial

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Meyhoff, Christian Sylvest; Lundvall, Lene

    2011-01-01

    between November 2006 and October 2008 and data from the DGCD. METHODS: Outcomes within 30 days from the trial and the database were compared and levels of agreements were calculated with kappa-statistics. MAIN OUTCOME MEASURES: Primary outcome was surgical-site infection. Other outcomes included re-operation...... registered in the PROXI trial, but not in the DGCD. Agreements between secondary outcomes were very varying (kappa-value 0.77 for re-operation, 0.37 for urinary tract infections, 0.19 for sepsis and 0.18 for pneumonia). CONCLUSIONS: The randomized trial reported significantly more surgical-site infections......OBJECTIVE: Surgical-site infections are serious complications and thorough follow-up is important for accurate surveillance. We aimed to compare the frequency of complications recorded in a clinical quality database with those noted in a randomized clinical trial with follow-up visits. DESIGN...

  19. Effect of a Standardized Protocol of Antibiotic Therapy on Surgical Site Infection after Laparoscopic Surgery for Complicated Appendicitis.

    Science.gov (United States)

    Park, Hyoung-Chul; Kim, Min Jeong; Lee, Bong Hwa

    Although it is accepted that complicated appendicitis requires antibiotic therapy to prevent post-operative surgical infections, consensus protocols on the duration and regimens of treatment are not well established. This study aimed to compare the outcome of post-operative infectious complications in patients receiving old non-standardized and new standard antibiotic protocols, involving either 5 or 10 days of treatment, respectively. We enrolled 1,343 patients who underwent laparoscopic surgery for complicated appendicitis between January 2009 and December 2014. At the beginning of the new protocol, the patients were divided into two groups; 10 days of various antibiotic regimens (between January 2009 and June 2012, called the non-standardized protocol; n = 730) and five days of cefuroxime and metronidazole regimen (between July 2012 and December 2014; standardized protocol; n = 613). We compared the clinical outcomes, including surgical site infection (SSI) (superficial and deep organ/space infections) in the two groups. The standardized protocol group had a slightly shorter operative time (67 vs. 69 min), a shorter hospital stay (5 vs. 5.4 d), and lower medical cost (US$1,564 vs. US$1,654). Otherwise, there was no difference between the groups. No differences were found in the non-standardized and standard protocol groups with regard to the rate of superficial infection (10.3% vs. 12.7%; p = 0.488) or deep organ/space infection (2.3% vs. 2.1%; p = 0.797). In patients undergoing laparoscopic surgery for complicated appendicitis, five days of cefuroxime and metronidazole did not lead to more SSIs, and it decreased the medical costs compared with non-standardized antibiotic regimens.

  20. Osteonecrosis - A rare complication of HIV infection. Association with numerous risk factors

    International Nuclear Information System (INIS)

    Meyer, D.; Behrens, G.; Stoll, M.; Schmidt, R.E.

    2000-01-01

    Osteonecrosis is a rare complication of HIV infection. The presumptive cause of the aseptic osteonecrosis is a disturbed blood supply to the bone. Most cases of osteonecrosis are associated with numerous risk factors, such as use of steroids, alcohol abuse, coagulopathies or metabolic derangements. Since conventional X-rays appear unremarkable, early forms often go unrecognized or are diagnosed late. Methods of establishing the diagnosis are MRI and three-phase skeletal scintigraphy. The pathogenesis of osteonecrosis in HIV infection is unclear. So far, about 30 cases have been reported in the literature. We would recommend that in HIV patients with typical symptoms - in particular when classical risk factors are present - osteonecrosis be included in the differential diagnostic considerations. (orig.) [de

  1. Treatment for infections complications of experimental acute radiation sickness with sulacillin, a combined antibiotic

    International Nuclear Information System (INIS)

    Chertkov, K.S.; Revskaya, E.A.

    1999-01-01

    The therapeutic efficiency of sulacillin (combination of ampicillin antibiotic with beta-lactamase sulbactam inhibitor) used for prevention and treatment of infections complications of the acute radiation disease (ARD) is considered. It is shown that sulacillin antiinfections effect essentially exceeds the activity of ampicillin by treatment of irradiated mice infected with a beta-lactamase-producing strain of Kl pneumoniae. Inclusion of the sulacillin as a principal antibiotic into the ARD therapeutic scheme provides for the 66.6 % survival of dogs at LD 90/45 [ru

  2. Untargeted antifungal therapy in adult patients with complicated intra-abdominal infection

    DEFF Research Database (Denmark)

    Petersen, Marie Warrer; Perner, Anders; Sjövall, Fredrik

    2017-01-01

    who are critically ill have provided conflicting results, and clinical equipoise exists. Accordingly, we aim to assess patient-important benefits and harms of untargeted antifungal therapy versus placebo or no treatment in adult patients with complicated intra-abdominal infection. Methods and analysis......-cause mortality, and secondary outcomes include adverse events, duration of mechanical ventilation and inotropic support, need for renal replacement therapy, emergence of antibiotic resistance and intensive care unit and hospital length-of-stay. Conventional meta-analysis, including sensitivity and subgroup...

  3. Effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection

    Directory of Open Access Journals (Sweden)

    Xi Chen1

    2017-06-01

    Full Text Available Objective: To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection. Methods: 100 patients with bronchiectasis complicated by infection who were treated in our hospital between May 2012 and January 2016 were divided into the control group (n=54 who received conventional treatment and the observation group (n=46 who received intravenous anti-infection combined with bronchoscopic ambroxol lavage after the therapies were reviewed. The contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were compared between the two groups. Results: Before treatment, the differences in contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were not statistically significant between two groups of patients. After treatment, inflammatory factors IL-4, IL-6, IL-10 and TNF-α contents in lavage fluid of observation group were lower than those of control group; adhesion molecules sICAM-1 and VCAM-1 contents in lavage fluid were lower than those of control group; acute phase proteins CRP, AAG, HPT and CER contents in lavage fluid were lower than those of control group. Conclusion: Bronchoscopic ambroxol lavage can reduce airway inflammation in patients with bronchiectasis complicated by infection.

  4. Skin Complications

    Science.gov (United States)

    ... Text Size: A A A Listen En Español Skin Complications Diabetes can affect every part of the ... lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis. General Skin Conditions Bacterial Infections Several kinds of bacterial infections ...

  5. Clinical features and prognosis of patients with primary biliary cholangitis complicated by hepatitis virus infection

    Directory of Open Access Journals (Sweden)

    ZHAO Dantong

    2017-08-01

    Full Text Available ObjectiveTo investigate the clinical features and prognosis of patients with primary biliary cholangitis(PBC complicated by hepatitis virus infection. MethodsA total of 16 patients who were admitted to Beijing YouAn Hospital from October 2004 to October 2012 and diagnosed with PBC complicated by hepatitis virus infection were enrolled, among whom 7 had chronic hepatitis B virus infection, 3 had hepatitis C, 4 had hepatitis E, 1 had hepatitis B and hepatitis C, and 1 had hepatitis A. A total of 76 hospitalized patients with PBC alone were enrolled as controls. The two groups were compared in terms of clinical features, laboratory markers, and autoantibodies, and follow-up visits were performed to investigate prognostic features. The independent samples t-test was used for comparison of normally distributed continuous data, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data; the chi-square test or Fisher′s exact test was used for comparison of categorical data. The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used to compare survival rates between groups. ResultsCompared with the control group, the PBC-hepatitis virus infection group had significantly lower proportion of female patients (χ2=12.22, P=0.002, alkaline phosphatase (U=225.00, P<0.001, CHO (U=363.50, P=0.036, and IgG level (t=2.79, P=0.007, and no patients in the PBC-hepatitis virus infection group experienced abdominal wall varices, upper gastrointestinal bleeding, or hepatic encephalopathy. The PBC-hepatitis virus infection group had various autoantibodies including anti-nuclear antibody, smooth muscle antibody, anti-parietal cell antibody (APCA, anti-liver specific protein antibody, and anti-myocardial antibody, as well as a significantly higher APCA positive rate than the control group (25% vs 3.9%, χ2=5.608, P=0.016. The median follow-up time was 49.5 months (2-312 months. The PBC

  6. Obstructive sleep apnea (OSA): a complication of acute infectious mononucleosis infection in a child.

    Science.gov (United States)

    Cheng, Jeffrey

    2014-03-01

    Independently, obstructive sleep apnea (OSA) and infectious mononucleosis are not uncommon in the pediatric population, but acute onset of OSA, as a respiratory complication in the setting of acute EBV infection is extremely uncommon. Previous reports of this clinical entity are sparse and from nearly two decades ago. Urgent adenotonsillectomy was commonly advocated. This complication may be managed medically with systemic corticosteroids and non-invasive continuous positive airway pressure (CPAP), and a case is presented to highlight an updated management approach to this rarely encountered clinical problem in children. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Unusual Infections Complicating the Use of Steroids with Severe Alcoholic Hepatitis: Report of 2 Cases

    Directory of Open Access Journals (Sweden)

    Vitor Arantes

    1995-01-01

    Full Text Available Corticosteroid therapy for acute alcoholic hepatitis has been demonstrated to enhance survival in patients who are encephalopathic, and who do not have renal failure or gastrointestinal bleeding. However, the complications of steroid therapy in such patients have been less well documented. The authors report two patients with alcoholic liver disease who developed life-threatening infections after steroid therapy was started. The first patient initially developed diabetes followed by Fournier's gangrene of the perineum, and a lung abscess following septic emboli. The second patient had established alcoholic cirrhosis rather than alcoholic hepatitis. She developed a necrotic ulcer on the arm at the site of an intravenous line, which was infected with a rhizopus species. Despite surgical debridement the lesion progressed and contributed to her death. Treatment of alcoholic hepatitis with steroids is not innocuous, and physicians should be aware of the potential for life-threatening complications.

  8. Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis.

    Science.gov (United States)

    Jacobsen, S M; Stickler, D J; Mobley, H L T; Shirtliff, M E

    2008-01-01

    Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. These infections are often caused by Escherichia coli and Proteus mirabilis. Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.

  9. Complications of shoulder arthroscopy.

    Science.gov (United States)

    Moen, Todd C; Rudolph, Glen H; Caswell, Kyle; Espinoza, Christopher; Burkhead, Wayne Z; Krishnan, Sumant G

    2014-07-01

    Over the past 20 to 30 years, arthroscopic shoulder techniques have become increasingly popular. Although these techniques have several advantages over open surgery, surgical complications are no less prevalent or devastating than those associated with open techniques. Some of the complications associated with arthroscopic shoulder surgery include recurrent instability, soft-tissue injury, and neurapraxia. These complications can be minimized with thoughtful consideration of the surgical indications, careful patient selection and positioning, and a thorough knowledge of the shoulder anatomy. Deep infection following arthroscopic shoulder surgery is rare; however, the shoulder is particularly susceptible to Propionibacterium acnes infection, which is mildly virulent and has a benign presentation. The surgeon must maintain a high index of suspicion for this infection. Thromboemoblic complications associated with arthroscopic shoulder techniques are also rare, and studies have shown that pharmacologic prophylaxis has minimal efficacy in preventing these complications. Because high-quality studies on the subject are lacking, minimal evidence is available to suggest strategies for prevention. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

  10. Antibiotic Treatment of Hospitalized Patients with Pneumonia Complicated by Clostridium Difficile Infection.

    Science.gov (United States)

    Zycinska, K; Chmielewska, M; Lenartowicz, B; Hadzik-Blaszczyk, M; Cieplak, M; Kur, Z; Krupa, R; Wardyn, K A

    2016-01-01

    Clostridium difficile infection (CDI) is one of the most common gastrointestinal complication after antimicrobial treatment. It is estimated that CDI after pneumonia treatment is connected with a higher mortality than other causes of hospitalization. The aim of the study was to assess the relationship between the kind of antibiotic used for pneumonia treatment and mortality from post-pneumonia CDI. We addressed the issue by examining retrospectively the records of 217 patients who met the diagnostic criteria of CDI. Ninety four of those patients (43.3 %) came down with CDI infection after pneumonia treatment. Fifty of the 94 patients went through severe or severe and complicated CDI. The distribution of antecedent antibiotic treatment of pneumonia in these 50 patients was as follows: ceftriaxone in 14 (28 %) cases, amoxicillin with clavulanate in 9 (18 %), ciprofloxacin in 8 (16.0 %), clarithromycin in 7 (14 %), and cefuroxime and imipenem in 6 (12 %) each. The findings revealed a borderline enhancement in the proportion of deaths due to CDI in the ceftriaxone group compared with the ciprofloxacin, cefuroxime, and imipenem groups. The corollary is that ceftriaxone should be shunned in pneumonia treatment. The study demonstrates an association between the use of a specific antibiotic for pneumonia treatment and post-pneumonia mortality in patients who developed CDI.

  11. Association Between Valvular Surgery and Mortality Among Patients With Infective Endocarditis Complicated by Heart Failure

    Science.gov (United States)

    Kiefer, Todd; Park, Lawrence; Tribouilloy, Christophe; Cortes, Claudia; Casillo, Roberta; Chu, Vivian; Delahaye, Francois; Durante-Mangoni, Emanuele; Edathodu, Jameela; Falces, Carlos; Logar, Mateja; Miró, José M.; Naber, Christophe; Tripodi, Marie Françoise; Murdoch, David R.; Moreillon, Philippe; Utili, Riccardo; Wang, Andrew

    2016-01-01

    Context Heart failure (HF) is the most common complication of infective endocarditis. However, clinical characteristics of HF in patients with infective endocarditis, use of surgical therapy, and their associations with patient outcome are not well described. Objectives To determine the clinical, echocardiographic, and microbiological variables associated with HF in patients with definite infective endocarditis and to examine variables independently associated with in-hospital and 1-year mortality for patients with infective endocarditis and HF, including the use and association of surgery with outcome. Design, Setting, and Patients The International Collaboration on Endocarditis–Prospective Cohort Study, a prospective, multicenter study enrolling 4166 patients with definite native- or prosthetic-valve infective endocarditis from 61 centers in 28 countries between June 2000 and December 2006. Main Outcome Measures In-hospital and 1-year mortality. Results Of 4075 patients with infective endocarditis and known HF status enrolled, 1359 (33.4% [95% CI, 31.9%–34.8%]) had HF, and 906 (66.7% [95% CI, 64.2%–69.2%]) were classified as having New York Heart Association class III or IV symptom status. Within the subset with HF, 839 (61.7% [95% CI, 59.2%–64.3%]) underwent valvular surgery during the index hospitalization. In-hospital mortality was 29.7% (95% CI, 27.2%–32.1%) for the entire HF cohort, with lower mortality observed in patients undergoing valvular surgery compared with medical therapy alone (20.6% [95% CI, 17.9%–23.4%] vs 44.8% [95% CI, 40.4%–49.0%], respectively; Pendocarditis complicated by HF, severity of HF was strongly associated with surgical therapy and subsequent mortality, whereas valvular surgery was associated with lower in-hospital and 1-year mortality. PMID:22110106

  12. The role of the internal medicine specialist in the management of infective complications in general surgical wards

    Directory of Open Access Journals (Sweden)

    Patrizia Zoboli

    2013-05-01

    Full Text Available BACKGROUND Internal medicine specialists are often asked to evaluate a patient before surgery. Perioperative risk evaluation for elderly patients is important, because complications increase with age. The increasing age of the general population increases the probabilities of surgery in the older patients. The manifestation of a surgical problem, is more likely to be severe and complicated in the elderly patients. In fact, emergency surgery treatment occurs more frequently in the elderly (e.g., it is much more common to see intestinal obstruction complicating colorectal cancer in the elderly compared with a younger population. Old age is an independent factor for long hospital stay after surgery. The role of the preoperative medical consultant is to identify and evaluate a patient’s current medical status and provide a clinical risk profile, in order to decide whether further tests are indicated prior to surgery, and to optimise the patient’s medical condition in the attempt of reducing the risk of complications. The medical consultant must know which medical condition could eventually influence the surgery, achieve a good contact and communication between the medical and surgical team, in order to obtain the best management planning. AIM OF THE STUDY This paper focuses on the rational use of antibiotic prophylaxis and on the treatment of the complications of post-surgery infections (e.g., pulmonary complication, peritonitis, intra-abdominal infection. Specific aspects of pre-operative risk evaluation and peri and post-operative management are discussed. CONCLUSIONS The internal medicin specialist in collaboration with the surgical team is necessary in the peri and post-surgery management.

  13. Recommendations for the empirical treatment of complicated urinary tract infections using surveillance data on antimicrobial resistance in the Netherlands

    NARCIS (Netherlands)

    Koningstein, Maike; van der Bij, Akke K.; de Kraker, Marlieke E. A.; Monen, Jos C.; Muilwijk, Jan; de Greeff, Sabine C.; Geerlings, Suzanne E.; van Hall, Maurine A. Leverstein-; Vlaspolder, F.; Cohen Stuart, J. W. T.; van Hees, B. C.; Wintermans, R. G. F.; Altorf-van der Kuil, W.; Alblas, J.; van der Bij, A. K.; Frentz, D.; Leenstra, T.; Monen, J. C.; Muilwijk, J.; Notermans, D. W.; de Greeff, S. C.; van Keulen, P. H. J.; Kluytmans, J. A. J. W.; Mattsson, E. E.; Sebens, F. W.; Frenay, H. M. E.; Maraha, B.; Heilmann, F. G. C.; Halaby, T.; Versteeg, D.; Hendrix, R.; Schellekens, J. F. P.; Diederen, B. M. W.; de Brauwer, E. I. G. B.; Stals, F. S.; Bakker, L. J.; Dorigo-Zetsma, J. W.; van Zeijl, J. H.; Bernards, A. T.; de Jongh, B. M.; Vlaminckx, B. J. M.; Horrevorts, A.; Kuipers, S.; Moffie, B.; Brimicombe, R. W.; Jansen, C. L.; Renders, N. H. M.; Hendrickx, B. G. A.; Buiting, A. G. M.; Kaan, J. A.

    2014-01-01

    Complicated urinary tract infections (c-UTIs) are among the most common nosocomial infections and a substantial part of the antimicrobial agents used in hospitals is for the treatment of c-UTIs. Data from surveillance can be used to guide the empirical treatment choices of clinicians when treating

  14. Imaging of the neurological complications of infective endocarditis

    International Nuclear Information System (INIS)

    Kim, S.J.; Lee, J.Y.; Kim, T.H.; Kim, S.C.; Choi, Y.H.; Pai, H.; Choi, W.S.

    1998-01-01

    We describe the findings on CT or MRI in five patients with neurological symptoms and underlying infective endocarditis (IE). We noted the size, number, and distribution of lesions, the presence or absence of haemorrhage, and contrast enhancement patterns. The number of lesions ranged from 4 to more than 10 in each patient. Their size varied from punctate to 6 cm; they were distributed throughout the brain. The lesions could be categorized into four patterns based on imaging features. A cortical infarct pattern was seen in all patients. Patchy lesions, which did not enhance, were found in the white matter or basal ganglia in three. Isolated, tiny, nodular or ring-enhancing white matter lesions were seen in three patients, and parenchymal haemorrhages in four. In addition to the occurrence of multiple lesions with various patterns in the same patient, isolated, tiny, enhancing lesions in the white matter seemed to be valuable features which could help to differentiate the neurological complications of IE from other thromboembolic infarcts. (orig.)

  15. Pulmonary complications in renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-04-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.

  16. Unexpected complication associated with balneotherapy: Skin and soft tissue infection

    Science.gov (United States)

    Alım, Bülent; Bostancı, Fahrettin; Servi, M. Alperen; Ćetinel, Sinan; Bingöl, M. Ozan

    2017-04-01

    Balneotherapy cure is an ongoing process, but patients can benefit most when cure is complete. For these reason, patients should be closely monitored and necessary precautions should be taken in terms of the complications that may occur in order to prevent the interruption or discontinuation of balneotherapy. Here, we wanted to represent a case that developed left leg soft tissue infection during the application of balneotherapy and because of this reason we stopped the balneotherapy As a result, when balneotherapy is planned for patients with risk factors such as diabetes and obesity, frequent examination of the skin and the application of skin moisturizers will be beneficial to prevent itching and skin dryness.

  17. Aortocavitary fistula as a complication of infective endocarditis and subsequent complete heart block in a patient with severe anemia

    Directory of Open Access Journals (Sweden)

    Jose N. Galeas

    2015-12-01

    Full Text Available Infective endocarditis has different presentations depending on the involvement of valvular and perivalvular structures, and it is associated with high morbidity and mortality. Aortocavitary fistula is a rare complication. We introduce the case of a 48-year-old female with native valve endocarditis, complicated by aortocavitary fistula to the right atrium, and consequently presented with syncope.

  18. Tube Thoracostomy: Complications and Its Management

    Directory of Open Access Journals (Sweden)

    Emeka B. Kesieme

    2012-01-01

    Full Text Available Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended.

  19. Tube Thoracostomy: Complications and Its Management

    Science.gov (United States)

    Kesieme, Emeka B.; Dongo, Andrew; Ezemba, Ndubueze; Irekpita, Eshiobo; Jebbin, Nze; Kesieme, Chinenye

    2012-01-01

    Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended. PMID:22028963

  20. Pregnancy Complications: Group B Strep Infection

    Science.gov (United States)

    ... cause some minor infections, like a bladder or urinary tract infection (UTI). While GBS may not be harmful to you, ... baby with a GBS infection. You had a UTI during your pregnancy that was caused by GBS. ...

  1. Off-label biologic regimens in psoriasis: a systematic review of efficacy and safety of dose escalation, reduction, and interrupted biologic therapy.

    Directory of Open Access Journals (Sweden)

    Elizabeth A Brezinski

    Full Text Available OBJECTIVES: While off-label dosing of biologic treatments may be necessary in selected psoriasis patients, no systematic review exists to date that synthesizes the efficacy and safety of these off-label dosing regimens. The aim of this systematic review is to evaluate efficacy and safety of off-label dosing regimens (dose escalation, dose reduction, and interrupted treatment with etanercept, adalimumab, infliximab, ustekinumab, and alefacept for psoriasis treatment. DATA SOURCES AND STUDY SELECTION: We searched OVID Medline from January 1, 1990 through August 1, 2011 for prospective clinical trials that studied biologic therapy for psoriasis treatment in adults. Individual articles were screened for studies that examined escalated, reduced, or interrupted therapy with etanercept, adalimumab, infliximab, ustekinumab, or alefacept. DATA SYNTHESIS: A total of 23 articles with 12,617 patients matched the inclusion and exclusion criteria for the systematic review. Data were examined for primary and secondary efficacy outcomes and adverse events including infections, malignancies, cardiovascular events, and anti-drug antibodies. The preponderance of data suggests that continuous treatment with anti-TNF agents and anti-IL12/23 agent was necessary for maintenance of disease control. Among non-responders, dose escalation with etanercept, adalimumab, ustekinumab, and alefacept typically resulted in greater efficacy than standard dosing. Dose reduction with etanercept and alefacept resulted in reduced efficacy. Withdrawal of the examined biologics led to an increase in disease activity; efficacy from retreatment did not result in equivalent initial response rates for most biologics. Safety data on off-label dosing regimens are limited. CONCLUSION: Dose escalation in non-responders generally resulted in increased efficacy in the examined biologics used to treat moderate-to-severe psoriasis. Continuous treatment with anti-TNF agents and anti-IL12/23 agent

  2. Antibiotic resistance in children with complicated urinary tract infection

    International Nuclear Information System (INIS)

    Yildiz, B.; Kural, N.; Yarar, C.; Ak, I.; Akcar, N.

    2007-01-01

    Objective was to determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI. Four hundred and twenty two urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey. Reflux was found to be most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p<0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p<0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clvalanate and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA. Aztreonam, meropenem and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides. (author)

  3. Empyema Necessitans Complicating Pleural Effusion Associated with Proteus Species Infection: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    M. S. Yauba

    2015-01-01

    Full Text Available Background. Empyema necessitans, a rare complication of pleural effusion, could result in significant morbidity and mortality in children. It is characterized by the dissection of pus through the soft tissues and the skin of the chest wall. Mycobacterium tuberculosis and Actinomyces israelii are common causes but Gram negative bacilli could be a rare cause. However, there were challenges in differentiating between Mycobacterium tuberculosis and nontuberculous empyema in a resource poor setting like ours. We report a child with pleural effusion and empyema necessitans secondary to Proteus spp. infection. Methods. We describe a 12-year-old child with empyema necessitans complicating pleural effusion and highlight management challenges. Results. This case was treated with quinolones, antituberculous drugs, chest tube drainage, and nutritional rehabilitation. Conclusion. Empyema necessitatis is a rare condition that can be caused by Gram negative bacterial pathogens like Proteus species.

  4. The relationship between cerebrovascular complications and previously established use of antiplatelet therapy in left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, Ulrika; Rasmussen, Rasmus Vedby; Hassager, Christian

    2011-01-01

    Cerebrovascular complications (CVC) in infective endocarditis (IE) are common. The only established treatments to reduce the incidence of CVC in IE are antibiotics and in selected cases early cardiac surgery. Potential effects of previously established antiplatelet therapy are under debate....

  5. A complication of meningitis and infective endocarditis due to Streptococcus pyogenes.

    Science.gov (United States)

    Inoue, Kosuke; Hagiwara, Akiyoshi; Kimura, Akio; Ohmagari, Norio

    2017-07-26

    We described a rare case of meningitis and infective endocarditis (IE) due to Streptococcus pyogenes. An 80-year-old woman was admitted to our hospital with unconsciousness. Glasgow Coma Scale was E1V3M5. We diagnosed her with acute meningitis due to S. pyogenes and started treatment using ceftriaxone. In spite of the improvement of her unconscious state, she developed a new-onset systolic murmur on day 13, and echocardiography revealed severe mitral valve regurgitation with vegetation. Therefore, we also diagnosed her with IE and continued the antibiotics for 6 weeks after we confirmed the negative blood cultures. The patient was finally transferred to another hospital for rehabilitation 57 days after admission. Considering that the number of S. pyogenes infections has been reported to increase in Japan and worldwide, we need to be more careful about the rare complication of meningitis and IE due to S. pyogenes . © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. [A postpartum woman with toxic shock syndrome: group A streptococcal infection, a much feared postpartum complication.

    NARCIS (Netherlands)

    Abbink, K.; Kortekaas, J.C.; Buise, M.P.; Dokter, J.; Kuppens, S.M.; Hasaart, T.H.M.

    2016-01-01

    BACKGROUND: The development of toxic shock syndrome (TSS) after an invasive group A streptococcal (GAS) infection in the postpartum period is a much feared complication. The mortality rate of TSS with necrotizing fasciitis is 30 to 50%. CASE DESCRIPTION: We present the case of a woman with atypical

  7. Imaging of the neurological complications of infective endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, S.J.; Lee, J.Y.; Kim, T.H.; Kim, S.C.; Choi, Y.H. [Department of Radiology, Dankook University College of Medicine, Chungnam (Korea, Republic of); Pai, H. [Department of Internal Medicine, Dankook University College of Medicine, Chungnam (Korea, Republic of); Choi, W.S. [Department of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    1998-02-01

    We describe the findings on CT or MRI in five patients with neurological symptoms and underlying infective endocarditis (IE). We noted the size, number, and distribution of lesions, the presence or absence of haemorrhage, and contrast enhancement patterns. The number of lesions ranged from 4 to more than 10 in each patient. Their size varied from punctate to 6 cm; they were distributed throughout the brain. The lesions could be categorized into four patterns based on imaging features. A cortical infarct pattern was seen in all patients. Patchy lesions, which did not enhance, were found in the white matter or basal ganglia in three. Isolated, tiny, nodular or ring-enhancing white matter lesions were seen in three patients, and parenchymal haemorrhages in four. In addition to the occurrence of multiple lesions with various patterns in the same patient, isolated, tiny, enhancing lesions in the white matter seemed to be valuable features which could help to differentiate the neurological complications of IE from other thromboembolic infarcts. (orig.) With 4 figs., 2 tabs., 11 refs.

  8. Serious complications after infective endocarditis

    DEFF Research Database (Denmark)

    Gill, Sabine

    2010-01-01

    The objective of the present study was to review all cases of infective endocarditis at our hospital between 2002 and 2006 concerning the bacteriological aetiology and outcomes.......The objective of the present study was to review all cases of infective endocarditis at our hospital between 2002 and 2006 concerning the bacteriological aetiology and outcomes....

  9. Complicaciones neurológicas de la endocarditis infecciosa: controversias Neurological complications of infective endocarditis: controversies

    Directory of Open Access Journals (Sweden)

    Federico A Silva

    2011-07-01

    Full Text Available En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia.Neurological complications of acute infective endocarditis are described in 20%-40% of cases, representing an important predictive factor of morbidity, mortality, sequels and disability. Acute endocarditis is characterized by a wide clinical spectrum due to its complex physiopathology that involves inflammatory, immune, infectious and embolic phenomena. Despite the remarkable frequency of neurological complications in the infective endocarditis especially by cerebrovascular disease and neuroinfections, there are still some controversies about some diagnostic and therapeutic aspects, partly because of the little evidence available. This paper describes a number of cases seen in the Fundación Cardiovascular de Colombia and discusses some aspects related with the diagnosis and treatment of the neurological complications of acute endocarditis.

  10. Phase 2, Dose-Ranging Study of Relebactam with Imipenem-Cilastatin in Subjects with Complicated Intra-abdominal Infection.

    Science.gov (United States)

    Lucasti, Christopher; Vasile, Liviu; Sandesc, Dorel; Venskutonis, Donatas; McLeroth, Patrick; Lala, Mallika; Rizk, Matthew L; Brown, Michelle L; Losada, Maria C; Pedley, Alison; Kartsonis, Nicholas A; Paschke, Amanda

    2016-10-01

    Relebactam (REL [MK-7655]) is a novel class A/C β-lactamase inhibitor intended for use with imipenem for the treatment of Gram-negative bacterial infections. REL restores imipenem activity against some resistant strains of Klebsiella and Pseudomonas In this multicenter, double-blind, controlled trial (NCT01506271), subjects who were ≥18 years of age with complicated intra-abdominal infection were randomly assigned (1:1:1) to receive 250 mg REL, 125 mg REL, or placebo, each given intravenously (i.v.) with 500 mg imipenem-cilastatin (IMI) every 6 h (q6h) for 4 to 14 days. The primary efficacy endpoint was the proportion of microbiologically evaluable (ME) subjects with a favorable clinical response at discontinuation of i.v. therapy (DCIV). A total of 351 subjects were randomized, 347 (99%) were treated, and 255 (73%) were ME at DCIV (55% male; mean age, 49 years). The most common diagnoses were complicated appendicitis (53%) and complicated cholecystitis (17%). Thirty-six subjects (13%) had imipenem-resistant Gram-negative infections at baseline. Both REL doses plus IMI were generally well tolerated and demonstrated safety profiles similar to that of IMI alone. Clinical response rates at DCIV were similar in subjects who received 250 mg REL plus IMI (96.3%) or 125 mg REL plus IMI (98.8%), and both were noninferior to IMI alone (95.2%; one-sided P imipenem exposure at the proposed dose of 500 mg IMI with 250 mg REL q6h provides coverage of >90% of carbapenem-resistant bacterial strains. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  11. Management of a Complicated Ruptured Infected Pseudoaneurysm of the Femoral Artery in a Drug Addict

    Directory of Open Access Journals (Sweden)

    Emmanouil Psathas

    2012-01-01

    Full Text Available Infected pseudoaneurysm of the femoral artery represents a devastating complication of intravenous drug abuse, especially in the event of rupture. Operative strategy depends upon the extent of arterial injury and the coexistence of infection or sepsis. Options range from simple common femoral artery (CFA ligation to complex arterial reconstruction with autologous grafts (arterial, venous, or homografts. We report herein the management of a 29-year-old male patient who was urgently admitted with a ruptured pseudoaneurysm of the right CFA, extending well above the inguinal ligament. Multidisciplinary approach with multiple arterial reconstructions and subsequent coverage of the tissue defect with a rectus abdominis musculocutaneous flap transposition was performed.

  12. Causative Role of Sexually Transmitted Infections in the Development of Chronic Cystitis Complicated with Leukoplakia of the Bladder

    Directory of Open Access Journals (Sweden)

    Alexander I. Neymark, PhD, ScD

    2012-09-01

    Full Text Available The objective of this study was the investigation of the influence of chlamydial, mycoplasmal and trichomonas infection on the development of urinary bladder leukoplakia. The article presents the results of the examination of women with chronic cystitis complicated with leukoplakia of the bladder, and associated with concomitant sexually transmitted infections, including the results of culture analysis of the cervical canal content and urinary bladder biopsy samples, as well as molecular-biological analyses confirming the presence of sexually transmitted infections, pathomorphological characteristics of tissue samples from leukoplakia foci typical for different types of infectious agents. In this study, 60 women with chronic cystitis, complicated with leukoplakia of the bladder and associated with concomitant sexually transmitted infections were examined. Using PCR diagnostics, Mycoplasma hominis and Chlamydia albicans were found to be the most frequently occurring agents, followed by Ureaplasma urealyticum, Chlamydia trachomatis and Trichomonas vaginalis. The results of culture analyses demonstrated that M. hominis and U. urealyticum were prevalent in patients with chronic urinary tract inflammatory processes, followed by Tr. vaginalis. Candida fungi show practically the same frequency of occurrence. The pathomorphological examination of the foci of leukoplakia in the urinary bladder (in 30 subjects demonstrated metaplasia of the transitional epithelium to the stratified pavement squamous epithelium with inflammatory cellular infiltration of the lamina propria in all types of infections. The intensity of the urothelial transformation and stromal inflammatory processes were determined by the type of predominant infection. Pathomorphological characteristics of the foci of leukoplakia correlate with the etiology of chronic inflammation and are relevant for etiological diagnosis and treatment.

  13. Infective Endocarditis Complicated by Septic Pulmonary Emboli in a Case of a Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Roodpeyma

    2015-11-01

    Full Text Available Introduction Infective endocarditis (IE causes serious complications in patients. Congenital heart disease (CHD is an important underlying condition in children. Septic pulmonary embolism is an uncommon syndrome, and pulmonary valve IE is rare. The current study presented a case of right-sided IE with pulmonary valve involvement and its complications as pulmonary septic emboli in a child with CHD. Case Presentation A 6-year-old girl with a ventricular septal defect (VSD was presented. Echocardiography revealed large vegetation in the right ventricular outflow tract near the pulmonary valve. The patient showed clinical symptoms of lung involvement, and radiologic investigation was compatible with a diagnosis of septic pulmonary emboli. She had good response to antibacterial therapy and underwent a successful surgical closure of the heart defect. Conclusions Children with CHD are at risk of severe complications with the involvement of other organs. long-term febrile illness should be taken seriously in these children. They need hospitalization and careful evaluation.

  14. Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications.

    Science.gov (United States)

    Punjani, Nahid; Winick-Ng, Jennifer; Welk, Blayne

    2017-01-01

    To determine if postoperative urinary retention and urinary tract infections (UTIs) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). Administrative data in Ontario, Canada, between 2002 and 2013 were used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh removal/erosion/fistula, or urethrolysis). Two potential risk factors were analyzed: postoperative retention (within 30 days of procedure) and number of postoperative emergency room visits or hospital admissions for UTI symptoms. A total of 59,556 women had a MUS, of which 1598 (2.7%) required revision surgery. Of the 2025 women who presented to the emergency room or were admitted to hospital for postoperative retention, 212 (10.5%) required operative mesh revision. Of the 11,747 patients who had at least one postoperative UTI, 366 (3.1%) patients required operative mesh revision. In adjusted analysis, postoperative retention was significantly predictive of future reoperation (hazard ratio [HR] 3.46, 95% confidence interval [CI] 2.97-4.02), and this difference persisted when urethrolysis was excluded as a reason for sling revision (HR 3.08, 95% CI 2.62-3.63). Similarly, in adjusted analysis, each additional postoperative hospital visit for UTI symptoms increased the risk for surgical intervention for mesh complications (HR 1.74, 95% CI 1.61-1.87). Postoperative urinary retention and hospital presentation for UTI symptoms are associated with an increased risk of reoperation for MUS complications. These patients should be followed and investigated for mesh complications when appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Safety and Efficacy of Intrapleural Tissue Plasminogen Activator and DNase during Extended Use in Complicated Pleural Space Infections

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    Jason R. McClune

    2016-01-01

    Full Text Available The use of intrapleural therapy with tissue plasminogen activator and DNase improves outcomes in patients with complicated pleural space infections. However, little data exists for the use of combination intrapleural therapy after the initial dosing period of six doses. We sought to describe the safety profile and outcomes of intrapleural therapy beyond this standard dosing. A retrospective review of patients receiving intrapleural therapy with tissue plasminogen activator and DNase was performed at two institutions. We identified 101 patients from January 2013 to August 2015 receiving intrapleural therapy for complicated pleural space infection. The extended use of intrapleural tissue plasminogen activator and DNase therapy beyond six doses was utilized in 20% (20/101 of patients. The mean number of doses in those undergoing extended dosing was 9.8 (range of 7–16. Within the population studied there appears to be no statistically significant increased risk of complications, need for surgical referral, or outcome differences when comparing those receiving standard or extended dosing intrapleural therapy. Future prospective study of intrapleural therapy as an alternative option for patients who fail initial pleural drainage and are unable to tolerate/accept a surgical intervention appears a potential area of study.

  16. Laser therapy in women genital Chlamydia trachomatis infection complicated with PID and infertility

    Science.gov (United States)

    Brinzan, Daniela; Paiusan, Lucian; Smeu, Claudia-Ramona

    2018-04-01

    Genital Chlamydia Trachomatis infection is one of the most common sexually transmitted infections with more than 50 million new cases occurred globally every year. Underdiagnosed and untreated, it can generate long term severe complications including PID, infertility, ectopic pregnancy and chronic pelvic pain. Among 20 patients diagnosed with PID and infertility in our medical office during one year, we selected a study group of 10 patients with genital Chlamydia Trachomatis infection. The diagnostic methods used were anamnesis, clinical examination, Pap smear, bacteriological and serological tests, ultra sound examination. The group of patients selected was monitored for one year. The treatment took into account general measures for both partners and specific measures (antibiotic treatment and focused laser therapy). The initial group was split in two, group A treated only with antibiotics and group B treated with both antibiotics and laser therapy. All the 5 patients of group B presented an improvement of the clinical manifestations and 3 of them ended up with pregnancy. On the other hand, in group B, only one patient manifested total disappearance of pains and the infertility persisted for all. It is noteworthy that the association of laser therapy in the treatment of Chlamydia Trachomatis infection has brought significant improvement in the inflammatory processes of internal genitalia (PID) and in the fertility of the couple.

  17. Oral complications of cancer therapies. Oral complications in the pediatric population

    International Nuclear Information System (INIS)

    Leggott, P.J.

    1990-01-01

    A number of acute oral complications may be associated with cancer therapy in children, but the extent and duration of these complications, and the most effective management techniques. have not been well described. The few studies differ in design, making comparisons difficult. Well-controlled, prospective clinical studies are needed to define the most effective strategies for the management of acute oral complications in children. However, it is clear that dental intervention prior to cancer therapy is an important factor in the optimal preparation of the patient. During cancer therapy, intensive supervised oral preventive protocols appear to be of benefit to the child's oral health, overall comfort, and well-being. Furthermore, the prevention of oral infection may significantly reduce the morbidity associated with cancer therapy. Long-term preventive oral care may help prevent dental disease and infection in medically compromised children and contribute to improving the quality of life. 41 references

  18. Total hip replacement infected with Mycobacterium tuberculosis complicated by Addison disease and psoas muscle abscess: a case report

    Directory of Open Access Journals (Sweden)

    De Nardo Pasquale

    2012-01-01

    Full Text Available Abstract Introduction Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease. Case presentation A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms. Conclusions Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected

  19. Guillain-Barre syndrome complicating chikungunya virus infection.

    Science.gov (United States)

    Agarwal, Ayush; Vibha, Deepti; Srivastava, Achal Kumar; Shukla, Garima; Prasad, Kameshwar

    2017-06-01

    Chikungunya virus (CHIKV) is a mosquito-borne alphavirus which presents with symptoms of fever, rash, arthralgia, and occasional neurologic disease. While outbreaks have been earlier reported from India and other parts of the world, the recent outbreak in India witnessed more than 1000 cases. Various systemic and rarely neurological complications have been reported with CHIKV. We report two cases of Guillain-Barré syndrome (GBS) with CHIKV. GBS is a rare neurological complication which may occur after subsidence of fever and constitutional symptoms by several neurotropic viruses. We describe two cases of severe GBS which presented with rapidly progressive flaccid quadriparesis progressing to difficulty in swallowing and breathing. Both required mechanical ventilation and improved partly with plasmapharesis. The cases emphasize on (1) description of the rare complication in a setting of outbreak with CHIKV, (2) acute axonal as well as demyelinating neuropathy may occur with CHIKV, (3) accurate identification of this entity during outbreaks with dengue, both of which are vector borne and may present with similar complications.

  20. Coxofemoral luxation in a border collie as a complication of a Clostridium tetani infection.

    Science.gov (United States)

    Goldhammer, M A; Chapman, P S; Grierson, J M

    2008-03-01

    A four-month-old male, entire, border collie was presented to the Queen Mother Hospital for Animals with a two day history of muscular spasms and "Risus sardonicus". Tetanus was diagnosed, and the dog was treated with tetanus antitoxin, antibiotics and supportive therapy. Coxofemoral luxation resulted as a complication of the tetanus and was successfully managed by performing a femoral head and neck excision. This is the first report of joint luxation associated with Clostridium tetani infection in a dog.

  1. Comparative assessment of renal Tc-99m DMSA scan and renal sonography findings in complication of urinary tract infections

    International Nuclear Information System (INIS)

    Alavi, M.; Rasekhi, A.

    2002-01-01

    Urinary tract infection is a common disease in childhood specially in female. In this study 50 patients with established diagnosis of urinary tract infection were evaluated by both renal scan with Tc-99m DMSA and renal sonography. The study revealed that most urinary tract infections are in children, female sex between 5-9 years of age. Therefore the most important complications (renal scarring) are also common in this age-sex distribution. Occurrence of renal scars increase with increasing the number of recurrent infections. Vesicoureteral reflux is one of the most important, common risk factors for renal scarring. Renal Tc-99m Dmsa scan is more sensitive than renal sonography in detecting the renal scars

  2. Risk factors and features of recurrent bacterial complications of upper respiratory tract viral infections in children

    Directory of Open Access Journals (Sweden)

    Karpenko A.V.

    2017-10-01

    Full Text Available The aim of the study was to determine risk factors for recurrent bacterial complications of the upper respiratory tract viral infection (URTI in children, as well as the clinical and immunological features of the course of such complications. We enrolled 214 children aged 3-18 years with URTIs complicated with acute otitis media or acute bacterial rhinosinusitis. Frequency of bacterial complications of URI in 128 children was low (group I and in 86 children it met the criteria of recurrent course (group II. In addition to the standard examination, lysozyme levels in the oropharyngeal secretion were determined three times during the disease. It was found that children of group II were characterized by an early debut of respiratory morbidity (at the age of 6.00 (4.00, 12.00 months against 13.00 (4.50, 16.00 months in children of group I (p<0,0001, as well as a longer duration of catarrhal and intoxication syndromes in similar forms of the disease. The most significant risk factors for the formation of the recurring complication pattern were maternal smoking (OR=2.73, 95% CI [1.34, 5.48], along with gastroenterological pathology and frequent URTI in the mother and a shortened period of breastfeeding. In children with recurrent bacterial complications of URTI, there was an impaired local resistance of the upper respiratory tract mucous membranes (as a decrease in the concentrations of lysozyme in all periods of the disease, which persisted after recovery.

  3. Multicenter Study of Pin Site Infections and Skin Complications Following Pinning of Pediatric Supracondylar Humerus Fractures.

    Science.gov (United States)

    Combs, Kristen; Frick, Steven; Kiebzak, Gary

    2016-12-03

    Pediatric supracondylar humerus fractures are the most common elbow fractures in pediatric patients. Surgical fixation using pins is the primary treatment for displaced fractures. Pin site infections may follow supracondylar humerus fracture fixation; the previously reported incidence rate in the literature is 2.34%, but there is significant variability in reported incidence rates of pin site infection. This study aims to define the incidence rate and determine pre-, peri-, and postoperative factors that may contribute to pin site infection following operative reduction, pinning, and casting. A retrospective chart analysis was performed over a one-year period on patients that developed pin site infection. A cast care form was added to Nemours' electronic medical records (EMR) system (Epic Systems Corp., Verona, WI) to identify pin site infections for retrospective review. The cast care form noted any inflamed or infected pins. Patients with inflamed or infected pin sites underwent a detailed chart review. Preoperative antibiotic use, number and size of pins used, method of postoperative immobilization, pin dressings, whether postoperative immobilization was changed prior to pin removal, and length of time pins were in place was recorded. A total of 369 patients underwent operative reduction, pinning, and casting. Three patients developed a pin site infection. The pin site infection incidence rate was 3/369=0.81%. Descriptive statistics were reported for the three patients that developed pin site infections and three patients that developed pin site complications. Pin site infection development is low. Factors that may contribute to the development of pin site infection include preoperative antibiotic use, length of time pins are left in, and changing the cast prior to pin removal.

  4. High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus

    Science.gov (United States)

    Viedma, Esther; Chaves, Fernando; Lalueza, Antonio; Fortún, Jesús; Loza, Elena; Pujol, Miquel; Ardanuy, Carmen; Morales, Isabel; de Cueto, Marina; Resino-Foz, Elena; Morales-Cartagena, Alejandra; Rico, Alicia; Romero, María P.; Orellana, María Ángeles; López-Medrano, Francisco; Fernández-Ruiz, Mario; Aguado, José María

    2016-01-01

    We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011–June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 μg/mL and 0.5 μg/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2–5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1–5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications. PMID:27192097

  5. Comparing between results and complications of doing voiding cystourethrogram in the first week following urinary tract infection and in 2-6 weeks after urinary tract infection in children referring to a teaching hospital.

    Science.gov (United States)

    Yousefichaijan, Parsa; Dorreh, Fatemeh; Shahsavari, Someyeh; Pakniyat, Abdolghader

    2016-01-01

    Urinary tract infection is the most common genitourinary disease in children so about 40% of the children with urinary tract infection suffering from reflux that caused some consequences such as pyelonephritis and kidney parenchymal injury. This research was conducted to compare the timing of voiding cystourethrogram (VCUG) in children with urinary tract infection in first week and after the first week of urinary tract infection. This research is a case-control study that both case and control groups include 208 children from 1 month to 12 years old with the complain of urinary tract infection. In case group, the VCUG was performed at the first week of infection and in control group, the VCUG was performed after the first week of infection. complication such as dysuria was observed in two-thirds of children who VCUG was performed during first week after urinary tract infection. Parents stress in case group was more than the other (P=0.015). For overall, the incidence of reflux in case and control groups was 49.5% and 50%, respectively. The mean of reflux grading in right kidney in case group was lower than control group resulting in significant differences between two groups. According to higher grade of stress in parents and complications due to VCUG at the first week of urinary tract infection, it is suggested that VCUG be conducted on selective patients in the hospital at the first week of urinary tract infection and during hospitalization.

  6. Quality of life and complications at the different stages of bone transport for treatment infected nonunion of the tibia.

    Science.gov (United States)

    Wang, Hu; Wei, Xing; Liu, Ping; Fu, Ya-Hui; Wang, Peng-Fei; Cong, Yu-Xuan; Zhang, Bin-Fei; Li, Zhong; Lei, Jin-Lai; Zhang, Kun; Zhuang, Yan

    2017-11-01

    The aim of this study was to assess Physical Component Summary (PCS), Mental Component Summary (MCS) of the Mos 36-item Short Form Health Survey (SF-36) score, and the virtual Analogue Scale (VAS) of pain during the treatment period and the complication rate associated with infected nonunion of the tibia managed surgically by bone transport.This is a retrospective analysis of prospectively collected data in a consecutive patient cohort. Patients suffering from infected nonunion of the tibia were treated by bone transport from 2012 to 2014. Follow-up was for at least 2 years after complete osseous consolidation. Standardized treatment included bacterial eradication by segmental resection, bone transport using Ilizarov apparatus, and docking maneuver. The main outcome measurements consisted of the quality of life (PCS and MCS scores) and the VAS of pain during the different stages of therapy. In addition, all complications were documented.Our series comprised 12 men and 3 women with an average age of 36.9 years (range: 20-55 years). All patients previously undergone an average of 2.9 operations (range: 1-6 operations). In all patients, bone defects were present with a mean size of 7.5 cm (range: 3-12 cm), and all patients were suffering from soft tissue defects (range: 5-17 cm). The mean external fixator time (EFT) was 48 weeks (range: 30-62 weeks) and the mean external fixation index was 43.1 days/cm (range: 33-62 days/cm). All patients achieved bone union, and no recurrence of infection was observed. According to the Paley classification, patients suffered 15 minor and 13 major complications. The average complication rate per patient comprised of 1.0 minor and 0.9 major complications. Bone grafting was required in 6 cases at the docking site. One patient suffered from equinus deformity, and refused any further surgical procedures. We performed 28 operations in 15 patients (average 1.9 operations per patient). After the period of bone transport, PCS and MCS

  7. Prenatal complicated duplex collecting system and ureterocele-Important risk factors for urinary tract infection.

    Science.gov (United States)

    Visuri, Sofia; Jahnukainen, Timo; Taskinen, Seppo

    2018-04-01

    To evaluate the risk of urinary tract infections (UTIs) in infants with prenatally detected complicated duplex collecting system (CDS) or ureterocele. All patients with prenatally detected CDS (n=34) or single system ureterocele (n=7) who were admitted to our institution between 2003 and 2013 were enrolled in this retrospective analysis. Duplex collecting systems with ureterocele (n=13), vesicoureteral reflux (VUR) (n=20) or nonrefluxing megaureter without ureterocele (n=7) were determined as complicated. Twenty-six (63%) patients were females. The prevalence of UTI was compared to 66 controls. The median follow-up time was 5.5 (1.7-12.2) years. Eighteen (44%) patients and 3 (5%) controls had at least one UTI (pduplex collecting system associated with nonrefluxing megaureter are at high risk of UTI despite prophylactic antibiotics. In case of prenatally detected ureterocele we suggest to consider early endoscopic perforation. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Complications in ankle fracture surgery

    OpenAIRE

    Ovaska, Mikko

    2015-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  9. Pulmonary artery intravascular abscess: A rare complication of incomplete infective endocarditis treatment in the setting of injection drug use

    Directory of Open Access Journals (Sweden)

    Simran Gupta

    Full Text Available Infective endocarditis (IE is a serious complication of injection drug use. Right-sided IE encompasses 5–10% of all IE cases, with the majority involving the tricuspid valve (TV. The predominant causal organism is Staphylococcus aureus. Most cases of right-sided IE can be successfully treated with antimicrobials, but approximately 5–16% require eventual surgical intervention. We report the case of a 36-year-old female with active injection drug use who developed methicillin-sensitive Staphylococcus aureus IE of the tricuspid valve. Associated with poor adherence to medical therapy as a consequence of opioid addiction, she developed septic emboli to the lungs and an intravascular abscess in the left main pulmonary artery. These long-term potentially fatal, sequelae of incompletely treated IE require surgical intervention, as medical therapy is unlikely to be sufficient. Surgical management may involve TV replacement, pulmonary artery resection, and pneumonectomy. Prevention of these complications may have been achieved by concurrent opioid addiction therapy. An intravascular pulmonary artery abscess is a novel complication of advanced IE that has not been previously reported. This complication likely arose due to incomplete IE treatment as a consequence of opioid addiction, highlighting the need for concurrent addiction management. Intravenous antimicrobial therapy is likely not adequate, and surgical intervention, including pulmonary artery resection and pneumonectomy may be necessary. Keywords: Pulmonary artery abscess, Infective endocarditis, Injection drug use, Opioid use disorder

  10. Computed tomography of complications of lung transplantation

    International Nuclear Information System (INIS)

    Soyer, P.; Devine, N.; Frachon, I.; Vinatier, I.; Stern, M.; Le Normand, S.; Scherrer, A.

    1997-01-01

    In spite of improvements in single or double lung transplantation (LT) technique, complications after LT are not uncommon; the most frequent ale anastomotic complications, infections and rejection (acute or chronic). Early detection of complications of LT allows the optimal therapeutic option to be taken, yielding decreased morbidity and mortality. In some cases, CT plays a key role in early detection of several complications of LT that may not be depicted with other diagnostic modalities, so that knowledge of their CT features is important. In this pictorial review, the authors describe the spectrum of CT features of the complications of LT (including reimplantation response, mechanical problems, acute and chronic rejection, infection, lymphoproliferative disorders, recurrence of the initial disease and complications involving the pleura and the anastomotic sites). In addition, the authors analyze the value of CT compared to that of the other available modalities for the detection of complications of LT. (orig.). With 19 figs

  11. Meningitis and subdural empyema as complication of pterygomandibular space abscess upon tooth extraction.

    Science.gov (United States)

    Cariati, Paolo; Cabello-Serrano, Almudena; Monsalve-Iglesias, Fernando; Roman-Ramos, Maria; Garcia-Medina, Blas

    2016-10-01

    Complication of dental infections might be various and heterogeneous. The most common complications are represented by maxilar celulitis, canine space celulitis, infratemporal space celulitis, temporal celulitis and bacteremia. Among rarest complications we found: sepsis, bacterial endocarditis, mediastinitis, intracranial complications, osteomyelitis, etc. Although dental infections are often considered trivial entities, sometimes they can reach an impressive gravity. In this regard, the present study describes a case of dental infection complicated by meningitis, subdural empiema and cerebral vasculitis. Furthermore, we observed other neurological complications, like thalamic ischemic infarction, during the disease evolution. Noteworthy, these entities were not presented when the patient was admitted to hospital. Therefore, the main aim of this report is to highlight the serious consequences that an infection of dental origin could cause. Key words: Meningitis, subdural empyema, odontogenic infections.

  12. Infective Endocarditis Complicated by Intraventricular Abscesses, Pericarditis, and Mycotic Aneurysm Due to an Emerging Strain of Serotype VI Streptococcus agalactiae.

    Science.gov (United States)

    Hirai, Nobuyasu; Kasahara, Kei; Uno, Kenji; Ogawa, Yoshihiko; Ogawa, Taku; Yonekawa, Shinsuke; Nakano, Ryuichi; Yano, Hisakazu; Sakagami, Azusa; Uemura, Takayuki; Okura, Hiroyuki; Saito, Yoshihiko; Yoshikawa, Masahide; Mikasa, Keiichi

    2017-11-22

    An increasing number of invasive infections due to Streptococcus agalactiae in non-pregnant adults have been reported. We report a case of infective endocarditis complicated by intraventricular abscesses, pericarditis, and mycotic aneurysm due to S. agalactiae belonging to ST681 with a capsular serotype VI in a woman with diabetes. The patient also had a myocardial infarction and was treated with percutaneous coronary intervention, pericardiocentesis, and 6 weeks of antibiotic treatment. Invasive infections due to serotype VI S. agalactiae are common in Asian countries such as Taiwan and Japan, so continuous monitoring of invasive S. agalactiae strains is warranted.

  13. Body piercing: complications and prevention of health risks.

    Science.gov (United States)

    Holbrook, Jaimee; Minocha, Julia; Laumann, Anne

    2012-02-01

    Body and earlobe piercing are common practices in the USA today. Minor complications including infection and bleeding occur frequently and, although rare, major complications have been reported. Healthcare professionals should be cognizant of the medical consequences of body piercing. Complications vary depending on the body-piercing site, materials used, experience of the practitioner, hygiene regimens, and aftercare by the recipient. Localized infections are common. Systemic infections such as viral hepatitis and toxic shock syndrome and distant infections such as endocarditis and brain abscesses have been reported. Other general complications include allergic contact dermatitis (e.g. from nickel or latex), bleeding, scarring and keloid formation, nerve damage, and interference with medical procedures such as intubation and blood/organ donation. Site-specific complications have been reported. Oral piercings may lead to difficulty speaking and eating, excessive salivation, and dental problems. Oral and nasal piercings may be aspirated or become embedded, requiring surgical removal. Piercing tracts in the ear, nipple, and navel are prone to tearing. Galactorrhea may be caused by stimulation from a nipple piercing. Genital piercings may lead to infertility secondary to infection, and obstruction of the urethra secondary to scar formation. In men, priapism and fistula formation may occur. Women who are pregnant or breastfeeding and have a piercing or are considering obtaining one need to be aware of the rare complications that may affect them or their child. Though not a 'complication' per se, many studies have reported body piercing as a marker for high-risk behavior, psychopathologic symptoms, and anti-social personality traits. When it comes to piercing complications, prevention is the key. Body piercers should take a complete medical and social history to identify conditions that may predispose an individual to complications, and candidates should choose a

  14. 55 HIV/AIDS, SURGICAL COMPLICATIONS AND CHALLENGES ...

    African Journals Online (AJOL)

    drclement

    Department of Surgery University of Benin Teaching Hospital Benin City. INTRODUCTION. Surgical complication resulting ... Bone/Joint Infections. Tuberculosis infection and bacteria infection are common in this patient and the treatment is the same for non HIV- infected individual. Chest Condition. This is usually due to ...

  15. Two different nervous system complications of mycoplasma pneumoniae

    OpenAIRE

    Faruk İncecik; M. Özlem Hergüner; Şakir Altunbaşak

    2010-01-01

    Mycoplasma pneumoniae is an important agent of the lower and upper respiratory system infections. It may resultin some complications and clinical conditions other than infections. Meningoencephalitis, encephalitis, transversemyelitis, acute disseminated encephalomyelitis, cerebral infarction and Gullian-Barre syndrome are major neurological complications.We present here two cases with meningoencephalitis and Gullian-Barre syndrome secondary to Mycoplasma pneumoniaeinfection.

  16. Two different nervous system complications of mycoplasma pneumoniae

    Directory of Open Access Journals (Sweden)

    Faruk İncecik

    2010-06-01

    Full Text Available Mycoplasma pneumoniae is an important agent of the lower and upper respiratory system infections. It may resultin some complications and clinical conditions other than infections. Meningoencephalitis, encephalitis, transversemyelitis, acute disseminated encephalomyelitis, cerebral infarction and Gullian-Barre syndrome are major neurological complications.We present here two cases with meningoencephalitis and Gullian-Barre syndrome secondary to Mycoplasma pneumoniaeinfection.

  17. MRI findings of neurologic complications in the enterovirus 71-infected hand-foot-mouth disease

    International Nuclear Information System (INIS)

    Chen Feng; Li Jianjun; Liu Tao; Xiang Wei; Wen Guoqiang

    2010-01-01

    Objective: To explore the imaging characteristics of neurologic complications associated with the enterovirus 71 (EV71) epidemic by analyzing 25 cases and reviewing the literature. Methods: Twenty-five cases of hand-foot-mouth disease with neurologic complications during the recent EV71 outbreaks of Hainan province were studied for the clinical features and imaging findings, and literature were reviewed. Results: In 5 cases, acute flaccid paralysis associated with EV71-infected hand-foot-mouth disease was related to the linear high signal in the spinal cord on sagittal images. Two cases showed symmetrical, well- defined hyperintense lesions in the spinal cord on T 2 WI transverse. Strong enhancement of the ventral horns and root was seen on the contrast-enhanced axial T 1 WI. In brainstem encephalitis, all lesions presented with significant hyperintensity on T 2 WI and hypointense on T 1 WI in the posterior portions of the medulla oblongata, midbrain, and pons. The manifestations of aseptic meningitis (AM) on MRI have no characteristics, but subdural effusion, meningeal enhancement and hydrocephalus can be the indirect signs of AM. Conclusions: MRI is an effective method to investigate neurologic complications associated with the EV71 epidemic. Posterior portions of the medulla oblongata and pons, bilateral ventral horns of spinal involvement are characteristic findings of enteroviral encephalomyelitis. (authors)

  18. Clostridium difficile infection : epidemiology, complications and recurrences

    NARCIS (Netherlands)

    Bauer, Martijn Philippe

    2014-01-01

    Clostridium difficile is a spore-forming bacterium, the toxin-producing strains of which cause colitis. Risk factors are antibiotics, advanced age and severe comorbidity. C. difficile infection (CDI) has been regarded as mostly a hospital-acquired infection. Preventing relapses is considered the

  19. Challenges in the management of cardiovascular emergencies in Sub-Saharan Africa: a case report of acute heart failure complicating infective endocarditis in a semi-urban setting in Cameroon.

    Science.gov (United States)

    Nkoke, Clovis; Teuwafeu, Denis; Nkouonlack, Cyrille; Abanda, Martin; Kouam, Wilfried; Mapina, Alice; Makoge, Christelle; Hamadou, Ba

    2018-04-25

    Infective endocarditis is a deadly disease if not promptly treated with antibiotics either in association with cardiac surgery or not. Cardiac complications are the most common complications seen in infective endocarditis. Heart failure remains the most common cause of mortality and the most common indication for cardiac surgery in patients with infective endocarditis which is increasingly available in resource limited settings. We report a case of native valve infective endocarditis of the aortic valve in a 27-year old female in a semi-urban setting in Cameroon complicated by severe aortic valve regurgitation and heart failure. She presented with a 2 month history of fever and a 2 weeks history of rapidly worsening shortness of breath. Emergency cardiac surgery was indicated which unfortunately could not be performed leading to the death of the patient. In spite of improvement in availability of diagnostic and therapeutic modalities for cardiovascular emergencies, affordability is still a challenge. Universal health coverage is advocated else the ravages of premature mortality from cardiovascular diseases may continue to remain unchecked in Sub-Saharan Africa.

  20. Antibacterial Treatment of Meticillin-Resistant Staphylococcus Aureus Complicated Skin and Soft Tissue Infections: a Cost and Budget Impact Analysis in Greek Hospitals

    OpenAIRE

    Athanasakis, Kostas; Petrakis, Ioannis; Ollandezos, Mark; Tsoulas, Christos; Patel, Dipen A.; Karampli, Eleftheria; Kyriopoulos, John

    2014-01-01

    Introduction Meticillin-resistant staphylococcus aureus (MRSA) is an important cause of antimicrobial-resistant infections worldwide. Its prevalence remains high in the Greek hospital setting. Complicated skin and soft tissue infections (cSSTIs) due to MRSA are associated with prolonged hospitalization, additional healthcare costs and significant morbidity. The purpose of this study was to conduct a cost analysis and a budget impact analysis relative to different management scenarios for MRSA...

  1. [Orbital cellulitis complicated by subperiosteal abscess due to Streptococcus pyogenes infection].

    Science.gov (United States)

    Ruíz Carrillo, José Daniel; Vázquez Guerrero, Edwin; Mercado Uribe, Mónica Cecilia

    Orbital cellulitis is an infectious disease that is very common in pediatric patients, in which severe complications may develop. Etiological agents related to this disease are Haemophilus influenzae B, Staphylococcus aureus, Streptococcus pneumoniae and Moraxella catarrhalis, which correspond to 95% of cases. Moreover, Streptococcus beta hemolytic and anaerobic microorganisms may also be present corresponding to < 5% of the cases. We present an uncommon case of cellulitis complicated by sub-periosteal abscess caused by Streptococcus pyogenes (Group A beta hemolytic streptococcus). A 9-year-old male patient with a history of deficit disorder and hyperactivity since 5 years of age. His current condition started with erythema in the external edge of the right eye, increase in peri-orbicular volume with limitation of eyelid opening, progression to proptosis, pain with eye movements and conjunctival purulent discharge. Image studies reported subperiosteal abscess and preseptal right with extraocular cellulitis. The patient started with empirical antibiotic treatment, surgical drainage and culture of purulent material from which Streptococcus pyogenes was isolated. Due to the implementation of vaccination schemes against H. influenza and S. pneumoniae since the 90s, the cases by these pathogens have decreased, causing new bacteria to take place as the cause of the infection. The importance of considering S. pyogenes as an etiology of orbital cellulitis is the rapid progression to abscess formation, and the few cases described in the literature. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  2. Medical complications following splenectomy.

    Science.gov (United States)

    Buzelé, R; Barbier, L; Sauvanet, A; Fantin, B

    2016-08-01

    Splenectomy is attended by medical complications, principally infectious and thromboembolic; the frequency of complications varies with the conditions that led to splenectomy (hematologic splenectomy, trauma, presence of portal hypertension). Most infectious complications are caused by encapsulated bacteria (Meningococcus, Pneumococcus, Hemophilus). These occur mainly in children and somewhat less commonly in adults within the first two years following splenectomy. Post-splenectomy infections are potentially severe with overwhelming post-splenectomy infection (OPSI) and this justifies preventive measures (prophylactic antibiotics, appropriate immunizations, patient education) and demands prompt antibiotic management with third-generation cephalosporins for any post-splenectomy fever. Thromboembolic complications can involve both the caval system (deep-vein thrombophlebitis, pulmonary embolism) and the portal system. Portal vein thrombosis occurs more commonly in patients with myeloproliferative disease and cirrhosis. No thromboembolic prophylaxis is recommended apart from perioperative low molecular weight heparin. However, some authors choose to prescribe a short course of anti-platelet medication if the post-splenectomy patient develops significant thrombocytosis. Thrombosis of the portal or caval venous system requires prolonged warfarin anticoagulation for 3 to 6 months. Finally, some studies have suggested an increase in the long-term incidence of cancer in splenectomized patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Successful treatment of acute renal failure secondary to complicated infective endocarditis by peritoneal dialysis: a case report.

    Science.gov (United States)

    Al-Osail, Aisha M; Al-Zahrani, Ibrahim M; Al-Abdulwahab, Abdullah A; Alhajri, Sarah M; Al-Osail, Emad M; Al-Hwiesh, Abdullah K; Al-Muhanna, Fahad A

    2017-09-07

    Infective endocarditis is one of the most common infections among intravenous drug addicts. Its complications can affect many systems, and these can include acute renal failure. There is a scarcity of cases in the literature related to acute renal failure secondary to infective endocarditis treated with peritoneal dialysis. In this paper, the case of a 48-year-old Saudi male is reported, who presented with features suggestive of infective endocarditis and who developed acute kidney injury that was treated successfully with high tidal volume automated peritoneal dialysis. To our knowledge, this is the second report of such an association in the literature. A 48-year-old Saudi gentleman diagnosed to have a glucose-6-phosphate dehydrogenase deficiency and hepatitis C infection for the last 9 years, presented to the emergency department with a history of fever of 2 days' duration. On examination: his temperature = 41 °C, there was clubbing of the fingers bilaterally and a pansystolic murmur in the left parasternal area. The results of the blood cultures and echocardiogram were supportive of the diagnosis of infective endocarditis, and the patient subsequently developed acute kidney injury, and his creatinine reached 5.2 mg/dl, a level for which dialysis is essential for the patient to survive. High tidal volume automated peritoneal dialysis is highly effective as a renal replacement therapy in acute renal failure secondary to infective endocarditis if no contraindication is present.

  4. Varicella complications: Is it time to consider a routine varicella vaccination?

    Directory of Open Access Journals (Sweden)

    Dulović Olga

    2010-01-01

    Full Text Available Background/Aim. Varicella is a common and benign disease of childhood. Complications are rare, but in some patients, even without risk factors, severe, life threatening complications could be seen. The aim of this study was to establish the type and frequency of varicella complications among hospitalized patients over an 8-year period. Methods. This retrospective analysis included medical charts of the patients hospitalized in the Infectious Disease Clinic, Belgrade, Serbia, from 2001-2008 (4.85% of all registered patients with varicella in Belgrade, 2001-2008. Among hospitalised patients dermografic characteristics were analyzed: hospitalisation lenght, presence and type of complications, presence of immunocompromising conditions and outcome of the disease. The diagnosis of varicella was made on clinical grounds, and in persons > 40 years, with negative epidemiological data of contacts, serological confirmation (ELISA VZV IgM/IgG BioRad® and avidity of IgG antibodies were done to exclude the possibility of disseminated herpes zoster. Results. A total of 474 patient were hospitalized over an 8-year period. The age of patients was from 5 months to 75 years (mean 22.4 ± 16.1, median 23.5 years. The majority of patients were adults (n = 279; 58.9% and 195 (41.1% patients were ≤ 15 years old. Complications were found in 321/474 (67.7% patients. The registered complications were: varicella pneumonia (n = 198; 41.38%, bacterial skin infections (n = 40; 8.4%, cerebelitis (n = 28; 5.9%, bacterial respiratory infection (n = 21; 4.4%, viral meningitis (n = 10; 2.31%, encephalitis (n = 9; 1.9%, thrombocytopenia (n = 2; 0.4%; 11 (2.3% patients had more than one complication, among them were sepsis, myopericarditis and retinal hemorrhages. When complications were analyzed according to the age, there were no statistical significance, but when type of complication was analyzed statistical significance was found (p < 0.05. In adults, pneumonia was the most

  5. Antimicrobial Treatmdent of "Complicated" Intra-Abdominal Infections and The New IDSA Guidelines - A Commentary and an Alternative European Approach According to Clinical Definitions

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    Eckmann C

    2011-03-01

    Full Text Available Abstract Recently, an update of the IDSA guidelines for the treatment of complicated intraabdominal infections has been published. No guideline can cater for all variations in ecology, antimicrobial resistance patterns, patient characteristics and presentation, health care and reimbursement systems in many different countries. In the short time the IDSA guidelines have been available, a number of practical clinical issues have been raised by physicians regarding interpretation of the guidelines. The main debatable issues of the new IDSA guidelines are described as follows: The authors of the IDSA guidelines present recommendations for the following subgroups of "complicated" IAI: community-acquired intra-abdominal infections of mild-to-moderate and high severity and health care-associated intra-abdominal infections (no general treatment recommendations, only information about antimicrobial therapy of specific resistant bacterial isolates. From a clinical point of view, "complicated" IAI are better differentiated into primary, secondary (community-acquired and postoperative and tertiary peritonitis. Those are the clinical presentations of IAI as seen in the emergency room, the general ward and on ICU. Future antibiotic treatment studies of IAI would be more clinically relevant if they included patients in studies for the efficacy and safety of antibiotics for the treatment of the above mentioned forms of IAI, rather than conducting studies based on the vague term "complicated" intra-abdominal infections. The new IDSA guidelines for the treatment of resistant bacteria fail to mention many of new available drugs, although clinical data for the treatment of "complicated IAI" with new substances exist. Further-more, treatment recommendations for cIAI caused by VRE are not included. This group of diseases comprises enough patients (i.e. the entire group of postoperative and tertiary peritonitis, recurrent interventions in bile duct surgery or

  6. Symptomatic and Asymptomatic Neurological Complications of Infective Endocarditis: Impact on Surgical Management and Prognosis

    Science.gov (United States)

    Delahaye, François; Tattevin, Pierre; Federspiel, Claire; Le Moing, Vincent; Chirouze, Catherine; Nazeyrollas, Pierre; Vernet-Garnier, Véronique; Bernard, Yvette; Chocron, Sidney; Obadia, Jean-François; Alla, François; Hoen, Bruno; Duval, Xavier

    2016-01-01

    Objectives Symptomatic neurological complications (NC) are a major cause of mortality in infective endocarditis (IE) but the impact of asymptomatic complications is unknown. We aimed to assess the impact of asymptomatic NC (AsNC) on the management and prognosis of IE. Methods From the database of cases collected for a population-based study on IE, we selected 283 patients with definite left-sided IE who had undergone at least one neuroimaging procedure (cerebral CT scan and/or MRI) performed as part of initial evaluation. Results Among those 283 patients, 100 had symptomatic neurological complications (SNC) prior to the investigation, 35 had an asymptomatic neurological complications (AsNC), and 148 had a normal cerebral imaging (NoNC). The rate of valve surgery was 43% in the 100 patients with SNC, 77% in the 35 with AsNC, and 54% in the 148 with NoNC (p<0.001). In-hospital mortality was 42% in patients with SNC, 8.6% in patients with AsNC, and 16.9% in patients with NoNC (p<0.001). Among the 135 patients with NC, 95 had an indication for valve surgery (71%), which was performed in 70 of them (mortality 20%) and not performed in 25 (mortality 68%). In a multivariate adjusted analysis of the 135 patients with NC, age, renal failure, septic shock, and IE caused by S. aureus were independently associated with in-hospital and 1-year mortality. In addition SNC was an independent predictor of 1-year mortality. Conclusions The presence of NC was associated with a poorer prognosis when symptomatic. Patients with AsNC had the highest rate of valve surgery and the lowest mortality rate, which suggests a protective role of surgery guided by systematic neuroimaging results. PMID:27400273

  7. Complicated acute appendicitis presenting as a rapidly progressive soft tissue infection of the abdominal wall: a case report.

    Science.gov (United States)

    Beerle, Corinne; Gelpke, Hans; Breitenstein, Stefan; Staerkle, Ralph F

    2016-12-01

    We report a case of a rare complication of acute appendicitis with perforation through the abdominal wall. The case points out that an intraabdominal origin should be considered in patients presenting with rapidly spreading soft tissue infections of the trunk. A 58-year-old European woman presented to our hospital with a 1-week history of severe abdominal pain accompanied by rapidly spreading erythema and emphysema of the lower abdomen. On admission, the patient was in septic shock with leukocytosis and elevation of C-reactive protein. Among other diagnoses, necrotizing fasciitis was suspected. Computed tomography showed a large soft tissue infection with air-fluid levels spreading through the lower abdominal wall. During the operation, we found a perforated appendicitis breaking through the fascia and causing a rapidly progressive soft tissue infection of the abdominal wall. Appendicitis was the origin of the soft tissue infection. The abdominal wall was only secondarily involved. Even though perforated appendicitis as an etiology of a rapidly progressive soft tissue infection of the abdominal wall is very rare, it should be considered in the differential diagnosis of abdominal wall cellulitis. The distinction between rapidly spreading subcutaneous infection with abscess formation and early onset of necrotizing fasciitis is often difficult and can be confirmed only by surgical intervention.

  8. Bilateral rectus sheath haematoma complicating dengue virus infection in a patient on warfarin for mechanical aortic valve replacement: a case report.

    Science.gov (United States)

    Rosa, Chamith Thushanga; Navinan, Mitrakrishnan Rayno; Samarawickrama, Sincy; Hamza, Himam; Gunarathne, Maheshika; Arulanantham, Arulprashanth; Subba, Neeha; Samarasiri, Udari; Mathias, Thushara; Kulatunga, Aruna

    2017-01-07

    The management of Dengue virus infection can be challenging. Varied presentations and numerous complications intrinsic to dengue by itself increase the complexity of treatment and potential mortality. When burdened with the presence of additional comorbidities and the need to continue compulsory medications, clear stepwise definitive guidance is lacking and patients tend to have more complex complications and outcomes calling to question the clinical decisions that may have been taken. The use and continuation of warfarin in dengue virus infection is one such example. We report a 65 year old South Asian female who presented with dengue fever. She had a history bronchial asthma, a prior abdominal surgery, and was on warfarin and maintained a therapeutically appropriate internationalized normalized ratio for a mechanical aortic valve replacement. Though preemptive decision to stop warfarin was taken with decreasing platelet counts, her clinical course was complicated with the development of bilateral rectus sheath haematoma's requiring resuscitation with blood transfusions. Though management of dengue viral fever has seen drastic evolution with recent updated guidance, clinical scenarios seen in the course of the illness still pose challenges to the managing physician. The need to continue obligatory anticoagulation which may seem counterintuitive during a complex disease such as dengue virus infection must be considered after understanding the potential risks versus that of its benefits. Though case by case decisions maybe warranted, a clear protocol would be very helpful in making clinical decisions, as the correct preemptive decision may potentially avert catastrophic and unpredictable bleeding events.

  9. A Case of Invasive Pneumococcal Infection with Septic Shock and Rare Complications

    Directory of Open Access Journals (Sweden)

    John R. Woytanowski

    2017-01-01

    Full Text Available Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and altered mental status. She initially presented with worsening back pain and was found to have leukocytosis with bandemia and acute renal failure but she was in septic shock upon arrival to our tertiary care center. Her blood cultures grew Streptococcus pneumoniae and MRI of the brain revealed pus within the posterior lateral ventricles and multiple infarcts. MRI of the spine revealed a psoas abscess. Transesophageal echocardiogram revealed mitral valve vegetation and her right eye developed endogenous endophthalmitis. She was treated with intravenous and intravitreal antibiotics and underwent drainage of the abscess with no improvement in mental status. Repeat imaging revealed multiple new thalamic, basal ganglia, and parietal lobe infarcts likely from septic emboli. After a protracted ICU stay, the patient’s family opted for comfort care. The incidence of invasive pneumococcal infections has declined rapidly since the advent of antibiotics and vaccines. With the growing incidence of antibiotic resistance as well as the emergence of new immunomodulating drugs for various pathologies, there is a concern that invasive infections will reemerge. Ventriculitis and endogenous endophthalmitis are very rare complications of pneumococcal bacteremia.

  10. Complications, effectiveness, and long term follow-up of fecal microbiota transfer by nasoduodenal tube for treatment of recurrent Clostridium difficile infection

    NARCIS (Netherlands)

    van Beurden, Yvette H.; De Groot, Pieter F.; van Nood, Els; Nieuwdorp, Max; Keller, Josbert J.; Goorhuis, Abraham

    2017-01-01

    Fecal microbiota transfer (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI), but data on procedure-related complications and long-term outcome are scarce. All patients treated with FMT for recurrent CDI at the Academic Medical Center between July 2010 and January

  11. Factors associated with neonatal ostomy complications.

    Science.gov (United States)

    Lockhat, Aliyah; Kernaleguen, Guen; Dicken, Bryan J; van Manen, Michael

    2016-07-01

    Neonatal ostomies, either temporary or permanent, are created for numerous reasons. Limited attention has been given to understanding what factors might place infants at risk for surgical wound complications. The purpose of the study is to identify factors associated with risk of significant abdominal wound complications (wound dehiscence and wound infection) following neonatal ostomy creation. This is a retrospective chart review of infants undergoing ostomy between January 2009 and December 2013 at the University of Alberta Hospital. 66 infants were identified of which 18.2% (12/66) had wound complications. Variables associated with wound dehiscence included: findings of bowel necrosis during laparotomy (7/9 wound dehiscence, 18/57 none, p=0.008), perioperative sepsis (3/9 wound dehiscence, 3/57 none, p=0.006), and perioperative blood transfusion (9/9 wound dehiscence, 30/57 none, p=0.007). Wound infection was not predicted by any variables collected. Neonates undergoing creation of an ostomy appear to be at substantial risk for wound complications. As wound complications are significant issues for infants undergoing surgery, emerging strategies should be explored to either avoid ostomy creation or promote wound healing. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. INFECTIOUS COMPLICATIONS IN CHRONIC LYMPHOCYTIC LEUKEMIA

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    AnnaMaria Nosari

    2012-11-01

    Full Text Available Infectious complications have been known to be a major cause of morbidity and mortality in CLL patients who are predisposed to infections because of both the humoral immunodepression inherent to hematologic disease, which is related to stage and duration of CLL, and to further immunosuppression related to therapy. The majority of infections in CLL patients treated with alkilating agents is of bacterial origin. The immunodeficiency and natural infectious history of alkylator-resistant, corticosteroid-treated patients appears to have changed with the administration of purine analogs, which has been complicated by very severe and unusual infections and also more viral infections due to sustained reduction of CD4-positive T lymphocytes. The following introduction of monoclonal antibody therapies, in particular alemtuzumab, further increased the immunodepression, increasing also infections which appeared more often in patients with recurrent neutropenia due to chemotherapy cycles. Epidemiological data regarding fungal infections in lymphoproliferative disorders are scarce. Italian SEIFEM group in a retrospective multicentre study regarding CLL patients reported an incidence of mycoses 0.5%; however, chronic lymphoproliferative disorders emerged as second haematological underlying disease after acute leukemia in a French study on aspergillosis; in particular CLL with aspergillosis accounted for a third of these chronic lymphoproliferative diseases presenting mould infection.

  13. Extravascular complications following abdominal organ transplantation

    International Nuclear Information System (INIS)

    Low, G.; Jaremko, J.L.; Lomas, D.J.

    2015-01-01

    A variety of transplants have been performed in the abdomen including liver, kidney, pancreas and islet, bowel, and multivisceral transplants. Imaging plays an important role in graft surveillance particularly to exclude post-transplant complications. When complications occur, therapeutic image-guided interventions are invaluable as these may be graft-saving and even life-saving. Vascular complications following transplantation have been extensively reported in recent reviews. The focus of this review is to discuss post-transplant complications that are primarily extravascular in location. This includes biliary, urological, intestinal, malignancy, infections, and miscellaneous complications. Familiarity with the imaging appearances of these complications is helpful for radiologists as accurate diagnosis and expedient treatment has an impact on graft and patient survival

  14. Meningitis and subdural empyema as complication of pterygomandibular space abscess upon tooth extraction

    OpenAIRE

    Cariati, Paolo; Cabello Serrano, Almudena; Monsalve Iglesias, Fernando; Román-Ramos, María; García Medina, Blas

    2016-01-01

    Complication of dental infections might be various and heterogeneous. The most common complications are represented by maxilar celulitis, canine space celulitis, infratemporal space celulitis, temporal celulitis and bacteremia. Among rarest complications we found: sepsis, bacterial endocarditis, mediastinitis, intracranial complications, osteomyelitis, etc. Although dental infections are often considered trivial entities, sometimes they can reach an impressive gravity. In this regard, the pre...

  15. Prevotella intermedia infection causing acute and complicated aortitis-A case report.

    Science.gov (United States)

    Boersma, C; Kampschreur, L M; Buter, H; Doorenbos, B M; Klinkert, P; Koning, G G

    2017-01-01

    Aortitis is a general term that refers to all conditions involving an inflammation of the aortic wall. This case report describes the surgical approach of a patient with infectious and symptomatic aortitis caused by the rare vector Prevotella intermedia. A 44-year old male patient was admitted with fever and general discomfort after a period of sore throat in a non-teaching hospital. After two weeks he developed acute abdominal and back pain accompanied by sweating and elevated infection parameters. Computed tomography angiography revealed atherosclerotic changes of the infrarenal aorta with a locally contained rupture of the aorta alongside peri-aortal signs of inflammation (and aortitis aspects). An urgent aortic reconstruction was performed according to Nevelsteen. The blood cultures turned out positive for Prevotella intermedia. Postoperatively the patient received antibiotics for six weeks. The patient recovered uneventful from this infection and surgical procedure. A complicated and acute aortitis is a rare but potentially life-threatening disease. The aetiology can be ordered into two main groups; inflammatory and infectious. Diagnosis is based upon symptoms, biochemical values, microbiological results and imaging modalities. Treatment depends on aetiology and should be discussed in an experienced multidisciplinary setting. Infectious aortitis should be treated with antibiotics for at least six weeks with close monitoring of the patient's clinic and biochemical values, even after surgery. Prevotella intermedia is a rare causative agent for aortitis. Acute aortitis is a challenging clinical entity which should be managed in an equipped medical center by an experienced multidisciplinary team. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Management of the complications of BPH/BOO

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    Mark J Speakman

    2014-01-01

    Full Text Available Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic, haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR. Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice.

  17. Management of the complications of BPH/BOO.

    Science.gov (United States)

    Speakman, Mark J; Cheng, Xi

    2014-04-01

    Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE) and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS) but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic), haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR). Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice.

  18. MICROBIOLOGICAL METHODS APPLICATION EXPERIENCE IN THE SEVERE INJURIES INFECTIOUS COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    S. A. Svistunov

    2016-01-01

    Full Text Available Modern clinical medicine and surgery problems are associated with infections complications after medical care. In recent years, surgery has made substantial progress related to the new organizational approaches and medical technology specialized medical care to the wounded and injured. However, these gains are offset by a high rate of infectious complications that require finding effective measures emerging infectious complications timely diagnosis and their prevention. Clinical manifestations are often nosocomial in patients with severe injuries and are largely determined by the influence of clinical and pathogenetic risk factors. Such infectious complications require a comprehensive assessment, including microbiological testing. The main causative agents of infectious complications in surgical hospitals are S. aureus, K. pneumoniae, P. aeruginosa, Acinetobacter spp., which can cause bloodstream infections, soft tissue, respiratory and urinary tract infections, especially in debilitated and immunocompromised patients and patients in intensive care units. These micro organisms are dangerous to patients and medical staff, as they can survive for a long time in the hospital environment, as well as to spread from patient to patient in violation of isolation restrictive measures and requirements for hygiene of medical workers hands. Clinical patterns of infection associated with medical care for severe injuries are to the possibility of serial and parallel development, both in different and in the same time frame of local, visceral and generalized infection with prevalence of combined forms of patients surgical hospital with a high risk of nosocomial infection against the background of factors, diagnostic and treatment process and hospital environment, introduction of the agent. Early etiological diagnosis allows timely assign empirical causal treatment and arrange for infection control to prevent the spread of microorganisms in the hospital. The

  19. [COMPLICATED AMOEBIC APENDICITIS.REPORT OF A CASE

    Science.gov (United States)

    Casavilca Zambrano, Sandro; Gomez Anchante, Victor; Cisneros Gallegos, Eduardo

    2000-01-01

    We report a case of acute abdomen that is operated with the presumptive diagnosis of complicated acute appendicitis. In the histologic examination we make the diagnosis of complicated amoebic appendicitis. We discuss clinical manifestations and histopathologic findings of this unusual presentation of amoebic infection.

  20. Management of liver complications in haemoglobinopathies

    Directory of Open Access Journals (Sweden)

    Pierre Brissot

    2014-12-01

    Full Text Available Liver complications in haemoglobinopathies (thalassaemia and sickle cell disease are due to several factors, dominated (beside chronic viral infections, not considered here by chronic iron overload, biliary obstruction and venous thrombosis. Whereas the latter two factors can cause acute hepatic syndromes, all three mechanisms - when becoming chronic- can produce fibrosis and cirrhosis and even, in thalassaemia, hepatocellular carcinoma. These chronic hepatic complications are an indirect consequence of the significant improvement in life expectancy due to the overall amelioration of disease management. The diagnostic approach has benefited from non invasive (biochemical and imaging approaches which have considerably reduced the indication of liver biopsy. The therapeutic management involves relatively efficient curative medical, endoscopic or surgical methods, but should rest primarily on preventive measures focused on the haematological causative factors but also on hepatic co-morbidities. This chapter will focus on hepatic complications in thalassaemia and sickle cell disease (SCD, without considering the complications related to virus B or C infections which will be described in another chapter.

  1. [Antimicrobial treatment in complicated intraabdominal infections--current situation].

    Science.gov (United States)

    Vyhnánek, F

    2009-04-01

    Compared to other infections, intraabdominal infections include wide spectrum of infections of various severity, have different ethiology, which is frequently polymicrobial, show different microbiological results, which are difficult to interpret. The role of surgical intervention is essential. Intraabdominal infections are common causes of morbidity and mortality. Their prognosis is significantly improved with early and exact diagnosis, appropriate surgical or radiological intervention and timely effective antimicrobial therapy. Practitioners may choose between older or more modern antibiotics, between monotherapy or combination therapy, however, they should also consider clinical condition of the patient, the antibiotic's spectrum of activity, the treatment timing and its duration, the dose and dosing scheme of the particular antimicrobials. Furthermore, antimicrobial therapy should be used with caution, with the aim to prevent development of antimicrobial resistence. Inappropriate choice of antimicrobials in initial empiric therapy results in relapsing infections, surgical intervention and prolongation of hospitalization, and even death rates reflect adequate and timely empiric therapy.

  2. Global health resource utilization associated with pacemaker complications.

    Science.gov (United States)

    Waweru, Catherine; Steenrod, Anna; Wolff, Claudia; Eggington, Simon; Wright, David Jay; Wyrwich, Kathleen W

    2017-07-01

    To estimate health resource utilization (HRU) associated with the management of pacemaker complications in various healthcare systems. Electrophysiologists (EPs) from four geographical regions (Western Europe, Australia, Japan, and North America) were invited to participate. Survey questions focused on HRU in the management of three chronic pacemaker complications (i.e. pacemaker infections requiring extraction, lead fractures/insulation breaches requiring replacement, and upper extremity deep venous thrombosis [DVT]). Panelists completed a maximum of two web-based surveys (iterative rounds). Mean, median values, and interquartile ranges were calculated and used to establish consensus. Overall, 32 and 29 panelists participated in the first and second rounds of the Delphi panel, respectively. Consensus was reached on treatment and HRU associated with a typical pacemaker implantation and complications. HRU was similar across regions, except for Japan, where panelists reported the longest duration of hospital stay in all scenarios. Infections were the most resource-intensive complications and were characterized by intravenous antibiotics days of 9.6?13.5 days and 21.3?29.2 days for pocket and lead infections respectively; laboratory and diagnostic tests, and system extraction and replacement procedures. DVT, on the other hand, was the least resource intensive complication. The results of the panel represent the views of the respondents who participated and may not be generalizable outside of this panel. The surveys were limited in scope and, therefore, did not include questions on management of acute complications (e.g. hematoma, pneumothorax). The Delphi technique provided a reliable and efficient approach to estimating resource utilization associated with chronic pacemaker complications. Estimates from the Delphi panel can be used to generate costs of pacemaker complications in various regions.

  3. [Complicated acute apendicitis. Open versus laparoscopic surgery].

    Science.gov (United States)

    Gil Piedra, Francisco; Morales García, Dieter; Bernal Marco, José Manuel; Llorca Díaz, Javier; Marton Bedia, Paula; Naranjo Gómez, Angel

    2008-06-01

    Although laparoscopy has become the standard approach in other procedures, this technique is not generally accepted for acute appendicitis, especially if it is complicated due reports on the increase in intra-abdominal abscesses. The purpose of this study was to evaluate the morbidity in a group of patients diagnosed with complicated apendicitis (gangrenous or perforated) who had undergone open or laparoscopic appendectomy. We prospectively studied 107 patients who had undergone appendectomy for complicated appendicitis over a two year period. Mean operation time, mean hospital stay and morbidity, such as wound infection and intra-abdominal abscess were evaluated. In the group with gangrenous appendicitis morbidity was significantly lower in laparoscopic appendectomy group (p = 0.014). Wound infection was significantly higher in the open appendectomy group (p = 0.041), and there were no significant differences in intra-abdominal abscesses (p = 0.471). In the perforated appendicitis group overall morbidity (p = 0.046) and wound infection (p = 0.004) was significantly higher in the open appendectomy group. There were no significant differences in intra-abdominal abscesses (p = 0.612). These results suggest that laparoscopic appendectomy for complicated appendicitis is a safe procedure that may prove to have significant clinical advantages over conventional surgery.

  4. Pulmonary complications in neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Randeep Guleria

    2012-01-01

    Full Text Available Pulmonary complications are a major cause of morbidity and mortality in neurosurgical patients. The common pulmonary complications in neurosurgical patients include pneumonia, postoperative atelectasis, respiratory failure, pulmonary embolism, and neurogenic pulmonary edema. Postoperative lung expansion strategies have been shown to be useful in prevention of the postoperative complications in surgical patients. Low tidal volume ventilation should be used in patients who develop acute respiratory distress syndrome. An antibiotic use policy should be put in practice depending on the local patterns of antimicrobial resistance in the hospital. Thromboprophylactic strategies should be used in nonambulatory patients. Meticulous attention should be paid to infection control with a special emphasis on hand-washing practices. Prevention and timely management of these complications can help to decrease the morbidity and mortality associated with pulmonary complications.

  5. A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Shahzad Khan

    2015-01-01

    Full Text Available Infective endocarditis (IE is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In the acute course, however, the classic peripheral stigmata may be few or absent, particularly among intravenous drug abuse (IVDA patients in whom IE is often due to a S. aureus infection of right-sided heart valves. We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse. His clinical course was complicated by aortic valve destruction and development of third-degree AV block, as well as an aorto-left atrial fistula requiring emergent operation for AV replacement and patch repair. The patient required two reoperations for recurrent endocarditis and its complications.

  6. A massive haemothorax as an unusual complication of infective endocarditis caused by Streptococcus sanguinis.

    Science.gov (United States)

    Kim, Kyoung Jin; Lee, Kang Won; Choi, Ju Hee; Sohn, Jang Wook; Kim, Min Ja; Yoon, Young Kyung

    2016-08-01

    Infective endocarditis involving the tricuspid valve is an uncommon condition, and a consequent haemothorax associated with pulmonary embolism is extremely rare. Particularly, there are no guidelines for the management of this complication. We describe a rare case of pulmonary embolism and infarction followed by a haemothorax due to infective endocarditis of the tricuspid valve caused by Streptococcus sanguinis. A 25-year-old man with a ventricular septal defect (VSD) presented with fever. On physical examination, his body temperature was 38.8 °C, and a grade III holosystolic murmur was heard. A chest X-ray did not reveal any specific findings. A transoesophageal echocardiogram showed a perimembranous VSD and echogenic material attached to the tricuspid valve. All blood samples drawn from three different sites yielded growth of pan-susceptible S. sanguinis in culture bottles. On day 12 of hospitalization, the patient complained of pleuritic chest pain without fever. Physical examination revealed reduced breathing sounds and dullness in the lower left thorax. On his chest computed tomography scan, pleural effusion with focal infarction and pulmonary embolism were noted on the left lower lung. Thoracentesis indicated the presence of a haemothorax. Our case was successfully treated using antibiotic therapy alone with adjunctive chest tube insertion, rather than with anticoagulation therapy for pulmonary embolism or cardiac surgery. When treating infective endocarditis caused by S. sanguinis, clinicians should include haemothorax in the differential diagnosis of patients complaining of sudden chest pain.

  7. Applications and complications of subclavian vein catheterization for hemodialysis

    International Nuclear Information System (INIS)

    Kamran, T.; Zaheer, K.; Khan, A.A.; Khalid, M.; Akhtar, M.S.

    2003-01-01

    Objective: To study the indications, complications and duration of 605 subclavian catheters inserted over a period of 4 years as venous access for the management of renal failure in local setup. Results: Among the patients who underwent subclavian vien catheterization, 75.2% patients were suffering from chronic renal failure and 24.7% patients were admitted for acute renal failure. Among chronic renal failure patients, 21.9% catheters had to be replaced due to various complications e.g. thrombosis, infection or kinking of the catheter. The subclavian catheters remained in place for a mean duration of 4 weeks. Early complications encountered were arterial puncture, inability to cannulate the innominate vein, hemo thorax, punctures of thoracic duct, hemo mediastinum, arrhythmias and pulmonary hematoma in 10.7%, 16.5%, 0.5%, 0.2%, 0.6% and 0.2% of patients respectively. Mortality attributed to the procedure occurred in 0.1 % cases. Delayed complications included early infection in 15% catheterizations while delayed infection occurred in 39 % cases. Conclusion: Percutaneous subclavian catheterization is valuable, relatively easy to learn and safe method with acceptable rate of complications for patients necessitating hemodialysis and no established permanent vascular access. (author)

  8. Infective complications in patients after transrectal ultrasound-guided prostate biopsy and the role of ciprofloxacin resistant Escherichia coli colonization in rectal flora.

    Science.gov (United States)

    Hamarat, Mustafa Bilal; Tarhan, Fatih; Horuz, Rahim; Öcal, Gülfem Akengin; Demirkol, Mehmet Kutlu; Kafkaslı, Alper; Yazıcı, Özgür

    2017-06-01

    In the present study, we aimed to invastigate the ciprofloxacin resistance in rectal flora of the patients undergoing prostate biopsy in our department. Additionally, the possible effects of the presence of ciprofloxacin resistant bacteria in faecal flora on the risk of infective complications after the procedure as well as the effect of antibiotic prophylaxis on such infectious complications have been evaluated. A total of 142 patients undergoing transrectal ultrasound-guided prostate biopsy were included into the study program. Rectal swab samples were taken from all patients prior to biopsy. The presence of complications have been evaluated after a week following the biopsy procedure. Patients with fever were also evaluated. The possible correlation between the presence of ciprofloxacin-resistant bacteria in faecal flora and the risk of urinary tract infection development and the other complications were evaluated. E. coli bacteria were present in all cultures of rectal swab samples obtained from 142 patients prior to prostate biopsy. Of all these patients, while ciprofloxacin-resistant E. coli (CR E. coli ) grew in 76 (53.5%) patients; ciprofloxacin susceptible E. coli (CS E. coli ) was obtained in 66 (46.5%) patients. In 16 patients (11.3%), infectious complications were observed. While the infective complications were present in the 14.5% of patients with CR E. coli ; they were present in the 7.6% of patients with CS E. coli (p=0.295). High fever was observed in nine patients (6.3%). Of these nine patients, although six had CR E. coli growth as detected during culture sensitivity tests; three had CS E. coli growth in their rectal swab culture tests. Sepsis was observed in three (2.1%) of these patients with high fever. Ciprofloxacin-resistant E. coli grew in all of the rectal swab cultures obtained from these patients with sepsis. In the light of our findings we may say that, it will be appropriate to reconsider the ciprofloxacin prophylaxis and prefer to use

  9. Pediatric ventriculoperitoneal shunts and their complications: An analysis

    Directory of Open Access Journals (Sweden)

    Nitin Agarwal

    2017-01-01

    Conclusion: With this retrospective review of complications of VP shunts, age at initial shunt insertion and the interval between the age of initial shunt placement and onset of complications were the most important patient-related predictors of shunt failure. The different predominant etiological factors responsible for early and late shunt failure were infective and mechanical complications, respectively.

  10. The postoperative complication for adenocarcinoma of esophagogastric junction

    Directory of Open Access Journals (Sweden)

    Hui Zhang

    2015-01-01

    Full Text Available Objective: The purpose of this study was to evaluate the postoperative complications for patients with adenocarcinoma of esophagogastric junction. Methods: Two hundred and eighty subjects with adenocarcinoma of esophagogastric junction who received operation were retrospectively analyzed from June 2006 to December 2010 in the Department of Oncology of First Affiliated Hospital of Bengbu Medical College, Bengbu, China. The postoperative complication such as ventricular premature beat, atrial fibrillation, supraventricular tachycardia, heart failure, pulmonary infection, pulmonary atelectasis, respiratory failure, bronchospasm, anastomotic leakage, gastroplegia, pleural infection, and cerebral accident were reviewed and recorded by to doctors. Moreover, the correlation between clinical characteristics and postoperative complication was analyzed by statistical methods. Results: A total of 70 complications were found for the included 280 cases of adenocarcinoma of esophagogastric junction with general incidence of 25%. For the relationship between clinical characteristics and postoperative complication analysis, no significant association of gender, age, operation time, operative approach, tumor differentiation, and clinical states was found with the postoperative complications (P > 0.05; but the complication rate in patients with basic disease of heart and lung was significant than the patients without this kind of disease (P < 0.05. Conclusion: The positive operative complications for patients with adenocarcinoma of esophagogastric junction were relative high. Moreover, basic heart and lung diseases can increase the risk of developing positive operative complications.

  11. Nosocomial infections in HIV-infected and HIV-uninfected children ...

    African Journals Online (AJOL)

    The interaction between tuberculosis and HIV-infected infection is well known and is responsible for the increase in the incidence of tuberculosis ... This retrospective case-control study evaluated the occurrence of nosocomial infections in (HIV)-infected children and age- and time of ... complicated disease, or whose social.

  12. Hyperparathyroidism and complications associated with vitamin D deficiency in HIV-infected adults in New York City, New York.

    Science.gov (United States)

    Kwan, Candice K; Eckhardt, Benjamin; Baghdadi, Jonathan; Aberg, Judith A

    2012-09-01

    Although recent studies report a high prevalence of vitamin D deficiency in HIV-infected adults similar to that in the general population, metabolic complications of vitamin D deficiency may be worsened with HIV infection and remain insufficiently characterized. We conducted a retrospective cross-sectional cohort study to determine prevalence and correlates of vitamin D deficiency and hyperparathyroidism among HIV-infected patients attending an urban clinic. Vitamin D deficiency was defined as 25(OH)-vitamin D hyperparathyroidism as parathyroid-hormone >65 pg/ml. We used the X(2) test to compare proportions and logistic regression to assess for associations. Among 463 HIV-infected patients, the prevalence of vitamin D deficiency was 59%. The prevalence of hyperparathyroidism was 30% among patients with vitamin D deficiency, 23% among those with insufficiency, and 12% among those with sufficient vitamin D levels. Vitamin D deficiency was associated with increased odds of hyperparathyroidism. Severe vitamin D deficiency was associated with elevated alkaline phosphatase, a marker for increased bone turnover. Although efavirenz use was associated with vitamin D deficiency, and protease inhibitor use with decreased odds of vitamin D deficiency, there was no statistical difference in rates of hyperparathyroidism stratified by combination antiretroviral therapy (cART) use. Given the increased risk of osteopenia with HIV infection and cART use, vitamin D supplementation for all HIV-infected patients on cART should be prescribed in accordance with the 2011 Endocrine Society guidelines. In HIV-infected patients with severe vitamin D deficiency or hyperparathyroidism, screening for osteomalacia and osteopenia may be warranted.

  13. [Oral complications of chemotherapy of malignant neoplasms].

    Science.gov (United States)

    Obralić, N; Tahmiscija, H; Kobaslija, S; Beslija, S

    1999-01-01

    Function and integrity disorders of the oral cavity fall into the most frequent complication of the chemotherapy of leucemias, malignant lymphomas and solid tumors. Complications associated with cancer chemotherapy can be direct ones, resulting from the toxic action of antineoplastic agents on the proliferative lining of the mouth, or indirect, as a result of myelosuppression and immunosuppression. The most frequent oral complications associated with cancer chemotherapy are mucositis, infection and bleeding. The principles of prevention and management of oral complications during cancer chemotherapy are considered in this paper.

  14. Sonographic evaluation of complications in patients with peritoneal dialysis

    International Nuclear Information System (INIS)

    Yoo, Won Don; Jho, O. K.; Kim, J. S.; Ko, B. H.; Park, H. C.

    1990-01-01

    Ultrasonography was performed prospectively in 20 patients who were undergoing continuous ambullatory peritoneal dialysis for evaluation of complications. We examined the abdominal wall along the course of catheter and the peritoneal cavity with special attention to the dialysate distribution, dialysate echogenecity, thickness of the peritoneum small bowel distribution and the position of the catheter tip. Peritonitis was the most common complication (n=7); sonographic findings were small bowel adhesion (n=5) multiseptated ascites(n=1), peritoneal thickening(n=4), and tunnel infection(n=1) and exith site infection(n=1). Our initial experience suggests that ultrasonography is useful for diagnosis of complications and monitoring of patient during long term peritoneal dialysis

  15. Polymorphisms in cytokine genes IL6, TNF, IL10, IL17A and IFNG influence susceptibility to complicated skin and skin structure infections

    NARCIS (Netherlands)

    Stappers, M.H.T.; Thys, Y.; Oosting, M.; Plantinga, T.S.; Ioana, M.; Reimnitz, P.; Mouton, J.W.; Netea, M.G.; Joosten, L.A.B.; Gyssens, I.C.J.

    2014-01-01

    Complicated skin and skin structure infections (cSSSIs) are caused by Gram-positive and Gram-negative, aerobic and anaerobic pathogens, with a polymicrobial aetiology being frequent. Recognition of invading pathogens by the immune system results in the production of pro- and anti-inflammatory

  16. Early Non-Immunological Post Transplant complications: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Jabur Wael

    2008-01-01

    Full Text Available To assess non-immunological complications affecting renal transplant patients in the first six months after transplantation in Al-Karama hospital, Baghdad, Iraq, we studied 68 patients (49 males, 19 females attending the clinic during the year 2006. Forty six (67% patients received kidneys from related and 22 (33% from unrelated donors. The patients revealed the following complications: post transplant hypertension in 28 (41% patient, infection (mostly bacterial in 27 (37%, new onset diabetes in 11 (16%, calcineurin inhibitor toxicity in 10 (14%, anemia in 8 (12%, surgical complications in 7 (10%, slow graft recovery in 4 (6%, cardiovascular complications in 3 (4%, and Kaposi sarcoma in 2 (2.9%.Transient hyperglycemia, hypertension, infection and diabetes mel-litus were the commonest early complications of renal transplantation. The incidence of complications is comparable to the average reported in the literature, especially in this region of the world.

  17. Cytokine responses to Staphylococcus aureus bloodstream infection differ between patient cohorts that have different clinical courses of infection.

    Science.gov (United States)

    McNicholas, Sinead; Talento, Alida Fe; O'Gorman, Joanne; Hannan, Margaret M; Lynch, Maureen; Greene, Catherine M; Humphreys, Hilary; Fitzgerald-Hughes, Deirdre

    2014-11-15

    The clinical course of Staphylococcus aureus bloodstream infection is unpredictable and bacterial virulence, host immune response and patient characteristics are among the factors that contribute to the clinical course of infection. To investigate the relationship between cytokine response and clinical outcome, circulating cytokine levels were investigated in response to S. aureus bloodstream infection in patients with different clinical courses of infection. A prospective study was carried out in 61 patients with S. aureus bloodstream infection and circulating levels of IL-6, GRO-γ, RANTES and leptin were assessed over the course of the infection. Levels were compared in patients with complicated courses of infection (e.g. infective endocarditis) versus uncomplicated courses of S. aureus bloodstream infection and methicillin-resistant S. aureus Vs methicillin-susceptible S. aureus infection. Significantly lower leptin levels (p < 0.05) and significantly higher IL-6 levels (p < 0.05) were detected at laboratory diagnosis in patients with complicated compared to uncomplicated S. aureus bloodstream infection. Significantly higher levels of GRO-γ were associated with MRSA infection compared to MSSA infection. IL-6 may be an early inflammatory marker of complicated S. aureus bloodstream infection. Leptin may be protective against the development of a complicated S. aureus bloodstream infection.

  18. Pyoderma gangraenosum as a complication to knee arthroscopy

    DEFF Research Database (Denmark)

    Madsen, Jakob Torp; Skov, Ole; Andersen, Klaus E

    2009-01-01

    Pyoderma gangraenosum (PG) is a rare immunologic ulcerative disease, which sometimes develop as a complication to surgery. PG is often misdiagnosed as an infected wound, but treatment is completely different. We report a case of PG as a complication to arthroscopic partial meniscectomy that resul...

  19. Radiological features of pulmonary complications in patients with AIDS

    International Nuclear Information System (INIS)

    Ruebesam, D.; Fuchs, H.F.

    1988-01-01

    Our experience with over 200 AIDS-patients emphasizes the good knowledge in radiological features of pulmonary complications in patients with AIDS for early diagnosis. We show the radiological appearance of the most frequent opportunistic infection of the lung, pneumocystis carinii pneumonia, and the different appearance of the other most frequently seen pulmonary complications as Kaposisarkoma, cytomegaly-virus-pneumonia, non-typical-mycobacteria-infection and tuberculosis. A synopsis over the most important symptoms is made for easier differential diagnosis. (orig.) [de

  20. Neurological Manifestations of Dengue Infection

    Directory of Open Access Journals (Sweden)

    Guo-Hong Li

    2017-10-01

    Full Text Available Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS, peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

  1. A case of IgG4-related lung disease complicated by asymptomatic chronic Epstein-Barr virus infection.

    Science.gov (United States)

    Kotetsu, Yasuaki; Ikegame, Satoshi; Takebe-Akazawa, Keiko; Koga, Takaomi; Okabayashi, Kan; Takata, Shohei

    2017-11-01

    IgG4-related disease is characterized by IgG4-positive plasmacyte infiltration into various organs, but its etiology is not unknown. To elucidate the etiology of IgG4-related disease. We experienced an interesting case of IgG4-related lung disease complicated by chronic EB virus infection. A 70-year-old male visited our hospital due to failure of pneumonia treatment. Chest computed tomography (CT) showed consolidation in the right middle field and slight mediastinal lymphadenopathy in the subcarinal region. Lung consolidation improved with antibiotics; subcarinal lymphadenopathy progressed after 4 months. Malignant lymphoma was suspected given elevated sIL2-R levels (1862 U/mL). Patchy ground glass opacities appeared in the bilateral lung field just before surgical biopsy. He was diagnosed with IgG4-related lung disease after inspection of a pathological specimen obtained from the right upper lung and right hilar lymph node. EB virus-infected cells were also detected in the lymph node. Blood examination revealed EB virus viremia, but the patient did not present with symptoms or organ involvement. This led to a diagnosis of asymptomatic chronic EB virus infection. Recent studies have suggested an association between EB virus infection and IgG4-related diseases in the pathological exploration of surgically resected lymph nodes. Our case is the first case of IgG4-related lung disease in which EB virus infection was both pathologically and clinically proved. The present case is of particular interest in view of this newly reported association, and may serve as a fundamental report for future studies connecting EB virus infection with IgG4-related diseases. © 2016 John Wiley & Sons Ltd.

  2. [Complications associated to central venous catheters in hematology patients].

    Science.gov (United States)

    García-Gabás, Carmen; Castillo-Ayala, Ana; Hinojo-Marín, Begoña; Muriel-Abajo, M Ángeles; Gómez-Gutiérrez, Isabel; de Mena-Arenas, Ana M; Rodríguez-Gonzalo, Ana; Chao-Lozano, Cristina; García-Menéndez, Carmen; Madroñero-Agreda, M Antonia

    2015-01-01

    To discover the incidence of central venous catheters (tunnelled, subcutaneous and PICC) in patients with onco-hematological conditions, hospitalized in the Hematology or Transplantations of Hematopoietic Stem Cells Units, in two tertiary care hospitals. A cross-sectional, descriptive study form was developed in order to gather sociodemographic, clinical data as well as complications and follow-up of the care protocol. Each catheter was assigned a correlative identification number. Information was collected on 366 catheters: 185 in the University Hospital Ramón y Cajal (HURYC), 80 tunnelled, 40 subcutaneous venous access and 65 PICC, and 181 in the University Hospital Gregorio Marañón (HUGM), 101 tunnelled and 80 subcutaneous venous access. Major complications in the tunnellized were infections (13.7% in HURYC vs. 6.8% in HUGM - p<0.001) and occlusions (at least once in 3.8% vs. 21.8%). In subcutaneous venous access, infections were confirmed in 5% in HURYC vs. 1.2% in HUGM. There were occlusions at least once in 10% in HUGM and no other significant complications were detected. Regarding PICC, information was only collected in HURYC, where complications were phlebitis 10.8%, thrombosis 7.7%, confirmed or suspected infection 4.6%, occlusion at least once 7.7%. Differences between hospitals with regard to major complications, infection and occlusion may be related to different care protocol. We need to stress the high incidence of phlebitis and thrombosis in PICC catheters, compared with data of lower incidence of other papers. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  3. Outcome of community-acquired pneumonia with cardiac complications

    Directory of Open Access Journals (Sweden)

    R. Eman Shebl

    2015-07-01

    Conclusions: Cardiac complications are common in the admitted patients with pneumonia and they are associated with increased pneumonia severity and increased cardiovascular risk, these complications adds to the risk of mortality, so optimal management of these events may reduce the burden of death associated with this infection.

  4. Lemierre's Syndrome Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    M. Thompson

    2007-01-01

    Full Text Available Lemierre's syndrome is an anaerobic suppurative thrombophlebitis involving the internal jugular vein secondary to oropharyngeal infection. There is only one previous case report in pregnancy which was complicated by premature delivery of an infant that suffered significant neurological damage. We present an atypical case diagnosed in the second trimester with a live birth at term. By reporting this case, we hope to increase the awareness of obstetricians to the possibility of Lemierre's syndrome when patients present with signs of unabating oropharyngeal infection and pulmonary symptoms.

  5. CROI 2017: Complications and Comorbidities of HIV Disease and Its Treatment

    OpenAIRE

    Currier, Judith S.; Havlir, Diane V.

    2017-01-01

    Complications of HIV disease remained a major focus at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI), and included studies focused on noncommunicable chronic diseases (eg, cardiovascular disease, obesity, bone disease, and malignancies) and opportunistic infections (Mycobacterium tuberculosis and cryptococcosis). Progress in identifying predictors of specific complications as well as interventions for the prevention and treatment of these comorbidities are summarized...

  6. Complications of deep brain stimulation: a collective review.

    Science.gov (United States)

    Chan, Danny T M; Zhu, Xian Lun; Yeung, Jonas H M; Mok, Vincent C T; Wong, Edith; Lau, Clara; Wong, Rosanna; Lau, Christine; Poon, Wai S

    2009-10-01

    Since the first deep brain stimulation (DBS) performed for movement disorder more than a decade ago, DBS has become a standard operation for advanced Parkinson's disease. Its indications are expanding to areas of dystonia, psychiatric conditions and refractory epilepsy. Additionally, a new set of DBS-related complications have arisen. Many teams found a slow learning curve from this complication-prone operation. We would like to investigate complications arising from 100 DBS electrode insertions and its prevention. We performed an audit in all DBS patients for operation-related complications in our centre from 1997 to 2008. Complications were classified into operation-related, hardware-related and stimulation-related. Operation-related complications included intracranial haemorrhages and electrode malposition. Hardware-related complications included fracture of electrodes, electrode migration, infection and erosion. Stimulation-related complications included sensorimotor conditions, psychiatric conditions and life-threatening conditions. From 1997 to the end of 2008, 100 DBS electrodes were inserted in 55 patients for movement disorders, mostly for Parkinsons disease (50 patients). There was one symptomatic cerebral haemorrhage (1%) and two electrode malpositions (2%). Meticulous surgical planning, use of microdriver and a reliable electrode anchorage device would minimise this group of complications. There were two electrode fractures, one electrode migration and one pulse-generator infection which contributed to the hardware-related complication rate of 5%. There were no sensorimotor or life-threatening complications in our group. However, three patients suffered from reversible psychiatric symptoms after DBS. DBS is, on the one hand, an effective surgical treatment for movement disorders. On the other hand, it is a complication-prone operation. A dedicated "Movement Disorder Team" consisting of neurologists, neurophysiologists, functional neurosurgeons

  7. Imaging evaluation of complications after liver transplantation

    Directory of Open Access Journals (Sweden)

    WANG Mingyue

    2016-12-01

    Full Text Available Liver transplantation is an effective treatment for end-stage chronic liver diseases and acute liver failure. With the rapid development of surgical techniques, organ preservation technology, and pharmacotherapy, patients' survival rates are improved constantly. However, postoperative complications are still major influencing factors for postoperative incidence and mortality rates. Since clinical and laboratory examinations lack specificity and it is difficult to diagnose various postoperative complications, the application of imaging techniques effectively solves such problems. This article summarizes the imaging findings of common complications after liver transplantation, such as vascular complications, biliary complications, liver parenchyma lesions, and postoperative infection, and points out that imaging examinations have significant advantages and can be used for comprehensive evaluation of disease progression.

  8. Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections.

    Science.gov (United States)

    Di Franco, Manuela; Lucchino, Bruno; Spaziante, Martina; Iannuccelli, Cristina; Valesini, Guido; Iaiani, Giancarlo

    2017-01-29

    Systemic rheumatic diseases have significant morbidity and mortality, due in large part to concurrent infections. The lung has been reported among the most frequent sites of infection in patients with rheumatic disease, who are susceptible to developing pneumonia sustained both by common pathogens and by opportunistic microorganisms. Patients with rheumatic disease show a peculiar vulnerability to infectious complications. This is due in part to intrinsic disease-related immune dysregulation and in part to the immunosuppressive treatments. Several therapeutic agents have been associated to a wide spectrum of infections, complicating the management of rheumatic diseases. This review discusses the most frequent pulmonary infections encountered in rheumatic diseases, focusing on opportunistic agents, consequent diagnostic challenges and appropriate therapeutic strategies.

  9. Huge hydrocephalus: definition, management, and complications.

    Science.gov (United States)

    Faghih Jouibari, Morteza; Baradaran, Nazanin; Shams Amiri, Rouzbeh; Nejat, Farideh; El Khashab, Mostafa

    2011-01-01

    Lack of comprehensive knowledge and numerous socioeconomic problems may make the parents leave hydrocephalic children untreated, leading to progressive hydrocephalus and eventual unordinary big head. Management of huge hydrocephalus (HH) differs from common hydrocephalus. We present our experience in the management of these children. HH is defined as head circumference larger than the height of the infant. Nine infants with HH have been shunted in Children's Hospital Medical Center and followed up for 0.5 to 7 years. The most common cause of hydrocephalus was aqueductal stenosis. The mean age of patients during shunting was 3 months. The head circumference ranged from 56 to 94 cm with the average of 67 cm. Cognitive statuses were appropriate based on their age in five patients. Motor development was normal only in one patient. Complications were found in most cases which included subdural effusion (six patients), shunt infection (four patients), skin injury (three patients), proximal catheter coming out of ventricle to the subdural space (two patients), and shunt exposure (one patient). Three patients died due to shunt infection and sepsis. Numerous complications may occur in patients with HH after shunt operation such as subdural effusion, ventricular collapse, electrolyte disturbance, skull deformity, scalp injury, and shunt infection. Mental and motor disabilities are very common in patients with HH. Many of these complications can be related to overdrainage; therefore, drainage control using programmable shunts is advisable.

  10. Measles and its Complications | Wesley | South African Medical ...

    African Journals Online (AJOL)

    The radiological features that accompany measles are reviewed. Changes due to viral infection may be complicated by those secondary to bacterial superinfection. The syndrome of relapsing pulmonary infection after measles is discussed, and studies on the pathogenesis are presented. S. Afr. Med. J., 48, 1001 (1974) ...

  11. Medical Complications of Tattoos: A Comprehensive Review.

    Science.gov (United States)

    Islam, Parvez S; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M Eric

    2016-04-01

    Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immune-mediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the

  12. Analysis of laparoscopic port site complications: A descriptive study.

    Science.gov (United States)

    Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

    2013-04-01

    The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Prospective descriptive study. In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

  13. Comparison of post circumcision complications and wound

    International Nuclear Information System (INIS)

    Malik, S.; Ahmad, S.A.; Habib, A.

    2015-01-01

    The objective of this study is to compare the frequency of post circumcision complications like bleeding and infection along with wound healing in infants by conventional open method and the bone-cutter method. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital and Military Hospital Rawalpindi, from March 2009 to March 2010. Patients and Methods: A total of 400 patients were included in the study that underwent circumcision. Patients were randomly allotted to either group A in whom the circumcision was done with conventional open technique (n = 200) or to group B, in whom circumcision was done with bone-cutter (n = 200). Patients were followed up in the surgical OPD after 5 days for assessment and earlier in case of any complication. Outcomes were measured by absence or presence of infection, post operative bleeding and cosmetic acceptance by the parents. Results: Comparison between the two groups showed that the bleeding rate was 8% in group A and 7% in group B (p = 0.704). Infection rate was 6% in group A and 5% in group B (p = 0.661). Delayed wound healing was seen in 4% of circumcisions in group A as opposed to 2% in group B ( p = 0.241). Conclusion: Complication is a part of any surgical procedure. So is the case with circumcision however no significant difference was found between the two procedures in terms of bleeding, infection, trauma to the glans and the cosmetic outcome. (author)

  14. Hand infections: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Tolga Türker

    2014-09-01

    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  15. Imaging patellar complications after knee arthroplasty

    International Nuclear Information System (INIS)

    Melloni, Pietro; Valls, Rafael; Veintemillas, Maite

    2008-01-01

    The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious

  16. Imaging patellar complications after knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Melloni, Pietro [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)], E-mail: pmelloni@cspt.es; Valls, Rafael; Veintemillas, Maite [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2008-03-15

    The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious.

  17. Complications of bladder distension during retrograde urethrography.

    Science.gov (United States)

    Barsanti, J A; Crowell, W; Losonsky, J; Talkington, F D

    1981-05-01

    A severe, ulcerative cystitis that resulted in macroscopic hematuria occurred in 8 of 20 healthy dogs undergoing a series of diagnostic tests. Four of the remaining 12 dogs had mild bladder lesions consisting of submucosal edema and hemorrhage. Nine of the 20 dogs developed urinary tract infection after the procedures. These complications seemed associated with the radiographic technique of retrograde urethrography performed when the urinary bladder was distended. To test this hypothesis, retrograde urethrography was performed on 5 additional dogs. With the bladder undistended, no complications occurred. However, distention of these same dogs' bladders for 1 minute or less with sterile lactated Ringer's solution administered through a Foley catheter in the penile urethra resulted in a macroscopic hematuria in all 5 dogs which persisted for 24 hours. A microscopic hematuria continued for 5 days. One dog developed a bacterial urinary tract infection. A severe fibrinopurulent cystitis was present at necropsy of 2 dogs 2 days after distention. The morphologic changes in the bladder gradually diminished over 7 days, but mild submucosal edema and hemorrhage were still present when 2 dogs were necropsied, 7 days after distention. These studies indicated that retrograde urethrography in dogs may be complicated by hemorrhagic cystitis and urinary tract infection if performed with urinary bladder distention.

  18. Medical Treatment of Tattoo Complications

    DEFF Research Database (Denmark)

    Serup, Jørgen

    2017-01-01

    Tattooing is a skin trauma and involves a special vulnus punctatum (with inserted tattoo ink, a vulnus venenatum), which should heal with no infection and no local complication. Local treatment in the healing phase ideally builds on the 'moist wound' principle using plastic film, hydrocolloids...

  19. Complications of cosmetic tattoos.

    Science.gov (United States)

    De Cuyper, Christa

    2015-01-01

    Cosmetic tattoos, which are better known as permanent make-up, have become popular in the last decades. This same procedure can be used to camouflage pathological skin conditions, to mask scars and to complete the aesthetic results of plastic and reconstructive surgeries. The risks and complications of tattooing procedures include infections and allergic reactions. Scarring can occur. Fanning and fading of the colorants and dissatisfaction with colour and shape are not unusual. Different lasers can offer solutions for the removal of unwanted cosmetic tattoos, but complications due to the laser treatment, such as paradoxical darkening and scarring, can arise. © 2015 S. Karger AG, Basel.

  20. Prevalence of Urinary Tract Infection Among Pregnant Women and its Complications in Their Newborns During the Birth in the Hospitals of Dezful City, Iran, 2012 - 2013

    OpenAIRE

    Amiri, Marziyeh; Lavasani, Zohreh; Norouzirad, Reza; Najibpour, Reza; Mohamadpour, Masoomeh; Nikpoor, Amin Reza; Raeisi, Mohammad; Zare Marzouni, Hadi

    2015-01-01

    Background: Urinary tract infection (UTI) is the most common disorder caused by bacterial agents in pregnancy, which can lead to important complications in newborn of such mothers in case of inappropriate diagnosis and treatment. Objectives: The purpose of this study was to study the prevalence of UTI among pregnant women and its complications in their newborns during the birth in the hospitals of Dezful City, Iran, during 2012 - 2013. Patients and Methods: In this cross-sectional retrospecti...

  1. Complication of nose and paranasal sinus disease

    International Nuclear Information System (INIS)

    Kazmi, H.S.; Ali, S.; Ali, Z.

    2012-01-01

    Diseases of nose and paranasal sinuses can complicate to involve the orbit and other surrounding structures because of their close proximity. These diseases are usually infective or can be neoplastic in origin. Method: All the patients presenting in ENT or Eye Departments of Ayub Teaching Hospital during the one year study period who had complicated nose or paranasal sinus disease were included in the study. A detailed history and examination followed by CT scanning and laboratory investigations to assess the type and extent of the disease, was carried out. Results: Infections were the most common cause of complicated sinus disease 11 (75%). The rest of the 4 (25%) cases were tumours. 12 (80%) of the cases presented with proptosis. In 1 of these 12 cases, there was complete blindness. In 2 (13%) of the cases there was only orbital cellulitis. Two of these patients had facial swelling and 2 had nasal obstruction and presented as snoring. Two patients presented with history of weight loss and these patients had malignant tumour of the paranasal sinuses. One patient presented with early signs of meningitis. In 1 case sub periosteal scalp abscess (Pott's puffy tumour) was the only complication noted. Conclusion: Nose and paranasal sinus diseases can complicate to involve mostly the orbit, but sometimes brain, meninges and skull bones can also get involved. (author)

  2. CNS complications of rotavirus gastroenteritis

    International Nuclear Information System (INIS)

    Volosinova, D.

    2010-01-01

    Rotavirus infection may be accompanied by serious complications, e.g. disabilities central nervous system (CNS). Theory rotavirus penetration across the blood-brain barrier and subsequent rota-associated convulsions by the 2-year case-history of the patient. Rotavirosis minor gastrointestinal symptoms may lead to erroneous diagnosis. (author)

  3. Analysis of laparoscopic port site complications: A descriptive study

    Directory of Open Access Journals (Sweden)

    Somu Karthik

    2013-01-01

    Full Text Available Context: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. Aims: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Settings and Design: Prospective descriptive study. Materials and Methods: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Statistical Analysis Used: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Results: Of the 570 patients undergoing laparoscopic surgery, 17 (3% had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI was the most frequent (n = 10, 1.8%, followed by port site bleeding (n = 4, 0.7%, omentum-related complications (n = 2; 0.35%, and port site metastasis (n = 1, 0.175%. Conclusions: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

  4. Analysis of laparoscopic port site complications: A descriptive study

    Science.gov (United States)

    Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

    2013-01-01

    CONTEXT: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. AIMS: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. SETTINGS AND DESIGN: Prospective descriptive study. MATERIALS AND METHODS: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. STATISTICAL ANALYSIS USED: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. RESULTS: Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). CONCLUSIONS: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit. PMID:23741110

  5. Complications of pneumoconiosis: Radiologic overview

    International Nuclear Information System (INIS)

    Jun, Jae Sup; Jung, Jung Im; Kim, Hyo Rim; Ahn, Myeong Im; Han, Dae Hee; Ko, Jeong Min; Park, Seog Hee; Lee, Hae Giu; Arakawa, Hiroaki; Koo, Jung-Wan

    2013-01-01

    A wide spectrum of pulmonary complications occurs in patients with pneumoconiosis. Those complications include chronic obstructive pulmonary disease, hemoptysis, pneumothorax, pleural disease, tuberculosis, autoimmune disease, anthracofibrosis, chronic interstitial pneumonia, and malignancy. Generally, imaging workup starts with plain chest radiography. However, sometimes, plain radiography has limited role in the diagnosis of pulmonary complications of pneumoconiosis because of overlapping pneumoconiotic infiltration. Computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI) are potentially helpful for the detection of pulmonary complications in patients with pneumoconiosis. CT, with its excellent contrast resolution, is more sensitive and specific method than plain radiograph in the evaluation of pulmonary abnormalities. CT is useful in detecting lung parenchymal abnormalities caused by infection, anthracofibrosis, and chronic interstitial pneumonia. Also, CT is valuable in distinguishing localized pneumothorax from bullae and aiding the identification of multiloculated effusions. US can be used in detection of complicated pleural effusions and guidance of the thoracentesis procedure. MRI is useful for differentiating between progressive massive fibrosis and lung cancer. Radiologists need to be familiar with the radiologic and clinical manifestations of, as well as diagnostic approaches to, complications associated with pneumoconiosis. Knowledge of the various imaging features of pulmonary complications of pneumoconiosis can enhance early diagnosis and improve the chance to cure

  6. Complications of pneumoconiosis: Radiologic overview

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Jae Sup [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Jung, Jung Im, E-mail: jijung@catholic.ac.kr [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Kim, Hyo Rim [Department of Radiology, Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Ahn, Myeong Im; Han, Dae Hee [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Ko, Jeong Min [Department of Radiology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Park, Seog Hee; Lee, Hae Giu [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Arakawa, Hiroaki [Department of Radiology, Dokkyo University School of Medicine (Japan); Koo, Jung-Wan [Department of Occupational and Environmental Medicine, Seoul St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of)

    2013-10-01

    A wide spectrum of pulmonary complications occurs in patients with pneumoconiosis. Those complications include chronic obstructive pulmonary disease, hemoptysis, pneumothorax, pleural disease, tuberculosis, autoimmune disease, anthracofibrosis, chronic interstitial pneumonia, and malignancy. Generally, imaging workup starts with plain chest radiography. However, sometimes, plain radiography has limited role in the diagnosis of pulmonary complications of pneumoconiosis because of overlapping pneumoconiotic infiltration. Computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI) are potentially helpful for the detection of pulmonary complications in patients with pneumoconiosis. CT, with its excellent contrast resolution, is more sensitive and specific method than plain radiograph in the evaluation of pulmonary abnormalities. CT is useful in detecting lung parenchymal abnormalities caused by infection, anthracofibrosis, and chronic interstitial pneumonia. Also, CT is valuable in distinguishing localized pneumothorax from bullae and aiding the identification of multiloculated effusions. US can be used in detection of complicated pleural effusions and guidance of the thoracentesis procedure. MRI is useful for differentiating between progressive massive fibrosis and lung cancer. Radiologists need to be familiar with the radiologic and clinical manifestations of, as well as diagnostic approaches to, complications associated with pneumoconiosis. Knowledge of the various imaging features of pulmonary complications of pneumoconiosis can enhance early diagnosis and improve the chance to cure.

  7. Dasatinib-induced hemorrhagic colitis complicated with cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Aya Nakaya

    2017-12-01

    Full Text Available A 69-year-old man with chronic-phase chronic myeloid leukemia was initially treated with 100 mg dasatinib once a day. Despite a major molecular response within 9 months, he developed hemorrhagic colitis 32 months after starting dasatinib. Colonoscopy identified multiple hemorrhagic ulcers in the transverse colon. The pathological findings indicated cytomegalovirus infection. Dasatinib was stopped and he was started on ganciclovir. Three months later, colonoscopy confirmed the disappearance of the hemorrhagic ulcers. Dasatinib is a second-generation tyrosine kinase inhibitor used to treat chronic myeloid leukemia. As a multi-kinase inhibitor that acts on SRC-family kinases, its broader off-target kinase-inhibitory activity may account for the adverse events of dasatinib. Although gastrointestinal bleeding is common in patients taking dasatinib, the combination of cytomegalovirus infection and hemorrhagic colitis in the absence of systemic immunodeficiency is rare. Based on this case of dasatinibinduced hemorrhagic colitis with cytomegalovirus infection, we describe a possible mechanism and effective treatment.

  8. Metastatic spine tumor surgery: does perioperative blood transfusion influence postoperative complications?

    Science.gov (United States)

    Zaw, Aye Sandar; Kantharajanna, Shashidhar B; Maharajan, Karthikeyan; Tan, Barry; Saparamadu, Amarasinghe A; Kumar, Naresh

    2017-11-01

    The question of independent association between allogeneic blood transfusion (ABT) and postoperative complications in cancer surgeries has been controversial and remains so. In metastatic spine tumor surgery (MSTS), previous studies investigated the influence of ABT on survival, but not on postoperative complications. We aimed to evaluate the influence of perioperative ABT on postoperative complications and infections in patients undergoing MSTS. This retrospective study included 247 patients who underwent MSTS at a single tertiary institution between 2005 and 2014. The outcome measures were postoperative complications and infections within 30 days after MSTS. Multivariate logistic regression analyses were performed to assess influence of blood transfusion on the outcomes after adjusting for potential confounders. Of 247 patients, 133 (54%) received ABT with overall median (range) of 2 (0-10) units. The adjusted odds of developing any postoperative complication was 2.27 times higher in patients with transfusion (95% confidence interval [CI], 1.17-4.38; p = 0.01) and 1.24 times higher odds per every unit increase in blood transfusion (95% CI, 1.05-1.46; p blood transfusion also increased the odds of having overall postoperative infections (odds ratio, 3.58; 95% CI, 1.15-11.11; p = 0.02) and there were 1.24 times higher odds per every unit increase in transfusion (95% CI, 1.01-1.54; p = 0.04). This study adds evidence to the literature implicating ABT to be influential on postoperative complications and infections in patients undergoing MSTS. Appropriate blood management measures should, therefore, be given a crucial place in the care of these patients so as to reduce any putative effect of blood transfusion. © 2017 AABB.

  9. Multicenter study in monitoring central venous catheters complications in hematologic patiennts

    Directory of Open Access Journals (Sweden)

    Carmen García Gabás

    2013-05-01

    Full Text Available Most hematological patients suffer a significant venous damage related to different administrated intravenous therapy, being necessary to place central venous catheters (CVC. CVC is associated with various complications. The most common catheter-related complications are occlusion and infection. To avoid such of them, the development of protocols for insertion and care are needed, as well as recording and following up complications. To this end, we propose a cross-sectional carried out during 13 months whose main goal is to know the incidence of CVC- related complications (mainly occlusion and infection in hematological patients.Population included all the =14 ages patients admitted to different hematological units at Ramon y Cajal and Gregorio Marañón hospitals in Madrid and who signed informed consent. Socio-demographic, clinical characteristics and complications were entered into a log which included a pursuit of care protocol.

  10. Role of imaging procedures in clarification of complications of pneumonia

    International Nuclear Information System (INIS)

    Lampichler, K.

    2017-01-01

    Despite a considerable number of antimicrobial agents and interdisciplinary treatment options, lower respiratory tract infections are still associated with high morbidity and mortality rates. Infections of the respiratory tract can lead to severe complications, such as empyema, lung abscesses and acute respiratory distress syndrome (ARDS). Besides intrapulmonary complications pneumonia can also impair other organs due to a systemic inflammatory response. Underlying cardiovascular diseases, such as chronic heart failure, arteriosclerosis and dysrhythmia can either deteriorate due to infections or be newly manifested as a result of pneumonia. Early diagnosis and therapy of these sometimes life-threatening complications are crucial and can have a severe impact on disease outcome. The most important imaging techniques include chest X-ray and computed tomography (CT) of the chest. Although a definite diagnosis is sometimes difficult or even impossible to establish using chest X-ray or CT, there are several findings indicative of intrapulmonary or extrapulmonary complications of pneumonia. Another useful and portable tool is thoracic ultrasound directly on the patient, which can be used to further define the underlying disease or as guidance during procedures. The chest X-ray is useful in initial diagnosis and follow-up. If complications or disease progression are suspected or the clinical course differs from the X-ray interpretation, a subsequent CT of the chest should be performed. (orig.) [de

  11. Complications of HIV Disease and Antiretroviral Therapy

    OpenAIRE

    Luetkemeyer, Anne F.; Havlir, Diane V.; Currier, Judith S.

    2010-01-01

    There is growing interest in the pathogenesis, treatment, and prevention of long-term complications of HIV disease and its therapies. Specifically, studies focused on cardiovascular, renal, bone, and fat abnormalities were prominent at the 17th Conference on Retroviruses and Opportunistic Infections. Although enthusiasm about the effectiveness of current antiretroviral therapy remains strong, collectively, the ongoing work in the area of HIV disease and treatment complications appears to refl...

  12. Postoperative complications associated with external skeletal fixators in cats.

    Science.gov (United States)

    Beever, Lee; Giles, Kirsty; Meeson, Richard

    2017-07-01

    The objective of this study was to quantify complications associated with external skeletal fixators (ESFs) in cats and to identify potential risk factors. A retrospective review of medical records and radiographs following ESF placement was performed. Case records of 140 cats were reviewed; fixator-associated complications (FACs) occurred in 19% of cats. The region of ESF placement was significantly associated with complication development. Complications developed most frequently in the femur (50%), tarsus (35%) and radius/ulna (33%). Superficial pin tract infection (SPTI) and implant failure accounted for 45% and 41% of all FACs, respectively. SPTI occurred more frequently in the femur, humerus and tibia, with implant failure more frequent in the tarsus. No association between breed, age, sex, weight, fracture type (open vs closed), ESF classification, number of pins per bone segment, degree of fracture load sharing, and the incidence or type of FAC was identified. No association between region of placement, breed, age, sex, weight, fracture type (open vs closed), ESF classification, number of pins per bone segment, fracture load sharing and the time to complication development was identified. Complication development is not uncommon in cats following ESF placement. The higher complication rate in the femur, tarsus and radius/ulna should be considered when reviewing options for fracture management. However, cats appear to have a lower rate of pin tract infections than dogs.

  13. Cost Comparison of Linezolid Versus Vancomycin for Treatment of Complicated Skin and Skin-Structure Infection Caused by Methicillin-Resistant Staphylococcus aureus in Quebec

    Directory of Open Access Journals (Sweden)

    Martine Pettigrew

    2012-01-01

    Full Text Available BACKGROUND: In Canada, complicated skin and skin-structure infection (cSSSI caused by methicillin-resistant Staphylococcus aureus (MRSA is usually treated with antibiotics in hospital, with a follow-up course at home for stable patients. The cost implications of using intravenous and oral linezolid instead of intravenous vancomycin in Canadian clinical practice have not been examined.

  14. Central nervous system aspergillus infection complicating renal transplantation

    International Nuclear Information System (INIS)

    Coates, M.; Wilson, J.

    2001-01-01

    A case of catastrophic intracerebral haemorrhage secondary to aspergillus infection in an immunocompromised renal transplant patient is presented. The pathological features and related images are described and the radiology of CNS aspergillus infection is reviewed. A 37-year-old woman was admitted with abdominal pain. She had recently received a cadaveric renal transplant following failure of the previous live donor kidney. Gastroscopy showed changes suspicious of cytomegalovirus (CMV) gastroduodenitis and she was treated with gancyclovir, with resolution of her symptoms. While in hospital her creatinine began to rise. The renal biopsy was suggestive of cyclosporin toxicity and the cyclosporin level was raised 537 mg/mL (normal 160-360 mg/mL). Several days later, she developed slurred speech and weakness in her right arm. Non-contrast CT showed multifocal regions of low attenuation over the right temporal convexity, within the basal ganglia, inferior frontal lobe and corona radiata on the left side. Magnetic resonance imaging on the same day showed multiple areas of high signal on the FLAIR images, some of which contained central areas of low signal. There was no significant enhancement post gadolinium but several of the lesions showed increased signal on the diffusion-weighted images, reflecting cytotoxic oedema. Repeat CT showed an increase in the size of the cerebral lesions with haemorrhagic transformation of the right basal ganglia mass. A further lesion with a peripheral dense rim on the non-contrast images was identified in the right cerebellar hemisphere. The possibility of a vasculitis secondary to a fungal infection was raised. Two days later the patient became comatose with CT showing a large intracerebral haematoma in the left basal ganglia, intraventricular blood and hydrocephalus. The patient died soon afterwards. Post-mortem examination showed multifocal cerebral haemorrhage associated with necrotizing vasculitis and aspergillus infection

  15. Infective endarteritis and false mycotic aneurysm complicating aortic coarctation

    Directory of Open Access Journals (Sweden)

    Ziadi Jaleleddine

    2012-01-01

    Full Text Available A 12-year-old boy with coarctation of aorta developed infective endarteritis and mycotic aneurysm at the site distal to coarctation. The computed tomography angiogram was very helpful in the diagnosis. Medical management and early surgical intervention was curative. Infective endarteritis in coarctation may be underdiagnosed.

  16. LVAD pannus complicating destination therapy

    Directory of Open Access Journals (Sweden)

    Maya Ignaszewski

    2017-11-01

    Full Text Available Despite advances in technology, ventricular assist devices still experience a number of complications limiting their long-term use. We present a 73-year-old woman implanted with a left ventricular assist device (LVAD five years prior due to end-stage dilated cardiomyopathy, who died several weeks after admission to the hospital. Post-mortem examination revealed a large obstructing pannus in the LVAD inflow. As a result of increased LVAD use, complications such as infection, device thrombosis and pannus must be promptly recognized and managed appropriately to ensure the greatest chance of patient survival.

  17. Complications after pinning of supracondylar distal humerus fractures.

    Science.gov (United States)

    Bashyal, Ravi K; Chu, Jennifer Y; Schoenecker, Perry L; Dobbs, Matthew B; Luhmann, Scott J; Gordon, J Eric

    2009-01-01

    Supracondylar distal humerus fractures are one of the most common skeletal injuries in children. The current treatment of choice in North America is closed reduction and percutaneous pin fixation. Often surgeons leave the pins exposed beneath a cast but outside the skin. Great variation exists with respect to preoperative skin preparation, and perioperative antibiotic administration. Few data exist regarding the rate of infection and other complications. The purpose of this study is to review a large series of children to evaluate the rate of infection and other complications. A retrospective review was carried out of all patients treated at our institution over an 11-year period. A total of 622 patients were identified that were followed for a minimum of 2 weeks after pin removal. Seventeen patients had flexion-type fractures, 294 had type II fractures, and 311 had type III fractures. Seventy-four fractures (11.9%) had preoperative nerve deficits with anterior interosseous palsies being the most common (33 fractures, 5.3%). Preoperative antibiotics were given to 163 patients (26.2%). Spray and towel draping were used in 362 patients, paint and towel draping were used in 65 patients, alcohol paint and towel draping were used in 146 patients, and a full preparation and draping were used in 13 patients. The pins were left exposed under the cast in 591 fractures (95%), and buried beneath the skin in 31 fractures (5.0%). A medial pin was placed in 311 fractures with a small incision made to aid placement in 18 of these cases. The most common complication was pin migration necessitating unexpected return to the operating room for pin removal in 11 patients (1.8%). One patient developed a deep infection with septic arthritis and osteomyelitis (0.2%). Five additional patients had superficial skin infections and were treated with oral antibiotics for a total infection rate of 6 of 622 patients (1.0%). One patient ultimately had a malunion and 4 others returned to the

  18. [Complicated pleural infection: Analysis of 2 consecutive cohorts managed with a different policy].

    Science.gov (United States)

    Moral, L; Loeda, C; Gómez, F; Pena, M A; Martínez, M; Cerdán, J M; Lillo, L; Toral, T

    2016-01-01

    The treatment of complicated pleural infection (CPI) is controversial. Clinical guidelines recommend drainage, but with the lowest grade of evidence. Recent reports have observed good outcomes with antibiotics alone. We retrospectively compared the outcomes in two consecutive cohorts treated with different policies: the first treated according to pleural fluid charactersitics (2005-2009, interventional-prone, group 1) and the second according to clinical assessment (2010-2013, conservative-prone, group 2). The clinical records of all children treated for CPI in our hospital between 2005 and 2013 were thoroughly reviewed. Primary outcomes were the proportion of children drained and the length of hospital stay (LHS). One hundred and nine patients (64 group 1 and 45 group 2) were analyzed. A chest tube was placed in 83% of patients in group 1 and 47% in group 2 (Pdrain most children with CPI. Clinical trials are now needed to identify when a drainage procedure would be useful. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  19. Mania as complication of HIV infection: case reports | Sulyman ...

    African Journals Online (AJOL)

    These case reports highlight the fact that organic mood disorder, manic episode, in HIV infection AIDS might not be uncommon in this part of the world. Patients present with irritable mood rather than euphoria and they respond rapidly to psychotropic medications. Key words: Manic episode, HIV infection; Acquired immune ...

  20. Complications after hysterectomy. A Danish population based study 1978-1983

    DEFF Research Database (Denmark)

    Andersen, T F; Loft, A; Brønnum-Hansen, Henrik

    1993-01-01

    years after the operation were 3.7% and 9.4%. The most frequently observed complications were post operative wound infections and bleeding, each affecting about 2% of all operated women. Logistic regression and Cox regression were used to identify prognostic indicators of readmission with complications...

  1. Infectious and non-infectious neurologic complications in heart transplant recipients.

    Science.gov (United States)

    Muñoz, Patricia; Valerio, Maricela; Palomo, Jesús; Fernández-Yáñez, Juan; Fernández-Cruz, Ana; Guinea, Jesús; Bouza, Emilio

    2010-05-01

    compared the OKT3-ATG and daclizumab groups, we found that the incidence of non-infectious complications was 15.1% vs. 7.3%, respectively, and the incidence of infectious complications was 7.5% vs. 1.4%, respectively. All but 1 opportunistic infection occurred in the OKT3-ATG time period. In conclusion, a wide variety of neurologic complications affected 19.5% of HT recipients. Non-infectious causes clearly predominated, but infections still accounted for 32% of the episodes. New monoclonal induction therapies have contributed to diminished CNS opportunistic infections in our program.

  2. [Analysis on influencing factor of the complications of percutaneous dilational tracheotomy].

    Science.gov (United States)

    Zhai, Xiang; Zhang, Jinling; Hang, Wei; Wang, Ming; Shi, Zhan; Mi, Yue; Hu, Yunlei; Liu, Gang

    2015-01-01

    To Analyze the influence factors on the complications of percutaneous dilational tracheotomy. Between August 2008 and February 2014, there were 3 450 patients with the indications of tracheotomy accepted percutaneous dilational tracheostomy, mainly using percutaneous dilational and percutaneous guide wire forceps in these cases. Statistical analysis was performed by SPSS 19.0 software on postoperative complications, the possible influence factors including age, gender, etiology, preoperative hypoxia, obesity, preoperative pulmonary infection, state of consciousness, operation method, operation doctor and whether with tracheal intubation. Among 3 450 patients, there were 164 cases with intraoperative or postoperative complications, including postoperative bleeding in 74 cases (2.14%), subcutaneous emphysema in 54 cases (1.57%), wound infection in 16 cases (0.46%), pneumothorax in 6 cases (0.17%), mediastinal emphysema in 5 cases (0.14%), operation failed and change to conventional incision in 4 cases (0.12%), tracheoesophageal fistula in 2 cases (0.06%), death in 3 cases(0.09%).Obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method were the main influence factors, with significant statistical difference (χ(2) value was 0.010, 0.000, 0.002, 0.000, 0.000, 0.000, all P Gender, age, operation doctor and whether there was the endotracheal intubation were not the main influence factors. There was no significant statistical difference (P > 0.05). Although percutaneous dilational tracheostomy is safe, but the complications can also happen. In order to reduce the complications, it is need to pay attention to the factors of obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method.

  3. Pleural puncture with thoracic epidural: A rare complication?

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2011-01-01

    Full Text Available Freedom from pain has almost developed to be a fundamental human right. Providing pain relief via epidural catheters in thoracic and upper abdominal surgeries is widely accepted. Pain relief through this technique not only provides continuous analgesia but also reduces post-operative pulmonary complications and also hastens recovery. But being a blind procedure it is accompanied by certain complications. Hypotension, dura puncture, high epidural, total spinal, epidural haematoma, spinal cord injury and infection are some of the documented side effects of epidural block. There are case reports eliciting neurological complications, catheter site infections, paresthesias, radicular symptoms and worsening of previous neurological conditions. Few technical problems related to breakage of epidural catheter are also mentioned in the literature. The patient had no sequelae on long term follow up even when a portion of catheter was retained. We present a case report where epidural catheter punctured pleura in a patient undergoing thoracotomy for carcinoma oesophagus.

  4. Assessment of Risk Factors, Treatment and Hospital Stay in Complicated Urinary Tract Infections in Men Caused by Pseudomonas: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Hasan Selçuk Özger

    2017-06-01

    Full Text Available Objective: It is known that Pseudomonas has been isolated more frequently in health care-related urinary tract infections (UTIs. It was aimed to determine the risk factors and empiric therapies due to antibiotic resistance in Pseudomonas-related male UTIs, and assess the effect of Pseudomonas isolation on treatment and length of hospital stay. Materials and Methods: The study was conducted between January 2011 and January 2013 with 228 male health care-related complicated UTI patients hospitalized in the Urology and Infectious Diseases Inpatient Clinics at Gazi University Faculty of Medicine. Three hundred UTI attacks in 228 patients were evaluated retrospectively with regard to agents. Results: Pseudomonas was isolated in 37 of 300 complicated UTI attacks in 228 male patients. Nephrolithiasis, recurrent UTI and internal urinary catheterization were determined as the risk factors for Pseudomonas related with health care-related UTI. It was understood that nephrolithiasis increased Pseudomonas isolated UTI risk 3.5 fold and recurrent UTI increased the risk 8.9 fold. The antibiotic resistance of Pseudomonas was higher than other agents. Pseudomonas related UTIs prolonged the duration of hospital stay and antibiotic treatment. Conclusion: In the presence of nephrolithiasis, recurrent UTI and internal urinary catheterization, drugs against Pseudomonas would be appropriate empiric treatment for health care-related complicated UTI. Ciprofloxacin use should be restricted when local antibiotic resistance, which leads empiric treatment, is taken into consideration. Increases in hospital stay and antibiotic treatment duration were thought to be associated with recurrent infection frequency and high antibiotics resistance in Pseudomonas related UTIs.

  5. Clostridium difficile infection after colorectal surgery: a rare but costly complication.

    Science.gov (United States)

    Damle, Rachelle N; Cherng, Nicole B; Flahive, Julie M; Davids, Jennifer S; Maykel, Justin A; Sturrock, Paul R; Sweeney, W Brian; Alavi, Karim

    2014-10-01

    The incidence and virulence of Clostridium difficile infection (CDI) are on the rise. The characteristics of patients who develop CDI following colorectal resection have been infrequently studied. We utilized the University HealthSystem Consortium database to identify adult patients undergoing colorectal surgery between 2008 and 2012. We examined the patient-related risk factors for CDI and 30-day outcomes related to its occurrence. A total of 84,648 patients met our inclusion criteria, of which the average age was 60 years and 50% were female. CDI occurred in 1,266 (1.5%) patients during the years under study. The strongest predictors of CDI were emergent procedure, inflammatory bowel disease (IBD), and major/extreme APR-DRG severity of illness score. CDI was associated with a higher rate of complications, intensive care unit (ICU) admission, longer preoperative inpatient stay, 30-day readmission rate, and death within 30 days compared to non-CDI patients. Cost of the index stay was, on average, $14,130 higher for CDI patients compared with non-CDI patients. Emergent procedures, higher severity of illness, and inflammatory bowel disease are significant risk factors for postoperative CDI in patients undergoing colorectal surgery. Once established, CDI is associated with worse outcomes and higher costs. The poor outcomes of these patients and increased costs highlight the importance of prevention strategies targeting high-risk patients.

  6. Prevalence of Helicobacter Pylori Infection Among Patients ...

    African Journals Online (AJOL)

    Conclusion: The prevalence of H. pylori infection is significantly high in rural and suburban population of Ernakulam district, Kerala. Early detection and prompt treatment are essential for prevention of serious complications. Keywords: Gastrointestinal complications, Helicobacter pylori infection, Histopathological ...

  7. Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

    DEFF Research Database (Denmark)

    Johansen, Jens Brock; Jørgensen, Ole Dan; Møller, Mogens

    2011-01-01

    Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population....

  8. A rare complication after renal transplantation: Forgotten stent

    Directory of Open Access Journals (Sweden)

    Mustafa Karabıcak

    2015-07-01

    Full Text Available In renal transplantation surgery, double J stents (DJS are often used to reduce complications, protect the anastomosis between ureter and bladder, provide drainage in ureteral obstructions and enhance healing if there is an ureter injury. Urinary tract infections, hematuria and irritative voiding symptoms are the early complications of DJS. Migration, fragmantation, encrustation and rarely sepsis are among the late complications of DJS. In this report we describe a renal transplantation case whose DJS stent was forgotten because the patient did not attend the regular follow-up and noticed 5 years after surgery.

  9. Prevalence of Helicobacter Pylori Infection Among Patients ...

    African Journals Online (AJOL)

    was seen. Conclusion: The prevalence of H. pylori infection is significantly high in rural and suburban population of Ernakulam district, Kerala. Early detection and prompt treatment are essential for prevention of serious complications. Keywords: Gastrointestinal complications, Helicobacter pylori infection, Histopathological ...

  10. Problems and complications of full-face carbon dioxide laser resurfacing for pathological lesions of the skin.

    Science.gov (United States)

    Read-Fuller, Andrew M; Yates, David M; Vu, David D; Hoopman, John E; Finn, Richard A

    2017-01-01

    Facial resurfacing with a CO 2 laser has been used for treatment of pathologic lesions and for cosmetic purposes. Postoperative complications and problems after laser resurfacing include infections, acneiform lesions, and pigment changes. This retrospective study describes the most common problems and complications in 105 patients and assesses postoperative pain in 38 patients. All patients received CO 2 laser resurfacing for treatment of malignant/premalignant lesions and had postoperative follow-up to assess problems and complications. Some had follow-up to assess postoperative pain. All patients had Fitzpatrick I-III skin types and underwent the same perioperative care regimen. There were 11 problems and 2 complications. Problems included infection, acneiform lesion/milia, and uncontrolled postoperative pain. Complications included hyperpigmentation. Among the postoperative pain group, 53% reported no pain and the rest had mild or moderate pain. Complications are rare. Infection and acneiform lesions/milia were the most common problems, as previously reported. Most patients do not experience postoperative pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Tigecycline Susceptibility Trends Among Pathogens Isolated from Complicated Skin and Soft-Tissue Infections in North and Latin America: 2012–2016

    Science.gov (United States)

    Hoban, Daryl; Renteria, Martha; Leister-Tebbe, Heidi; Sahm, Dan

    2017-01-01

    Abstract Background The Tigecycline Evaluation Surveillance Trial (TEST) monitors the activity of tigecycline and other antimicrobials against clinically-relevant pathogens collected globally. This study reports the activity of tigecycline (TGC) against Gram-positive and Gram-negative isolates collected in North and Latin America from patients with complicated skin and soft-tissue infections (CSSTI). Methods Hospital sites from North America (NA) and Latin America (LA) collected non-duplicate clinical Gram-positive and -negative isolates from various complicated skin and skin structure infection sources during 2012–2016. Organism identification and antibiotic susceptibility (S) testing was performed by the local laboratories. Susceptibility testing was determined using the broth microdilution method according to CLSI guidelines and categorical interpretation of results was done using CLSI or FDA (tigecycline) breakpoint criteria where appropriate. Cefoxitin disk testing was performed for all S. aureus to determine methicillin susceptibility (i.e., MRSA and MSSA). Results The table provides %S and MIC90 data for TGC against CSSTI isolates Region, n, %S, MIC 90 (µg/ml) North America Latin America Organism n %S MIC 90 n %S MIC 90 S. aureus 2270 100 0.12 310 100 0.25 Enterobacter spp. 925 96.4 1 159 92.5 2 P. aeruginosa 758 na* > 8 165 na > 8 E. coli 716 99.9 0.25 241 100 0.25 Enterococcus spp. 691 99.3 0.12 135 100 0.12 S. agalactiae 503 100 0.12 58 100 0.06 K. pneumoniae 471 94.9 2 152 91.5 2 S. marcescens 347 96.8 2 67 97.0 2 A. baumannii 310 na* 2 97 na 1 K. oxytoca 204 99.0 0.5 15 100 1 *na = not applicable or no breakpoints available for this species. Conclusion Based on %S and MIC90 data TGC exhibited potent activity against isolates of all organism groups from complicated skin and soft-tissue infections, regardless of the geographic region. However, given the potential many of these organisms have for developing resistance, continued and careful

  12. Dobrava Hantavirus Infection Complicated by Panhypopituitarism, Istanbul, Turkey, 2010

    Science.gov (United States)

    Hofmann, Jörg; Canpolat, Alper Tunga; Türk, Ali; Ettinger, Jakob; Atmaca, Deniz; Akyar, Işın; Yücel, Serap; Arıkan, Ender; Uyar, Yavuz; Çağlayık, Dilek Y.; Kocagöz, Ayşe Sesin; Kaya, Ayşin; Kruger, Detlev H.

    2012-01-01

    We identified Dobrava-Belgrade virus infection in Turkey (from a strain related to hantavirus strains from nearby countries) in a patient who had severe symptoms leading to panhypopituitarism, but no known risk for hantavirus. Our findings emphasize the need for increased awareness of hantaviruses in the region and assessment of symptomatic persons without known risk factors for infection. PMID:22709722

  13. How to Diagnose and Classify Tattoo Complications in the Clinic

    DEFF Research Database (Denmark)

    Serup, Jørgen

    2017-01-01

    Tattoo complications represent a broad spectrum of clinical entities and disease mechanisms. Infections are known, but chronic inflammatory reactions have hitherto been inconsistently reported and given many interpretations and terms. A clinical classification system of distinct patterns with emp...... is reported to the 11th revision of the WHO diagnosis classification used as international standard.......Tattoo complications represent a broad spectrum of clinical entities and disease mechanisms. Infections are known, but chronic inflammatory reactions have hitherto been inconsistently reported and given many interpretations and terms. A clinical classification system of distinct patterns...... with sarcoidosis affecting other organs. Tattoo complications include a large group of less frequent but nevertheless specific entities, i.e. irritant and toxic local events, photosensitivity, urticaria, eczematous rash due to soluble allergen, neurosensitivity and pain syndrome, lymphopathies, pigment diffusion...

  14. Genital herpes simplex virus infections in adults.

    Science.gov (United States)

    Mertz, G; Corey, L

    1984-02-01

    With the decline in prevalence of childhood-acquired oral-labial herpes simplex type 1 infections in some populations and the increasing incidence of genital herpes infections in adults, clinicians are more likely to see patients with severe primary, first-episode genital herpes infections. Complications of these primary infections may include aseptic meningitis and urine retention secondary to sacral radiculopathy or autonomic dysfunction. Presented are the clinical course of first-episode and recurrent infections, complications, diagnostic laboratory methods, and results of controlled clinical trials evaluating the efficacy of topical, intravenous, and oral preparations of acyclovir.

  15. Treatment of infectious complications of acquired immunodeficiency syndrome.

    Science.gov (United States)

    Furio, M M; Wordell, C J

    1985-01-01

    The infectious complications of the acquired immunodeficiency syndrome (AIDS) are discussed, and the conventional and nonconventional therapies used for these infections are reviewed. The infections most commonly encountered in patients with AIDS are Pneumocystis carinii pneumonia (58%), Candida esophagitis (31%), toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus infections (12%). Pneumocystis carinii pneumonia is the most common life-threatening process in these patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the drug of choice for its treatment. Oral candidiasis often indicates the progression to AIDS in the high-risk populations of homosexual or bisexual men, intravenous drug abusers, and individuals with hemophilia. Nystatin suspension is commonly used to treat oral candidiasis, while Candida esophagitis demands systemic therapy with ketoconazole. Toxoplasmosis most commonly manifests itself in patients with AIDS as a cerebral mass lesion. The recommended therapy includes sulfadiazine and pyrimethamine. AIDS patients frequently experience protozoal invasion of the intestinal tract with Giardia lamblia, Isospora belli, and Cryptosporidium muris. Various drugs have been tried for these infections, including quinacrine hydrochloride, metronidazole, TMP-SMZ, and spiramycin. Cytomegalovirus (CMV) infections commonly involve the lungs, gastrointestinal tract, eyes, brain, and nervous system. Attempts to treat these disseminated CMV infections with antiviral agents, including acyclovir, have not been successful. However, acyclovir has been found beneficial in the treatment of herpes-simplex virus infections. Multiple infectious complications may occur in patients with AIDS as a result of the cellular-immune deficiency associated with this disease. Until more research is done with AIDS patients, therapy must be based on the data available from the treatment of these infections in immunosuppressed patients without AIDS.

  16. Plasmodium vivax cerebral malaria complicated with venous sinus thrombosis in Colombia

    Institute of Scientific and Technical Information of China (English)

    Miguel A Pinzn; Juan C Pineda; Fernando Rosso; Masaru Shinchi; Fabio Bonilla-Abada

    2013-01-01

    Complicated malaria is usually due to Plasmodium falciparum. Nevertheless, Plasmodium vivax is infrequently related with life-threatening complications. Few cases have been reported of severe Plasmodium vivax infection, and most of them from Southeast Asia and India. We report the first case of cerebral malaria due to Plasmodium vivax in Latin America, complicated with sagittal sinus thrombosis and confirmed by a molecular method.

  17. Neurologic Complications of Transplantation.

    Science.gov (United States)

    Dhar, Rajat

    2018-02-01

    Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

  18. Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

    Energy Technology Data Exchange (ETDEWEB)

    Walser, Eric M., E-mail: walser.eric@mayo.edu [Mayo Clinic, Department of Radiology (United States)

    2012-08-15

    The subcutaneous venous access device (SVAD or 'port') is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist of catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.

  19. Complications of laser in situ keratomileusis (LASIK) for correction of myopia and their management

    Energy Technology Data Exchange (ETDEWEB)

    Lotfy, A A

    2002-07-01

    Complication of Laser in situ keratomileusis (Lasik) For correction of myopia and their management. Lasik has many many complications that the study discussed and also their management. Complications include; bleeding, infection, corneal haze and scarring, lost or displaced flap, corneal complications, over and under correction, and regression of refraction.

  20. Complications of laser in situ keratomileusis (LASIK) for correction of myopia and their management

    International Nuclear Information System (INIS)

    Lotfy, A. A.

    2002-01-01

    Complication of Laser in situ keratomileusis (Lasik) For correction of myopia and their management. Lasik has many many complications that the study discussed and also their management. Complications include; bleeding, infection, corneal haze and scarring, lost or displaced flap, corneal complications, over and under correction, and regression of refraction

  1. Postoperative spine infections

    Directory of Open Access Journals (Sweden)

    Paolo Domenico Parchi

    2015-09-01

    Full Text Available Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of post-operative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication.

  2. Posttransplant complications in adult recipients of intestine grafts without bowel decontamination.

    Science.gov (United States)

    Clouse, Jared W; Kubal, Chandrashekhar A; Fridell, Jonathan A; Mangus, Richard S

    2018-05-01

    Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. This study reports complication rates of an intestine transplant program that has never used bowel decontamination. All adult patients who underwent intestine transplant from 2003 to 2015 at a single center were reviewed. Posttransplant complications included intra-abdominal abscess, enteric fistula, and leak from the enteric anastomosis. Viral, fungal, and bacterial infections in the first year after transplant are reported. There were 184 adult patients who underwent deceased donor intestine transplant during the study period. Among these patients, 30% developed an infected postoperative fluid collection, 4 developed an enteric fistula (2%), and 16 had an enteric or anastomotic leak (8%). The rate of any bacterial infection was 91% in the first year, with a wound infection rate of 25%. Fungal infection occurred in 47% of patients. Rejection rates were 55% at 1 y for isolated intestine patients and 17% for multivisceral (liver inclusive) patients. Among this population of intestine transplant patients in which no bowel decontamination was used, rates of surgical complications, infections, and rejection were similar to those reported by other centers. Bowel decontamination provides no identifiable benefit in intestine transplantation. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. [Surgical assessment of complications after thyroid gland operations].

    Science.gov (United States)

    Dralle, H

    2015-01-01

    The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

  4. Wound complications following laparoscopic surgery in a Nigerian Hospital

    Directory of Open Access Journals (Sweden)

    Adewale O Adisa

    2014-01-01

    Full Text Available Background: Different complications may occur at laparoscopic port sites. The incidence of these varies with the size of the ports and the types of procedure performed through them. Objectives: The aim was to observe the rate and types of complications attending laparoscopic port wounds and to identify risk factors for their occurrence. Patients and Methods: This is a prospective descriptive study of all patients who had laparoscopic operations in one general surgery unit of a University Teaching Hospital in Nigeria between January 2009 and December 2012. Results: A total of 236 (155 female and 81 male patients were included. The laparoscopic procedures include 63 cholecystectomies, 49 appendectomies, 62 diagnostic, biopsy and staging procedures, 22 adhesiolyses, six colonic surgeries, eight hernia repairs and 22 others. Port site complications occurred in 18 (2.8% ports on 16 (6.8% patients including port site infections in 12 (5.1% and hypertrophic scars in 4 (1.7% patients, while one patient each had port site bleeding and port site metastasis. Nine of 11 infections were superficial, while eight involved the umbilical port wound. Conclusion: Port site complications are few following laparoscopic surgeries in our setting. We advocate increased adoption of laparoscopic surgeries in Nigeria to reduce wound complications that commonly follow conventional open surgeries.

  5. Computed tomography findings of postoperative complications in lung transplantation

    International Nuclear Information System (INIS)

    Hochhegger, Bruno; Irion, Klaus Loureiro; Marchiori, Edson; Bello, Rodrigo; Moreira, Jose; Camargo, Jose Jesus; Universidade Federal do Rio de Janeiro

    2009-01-01

    Due to the increasing number and improved survival of lung transplant recipients, radiologists should be aware of the imaging features of the postoperative complications that can occur in such patients. The early treatment of complications is important for the long-term survival of lung transplant recipients. Frequently, HRCT plays a central role in the investigation of such complications. Early recognition of the signs of complications allows treatment to be initiated earlier, which improves survival. The aim of this pictorial review was to demonstrate the CT scan appearance of pulmonary complications such as reperfusion edema, acute rejection, infection, pulmonary thromboembolism, chronic rejection, bronchiolitis obliterans syndrome, cryptogenic organizing pneumonia, post transplant lymphoproliferative disorder, bronchial dehiscence and bronchial stenosis. (author)

  6. Shoulder Arthroplasty for Humeral Head Avascular Necrosis Is Associated With Increased Postoperative Complications.

    Science.gov (United States)

    Burrus, M Tyrrell; Cancienne, Jourdan M; Boatright, Jeffrey D; Yang, Scott; Brockmeier, Stephen F; Werner, Brian C

    2018-02-01

    Humeral head avascular necrosis (AVN) of differing etiologies may lead to shoulder arthroplasty due to subchondral bone collapse and deformity of the articular surface. There have been no large studies evaluating the complications for these patients after they undergo total shoulder arthroplasty (TSA). The first objective of this study is to evaluate the complication rate after TSA in patients with humeral head AVN. The secondary objective is to compare the complication rates among the different etiologies of the AVN. Patients who underwent TSA were identified in the PearlDiver database using ICD-9 codes. Patients who underwent shoulder arthroplasty for humeral head AVN were identified using ICD-9 codes and were subclassified according to AVN etiology (posttraumatic, alcohol use, chronic steroid use, and idiopathic). Complications evaluated included postoperative infection within 6 months, dislocation within 1 year, revision shoulder arthroplasty up to 8 years postoperatively, shoulder stiffness within 1 year, and periprosthetic fracture within 1 year and systemic complications within 3 months. Postoperative complication rates were compared to controls. The study cohorts included 4129 TSA patients with AVN with 141,778 control TSA patients. Patients with posttraumatic AVN were significantly more likely to have a postoperative infection (OR 2.47, P  AVN was associated with a significantly increased risk for a postoperative infection (OR 1.72, P  = 0.004), revision surgery (OR 1.33, P  = 0.040), fracture (OR 2.76, P  = 0.002), and systemic complication (OR 1.59, P  AVN were not significantly associated with any of the postoperative evaluated complications. TSA in patients with humeral head AVN is associated with significantly increased rates of numerous postoperative complications compared to patients without a diagnosis of AVN, including infection, dislocation, revision arthroplasty, stiffness, periprosthetic fracture, and medical complications

  7. STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection.

    Science.gov (United States)

    Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M

    2015-01-01

    Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. © The Author(s) 2014.

  8. [A case of the myelitis due to Toxocara canis infection complicated with cervical spondylosis].

    Science.gov (United States)

    Mitsuhashi, Yutaka; Naitou, Kentarou; Yamauchi, Shigeru; Naruse, Hirotsune; Matsuoka, Yoshimi; Nakamura-Uchiyama, Fukumi; Hiromatsu, Kenji

    2006-11-01

    A 59-year-old male had suffered from numbness of the hands for 7 months. With a diagnosis of cervical spondylosis, he had been treated conservatively at a nearby clinic. After he fell off his bicycle, the numbness intensified and limb weakness developed. Cervical MRI revealed spinal cord compression at the C4/5 and C5/6 levels due to cervical spondylosis with prominent edema in the spinal cord spreading from the C4 to C6 level. The edema was very serious. Therefore, we suspected that the traumatic spinal injury underlying the cervical spondylosis was complicated by another disease. Cervical spinal angiography revealed no apparent vascular disorder. Contrast enhanced MRI showed a small enhanced area in the spinal cord at the C5 level. Because of the rapid progression of gait disturbance, expansive laminoplasty was performed without further examination. Although remarkable amelioration of the symptoms was seen just after the surgery, the symptoms worsened again about 1 month later. The patient's clinical history was reconsidered, revealing that he likes raw bovine liver. Serological examination, because of suspicion of parasitic infection showed elevated titers of anti-Toxocara canis antibody in the serum and cerebrospinal fluid. Administration of albendazole improved the clinical symptoms, and normalized the serological and MRI findings. Myelitis due to T canis infection is a rare disease. For an early and accurate diagnosis, it is important to be fully aware of this disease and to include detailed information on food preferences and pet-keeping in the process of compiling a clinical history.

  9. Acute pyelonephritis can have serious complications.

    Science.gov (United States)

    Shields, Joanne; Maxwell, Alexander P

    2010-04-01

    Urinary tract infection (UTI) may predominantly involve the lower urinary tract, i.e. acute cystitis, or upper urinary tract consisting of the renal pelvis and kidney,, i.e. acute pyelonephritis The incidence of acute pyelonephritis is higher in young women than in men but the incidence in men over 65 is similar to that in older women. Women have up to a 10% risk of recurrent acute pyelonephritis in the year following a first acute episode. The equivalent risk in men is 6%. Acute pyelonephritis may be uncomplicated and resolve without serious sequelae. A minority of episodes may be complicated by acute kidney injury, papillary necrosis, renal or perinephric abscess or the development of emphysematous pyelonephritis. Acute pyelonephritis is generally caused by microorganisms ascending from the urethra via the bladder into the upper urinary tract. Rarely the kidney may be seeded by blood-borne infection. Ecoli is the most common uropathogen causing pyelonephritis accounting for 70-90% of infections. Species of Enterococci, Klebsiella, Pseudomonas, Proteus and Staphylococci are responsible for the remaining infections. There is a rising incidence in the community of UTI with bacteria that produce extended spectrum beta-lactamase (ESBL) enzymes. These ESBL bacteria have developed resistance to antibiotics such as penicillin, cephalosporins and increasingly to quinolones. Risk factors for uncomplicated acute pyelonephritis include recent sexual intercourse, acute cystitis, stress incontinence and diabetes and for complicated acute pyelonephritis include pregnancy, diabetes, anatomical abnormalities of the urinary tract and renal calculi.

  10. Genital infections and reproductive complications associated with Trichomonas vaginalis, Neisseria gonorrhoeae, and Streptococcus agalactiae in women of Qom, central Iran

    Directory of Open Access Journals (Sweden)

    Mahmoud Nateghi Rostam

    2017-07-01

    Full Text Available Background: Trichomonas vaginalis (T.vaginalis and Neisseria gonorrhoeae (N.gonorrhoeae are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran. Objective: Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran. Materials and Methods: Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler® real-time PCR (for N.gonorrhoeae and ITS-PCR (for T.vaginalis. Results: Of 420 volunteers, 277 (65.9% had genital signs/symptoms, including 38.3% malodorous discharge, 37.9% dyspareunia, and 54.8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens (1.2% in Thayer-Martin culture and 17 (4.1% in real-time PCR were identified as N.gonorrhoeae. Fifty-four specimens (12.9% in wet mount, 64 (15.2% in Dorset’s culture, and 81 (19.3% in ITS-PCR showed positive results for T.vaginalis. Five mixed infections of T.vaginalis+ N.gonorrhoeae were found. The risk of T.vaginalis infection was increased in women with low-birth-weight (p=0.00; OR=43.29, history of abortion (p=0.00; OR=91.84, and premature rupture of membranes (PROM (p=0.00; OR=21.75. The probability of finding nuclear leukocytes (p=0.00; OR=43.34 in vaginal smear was higher in T.vaginalis infection. Conclusion: The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women.

  11. Nephrobronchial fistula complicating neglected nephrolithiasis and xanthogranulomatous pyelonephritis

    Directory of Open Access Journals (Sweden)

    Indu B Dubey

    2011-01-01

    Full Text Available Nephrobronchial fistula is a rare complication seen in association with renal infections, trauma or stone disease. Xanthogranulomatous pyelonephritis (XGP is an infectious disease with a potential for fistulization to lung, skin, colon and other organs. We present a case of nephrolithiasis complicated by obstruction leading to pyonephrosis and nephrobronchial fistula, treated successfully by nephrectomy and excision of fistulous tracts. Nephrobronchial fistula, although a rare complication of longstanding renal stone, should be considered when a patient presents with perirenal suppurative process. This clinical case illustrates the natural history of nephro-bronchial fistula and the relevance of early treatment of nephrolithiasis.

  12. [Urinary tract infections in adults].

    Science.gov (United States)

    Michno, Mikolaj; Sydor, Antoni

    Review of urinary tract infections in adults including etiology, pathogenesis, classification and the most important therapeutic recommendations. Urinary tract infections are still a common clinical problem occurring more often in sexually active women, pregnancy, elderly , after catherization of a urinary bladder and urological surgery as well as in the co-existence of diabetes or nephrolithiasis. Due to the anatomical differences, women suffer more often than men. The main etiological factor is Escherichia coli, even though it plays a lesser role in the complicated infections, than in non-complicated ones. Apart from that, the infections may also be caused by atypical microbes, viruses and fungi. Relapses as well as reinfections are typical features of urinary tract infections and in some cases prolonged infections can spread from lower to upper urinary tract contributing to pyelonephritis, urosepsis or even death. These long-term infections can progress in a hidden, insidious, oligosymptomatic or asymptomatic manner leading to irreversible, progressive deterioration of renal function. They can also mask other diseases such as tuberculosis or neoplasms of the urinary tract, which leads to the delayed diagnosis and treatment. Diagnosis and treatment of urinary tract infections is a complex problem, often requiring specialized procedures as well as hospitalization. The choice of a therapy is determined by the type of infection, general condition, age and coexisting diseases. Rapid diagnosis and implementation of proper pharmacotherapy may shorten the time of treatment and hospitalization, preventing serious complications and reinfections.

  13. Soft contact lenses: Basic characteristics, advantages and complications associated with their use

    Directory of Open Access Journals (Sweden)

    Milosavljević Miloš

    2016-01-01

    Full Text Available Soft contact lenses have an important place in ophthalmology, both for the correction of refractive anomalies and tor the treatment of some eye diseases. From the moment when adequately biocompatible materials were found, for a very sensitive environment such as the human eye, from early 60s of the 20th century, starts irrepressible expansion of soft contact lenses. The reason for this expansion of soft contact lenses lies in advantages they undoubtedly have in comparison to glasses, but also in comparison to hard and semi-hard contact lenses. Unfortunately, in parallel with the increasing number of users of this type of optical aids, increases the incidence of complications that can arise. Complications can be very diverse in nature and severity, and they can be classified into three major groups: symptoms of eye dryness, infections and allergic-toxic complications. Symptoms of dry eye are very common for users of contact lenses, and their occurrence is especially provoked by certain factors, such as cigarette smoke or prolonged watching the computer screen or TV. These complications are usually not so dangerous and can easily be solved by applying artificial tears. Infections are not so common and occur as a result of inadequate maintenance of contact lenses. If the symptoms are recognized early, infections are mostly stopped at the level of conjunctivitis and are treated fairly quickly and easily. Otherwise, the infection can progress to ulcerative keratitis, the most severe complication of inadequate application of soft contact lenses, and in some cases it can even lead to blindness. Allergic-toxic complications generally occur in susceptible persons and their occurrence in most cases means contraindication for further wearing of soft contact lenses. This case report underlines possible role of rheumatoid factor in estimation of the patient's response to administered therapy.

  14. Post thyroidectomy complications: the Hyderabad experience

    International Nuclear Information System (INIS)

    Khanzada, T.W.; Samad, A.; Memonb, W.; Kumar, B.

    2010-01-01

    Objective: Thyroidectomy is a very common surgical procedure worldwide and is performed by surgeons with varied training. The outcome and complication rates are largely dependent on surgeon's skill and experience, the extent of surgery, indication of surgery and number of thyroid surgeries performed at that particular centre. The objective of this study was to determine the frequency of postoperative complications after thyroid surgery in Hyderabad, Pakistan. Study Design: It was a descriptive study and was carried out at 2 private hospitals including a teaching University Hospital over a period of 3 years from April 2005 to March 2008. Patients and Methods: All patients with goitre, who underwent any sort of thyroid surgery, were included in this study. Patients' bio-data including name, age sex, clinical status of thyroid, thyroid function tests, ultrasound, fine needle aspiration cytology and operative procedure, findings, post operative complications and histopathology reports were recorded. Data were analysed using SPSS 16.0. Results: The overall postoperative complication rate was 10.7%. Postoperative hypocalcaemia was the most frequent complication observed in 3.5% of all patients followed by recurrent laryngeal nerve (RLN) injury noted in 2.8% patients. The less common complications were bleeding, seroma formation and wound infection. Majority of these complications were associated with total thyroidectomy, male gender, and in patients with age more than 30 years. Conclusion: The commonest post thyroidectomy complication was hypocalcaemia. Male gender, old age, and extensive thyroid surgery were associated with increased complication rate. (author)

  15. Imaging of the ventriculoperitoneal shunt-related complications in infants and children with hydrocephalus

    International Nuclear Information System (INIS)

    Jeon, Se Ok; Kim, Ji Hye; Oh, Eun Young; Hwang, Hee Young; Lee, Seon Kyu; Lee, Eun Joo; Kwak, Min Sook; Kim, Hyung Sik

    1999-01-01

    To evaluate the frequency and imaging findings of various ventriculo-peritoneal shunt-related complications in pediatric patients with hydrocephalus. We retrospectively reviewed 246 plain radiographs, three shuntograms, 53 ultrasounds, 133 CT scans, and 24 MR images obtained before and after the ventriculo-peritoneal shunt procedure in 33 pediatric patients with hydrocephalus. Using preoperative images, the etiology of the hydrocephalus was assessed. Changes in the size and shape of the ventricles, the location and continuity of shunt apparatus, and the presence of any abnormal enhancement, hemorrhage, edema or tissue loss, or other findings of complications, were analyzed on postoperative images ; the frequency and imaging findings of shunt-related complications such as shunt malfunction, infection, homorrhage or isolated ventricle, and complications caused by overdrainage, were thus evaluated. The frequency of such complications was analyzed according to the etiology of the hydrocephalus, and in addition, medical records were reviewed and correlated with imaging findings. In 18 of the 33 patients(54%), a total of 31 complications was detected. These were present in four of five cases (80%) of hydrocephalus caused by meningitis and ventriculitis, seven of twelve (58%) intraventricular hemorrhage, two of four (50%) unknown cases, three of nine (33%) congenital malformations, one of two (50%) tumors, and one (100%) congenital infection. Shunt malfunction was most common (n=15), and was accompanied by findings of enlarged ventricles, periventricular and peritubal edema, and abnormal location of the shunt tube. Symptoms and signs of increased intracranial pressure were also noted. Subdural hemorrhage and infection were present in four cases each ; findings of infection were enhancement of the ventricular wall, meninges, and parenchyma, as well as sonographically noted intraventricular septation and increased ventricular wall echo. Isolated lateral ventricle (n=4) or 4

  16. Imaging findings of liposuction with an emphasis on postsurgical complications

    Energy Technology Data Exchange (ETDEWEB)

    You, Je Sung; Chung, Sung Phil; Kim, Myeong Jin [Dept. of mergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chung, Yong Eun; Baek, Song Ee [Dept. of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.

  17. Bacterial translocation and cardiovascular complications of cirrhosis. Authors' response to letter

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    2008-01-01

    dysfunction have been somewhat unpredictable.3-5 In two conditions, however, a direct relationship between bacterial infection and increased mortality have been proved, namely infections in relation to bleeding from oesophageal varices and spontaneous bacterial peritonitis.6-8 In both of these complications...

  18. Prevalence of complications in neuromuscular scoliosis surgery

    DEFF Research Database (Denmark)

    Sharma, Shallu; Wu, Chunsen; Andersen, Thomas

    2013-01-01

    .71 %) followed by implant complications (PR = 12.51 %), infections (PR = 10.91 %), neurological complications (PR = 3.01 %) and pseudoarthrosis (PR = 1.88 %). Revision, removal and extension of implant had highest PR (7.87 %) followed by malplacement of the pedicle screws (4.81 %). Rates of individual studies...... have moderate to high variability. The studies were heterogeneous in methodology and outcome types, which are plausible explanations for the variability; sensitivity analysis with respect to age at surgery, sample size, publication year and diagnosis could also partly explain this variability...

  19. Fatal Lemierre's syndrome as a complication of chronic otitis media ...

    African Journals Online (AJOL)

    South African Journal of Child Health ... Background. Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein, initiated by an infection of the head and neck region. This septic ... We discuss the case of a 14-year-old male with Lemierre's syndrome as a complication of chronic middle ear infection. Results.

  20. Ureterovaginal fistula: A complication of a vaginal foreign body

    Directory of Open Access Journals (Sweden)

    Tsia-Shu Lo

    2018-02-01

    Conclusion: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.

  1. Pulmonary infections in immunocompromised patients

    International Nuclear Information System (INIS)

    Choneva, I.; Abadjieva, D.; Kirilov, R.

    2013-01-01

    Full text: Introduction: The lung is one of the most commonly affected organs in immunocompromised patients. Primary complication is pulmonary infection which is associated with high morbidity and mortality. Although radiography and CT, as main diagnostic tools are reliable and credible methods, often there is difficulty with the correct diagnose. The reasons for this are that immunocompromised patients are potentially susceptible to infection by various microorganisms and that the radiographic findings are rarely specific for detecting a particular pathogen. What you will learn : Our objective is to present general nosological classification of pulmonary infections in immunocompromised patients, and to evaluate and analyze new imaging methods and discuss their correlation with the clinical setting, which aims to facilitate the diagnosis and to take a decision for the treatment. The experience indicates that a clinical environment conducive the immunocompromised patients to infection with certain pathogens, thereby changing the frequency of their occurrence. The most commonly cited fungal infections, cytomegalovirus infections, Pneumocystis carinii pneumonia and Pulmonary tuberculosis (PTB) of which convincing is the Imaging diagnosis primarily in fungal infections, and Pneumocystis carinii pneumonia and less accurate - in bacterial and viral infections. Discussion: The term 'immunocompromised' describes a subject with an increased risk for life-threatening infection as a result of congenital or acquired abnormalities of the immune system. Over the past few decades, the number of immunocompromised patients has grown considerably, reflecting the increased use of immunosuppressive drugs, and the syndrome of acquired immunodeficiency. Given the high incidence of pulmonary infections in immunocompromised patients (lung is one of the most commonly affected organs, such as lung infection is about 75% of pulmonary complications), rapid and accurate diagnosis is important

  2. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2012-05-01

    Full Text Available Abstract The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012. This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs were included in the study. 912 patients with a mean age of 54.4 years (range 4–98 were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified. The overall mortality rate was 6.4% (58/912. According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality. White Blood Cell counts (WBCs greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.

  3. Concurrent Infection with Hepatitis C Virus and Streptococcus pneumoniae.

    Science.gov (United States)

    Marrie, Thomas J; Tyrrell, Gregory J; Majumdar, Sumit R; Eurich, Dean T

    2017-07-01

    Little is known about concurrent infection with hepatitis C virus (HCV) and Streptococcus pneumoniae, which causes invasive pneumococcal disease (IPD). We hypothesized that co-infection with HCV and S. pneumoniae would increase risk for death and complications. We captured sociodemographic and serologic data for adults with IPD in a population-based cohort study in northern Alberta, Canada, during 2000-2014. IPD patients infected with HCV were compared with IPD patients not infected with HCV for risk of in-hospital deaths and complications by using multivariable logistic regression. A total of 355 of 3,251 patients with IPD were co-infected with HCV. The in-hospital mortality rate was higher for IPD patients infected with HCV. Prevalence of most IPD-related complications (e.g., cellulitis, acute kidney injury, mechanical ventilation) was also higher in HCV-infected patients. Infection with HCV is common in patients with IPD, and HCV is independently associated with an increased risk for serious illness and death.

  4. Venous thromboembolism and arterial complications.

    Science.gov (United States)

    Prandoni, Paolo; Piovella, Chiara; Pesavento, Raffaele

    2012-04-01

    An increasing body of evidence suggests the likelihood of a link between venous and arterial thrombosis. The two vascular complications share several risk factors, such as age, obesity, smoking, diabetes mellitus, blood hypertension, hypertriglyceridemia, and metabolic syndrome. Moreover, there are many examples of conditions accounting for both venous and arterial thrombosis, such as the antiphospholipid antibody syndrome, hyperhomocysteinemia, malignancies, infections, and the use of hormonal treatment. Finally, several recent studies have consistently shown that patients with venous thromboembolism are at a higher risk of arterial thrombotic complications than matched control individuals. We, therefore, speculate the two vascular complications are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Addressing social influences reduces antibiotic duration in complicated abdominal infection: a mixed methods study.

    Science.gov (United States)

    Broom, Jennifer; Tee, Chin Li; Broom, Alex; Kelly, Mark D; Scott, Tahira; Grieve, David A

    2018-03-06

    Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed. Qualitative: Semi-structured interviews were performed to evaluate which elements of the intervention were perceived to be effective. An intervention including collaborative inter-specialty and inter-professional educational meetings, and education of all professional streams was undertaken. Quantitative: Twenty-three patients before and 22 patients after the intervention were included. The total duration of antibiotics decreased significantly following the intervention (9.2 versus 6.6 days P = 0.02). The duration of intravenous antibiotics did not change significantly (5.4 versus 4.5 days, P = 0.06). Qualitative: Eighteen health-care professionals participated. Thematic analysis indicated that a collaborative approach between senior surgical and infectious disease specialists in the pre-intervention stage led to perceived ownership and leadership of the intervention by the surgical team, which was thought critical to the success of the intervention. Conversely, the ability of nurses and pharmacists to influence antibiotic practice was considered limited and a poster promoting the intervention was perceived as ineffective. Consultant leadership and specialty ownership of the process were perceived to be critical in the success of the intervention. Antibiotic stewardship programs which address social factors may have greater efficacy to optimize antimicrobial prescribing. © 2018 Royal Australasian College of Surgeons.

  6. Illicit intravenous drug use in Johannesburg - medical complications ...

    African Journals Online (AJOL)

    mortality and prevalence of HIV infection. Design. We conducted a ... Table I. Other complications of intravenous drug abuse ... In 2 cases (2%) an initial screen positivity .... patients with Gram-negative, anaerobic or fungal organisms. Our study ...

  7. Computed Tomography of the complications of prosthetic surgery of the abdominal aorta

    International Nuclear Information System (INIS)

    Giovagnorio, Francesco; Andreoli, Chiara; De Cicco, Maria Luisa

    1997-01-01

    Computerized Tomography has gained an important role in the diagnosis of the complications of prosthetic surgery of the abdominal aorta: the importance of such complications come from their frequency, which is proportional to the increasing number of interventions, and their severity. The authors investigated the CT patterns of the most frequent complications. 24 patients referred for strongly suspected postoperative complications were examined in 2 years: fever and leukocytosis (20 cases) and progressive anemia (4 cases) were the most frequent findings. The operation had been performed 7± 12 weeks before (2 patients were excluded because surgery dated less than 3 weeks. 14 patients had infective complications: thickening (57%) and inhomogeneity (43%) of the periprosthetic wrap and ectopic gas bubble (78%) were the most frequent Computerized Tomography findings. The authors also observed 2 periprosthetic hematomas, 1 aneurysm relapse and 1 prosthetic graft rupture. In conclusion, CT confirmed its important role in the study of the complications of prosthetic aortic surgery, despite its know poor specificity in the demonstration of the aorta in the first 2-3 months postoperatively, in the initial stages of infection and in the diagnosis of aorta-enteric fistulas

  8. Oral complications in cancer patients

    International Nuclear Information System (INIS)

    Carl, W.

    1983-01-01

    Ionizing radiation used in treating the head and neck area produces oral side effects such as mucositis, salivary changes, trismus and radiation caries. Sequelae of cancer chemotherapy often include oral stomatitis, myelosuppression and immunosuppression. Infections of dental origin in compromised patients are potentially lethal. Specific programs to eliminate dental pathology before radiation and chemotherapy, and to maintain oral hygiene during and after therapy, will minimize these complications

  9. Infectious complications after vehicular trauma in the United States.

    Science.gov (United States)

    Fraser, Douglas R; Dombrovskiy, Viktor Y; Vogel, Todd R

    2011-08-01

    The purpose of this analysis was to evaluate and define the rates of infectious complications (IC) after vehicular trauma. Secondary goals were to identify the injuries associated with the greatest risk of nosocomial infection and to measure the utilization of hospital resources associated with IC and vehicular trauma. A secondary analysis of the Nationwide Inpatient Sample (2003-2007) was performed to classify major vehicular trauma injuries utilizing International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Emergency (E) codes. The post-traumatic IC evaluated were pneumonia, urinary tract infection (UTI), sepsis, and surgical site infection (SSI). All data were analyzed by χ(2) analysis, multivariable logistic regression, and the Cochran-Armitage test for trends. A total of 784,037 vehicular trauma patients were identified (462,543 [59.0%] motor vehicle drivers, 142,283 [18.2%] motor vehicle passengers, 98,767 [12.6%] motorcyclists; 6,568 [colon injuries. After adjustment by age, sex, and co-morbidities, patients with SCI were 4.4 times as likely (95% confidence interval [CI] 4.20-4.63) and those with cranial injuries were 2.1 times as likely (95% CI 2.06-2.19) to develop IC as patients without these injuries. Secondary infection increased significantly the length of stay and hospital charges in all groups. Patients sustaining vehicular trauma in combination with SCI had the highest rate of IC. Infectious complications increased hospital resource utilization significantly after vehicular trauma. Future root-cause analysis of high-risk groups may decrease complications and hospital utilization.

  10. Clinical and economic consequences of failure of initial antibiotic therapy for patients with community-onset complicated intra-abdominal infections.

    Directory of Open Access Journals (Sweden)

    Yong Pil Chong

    Full Text Available Complicated intra-abdominal infection (cIAI is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI.A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week.A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14% had health care-associated infection, and 48 (9% experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred $3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13.To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed.

  11. Predictive factors of neurological complications and one-month mortality after liver transplantation

    Directory of Open Access Journals (Sweden)

    Katherine eFu

    2014-12-01

    Full Text Available Background: Neurological complications are common after orthotopic liver transplantation (OLT. We aimed to characterize the risk factors associated with neurological complications and mortality among patients who underwent OLT in the post-model for end-stage liver disease (MELD era.Methods: In a retrospective review, we evaluated 227 consecutive patients at the Keck Hospital of the University of Southern California before and after OLT to define the type and frequency of and risk factors for neurological complications and mortality.Results: Neurological complications were common (n=98, with encephalopathy being most frequent (56.8%, followed by tremor (26.5%, hallucinations (11.2%, and seizure (8.2%. Factors associated with neurological complications after OLT included preoperative dialysis, hepatorenal syndrome, renal insufficiency, intra-operative dialysis, preoperative encephalopathy, preoperative mechanical ventilation, and infection. Preoperative infection was an independent predictor of neurological complications (OR 2.83, 1.47 – 5.44. One-month mortality was 8.8% and was independently associated with urgent re-transplant, preoperative intubation, intraoperative arrhythmia, and intraoperative use of multiple pressors.Conclusion: Neurological complications are common in patients undergoing OLT in the post-MELD era, with encephalopathy being most frequent. An improved understanding of the risk factors related to both neurological complications and one-month mortality post-transplantation can better guide perioperative care and help improve outcomes among OLT patients.

  12. Indications and Complications of Tube Thoracostomy with ...

    African Journals Online (AJOL)

    an accumulation of fluid within the pleural considered significant enough to warrant drainage. This is to prevent possible complications like infection of the fluid or to prevent respiratory compromise when excessive. Where the ideal drainage receptacle is unavailable, the underwater seal device has been improvised in.

  13. Unexpected findings and surgical complications in 505 consecutive cochlear implantations: a proposal for reporting consensus

    DEFF Research Database (Denmark)

    Hansen, Søren; Anthonsen, Kristian; Stangerup, Sven-Eric

    2010-01-01

    Cochlear implantation is a safe procedure in experienced hands, as the rate of severe complications is below 2%. Complications differ between children and adults, and transient disequilibrium/vertigo is the most common complication, followed by wound infection, haematoma/oedema and transient chorda...

  14. Unexpected findings and surgical complications in 505 consecutive cochlear implantations: a proposal for reporting consensus

    DEFF Research Database (Denmark)

    Hansen, Søren; Anthonsen, Kristian; Stangerup, Sven-Eric

    2010-01-01

    Cochlear implantation is a safe procedure in experienced hands, as the rate of severe complications is below 2%. Complications differ between children and adults, and transient disequilibrium/vertigo is the most common complication, followed by wound infection, haematoma/oedema and transient chor...

  15. Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae

    OpenAIRE

    Arai, Masaru; Nagashima, Koichi; Kato, Mahoto; Akutsu, Naotaka; Hayase, Misa; Ogura, Kanako; Iwasawa, Yukino; Aizawa, Yoshihiro; Saito, Yuki; Okumura, Yasuo; Nishimaki, Haruna; Masuda, Shinobu; Hirayama, Atsushi

    2016-01-01

    Patient: Male, 74 Final Diagnosis: Infective endocarditis Symptoms: Apetite loss ? fever Medication: ? Clinical Procedure: Transesophageal echocardiography Specialty: Cardiology Objective: Rare co-existance of disease or pathology Background: Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB). Case Report: A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our ...

  16. Maternal and Obstetric Complications among HIV-infected Women ...

    African Journals Online (AJOL)

    2018-01-24

    Jan 24, 2018 ... that despite the use of HAART, HIV‑infected women were at increased risk of both respiratory .... daily during the antenatal period and a single dose of 200 mg NVP in ... by regimen using a 1° of freedom Chi‑square test with.

  17. Infection in the ischemic lower extremity.

    Science.gov (United States)

    Fry, D E; Marek, J M; Langsfeld, M

    1998-06-01

    Infections in the lower extremity of the patient with ischemia can cover a broad spectrum of different diseases. An understanding of the particular pathophysiologic circumstances in the ischemic extremity can be of great value in understanding the natural history of the disease and the potential complications that may occur. Optimizing blood flow to the extremity by using revascularization techniques is important for any patient with an ischemic lower extremity complicated by infection or ulceration. Infections in the ischemic lower extremity require local débridement and systemic antibiotics. For severe infections, such as necrotizing fasciitis or the fetid foot, more extensive local débridement and even amputation may be required. Fundamentals of managing prosthetic graft infection require removing the infected prosthesis, local wound débridement, and systemic antibiotics while attempting to preserve viability of the lower extremity using autogenous graft reconstruction.

  18. Intra-abdominal hypertension in fulminant Clostridium difficile infection--an under-recognized treatable complication.

    Science.gov (United States)

    Oud, Lavi

    2010-09-01

    Clostridium difficile is the most common cause of nosocomial infectious diarrhea in adults, with recent reports of increased severity and case fatality. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized and treatable complications of severe illness in medical patients, and are independent predictors of mortality. Patients with severe Clostridium difficile infection (CDI) are at increased risk for IAH and ACS. However, ACS has been only rarely described in this population. We report a case of a 61 year-old morbidly obese, chronically ill, ventilator dependent patient, who developed fulminant CDI, including progressive colonic distension, acute renal failure and intra-abdominal fluid sequestration. Her clinical course worsened abruptly, with new shock, worsening hypoxic respiratory failure, increased peak airway pressures and reduced tidal volumes. Intra-abdominal pressure was 30 mm Hg. The patient was not considered a surgical candidate, was refractory to escalating non-surgical support, and died following withdrawal of life support. Although patients with fulminant CDI share many risk factors for IAH and ACS, these conditions were rarely reported in this population and are likely under recognized, as was the case with the present patient. Increased vigilance for IAH is needed in this at-risk population.

  19. Impact of evidence-based interventions on wound complications after cesarean delivery.

    Science.gov (United States)

    Temming, Lorene A; Raghuraman, Nandini; Carter, Ebony B; Stout, Molly J; Rampersad, Roxane M; Macones, George A; Cahill, Alison G; Tuuli, Methodius G

    2017-10-01

    A number of evidence-based interventions have been proposed to reduce post-cesarean delivery wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. We sought to estimate the impact of a group of evidence-based surgical measures (prophylactic antibiotics administered before skin incision, chlorhexidine-alcohol for skin antisepsis, closure of subcutaneous layer, and subcuticular skin closure with suture) on wound complications after cesarean delivery and to estimate residual risk factors for wound complications. We conducted a secondary analysis of data from a randomized controlled trial of chlorhexidine-alcohol vs iodine-alcohol for skin antisepsis at cesarean delivery from 2011-2015. The primary outcome for this analysis was a composite of wound complications that included surgical site infection, cellulitis, seroma, hematoma, and separation within 30 days. Risk of wound complications in women who received all 4 evidence-based measures (prophylactic antibiotics within 60 minutes of cesarean delivery and before skin incision, chlorhexidine-alcohol for skin antisepsis with 3 minutes of drying time before incision, closure of subcutaneous layer if ≥2 cm of depth, and subcuticular skin closure with suture) were compared with those women who did not. We performed logistic regression analysis limited to patients who received all the evidence-based measures to estimate residual risk factors for wound complications and surgical site infection. Of 1082 patients with follow-up data, 349 (32.3%) received all the evidence-based measures, and 733 (67.7%) did not. The risk of wound complications was significantly lower in patients who received all the evidence-based measures compared with those who

  20. Complications of massive allograft reconstruction for bone tumors

    Directory of Open Access Journals (Sweden)

    Abolhasan Borjian

    2006-11-01

    Full Text Available BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD. Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60% were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb

  1. Does Acellular Dermal Matrix Thickness Affect Complication Rate in Tissue Expander Based Breast Reconstruction?

    Directory of Open Access Journals (Sweden)

    Jessica F. Rose

    2016-01-01

    Full Text Available Background. While the benefits of using acellular dermal matrices (ADMs in breast reconstruction are well described, their use has been associated with additional complications. The purpose of this study was to determine if ADM thickness affects complications in breast reconstruction. Methods. A retrospective chart review was performed including all tissue expander based breast reconstructions with AlloDerm (LifeCell, Branchburg, NJ over 4 years. We evaluated preoperative characteristics and assessed postoperative complications including seroma, hematoma, infection, skin necrosis, and need for reintervention. We reviewed ADM thickness and time to Jackson-Pratt (JP drain removal. Results. Fifty-five patients underwent 77 ADM-associated tissue expander based breast reconstructions, with average age of 48.1 years and average BMI of 25.9. Average ADM thickness was 1.21 mm. We found higher complication rates in the thick ADM group. Significant associations were found between smokers and skin necrosis (p<0.0001 and seroma and prolonged JP drainage (p=0.0004; radiated reconstructed breasts were more likely to suffer infections (p=0.0085, and elevated BMI is a significant predictor for increased infection rate (p=0.0037. Conclusion. We found a trend toward increased complication rates with thicker ADMs. In the future, larger prospective studies evaluating thickness may provide more information.

  2. Atypical hemolytic uremic syndrome triggered by varicella infection

    Directory of Open Access Journals (Sweden)

    Pauline Condom

    2017-01-01

    The current case describes an aHUS associated to varicella infection as demonstrated by the simultaneous occurrence of the viral infection and aHUS manifestations. Apart from typical Hemolytic Uremic Syndrome which is triggered by bacteria mostly Shiga toxin producing Echerichia coli and Streptococcus pneumoniae or Shigella, aHUS may be linked to viral infections such as HIV, EBV and enteroviruses, but very rarely by varicella. This case highlights a possible even rare complication of varicella infection a very common childhood disease. This complication could be avoided by to anti-VZV vaccination.

  3. Complications of anterior cruciate ligament reconstruction: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Papakonstantinou, Olympia; Chung, Christine B.; Chanchairujira, Kullanuch; Resnick, Donald L. [Department of Radiology, Veterans Affairs Medical Center, University of California, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States)

    2003-05-01

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is being performed with increasing frequency, particularly in young athletes. Although the procedure is generally well tolerated, with good success rates, early and late complications have been documented. As clinical manifestations of graft complications are often non-specific and plain radiographs cannot directly visualize the graft and the adjacent soft tissues, MR imaging has a definite role in the diagnosis of complications after ACL reconstruction and may direct subsequent therapeutic management. Our purpose is to review the normal MR imaging of the ACL graft and present the MR imaging findings of a wide spectrum of complications after ACL reconstruction, such as graft impingement, graft rupture, cystic degeneration of the graft, postoperative infection of the knee, diffuse and localized (i.e., cyclops lesion) arthrofibrosis, and associated donor site abnormalities. Awareness of the MR imaging findings of complications as well as the normal appearances of the normal ACL graft is essential for correct interpretation. (orig.)

  4. Complications of anterior cruciate ligament reconstruction: MR imaging

    International Nuclear Information System (INIS)

    Papakonstantinou, Olympia; Chung, Christine B.; Chanchairujira, Kullanuch; Resnick, Donald L.

    2003-01-01

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is being performed with increasing frequency, particularly in young athletes. Although the procedure is generally well tolerated, with good success rates, early and late complications have been documented. As clinical manifestations of graft complications are often non-specific and plain radiographs cannot directly visualize the graft and the adjacent soft tissues, MR imaging has a definite role in the diagnosis of complications after ACL reconstruction and may direct subsequent therapeutic management. Our purpose is to review the normal MR imaging of the ACL graft and present the MR imaging findings of a wide spectrum of complications after ACL reconstruction, such as graft impingement, graft rupture, cystic degeneration of the graft, postoperative infection of the knee, diffuse and localized (i.e., cyclops lesion) arthrofibrosis, and associated donor site abnormalities. Awareness of the MR imaging findings of complications as well as the normal appearances of the normal ACL graft is essential for correct interpretation. (orig.)

  5. A study of association of obesity with maternal complications

    International Nuclear Information System (INIS)

    Iqbal, N.; Rahim, S.; Azhar, I.A.

    2013-01-01

    To determine the association of obesity with maternal complications. Methodology: A prospective cohort study was conducted at Gynae Unit lll Jinnah Hospital Lahore, from 21st May 2011 to 20th Nov.2011 All women fulfilling the inclusion were included in this study. Two groups were made, Group l was allotted to obese pregnant women and Group ll was allotted to non-obese pregnant women. Demographic data included age, parity, duration of pregnancy and maternal complications i-e urinary tract infection , instrumental vaginal delivery and post-partum haemorrhage were recorded and analyzed by SPSS -version 13. Results: The results of this study revealed that demographics like age parity and duration of pregnancy were almost similar in both groups , common age was 25.21 +- 2.73 in group-A and 26.34 +- 3.56 years in group -B . Comparison of maternal complications revealed that 22.23 % in group-A and 10.70% in group -B had urinary tract infection, relative risk was 2.087, instrumental delivery in group -A was 14.42% and in group-B was 4.19% relative risk was 3.44 while post-partum haemorrhage was 9.77% in group -A and 3.26% in group -B , relative risk was 3.00. Conclusion: The frequency of maternal complications is higher among obese pregnant women so it is recommended that every pregnant woman who presents with increased BMI should be sort out for maternal complications. (author)

  6. [Herpes zoster infection with acute urinary retention].

    Science.gov (United States)

    Jakab, G; Komoly, S; Juhász, E

    1990-03-11

    The history of a young female patient is presented. She developed urine retention of sudden onset as a complication of herpes zoster infection manifested in the sacral dermatomes. Symptomatic and antiviral treatments were introduced with full recovery of bladder function. The correct diagnosis of this rare and benign complication of herpes zoster infection can help to avoid unnecessary and invasive examinations.

  7. Diagnostic Tools for Doctors' Evaluation of Tattoo Complications

    DEFF Research Database (Denmark)

    Serup, Jørgen

    2017-01-01

    Diagnosis of tattoo complications is a multi-facetted field since many clinical entities and disease mechanisms are represented. Infections, allergies, and pigment foreign body reactions with granuloma are the major groups. The clinician needs a structured approach to diagnosis and an armamentari...

  8. Infective endocarditis causing mitral valve stenosis - a rare but deadly complication: a case report.

    Science.gov (United States)

    Hart, Michael A; Shroff, Gautam R

    2017-02-17

    Infective endocarditis rarely causes mitral valve stenosis. When present, it has the potential to cause severe hemodynamic decompensation and death. There are only 15 reported cases in the literature of mitral prosthetic valve bacterial endocarditis causing stenosis by obstruction. This case is even more unusual due to the mechanism by which functional mitral stenosis occurred. We report a case of a 23-year-old white woman with a history of intravenous drug abuse who presented with acute heart failure. Transthoracic echocardiography failed to show valvular vegetation, but high clinical suspicion led to transesophageal imaging that demonstrated infiltrative prosthetic valve endocarditis causing severe mitral stenosis. Despite extensive efforts from a multidisciplinary team, she died as a result of her critical illness. The discussion of this case highlights endocarditis physiology, the notable absence of stenosis in modified Duke criteria, and the utility of transesophageal echocardiography in clinching a diagnosis. It advances our knowledge of how endocarditis manifests, and serves as a valuable lesson for clinicians treating similar patients who present with stenosis but no regurgitation on transthoracic imaging, as a decision to forego a transesophageal echocardiography could cause this serious complication of endocarditis to be missed.

  9. Tuberculous Hip Infection Leading to Life Threatening Complications

    African Journals Online (AJOL)

    The infection runs a chronic course with destruction of the affected part. The diagnosis usually requires high level of suspicion followed by biopsy to confirm and they usually respond well to chemotherapy with surgery only being adjuvant for specific indication. The natural cause of tuberculous arthritis evolves over several ...

  10. Which postoperative complications matter most after bariatric surgery? Prioritizing quality improvement efforts to improve national outcomes.

    Science.gov (United States)

    Daigle, Christopher R; Brethauer, Stacy A; Tu, Chao; Petrick, Anthony T; Morton, John M; Schauer, Philip R; Aminian, Ali

    2018-01-12

    National quality programs have been implemented to decrease the burden of adverse events on key outcomes in bariatric surgery. However, it is not well understood which complications have the most impact on patient health. To quantify the impact of specific bariatric surgery complications on key clinical outcomes. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Data from patients who underwent primary bariatric procedures were retrieved from the MBSAQIP 2015 participant use file. The impact of 8 specific complications (bleeding, venous thromboembolism [VTE], leak, wound infection, pneumonia, urinary tract infection, myocardial infarction, and stroke) on 5 main 30-day outcomes (end-organ dysfunction, reoperation, intensive care unit admission, readmission, and mortality) was estimated using risk-adjusted population attributable fractions. The population attributable fraction is a calculated measure taking into account the prevalence and severity of each complication. The population attributable fractions represents the percentage reduction in a given outcome that would occur if that complication were eliminated. In total, 135,413 patients undergoing sleeve gastrectomy (67%), Roux-en-Y gastric bypass (29%), adjustable gastric banding (3%), and duodenal switch (1%) were included. The most common complications were bleeding (.7%), wound infection (.5%), urinary tract infection (.3%), VTE (.3%), and leak (.2%). Bleeding and leak were the largest contributors to 3 of 5 examined outcomes. VTE had the greatest effect on readmission and mortality. This study quantifies the impact of specific complications on key surgical outcomes after bariatric surgery. Bleeding and leak were the complications with the largest overall effect on end-organ dysfunction, reoperation, and intensive care unit admission after bariatric surgery. Furthermore, our findings suggest that an initiative targeting reduction of post-bariatric surgery

  11. Epidemiology and Outcomes of Complicated Skin and Soft Tissue Infections among Inpatients in Southern China from 2008 to 2013.

    Directory of Open Access Journals (Sweden)

    Xiaoyan Li

    Full Text Available Complicated skin and soft tissue infections (cSSTI are some of the most commonly treated infections in hospitals, and place heavy economic burdens on patients and society. Here we report the findings from an analysis of cSSTI based on a retrospective study which was conducted within the Chinese inpatient population. We focused our research on the analysis of the patient population, antibiotic treatment, clinical outcome and economic burden. The study population comprised 527 selected patients hospitalized between 2008 and 2013. Among the hospitalizations with microbiological diagnoses, 61.41% (n = 113 were diagnosed as infected with Gram-positive bacteria, while 46.20% (n = 85 were infected with Gram-negative bacteria. The most commonly found Gram-positive bacteria was Staphylococcus aureus (40.76%, n = 75, and the most common Gram-negative bacteria was Escherichia coli (14.13%, n = 26. About 20% of the Staphylococcus aureus were methicillin-resistant. The resistance rate of isolated Staphylococcus aureus or Escherichia coli to penicillin was around 90%; in contrast, the resistance rate to vancomycin, linezolid or imipenem was low (<20%. A large percentage of patients were treated with cephalosporins and fluoroquinolones, while vancomycin and imipenem were also included to treat drug-resistant pathogens. Over half of the hospitalizations (58.43%, n = 336 experienced treatment modifications. The cost to patients with antibiotic modifications was relatively higher than to those without. In conclusion, our study offers an analysis of the disease characteristics, microbiological diagnoses, treatment patterns and clinical outcomes of cSSTI in four hospitals in Guangdong Province, and sheds lights on the current clinical management of cSSTI in China.

  12. Complications of Tattoos and Tattoo Removal: Stop and Think Before you ink.

    Science.gov (United States)

    Khunger, Niti; Molpariya, Anupama; Khunger, Arjun

    2015-01-01

    Tattooing is a process of implantation of permanent pigment granules in the skin. Tattoos can be decorative, medical or accidental. There has been a exponential increase in decorative tattooing as a body art in teenagers and young adults. Unfortunately there are no legislations to promote safe tattooing, hence complications are quite common. Superficial and deep local infections, systemic infections, allergic reactions, photodermatitis, granulomatous reactions and lichenoid reactions may occur. Skin diseases localised on the tattooed area, such as eczema, psoriasis, lichen planus, and morphea can be occasionally seen. When used as a camouflage technique, colour mismatch and patient dissatisfaction are common complications. On the other hand, regrets after a tattoo are also seen and requests for tattoo removal are rising. Laser tattoo removal using Q-switched lasers are the safest; however, complications can occur. Acute complications include pain, blistering, crusting and pinpoint hemorrhage. Among the delayed complications pigmentary changes, hypopigmentation and hyperpigmentation, paradoxical darkening of cosmetic tattoos and allergic reactions can be seen. Another common complication is the presence of residual pigmentation or ghost images. Scarring and textural changes are potential irreversible complications. In addition, tattoo removal can be a prolonged tedious procedure, particularly with professional tattoos, which are difficult to erase as compared to amateur tattoos. Hence the adage, stop and think before you ink holds very much true in the present scenario.

  13. Prosthesis infections after orthopedic joint replacement

    DEFF Research Database (Denmark)

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore...

  14. Complications in pediatric intestine transplantation in the absence of peri-operative donor or recipient bowel decontamination.

    Science.gov (United States)

    Clouse, Jared W; Kubal, Chandrashekhar A; Fridell, Jonathan A; Mangus, Richard S

    2018-05-01

    This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%). The rate of any bacterial infection was 90% in the first year, with a wound infection rate of 23%. Any fungal infection occurred in 25% of patients. Any viral infection occurred in 75% of patients. Gastrointestinal viruses were diagnosed in 52% of patients, and cytomegalovirus infections occurred in 17%. Rejection rates were 39% at any time post-transplant (isolated 44% and 35% for multivisceral patients). At this center in which no bowel decontamination was used, rates of surgical complications, infections, and rejection were similar to those reported by other centers. These findings suggest bowel decontamination may provide no significant benefit in this population of high-risk transplant patients. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. [Localized purpura revealing vascular prosthetic graft infection].

    Science.gov (United States)

    Boureau, A S; Lescalie, F; Cassagnau, E; Clairand, R; Connault, J

    2013-07-01

    Prosthetic graft infection after vascular reconstruction is a rare but serious complication. We report a case of infection occurring late after implantation of an iliofemoral prosthetic vascular graft. The Staphylococcus aureus infection was revealed by vascular purpura localized on the right leg 7 years after implantation of a vascular prosthesis. This case illustrates an uncommonly late clinical manifestation presenting as an acute infection 7 years after the primary operation. In this situation, the presentation differs from early infection, which generally occurs within the first four postoperative months. Diagnosis and treatment remain a difficult challenge because prosthetic graft infection is a potentially life-threatening complication. Morbidity and mortality rates are high. Here we detail specific aspects of the clinical and radiological presentation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae.

    Science.gov (United States)

    Arai, Masaru; Nagashima, Koichi; Kato, Mahoto; Akutsu, Naotaka; Hayase, Misa; Ogura, Kanako; Iwasawa, Yukino; Aizawa, Yoshihiro; Saito, Yuki; Okumura, Yasuo; Nishimaki, Haruna; Masuda, Shinobu; Hirayama, Astushi

    2016-09-08

    BACKGROUND Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB). CASE REPORT A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our emergency room with fever and loss of appetite, which had lasted for 5 days. On admission, results of serologic tests pointed to severe infection. Electrocardiography showed normal sinus rhythm with first-degree atrioventricular block and incomplete right bundle branch block, and transthoracic echocardiography and transesophageal echocardiography revealed severe mitral regurgitation caused by posterior leaflet perforation and 2 vegetations (5 mm and 6 mm) on the tricuspid valve. The patient was initially treated with ceftriaxone and gentamycin because blood and cutaneous ulcer cultures yielded S. agalactiae. On hospital day 2, however, sudden CAVB requiring transvenous pacing occurred, and the patient's heart failure and infection worsened. Although an emergent surgery is strongly recommended, even in patients with uncontrolled heart failure or infection, surgery was not performed because of the Child-Pugh class B liver cirrhosis. Despite intensive therapy, the patient's condition further deteriorated, and he died on hospital day 16. On postmortem examination, a 2×1-cm vegetation was seen on the perforated posterior mitral leaflet, and the infection had extended to the interventricular septum. Histologic examination revealed extensive necrosis of the AV node. CONCLUSIONS This rare case of CAVB resulting from S. agalactiae IE points to the fact that in monitoring patients with IE involving the mitral valve, clinicians should be aware of the potential for perivalvular extension of the infection, which can lead to fatal heart block.

  17. Oxidative stress and mitochondrial dysfunction in infected pregnant

    Directory of Open Access Journals (Sweden)

    Нана Мерабівна Пасієшвілі

    2015-04-01

    Full Text Available The infected pregnant women have been various perinatal complications. The aim of the work was to clarify the role of oxidative stress and mitochondrial dysfunction in the development of perinatal complications in infected pregnant.Methods. The study included 68 pregnant women with signs of maternal-fetal infection (MFI and 30 pregnant women who were found infected (control group. Later pregnant with MFI were divided into 2 groups: the first included 30 women who received traditional antibacterial and antiviral therapy, the second group consisted of 28 women who were additionally given an immunomodulator in combination with ozone therapy.Results. During pregnancy with MFI it is characterized the thrombophilic disorders, break immune homeostasis pregnant, endothelial dysfunction, which adversely affects perinatal indicators.Conclusions. The use of immunomodulators and ozone therapy in the complex treatment of MFI is pathogenetically substantiated effective treatment of oxidative stress and mitochondrial toxicity in the prevention of perinatal complications in infected women

  18. Neurological complications of dengue fever: Experience from a tertiary center of north India

    Directory of Open Access Journals (Sweden)

    Rajesh Verma

    2011-01-01

    Full Text Available Introduction: Dengue, an acute viral disease transmitted by Aedes mosquitoes, is highly endemic in many tropical and subtropical areas of the world. Neurological complications of dengue infection have been observed more frequently in the recent past and some studies highlighted varied neurological complications arising in the course of dengue illness. In this retrospective study, we report various neurological complications observed during the last 2 years in patients of dengue fever. Materials and Methods: The patients presenting with neurological complications with positive serology (IgM antibody for dengue infection were consecutively recruited from the Department of Neurology/Medicine from a tertiary center of Lucknow, India. These patients were subjected to a detailed clinical evaluation, laboratory assessment including blood count, hematocrit, coagulation parameters, biochemical assays, serology for dengue fever, enzyme-linked immunosorbent assay for human immunodeficiency virus and other relevant investigations. Results: Twenty-six patients with neurological complications associated with confirmed dengue infection were observed during the last 2 years. Eighteen of these patients were male. Of the 26 patients, 10 patients were suffering from brachial neuritis, four patients had encephalopathy, three patients were consistent with the diagnosis of Guillain Barre syndrome, three patients had hypokalemic paralysis associated with dengue fever and two patients had acute viral myositis. Opsoclonus-myoclonus syndrome was diagnosed in two patients, myelitis in one patient and acute disseminated encephalo-myelitis also in one patient. Conclusion: Dengue fever was associated with widespread neurological complications. Brachial neuritis and opsoclonus-myoclonus syndrome were observed for the first time in this study.

  19. [Subdural empyema due to gemella morbillorum as a complication of acute sinusitis].

    Science.gov (United States)

    Boto, Leonor Reis; Calado, Cláudia; Vieira, Marisa; Camilo, Cristina; Abecasis, Francisco; Campos, Alexandre R; Correia, Manuela

    2011-01-01

    Subdural empyema is a life-threatening infection that may complicate acute sinusitis. The authors report the case of a previously healthy 10 year-old girl who presented with subdural empyema due to Gemella morbillorum after an untreated maxillary, ethmoidal and esphenoidal sinusitis. Despite immediate drainage of the empyema and underlying primary infection and treatment with broad spectrum antibiotics, she later developed frontal cerebritis and refractory intracranial hypertension, needing urgent decompressive craniectomy. She recovered gradually, maintaining to date slight right hemyparesis and aphasia. Even though it is considered a low virulence organism, G. morbillorum has been increasingly described in central nervous system infection. In this case, the prompt institution of broad spectrum antibiotics and surgical drainage, as well as the agressive treatment of complications, including decompressive craniectomy, were crucial to the patient's recovery.

  20. Ethanol embolization of arteriovenous malformations: results and complications of 33 cases

    International Nuclear Information System (INIS)

    Jeon, Yong Hwan; Do, Young Soo; Shin, Sung Wook; Liu, Wei Chiang; Cho, Jae Min; Lee, Min Hee; Kim, Dong Ik; Lee, Byung Boong; Choo, Sung Wook; Choo, In Wook

    2003-01-01

    To assess the effectiveness of ethanol embolization for the treatment of arteriovenous malformation (AVM), and the complications, if any, arising. Thirty-three patients with AVMs underwent 145 staged sessions of ethanol embolization. AVMs were located in an upper extremity (n=14), a lower extremity (n=10), the pelvis (n=7), the thorax (n=1), or the abdomen (n=1). Eighty-five transcatheter embolizations and 60 direct percutaneous puncture embolizations were performed, and seven patients underwent additional coil embolization of the dilated outflow vein. The therapeutic effectiveness of embolization was evaluated in terms of the extent to which an AVM was obliterated between baseline and the final angiogram. Complications were classified as minor or major. In 13 patients (39%), AVMs were totally obliterated. In eight patients (24%), more than 75% were obliterated; in three (9%), the proportion was 50-75%; and in four (12%), less than 50%. Five patients (15%), were not treated. The reasons for failure were the difficulty of approaching the nidus due to previous surgical ligation or coil embolization of the feeding artery, the subcutaneous location of an AVM, post-procedural infection, and massive bleeding during the follow-up period. Twenty-one minor complications such as focal skin necrosis or transient nerve palsy developed during 145 sessions of (an incidence of 14%), but these were relieved by conservative treatment. The five major complications arising (3%) were cerebral infarction, urinary tract infection, acute renal failure due to rhabdomyolysis, permanent median nerve palsy, and infection. Ethanol embolization by direct percutaneous puncture or using a transcatheter technique is an effective approach to the treatment of an AVM. However, to overcome the considerable number of complications, arising, further investigation is required

  1. Ethanol embolization of arteriovenous malformations: results and complications of 33 cases

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Yong Hwan; Do, Young Soo; Shin, Sung Wook; Liu, Wei Chiang; Cho, Jae Min; Lee, Min Hee; Kim, Dong Ik; Lee, Byung Boong; Choo, Sung Wook; Choo, In Wook [School of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2003-10-01

    To assess the effectiveness of ethanol embolization for the treatment of arteriovenous malformation (AVM), and the complications, if any, arising. Thirty-three patients with AVMs underwent 145 staged sessions of ethanol embolization. AVMs were located in an upper extremity (n=14), a lower extremity (n=10), the pelvis (n=7), the thorax (n=1), or the abdomen (n=1). Eighty-five transcatheter embolizations and 60 direct percutaneous puncture embolizations were performed, and seven patients underwent additional coil embolization of the dilated outflow vein. The therapeutic effectiveness of embolization was evaluated in terms of the extent to which an AVM was obliterated between baseline and the final angiogram. Complications were classified as minor or major. In 13 patients (39%), AVMs were totally obliterated. In eight patients (24%), more than 75% were obliterated; in three (9%), the proportion was 50-75%; and in four (12%), less than 50%. Five patients (15%), were not treated. The reasons for failure were the difficulty of approaching the nidus due to previous surgical ligation or coil embolization of the feeding artery, the subcutaneous location of an AVM, post-procedural infection, and massive bleeding during the follow-up period. Twenty-one minor complications such as focal skin necrosis or transient nerve palsy developed during 145 sessions of (an incidence of 14%), but these were relieved by conservative treatment. The five major complications arising (3%) were cerebral infarction, urinary tract infection, acute renal failure due to rhabdomyolysis, permanent median nerve palsy, and infection. Ethanol embolization by direct percutaneous puncture or using a transcatheter technique is an effective approach to the treatment of an AVM. However, to overcome the considerable number of complications, arising, further investigation is required.

  2. Paediatric gastrostomy stoma complications and treatments: A rapid scoping review.

    Science.gov (United States)

    Townley, Ashleigh; Wincentak, Joanne; Krog, Kim; Schippke, Julia; Kingsnorth, Shauna

    2018-04-01

    To provide a scoping review of the types of treatments used to address paediatric skin-related stoma complications specific to infection, hypergranulation and gastric leakage, and explore their effectiveness and indications for use. Stoma-related complications can be a common occurrence for children with gastrostomy (G) and gastrojejunostomy (GJ) tubes. Nurses require guidance to inform decision-making of the broad spectrum of treatments used in clinical practice. A scoping review using a rapid review approach. Working with a multidisciplinary health professional team, search terms were generated. A systematic search of CINAHL, MEDLINE and EMBASE databases was completed, coupled with an Internet search to identify relevant clinical practice guidelines and hand searching of citation lists. Eligible articles were peer-reviewed English publications, focused on paediatric populations aged 18 years and under, dating from 2002-2016 and described complications and treatment approaches related to G- and GJ-tube stomas. Pertinent information was extracted using a standardised template, and a narrative synthesis approach was used to analyse the data. Twenty-five articles were included in this review. Study designs varied, and complication management was often a secondary focus. A broad spectrum of treatments was used to manage each complication type. There was a lack of consensus on lines of therapy; however, a stepwise approach was often used for complication management, particularly for infections. The evidence on the comparative effectiveness of different treatment strategies of skin-related gastrostomy stoma complications in paediatric practice is sparse. Current evidence is generally limited to expert opinions. Future studies examining efficacy of treatments and their indications for use with children are warranted. Effective management of skin-related stoma complications is important to maintain health and wellness among children who rely on G- and GJ-tubes for

  3. Comparison of Risk Scores for Prediction of Complications following Aortic Valve Replacement.

    Science.gov (United States)

    Wang, Tom Kai Ming; Choi, David Hyun-Min; Haydock, David; Gamble, Greg; Stewart, Ralph; Ruygrok, Peter

    2015-06-01

    Risk models play an important role in stratification of patients for cardiac surgery, but their prognostic utilities for post-operative complications are rarely studied. We compared the EuroSCORE, EuroSCORE II, Society of Thoracic Surgeon's (STS) Score and an Australasian model (Aus-AVR Score) for predicting morbidities after aortic valve replacement (AVR), and also evaluated seven STS complications models in this context. We retrospectively calculated risk scores for 620 consecutive patients undergoing isolated AVR at Auckland City Hospital during 2005-2012, assessing their discrimination and calibration for post-operative complications. Amongst mortality scores, the EuroSCORE was the best at discriminating stroke (c-statistic 0.845); the EuroSCORE II at deep sternal wound infection (c=0.748); and the STS Score at composite morbidity or mortality (c=0.666), renal failure (c=0.634), ventilation>24 hours (c=0.732), return to theatre (c=0.577) and prolonged hospital stay >14 days post-operatively (c=0.707). The individual STS complications models had a marginally higher c-statistic (c=0.634-0.846) for all complications except mediastinitis, and had good calibration (Hosmer-Lemeshow test P-value 0.123-0.915) for all complications. The STS Score was best overall at discriminating post-operative complications and their composite for AVR. All STS complications models except for deep sternal wound infection had good discrimination and calibration for post-operative complications. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  4. Current Indications for Transurethral Resection of the Prostate and Associated Complications

    Directory of Open Access Journals (Sweden)

    Chia-Chu Liu

    2003-02-01

    Full Text Available Transurethral resection of the prostate (TURP is the most common surgical procedure for relieving symptoms of benign prostatic hyperplasia. Here, we report our experience of current indications for TURP and their associated outcomes at Kaohsiung Medical University Hospital (KMUH. A total of 111 patients who underwent TURP at KMUH between May 2000 and December 2001 were included in this retrospective review. For each patient, the surgical indication was categorized into acute urinary retention, chronic complications (including renal impairment, recurrent urinary infection, bladder stone/diverticulum, post-void residue, and recurrent hematuria, and symptomatic prostatism. Thirty-five patients (31% had acute urinary retention, 28 (27% had chronic complications, and 48 (42% had symptomatic prostatism. Most patients chose TURP only when medical treatment had failed to relieve symptoms, no matter what category they belonged to. Patients with acute urinary retention and chronic complications had larger prostates (p = 0.002 and more tissue resected (p = 0.05 than those with symptomatic prostatism. Patients with acute urinary retention seemed to be at greater risk of postoperative complications such as recurrent urinary retention and urinary tract infection. We suggest that urodynamic study may be necessary to rule out concomitant bladder dysfunction before surgery and that adequate prophylactic antibiotic treatment be used to decrease the risk of urinary tract infection during or after TURP, especially when pyuria is noted preoperatively in patients with acute urinary retention.

  5. Infectious complications of pediatric cochlear implants are highly influenced by otitis media.

    Science.gov (United States)

    Vila, Peter M; Ghogomu, Nsangou T; Odom-John, Audrey R; Hullar, Timothy E; Hirose, Keiko

    2017-06-01

    Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus. Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. [Infectious complications in patients undergoing a heart transplant].

    Science.gov (United States)

    Bouza, E; Muñoz, P

    1995-01-01

    Infectious complications are, with rejection, the main cause of morbidity and mortality in heart transplantation recipients. Adequate management of these patients requires an adequate knowledge of risk factors, of most common infectious syndromes and of relevant microorganism, as long as of their resistance pattern. Among the first group, we may mention lower respiratory tract infections, mediastinitis and meningitis, and among the microorganisms, Citomegalovirus, Aspergillus and Toxoplasma gondii. The impressive development of diagnostical techniques and of prophylactic and therapeutical possibilities suggest the convenience of a multidisciplinar approach to these complications.

  7. Technical note: Dynamic MRI in a complicated giant posterior urethral diverticulum

    International Nuclear Information System (INIS)

    Kundum, Prasad R; Gupta, Arun K; Thottom, Prasad V; Jana, Manisha

    2010-01-01

    Congenital posterior urethral diverticulum is an uncommon anomaly, sometimes complicated by infection or calculi formation. A conventional voiding cystourethrogram (VCUG) is the most commonly used diagnostic modality. Dynamic magnetic resonance imaging (MRI) has not been frequently described in this entity. We describe a case of posterior urethral diverticulum complicated with secondary calculi, where the patient was evaluated using dynamic MRI and conventional VCUG

  8. Substantiation of the active ingredients rational concentration of ointment for treatment of allergic dermatitis complicated by fungal infection

    Directory of Open Access Journals (Sweden)

    O. A. Rukhmakova

    2015-08-01

    Full Text Available Aim. Due to the rapid growth of number of allergic skin diseases complicated by secondary fungal infection, creation of new drugs with an integrated anti-allergic and anti-fungal action for their local treatment is especially important. Methods and results. In the process of developing an ointment under conventional name “Allergolik” microbiological studies have been conducted to determine its rational composition. Concentrations of licorice root extract, terbinafine hydrochloride and lavender essential oil have been substantiated as parts of the studied medication. Study of acute toxicity of the developed dosage form has set that it belongs to the IV class of low-toxic substances due to the standard classification of K.K. Sidorova. Conclusion. This testifies the correctness of the choice of drug active ingredients and their concentrations.

  9. [Infectious complications during treatments with interleukin-2].

    Science.gov (United States)

    Morère, J F; Darras, C; Boaziz, C; Mihaila, L; Breau, J L; Scavizzi, M; Israël, L

    1993-03-13

    Between January 1989 and May 1991, 97 patients were treated with interleukin 2 in the Oncology Department of the Avicenne Hospital (Bobigny, France). IL 2 was given over 5 days by continuous infusion through an implantable port. Ten patients (4 males, 6 females), mean age 46 years (36-67) with various cancers (breast 3, kidney 1, melanoma 1, colorectal 5), developed infection: 4 local infections around the port, 1 phlebitis, 4 septicemias, 1 bacteremia were observed. In 9 cases blood cultures were positive: Staphylococcus aureus 5, Staphylococcus epidermidis 3, Streptococcus G 1. In 5 cases the same pathogen was isolated from the port and from the blood. The mean leucocyte count was 10,627/mm3 at the time of infection. The delay between the beginning of interleukin 2 treatment and the infection was 3 months. The mean dose of IL 2 administered before infection was 456 million IU. In all cases infection was controlled without lethal complication by antibiotics and catheter removal. This high incidence (8 percent) of staphylococcal infection is partly due to the skin toxicity of IL 2 and to depressed neutrophil chemotactic response. Prophylactic antibiotics are warranted during IL 2 intravenous therapy.

  10. Fatal Lemierre’s syndrome as a complication of chronic otitis media with cholesteatoma

    Directory of Open Access Journals (Sweden)

    Tashneem Harris

    2016-12-01

    Full Text Available Background. Lemierre’s syndrome is septic thrombophlebitis of the internal jugular vein, initiated by an infection of the head and neck region. This septic thrombophlebitis gives rise to septic microemboli that can disseminate throughout the body to form septic infarctions and abscesses, with the most frequent site being pulmonary. Methods. We discuss the case of a 14-year-old male with Lemierre’s syndrome as a complication of chronic middle ear infection. Results. The patient developed septic shock and microemboli, and subsequently died. Conclusion. This case report illustrates that untreated chronic middle ear infection can lead to potentially fatal complications such as Lemierre’s syndrome, and emphasises the importance of timeous treatment of chronic middle ear pathology.

  11. Management of complications encountered with Essure hysteroscopic sterilization: a systematic review.

    Science.gov (United States)

    Adelman, Marisa R; Dassel, Mark W; Sharp, Howard T

    2014-01-01

    Essure hysteroscopic sterilization has been US Food and Drug Administration-approved in the United States since 2002. Complications associated with the Essure device include improper placement (malpositioning), unintended pregnancy, pain, infection, and nickel allergy. The rarity of complications, compounded by underreporting, makes it difficult to determine best practices insofar as management. This systematic review synthesizes the national and global experience with management of Essure-related complications and suggests treatment options when data allow. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  12. Complications of gastro-oesophageal reflux disease.

    Science.gov (United States)

    Parasa, S; Sharma, P

    2013-06-01

    Gastro-oesophageal reflux disease (GORD) is on the rise with more than 20% of the western population reporting symptoms and is the most common gastrointestinal disorder in the United States. This increase in GORD is not exactly clear but has been attributed to the increasing prevalence of obesity, changing diet, and perhaps the decreasing prevalence of H. pylori infection. Complications of GORD could be either benign or malignant. Benign complications include erosive oesophagitis, bleeding and peptic strictures. Premalignant and malignant lesions include Barrett's metaplasia, and oesophageal cancer. Management of both the benign and malignant complications can be challenging. With the use of proton-pump inhibitors, peptic strictures (i.e., strictures related to reflux) have significantly declined. Several aspects of Barrett's management remain controversial including the stage in the disease process which needs to be intervened, type of the intervention and surveillance of these lesions to prevent development of high grade dysplasia and oesophageal adenocarcinoma. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Pandemic (H1N1 2009 Influenza Virus Infection in A Survivor who has recovered from severe H7N9 Virus Infection, China

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    Shan-Hui Chen

    2016-10-01

    Full Text Available We firstly report a patient who presented with severe complications after infection with influenza A(H1N1 pdm2009, more than one year after recovery from severe H7N9 virus infections. The population of patients who recovered from severe H7N9 infections might be at a higher risk to suffer severe complications after seasonal influenza infections, and they should be included in the high-risk populations recommended to receive seasonal influenza vaccination.

  14. Fatal Complications after Pediatric Surgical Interventions: Lessons Learned

    NARCIS (Netherlands)

    Klein, W.M.; Putten, M.E. van der; Kusters, B.; Verhoeven, B.H.

    2017-01-01

    Placement of catheters, drains, shunts, and tubes in children can lead to serious or even fatal complications at the moment of placement, such as hemorrhage at insertion, or in the longterm, such as infections and migration into adjacent organs. The clinician should always be aware of these

  15. Outcome after Reconstruction of the Proximal Tibia--Complications and Competing Risk Analysis.

    Directory of Open Access Journals (Sweden)

    Stephan E Puchner

    Full Text Available The proximal tibia (pT is a common site for bone tumors. Improvements in imaging, chemotherapy and surgical technique made limb salvage surgery the treatment of choice. Yet, reconstructions of the pT have been associated with less favorable outcome compared to other parts of the extremities. The aim of this study was to evaluate the outcome of patients with a modular endoprosthetic reconstruction of the pT.Eighty-one consecutive patients with an average age of 29 years underwent endoprosthetic reconstruction of the pT. Postoperative complications were categorized according to the ISOLS classification, and revision-free survival until first complication (any Type 1-5, soft tissue failure (Type 1, aseptic loosening (Type 2, structural failure (Type 3, infection (Type 4, and local tumor progression (Type 5 was estimated by using a Fine-Gray model for competing risk analyses for univariate and multivariable regression with Firth's bias correction.A total of 45 patients (56% had at least one complication. Cumulative incidence for complication Types 1 to 5 at 5 years with death and amputation as competing events revealed a risk of 41% for the first complication, 14% for Type 1, 16% for Type 2, 11% for Type 3, 17% for Type 4, and 1% for Type 5.Despite inclusion of amputation and death as strong competing events, pT replacements are still associated with a high risk of postoperative failures. The results suggest that infection and soft tissue failures (Type 1 and 5 seem to depend from each other. Sufficient soft tissue reconstruction and closure allow better function and reduce the risk of infection as the most prominent complication. The use of a rotating hinge design has significantly reduced structural failures over time.

  16. A prospective, multicenter, observational study of complicated skin and soft tissue infections in hospitalized patients: clinical characteristics, medical treatment, and outcomes

    Directory of Open Access Journals (Sweden)

    Lipsky Benjamin A

    2012-09-01

    Full Text Available Abstract Background Complicated skin and soft tissue infections (cSSTIs occur frequently, but limited data do not allow any consensus on an optimal treatment strategy. We designed this prospective, multicenter, observational study to to explore the current epidemiology, treatment, and resulting clinical outcomes of cSSTIs to help develop strategies to potentially improve outcomes. Methods From June 2008 to December 2009 we enrolled a pre-specified number of adults treated in 56 U.S. hospitals with intravenous antibiotic(s for any of the following cSSTIs: diabetic foot infection (DFI; surgical site infection (SSI; deep soft tissue abscess (DSTA; or, cellulitis. Investigators treated all patients per their usual practice during the study and collected data on a standardized form. Results We enrolled 1,033 patients (DFI 27%; SSI 32%; DSTA 14%; cellulitis 27%; mean age 54 years; 54% male, of which 74% had healthcare-associated risk factors. At presentation, 89% of patients received initial empiric therapy with intravenous antibiotics; ~20% of these patients had this empiric regimen changed or discontinued based on culture and sensitivity results. Vancomycin was the most frequently used initial intravenous antibiotic, ordered in 61% of cases. During their stay 44% of patients underwent a surgical procedure related to the study infection, usually incision and drainage or debridement. The mean length of stay was 7.1 days, ranging from 5.8 (DSTA to 8.1 (SSI. Conclusion Our findings from this large prospective observational study that characterized patients with cSSTIs from diverse US inpatient populations provide useful information on the current epidemiology, clinical management practices and outcomes of this common infection.

  17. Identification of complications in mastectomy with immediate reconstruction using tissue expanders and permanent implants for breast cancer patients.

    Science.gov (United States)

    Ota, Daisuke; Fukuuchi, Atsushi; Iwahira, Yoshiko; Kato, Takao; Takeuchi, Masashi; Okamoto, Joji; Nishi, Tsunehiro

    2016-05-01

    Since complications of postmastectomy breast reconstruction may reduce patient satisfaction, we investigated complications of reconstruction with tissue expanders (TEs), particularly surgical site infections requiring TE/permanent implant (PI) removal. A retrospective review was performed of 234 primary breast cancer patients undergoing 239 postmastectomy breast reconstructions with TEs/PIs from 1997 to 2009. Clinicopathological findings and postoperative complications, particularly infections, were analyzed. Data were analyzed by the Chi-square test and a multivariate logistic regression model. TE infection risk factors considered for model inclusion were excisional biopsy, (neo) adjuvant chemotherapy, lymph node resection, body mass index (BMI), simultaneous bilateral reconstructions, and seroma aspiration. Removal of TEs/PIs was observed in 15.5% (37/239) of reconstructions, and 18/37 underwent re-reconstructions. Of the 19/37 reconstructions that were not achieved completely, the most frequent reason was TE infection (11 reconstructions). The completion rate was 92% (220/239 reconstructions) and it was significantly higher in reconstructions without TE infection than with infection (96 vs. 54%, p breast reconstruction, prevention of TE infection plays a key role. We should reduce unnecessary seroma aspirations and delay elevation/exercise of the ipsilateral arm.

  18. Neurological manifestations of dengue viral infection

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    Carod-Artal FJ

    2014-10-01

    Full Text Available Francisco Javier Carod-Artal1,21Neurology Department, Raigmore hospital, Inverness, UK; 2Universitat Internacional de Catalunya (UIC, Barcelona, Spain Abstract: Dengue is the most common mosquito-borne viral infection worldwide. There is increased evidence for dengue virus neurotropism, and neurological manifestations could make part of the clinical picture of dengue virus infection in at least 0.5%–7.4% of symptomatic cases. Neurological complications have been classified into dengue virus encephalopathy, dengue virus encephalitis, immune-mediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain–Barré syndrome, neuritis brachialis, acute cerebellitis, and others, neuromuscular complications (hypokalemic paralysis, transient benign muscle dysfunction and myositis, and dengue-associated stroke. Common neuro-ophthalmic complications are maculopathy and retinal vasculopathy. Pathogenic mechanisms include systemic complications and metabolic disturbances resulting in encephalopathy, direct effect of the virus provoking encephalitis, and postinfectious immune mechanisms causing immune-mediated syndromes. Dengue viruses should be considered as a cause of neurological disorders in endemic regions. Standardized case definitions for specific neurological complications are still needed. Keywords: encephalitis, encephalopathy, dengue fever, neurological complications

  19. Severe neurological complications in association with Epstein-Barr virus infection

    NARCIS (Netherlands)

    Corssmit, E. P.; Leverstein-van Hall, M. A.; Portegies, P.; Bakker, P.

    1997-01-01

    Involvement of the nervous system in infectious mononucleosis is common. About 50% have headache on presentation. Neck stiffness without meningitis is a frequent finding. Severe neurological complications are rare though, occurring in fewer than 0.5%. We describe two patients with unusual and severe

  20. Overview of complications secondary to tongue and lip piercings.

    Science.gov (United States)

    Maheu-Robert, Léo-François; Andrian, Elisoa; Grenier, Daniel

    2009-07-01

    In recent years, intraoral and perioral piercings have grown in popularity among teenagers and young adults. This is of concern to dental and medical professionals because of the risks and complications for oral, dental and general health. The risks and complications associated with tongue and lip piercings range from abnormal tooth wear and cracked tooth syndrome to gingival recession and systemic infections. In this report, we provide an overview of possible problems associated with oral piercings that may be encountered by dentists.

  1. Retinitis due to opportunistic infections in Iranian HIV infected patients.

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    Ali Abdollahi

    2013-10-01

    Full Text Available We tried to evaluate prevalence and characteristics of Iranian HIV infected patients with retinitis due to opportunistic infections. In this cross sectional study, we evaluated 106 HIV infected patients via indirect ophthalmoscopy and slit lamp examination by 90 lens to find retinitis cases. General information and results of ophthalmologic examination were analyzed. Prevalence of retinitis due to opportunistic infections was 6.6%: cytomegalovirus (CMV retinitis 1.88%, toxoplasmosis retinochoroiditis 1.88% and tuberculosis chorioretinitis 2.83%. CD4 count was higher than 50 cell/µlit in both cases with CMV retinitis. Along with increasing survival in the HIV infected patients, the prevalence of complications such as ocular manifestation due to opportunistic infections are increasing and must be more considered.

  2. Complications of allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Arnaout, Karim; Patel, Nihar; Jain, Maneesh; El-Amm, Joelle; Amro, Farah; Tabbara, Imad A

    2014-08-01

    Infection, graft-versus-host disease (GVHD), and to a lesser extent sinusoidal obstructive syndrome (SOS) represent the major causes of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (AHSCT). During the last decade, progress in prevention and treatment of these complications led to improvement in the outcome of these patients. Despite the fact that nonmyeloablative regimens have been increasingly used in elderly patients and in patients with co-morbidities, the nonrelapse related mortality remains a challenge and long-term follow-up is required. The objective of this manuscript is to provide an updated concise review of the complications of AHSCT and of the available treatment interventions.

  3. Retrospective Analysis of Clinical and Cost Outcomes Associated with Methicillin-Resistant Staphylococcus aureus Complicated Skin and Skin Structure Infections Treated with Daptomycin, Vancomycin, or Linezolid

    Directory of Open Access Journals (Sweden)

    Bradley M. Wright

    2011-01-01

    Full Text Available Objective. The objective of this analysis was to compare clinical and cost outcomes associated with patients who had suspected or documented methicillin-resistant Staphylococcus aureus (MRSA infections treated with daptomycin, vancomycin, or linezolid in complicated skin and skin structure infections (cSSSIs. Design. This was a retrospective analysis conducted from February to June of 2007. Appropriate data was collected, collated, and subsequently evaluated with the purpose of quantifying length of stay, antibiotic therapy duration, clinical cure rates, adverse drug events, and cost of hospitalization. Results. All 82 patients included in the analysis experienced clinical cure. The duration of antibiotic therapy was similar among the three groups yet the length of hospitalization was slightly shorter in the daptomycin group. Conclusions. The incidence of resistant staphylococcal infections is increasing; therefore, judicious use of MRSA active agents is paramount. Future studies are necessary to determine if MRSA treatment options can be stratified based on the severity of the infectious process.

  4. Complications of Open Tibial Fracture Management: Risk Factors and Treatment

    OpenAIRE

    Lua, JYC; Tan, VH; Sivasubramanian, H; Kwek, EBK

    2017-01-01

    Open tibial fractures result in high rates of complications. This study aims to elucidate the risk factors causing these complications, and suggest antimicrobial regimens based on the organisms grown in post-operative infections. Over a period of five years, 173 patients had sustained open tibial fractures and undergone operative treatment at a single institution. All surgical data was gathered retrospectively through online medical records. Thirty-one patients (17.9%) had sustained post-oper...

  5. Puerperal infections.

    Science.gov (United States)

    Eschenbach, D A; Wager, G P

    1980-12-01

    This comprehensive review on puerperal infections covers risk factors, causative bacteria, pathophysiology, diagnosis, therapy of specific entities, and prevention. Puerperal infection is problematic to define especially with antibiotics that change the course of fever. I may present as endometritis (most common), myometritis, parametritis, pelvic abscess, salpingitis, septic pelvic thrombophlebitis or septicemia, and also includes infections of the urinary tract, episiotomy, surgical wounds, lacerations or breast. Each of these is discussed in terms of contributing factors, microbiology, clinical findings, diagnosis, treatment, prevention and complications. Risk factors in general are cesarean section, premature rupture of the membranes, internal fetal monitoring, general anesthesia, pelvic examinations. The most common bacterial involved are group B and other streptococci, E. coli, Gardnerella vaginalis, Gram positive anaerobic cocci, Mycoplasma and pre-existing Chlamydial infections. Diagnosis of the causative organism is difficult because of polyinfection and difficulty of getting a sterile endometrial swab. Diagnosis of the infection is equally difficult because of the wide variety of symptoms: fever, abnormal lochia, tachycardia, tenderness, mass and abnormal bowel sounds are common. Therapy depends of the responsible microorganism, although 3 empirical tactics are suggested while awaiting results of culture: 1) choose an antibiotic for the most common aerobic bacteria; 2) an antibiotic effective against B. fragilis and one for aerobic bacteria, e.g. clindamycin and an aminoglycoside; 3) a nontoxic antibiotic active against most aerobic and anaerobic organisms, e.g. doxycycline or cefoxitin. An example of an infection recently described is pudendal-paracervical block infection, often signaled by severe hip pain. It is associated with vaginal bacteria, is usually complicated by abscess even with antibiotic coverage, and may end in paraplegia or fatal sepsis

  6. Grisel's syndrome: A rare complication following traditional uvulectomy

    African Journals Online (AJOL)

    A case is reported of an eight-month-old female patient who had traditional uvulectomy for sore throat complicated by Grisel's syndrome. She was admitted into the hospital one week after uvulectomy with Torticolis. Grisel's syndrome is a nontraumatic atlantoaxial subluxation, usually secondary of an infection or an ...

  7. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Science.gov (United States)

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications. © 2015 Japan Pediatric Society.

  8. Acute disseminated encephalomyelitis complicating dengue infection with neuroimaging mimicking multiple sclerosis: A report of two cases.

    Science.gov (United States)

    Viswanathan, S; Botross, N; Rusli, B N; Riad, A

    2016-11-01

    Acute disseminated encephalomyelitis (ADEM) complicating dengue infection is still exceedingly rare even in endemic countries such as Malaysia. Here we report two such cases, the first in an elderly female patient and the second in a young man. Both presented with encephalopathy, brainstem involvement and worsening upper and lower limb weakness. Initial magnetic resonance imaging (MRI) of the brain was normal in the first case. Serum for dengue Ig M and NS-1 was positive in both cases. Cerebrospinal fluid (CSF) showed pleocytosis in both with Dengue IgM and NS-1 positive in the second case but not done in the first. MRI brain showed changes of perpendicular subcortical palisading white matter, callosal and brainstem disease mimicking multiple sclerosis (MS) in both patients though in the former case there was a lag between the onset of clinical symptoms and MRI changes which was only clarified on reimaging. The temporal evolution and duration of the clinical symptoms, CSF changes and neuroimaging were more suggestive of Dengue ADEM rather than an encephalitis though initially the first case began as dengue encephalitis. Furthermore in dengue encephalitis neuroimaging is usually normal or rarely edema, haemorrhage, brainstem, thalamic or focal lesions are seen. Therefore, early recognition of ADEM as a sequelae of dengue infection with neuroimaging mimicking MS and repeat imaging helped in identifying these two cases. Treatment with intravenous steroids followed by maintenance oral steroids produced good outcome in both patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Neurological complication in HIV patients

    Science.gov (United States)

    Ritarwan, K.

    2018-03-01

    Human Immunodeficiency Virus (HIV) is neurotropic and immunotropic, making themassive destruction of both systems. Although their amount has been reduced, there is still neurological presentations and complications of HIV remain common in the era of combination antiretroviral therapy (cART). Neurological opportunistic infections (OI) occur in advanced HIV diseases such as primary cerebral lymphoma, cryptococcal meningitis, cerebral toxoplasmosis, and progressive multifocal encephalopathy. Neurological problem directly related to HIV appear at any stage in the progress of HIV disease, from AIDS-associated dementia to the aseptic meningitis of primary HIV infection observed in subjects with an immune deficiency. The replication of peripheral HIV viral is able to be controlled in the era of effective antiretroviral therapy. Non-HIV-related neurological disease such as stroke increased important as the HIV population ages.

  10. Scroto-perineal hidradenitis suppurativa complicated by giant scrotal elephantiasis.

    Science.gov (United States)

    Alharbi, Badr; Shlash, Ahmed; Bedaiwi, Khaled; Hooti, Qais Al; Almohaisen, Abdulrahman; Shlash, Saud; Said, Mohammad

    2015-01-01

    Scrotal elephantiasis has been a recognized complication of inguinal node irradiation, filarial infection, tumor involvement and surgical lymphatic destruction, but has rarely been reported in association with hidradenitis suppurativa (HS). HS, also known as acne inversa, is a chronic and often debilitating disease primarily affecting the axillae, inframammary regions and perineum. The location of the lesions may lead to social embarrassment and failure to seek medical treatment. Scroto-preineal HS complicated by scrotal elephantiasis is a distressing disease. Excisional surgery with reconstruction is the recommended treatment with a high likelihood of good outcome. We present a 38-year-old male patient with long-standing scroto-perineal HS complicated by giant scrotal elephantiasis.

  11. Scroto-perineal hidradenitis suppurativa complicated by giant scrotal elephantiasis

    Directory of Open Access Journals (Sweden)

    Badr Alharbi

    2015-01-01

    Full Text Available Scrotal elephantiasis has been a recognized complication of inguinal node irradiation, filarial infection, tumor involvement and surgical lymphatic destruction, but has rarely been reported in association with hidradenitis suppurativa (HS. HS, also known as acne inversa, is a chronic and often debilitating disease primarily affecting the axillae, inframammary regions and perineum. The location of the lesions may lead to social embarrassment and failure to seek medical treatment. Scroto-preineal HS complicated by scrotal elephantiasis is a distressing disease. Excisional surgery with reconstruction is the recommended treatment with a high likelihood of good outcome. We present a 38-year-old male patient with long-standing scroto-perineal HS complicated by giant scrotal elephantiasis.

  12. Complications of hip fractures: A review

    Science.gov (United States)

    Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

    2014-01-01

    Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

  13. [Preoperative Prognostic Nutrition Index Is a Predictive Factor of Complications in Laparoscopic Colorectal Surgery].

    Science.gov (United States)

    Yano, Yuki; Sagawa, Masano; Yokomizo, Hajime; Okayama, Sachiyo; Yamada, Yasufumi; Usui, Takebumi; Yamaguchi, Kentaro; Shiozawa, Shunichi; Yoshimatsu, Kazuhiko; Shimakawa, Takeshi; Katsube, Takao; Kato, Hiroyuki; Naritaka, Yoshihiko

    2017-10-01

    Paitients and methods: We retrospectively reviewed a database of 188 patients who underwent resection for colorectal cancer with laparoscopic surgery between July 2007 and March 2015. The prognostic nutrition index(PNI), modified Glas- gow prognostic score(mGPS), controlling nutritional status(CONUT), and neutrophil/lymphocyte ratio(N/L)were measured in these patients. We examined the association between postoperative complications and clinicopathological factors. The study included 110 men and 78 women. Median age was 68 years. The site of the primary lesion was colon in 118 and rectum in 70 patients. Postoperative complications higher than Grade II(Clavien-Dindo classification)were reported in 24(12.8%)patients: Surgical site infection(SSI)in 12, remote infection in 7, ileus in 5, and others in 2 patients. Clinicopathological factors related to complications were rectal surgery, large amount of intraoperative bleeding, and long operative time. The related immunologic and nutritional factors were mGPS 2, PNI below 40, and N/L above 3. CONUT was not associated with complications in ourcases. mGPS, PNI, and N/L are predictive factors for complications in laparoscopic colorectal surgery.

  14. The relevance of aortic endograft prosthetic infection

    NARCIS (Netherlands)

    Cernohorsky, Paul; Reijnen, Michel M. P. J.; Tielliu, Ignace F. J.; van Sterkenburg, Steven M. M.; van den Dungen, Jan J. A. M.; Zeebregts, Clark J.

    Background: Vascular prosthetic graft infection is a severe complication after open aortic aneurysm repair. Reports of infected endografts are scarce. General treatment consensus with infected graft material is that it should be removed completely. The objective of this study was to describe the

  15. In-hospital cerebrovascular complications following orthotopic liver transplantation: A retrospective study

    Directory of Open Access Journals (Sweden)

    Liang Zhijian

    2008-12-01

    Full Text Available Abstract Background Cerebrovascular complications are severe events following orthotopic liver transplantation (OLT. This study aimed to observe the clinical and neuroimaging features and possible risk factors of in-hospital cerebrovascular complications in the patients who underwent OLT. Patients and methods We retrospectively reviewed 337 consecutive patients who underwent 358 OLTs. Cerebrovascular complications were determined by clinical and neuroimaging manifestations, and the possible risk factors were analyzed in the patients with intracranial hemorrhage. Results Ten of 337 (3.0% patients developed in-hospital cerebrovascular complications (8 cases experienced intracranial hemorrhage and 2 cases had cerebral infarction, and 6 of them died. The clinical presentations were similar to common stroke, but with rapid deterioration at early stage. The hematomas on brain CT scan were massive, irregular, multifocal and diffuse, and most of them were located at brain lobes and might enlarge or rebleed. Infarcts presented lacunar and multifocal lesions in basal gangliar but with possible hemorrhagic transformation. The patients with intracranial hemorrhage had older age and a more frequency of systemic infection than non-intracranial hemorrhage patients. (P = 0.011 and 0.029, respectively. Conclusion Posttransplant cerebrovascular complications have severe impact on outcome of the patients who received OLT. Older age and systemic infection may be the possible risk factors of in-hospital intracranial hemorrhage following OLT.

  16. Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis: case series

    Energy Technology Data Exchange (ETDEWEB)

    Cilloniz, Catia; Torres, Antoni [Servicio de Neumologia, Hospital Clinic de Barcelona, Ciber de Enfermedades Respiratorias (CIBERES), Instituto de Investigacion Biomedica Agusti Pi i Sunyer, Universidad de Barcelona (Spain); Rangel, Ernesto [Facultad de Medicina, Universidad Autonoma de Nayarit, Tepic (Mexico); Barlascini, Cornelius [Servizio di Igiene e Sanita Pubblica, Ospedale Generale di Sestri Levante, Sestri Levante (Italy); Piroddi, Ines Maria Grazia; Nicolini, Antonello, E-mail: antonellonicolini@gmail.com [Servizio di Pneumologia, Ospedale Generale di Sestri Levante, Sestri Levante (Italy)

    2015-07-15

    Objective: In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. Methods: We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. Results: In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. Conclusions: In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis. (author)

  17. Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis: case series

    International Nuclear Information System (INIS)

    Cilloniz, Catia; Torres, Antoni; Rangel, Ernesto; Barlascini, Cornelius; Piroddi, Ines Maria Grazia; Nicolini, Antonello

    2015-01-01

    Objective: In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. Methods: We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. Results: In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. Conclusions: In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis. (author)

  18. Nocardia infection following phacoemulsification

    Directory of Open Access Journals (Sweden)

    Gokhale Nikhil

    2007-01-01

    Full Text Available Infection of a self-sealing tunnel incision is a rare but vision-threatening complication of cataract surgery. We describe two cases of side port infection following an uneventful phacoemulsification. Nocardia was isolated in one case. Both the cases were worsening on medical treatment and were successfully treated by therapeutic keratoplasty.

  19. Complications after orthognathic surgery: our experience on 423 cases.

    Science.gov (United States)

    Friscia, Marco; Sbordone, Carolina; Petrocelli, Marzia; Vaira, Luigi Angelo; Attanasi, Federica; Cassandro, Francesco Maria; Paternoster, Mariano; Iaconetta, Giorgio; Califano, Luigi

    2017-06-01

    Orthognathic surgery is widely used to correct dentofacial discrepancies. However, this procedure presents numerous possible complications. The aim of our study is to review intraoperative and postoperative complications related to orthognathic surgery based upon a 10-year period in the Maxillofacial Surgery Department of Federico II University of Naples. Medical records of 423 patients who undergone orthognathic surgery in a 10-year period were retrospectively analyzed and complications was noted. Statistical analysis was conduced in order to understand if the type of surgical procedure influenced complications rate. One hundred eighty-five complications in 143 (33.8%) of the 423 treated patients were reported. Complications detected were nerve injury (49 cases, 11.9%), infections (10 cases, 2.4%), complications related to fixation plates or screws (30 cases, 7.1%), bad split osteotomy (8 cases, 1.9%), secondary temporo-mandibular joint disorders (36 cases, 8.5%), dental injuries (21 cases, 5%), condilar resorption (2 cases, 0.5%), and necessity of a second-time surgery (24 cases, 5.7%). Serious complications seem to be quite rare in orthognathic surgery. Some of the surgical complications found are related to the surgeon experience and not strictly to the risks of the operation itself. Understanding potential complications allows the surgeon to guarantee safe care through early intervention and correctly inform the patient in the preoperative colloquy.

  20. [Bilateral vestibular loss as a post-infection complication of yersiniosis?].

    Science.gov (United States)

    Bücheler, M; Löwenheim, H

    1997-08-01

    Yersinia infections other than plaque are caused by Yersinia pseudotuberculosis and Yersinia enterocolitica. Food and water contamination as well as animal-to-person and person-to-person contact are common pathways of transmission. Clinical manifestations include enteritis, enterocolitis, acute appendicitis, inflammation of the terminal ileum, and mesenteric adenitis. Y. enterocolitica may cause bacteremia with subsequent septicemia predominantly in patients with underlying illnesses such as diabetes mellitus or malignancy. More frequently enteritis is followed by immunological post-infectious syndromes such as arthritis and erythema nodosum. The present case report discusses bilateral vestibular loss possibly caused by an infection with Y. enterocolitica. A 27-year-old caucasian woman initially presented with the otologic symptom of spinning vertigo accompanied by nausea and vomiting. Physical exam revealed spontaneous nystagmus to the left. Bithermal caloric responses were absent. Pure tone audiometry showed a bilateral symmetric high-frequency sensorineural hearing loss. Neurologic exams did not reveal involvement of the central vestibular system. Perilymphatic fistula on the left side was excluded by tympanoscopy. Serology for rheumatoid factors and HLA B27 was negative. Lead or mercury intoxication was also excluded. In her medical history the patient reported intermittent watery diarrhea and stress dependent arthralgia that had commenced during a stay in Argentina three years ago. Serology was positive, revealing elevated titers for Y. enterocolitica type 3 (1:200) and type 9 (1:400). Bilateral vestibular loss is rare. The main cause is aminoglycoside ototoxicity or meningitis. Yersina infections have not yet been described as inducing disease of the labyrinth. Present pathophysiologic knowledge of yersinia infections is described as follows: After peroral infection, gastrointestinal permeability is increased. Low-molecular-weight substances may enter the

  1. Isolated Unilateral Pulmonary Artery Agenesis complicated by Symptomatic Aspergilloma

    LENUS (Irish Health Repository)

    Daly, A

    2017-11-01

    Isolated unilateral pulmonary artery agenesis is a rare diagnosis. Poor blood flow to the lung parenchyma renders the tissue susceptible to opportunistic infections. We present the unusual case of isolated unilateral pulmonary artery agenesis complicated by aspergilloma. Management options and considerations are discussed.

  2. The left atrial catheter: its uses and complications.

    Science.gov (United States)

    Leitman, B S; Naidich, D P; McGuinness, G; McCauley, D I

    1992-11-01

    The authors describe the radiographic appearance of the left atrial catheter, a widely used postsurgical intracardiac device. Recognition of the characteristic appearance of this catheter should be of value in detection of potential complications, including line fracture with resultant retention and/or embolization, infection, prosthetic valve dysfunction, and even cardiac tamponade.

  3. Clinical Features, Complications and Treatment Outcome of Brucella ...

    African Journals Online (AJOL)

    Purpose: Brucellosis is a multi-systemic infection that is endemic in some parts of the world. The purpose of this study was to examine the epidemiology as well as the clinical and haematological characteristics, complications, and treatment outcome of patients with brucellosis at the King Fahd Hospital of the University ...

  4. Ascending infection of foot tendons in diabetic patients.

    Science.gov (United States)

    Mismar, Ayman; Yousef, Mohammad; Badran, Darwish; Younes, Nidal

    2013-12-01

    Bone and soft tissue infection in the foot of diabetic patients is a well-described issue in the literature. A sound anatomical knowledge of the foot anatomy and compartments is mandatory to understand the mechanisms of infection spread. We describe four cases of diabetic foot infection complicated by long ascending infection. All did not respond initially to antibiotic treatment and the usual surgical debridement and were cured only after excision of the infected tendons. We highlight a rare but serious complication of the diabetic foot disease not commonly seen by the surgical community. We hope that this report raises the awareness of this condition so that a prompt diagnosis is made and appropriate treatment started, thereby reducing the risk of major lower limb amputations.

  5. Automating the surveillance of healthcare-associated infections

    NARCIS (Netherlands)

    van Mourik, M.S.M.

    2014-01-01

    Healthcare-associated infections (HAI) are among the most common complications of medical care, affecting one in twenty-five hospitalized patients on any given day. Surveillance of HAI by systematically assessing patients for the development of an infection is a key component of successful infection

  6. Complications in paediatric craniofacial surgery: an initial four year experience.

    Science.gov (United States)

    Jones, B M; Jani, P; Bingham, R M; Mackersie, A M; Hayward, R

    1992-04-01

    107 children undergoing transcranial craniofacial surgery in a paediatric hospital have been reviewed to assess the incidence and type of complications which arose. This represents the first 4 years' experience of the craniofacial team. There were no deaths or permanent adverse sequelae of surgery. A total of 53 complications were seen in 42 patients. In 9.3% of patients they were potentially life-threatening, serious in 12.1% and of a minor nature in 28%. The more serious complications were related either to haemorrhage and/or vasovagal shock at operation or to infection post-operatively. Infants undergoing monoblock frontofacial advancements and those with tracheostomies were at particular risk.

  7. EARLY COMPLICATIONS IN BARIATRIC SURGERY: incidence, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Marco Aurelio SANTO

    2013-03-01

    Full Text Available Context Bariatric surgery has proven to be the most effective method of treating severe obesity. Nevertheless, the acceptance of bariatric surgery is still questioned. The surgical complications observed in the early postoperative period following surgeries performed to treat severe obesity are similar to those associated with other major surgeries of the gastrointestinal tract. However, given the more frequent occurrence of medical comorbidities, these patients require special attention in the early postoperative follow-up. Early diagnosis and appropriate treatment of these complications are directly associated with a greater probability of control. Method The medical records of 538 morbidly obese patients who underwent surgical treatment (Roux-en-Y gastric bypass surgery were reviewed. Ninety-three (17.2% patients were male and 445 (82.8% were female. The ages of the patients ranged from 18 to 70 years (average = 46, and their body mass indices ranged from 34.6 to 77 kg/m2. Results Early complications occurred in 9.6% and were distributed as follows: 2.6% presented bleeding, intestinal obstruction occurred in 1.1%, peritoneal infections occurred in 3.2%, and 2.2% developed abdominal wall infections that required hospitalization. Three (0.5% patients experienced pulmonary thromboembolism. The mortality rate was 0,55%. Conclusion The incidence of early complications was low. The diagnosis of these complications was mostly clinical, based on the presence of signs and symptoms. The value of the clinical signs and early treatment, specially in cases of sepsis, were essential to the favorable surgical outcome. The mortality was mainly related to thromboembolism and advanced age, over 65 years.

  8. Complications of hematopoietic stem transplantation: Fungal infections.

    Science.gov (United States)

    Omrani, Ali S; Almaghrabi, Reem S

    2017-12-01

    Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk of invasive fungal infections, especially during the early neutropenic phase and severe graft-versus-host disease. Mold-active prophylaxis should be limited to the highest risk groups. Empiric antifungal therapy for HSCT with persistent febrile neutropenia is associated with unacceptable response rates, unnecessary antifungal therapy, increased risk of toxicity, and inflated costs. Empiric therapy should not be a substitute for detailed work up to identify the cause of fever in such patients. The improved diagnostic performance of serum biomarkers such as galactomannan and β-D-glucan, as well as polymerase chain reaction assays has allowed the development of diagnostic-driven antifungal therapy strategies for high risk patients. Diagnostic-driven approaches have resulted in reduced unnecessary antifungal exposure, improved diagnosis of invasive fungal disease, and reduced costs without increased risk of mortality. The appropriateness of diagnostic-driven antifungal strategy for individual HSCT centers depends on the availability and turnaround times for diagnostics, multidisciplinary expertise, and the local epidemiology of invasive fungal infections. Echinocandins are the treatment of choice for invasive candidiasis in most HSCT recipients. Fluconazole may be used for the treatment of invasive candidiasis in hemodynamically stable patients with no prior azole exposure. The primary treatment of choice for invasive aspergillosis is voriconazole. Alternatives include isavuconazole and lipid formulations of amphotericin. Currently available evidence does not support routine primary combination antifungal therapy for invasive aspergillosis. However, combination salvage antifungal therapy may be considered in selected patients. Therapeutic drug monitoring is recommended for the majority of HSCT recipients on itraconazole, posaconazole, or voriconazole. Copyright © 2017

  9. Complications After Cosmetic Surgery Tourism.

    Science.gov (United States)

    Klein, Holger J; Simic, Dario; Fuchs, Nina; Schweizer, Riccardo; Mehra, Tarun; Giovanoli, Pietro; Plock, Jan A

    2017-04-01

    Cosmetic surgery tourism characterizes a phenomenon of people traveling abroad for aesthetic surgery treatment. Problems arise when patients return with complications or need of follow-up care. To investigate the complications of cosmetic surgery tourism treated at our hospital as well as to analyze arising costs for the health system. Between 2010 and 2014, we retrospectively included all patients presenting with complications arising from cosmetic surgery abroad. We reviewed medical records for patients' characteristics including performed operations, complications, and treatment. Associated cost expenditure and Diagnose Related Groups (DRG)-related reimbursement were analyzed. In total 109 patients were identified. All patients were female with a mean age of 38.5 ± 11.3 years. Most procedures were performed in South America (43%) and Southeast (29.4%) or central Europe (24.8%), respectively. Favored procedures were breast augmentation (39.4%), abdominoplasty (11%), and breast reduction (7.3%). Median time between the initial procedure abroad and presentation was 15 days (interquartile range [IQR], 9) for early, 81.5 days (IQR, 69.5) for midterm, and 4.9 years (IQR, 9.4) for late complications. Main complications were infections (25.7%), wound breakdown (19.3%), and pain/discomfort (14.7%). The majority of patients (63.3%) were treated conservatively; 34.8% became inpatients with a mean hospital stay of 5.2 ± 3.8 days. Overall DRG-related reimbursement premiums approximately covered the total costs. Despite warnings regarding associated risks, cosmetic surgery tourism has become increasingly popular. Efficient patients' referral to secondary/tertiary care centers with standardized evaluation and treatment can limit arising costs without imposing a too large burden on the social healthcare system. 4. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  10. Exposed versus buried intramedullary implants for pediatric forearm fractures: a comparison of complications.

    Science.gov (United States)

    Kelly, Brian A; Miller, Patricia; Shore, Benjamin J; Waters, Peter M; Bae, Donald S

    2014-12-01

    The purpose of this study was to compare the rate of complications between buried and exposed intramedullary implants after fixation of pediatric forearm fractures. A retrospective comparative cohort study of 339 children treated with intramedullary fixation for displaced forearm fractures between 2004 and 2009 was performed. Implants were left exposed in 128 patients (37.8%) and buried beneath the skin in 208 patients (61.4%); 3 patients had buried and exposed hardware (0.9%). Data on demographics, injury, surgical technique, and complications were analyzed. The buried implant group was older (mean 10.3 vs. 8.5 y; P exposed implant group. The buried group had their implants removed later than the exposed group (median 3.5 vs. 1.2 mo; P exposed implants were successfully removed in the office. Complications were seen in 56 patients (16.5%). There were 16 patients (4.7%) with refracture and 12 patients (3.5%) with infection. The buried and exposed implant groups did not differ significantly with respect to refracture (3.1% vs. 7.0%; P = 0.20), infection (3.5% vs. 2.3%; P = 0.66), or overall complications (14.5% vs. 17.2%; P = 0.87). There was also no difference between groups with respect to loss of reduction, nondelayed or delayed union, loss of motion, hypertrophic granuloma, or tendon rupture. Buried implants were also associated with penetration through the skin (3.9%). Injury to the dominant arm and need for open reduction were significant predictors of complication (OR = 1.01; 95% CI, 1.001-1.012; P = 0.02 and OR = 0.51; 95% CI, 0.264-0.974; P = 0.04, respectively). There were no significant differences seen in number of infections, refractures, or overall complications based on whether implants were left exposed or buried beneath the skin after surgery. Level III, therapeutic.

  11. Postoperative Complications of Total Joint Arthroplasty in Obese Patients Stratified by BMI.

    Science.gov (United States)

    Zusmanovich, Mikhail; Kester, Benjamin S; Schwarzkopf, Ran

    2018-03-01

    High body mass index (BMI) is associated with significant complications in patients undergoing total joint arthroplasty. Many studies have evaluated this trend, but few have looked at the rates of complications based on BMI as a continuous variable. The purpose of this study was to stratify obese patients into 3 BMI categories and evaluate their rates of complications and gauge whether transitioning from higher to lower BMI category lowers complication. Patients undergoing primary total joint arthroplasty were selected from the National Surgical Quality Improvement Program database from 2008-2015 and arranged into 3 groups based on BMI: O1 (BMI 30-34.9 kg/m 2 ), O2 (BMI 35-39.9 kg/m 2 ), and O3 (BMI >40 kg/m 2 ). Thirty-day complications were recorded and evaluated utilizing univariate and multivariate analyses stratified by BMI. A total of 268,663 patients were identified. Patients with a BMI >30 kg/m 2 had more infectious and medical complications compared with nonobese patients. Furthermore, there were increased complications as the BMI categories increased. Patients with a BMI >40 kg/m 2 (O3) had longer operating times, length of stay, higher rates of readmissions, reoperations, deep venous thrombosis, renal insufficiency, superficial infections, deep infections, and wound dehiscence. These trends were present when comparing the O2 with O1 category as well. We have demonstrated increased rates of medical and surgical complications in obese patients. Furthermore, we demonstrated a stepwise increase in complication rates when transitioning to higher BMI groups. Based on our data, we believe that preoperative counseling and interventions to decrease BMI should be explored before offering elective surgery to obese patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Pulmonary complications after bone marrow transplantation in chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Schuster, J.; Sailer, M.; Schmeiser, T.; Schumacher, K.A.; Heit, W.

    1988-01-01

    In a retrospective study chest radiographs of 87 bone marrow transplant recipients were analysed. 36 patients had pulmonary complications with lung opacifications. Interstitial changes were more frequent than air-space pneumonias. The latter were caused by bacteria and fungi only. The most common cause of pulmonary complications was cytomegalovirus pneumonia. It was characterised uniformly by a bilateral diffuse interstitial pattern. Idiopathic interstitial pneumonias were indistinguishable from CMV infection. Pneumonias caused by Epstein-Barr virus and protozoa, diffuse radiation pneumonitis and leukaemic infiltrates were rare and also associated with interstitial changes.

  13. Pulmonary complications after bone marrow transplantation in chest radiography

    International Nuclear Information System (INIS)

    Schuster, J.; Sailer, M.; Schmeiser, T.; Schumacher, K.A.; Heit, W.; Ulm Univ.

    1988-01-01

    In a retrospective study chest radiographs of 87 bone marrow transplant recipients were analysed. 36 patients had pulmonary complications with lung opacifications. Interstitial changes were more frequent than air-space pneumonias. The latter were caused by bacteria and fungi only. The most common cause of pulmonary complications was cytomegalovirus pneumonia. It was characterised uniformly by a bilateral diffuse interstitial pattern. Idiopathic interstitial pneumonias were indistinguishable from CMV infection. Pneumonias caused by Epstein-Barr virus and protozoa, diffuse radiation pneumonitis and leukaemic infiltrates were rare and also associated with interstitial changes. (orig.) [de

  14. Enteral Antibiotics are Non-inferior to Intravenous Antibiotics After Complicated Appendicitis in Adults

    DEFF Research Database (Denmark)

    Kleif, Jakob; Rasmussen, Louise; Fonnes, Siv

    2017-01-01

    BACKGROUND: Prolonging post-operative antibiotic treatment beyond 3 days does not seem to reduce the incidence of post-operative abscess formation or wound infection after surgery for complicated appendicitis. The route of administration seems to be based on an empirical basis. Using enteral...... antibiotics could reduce length of stay and reduce overall costs. We aimed to examine whether treatment with enteral antibiotics during the first three post-operative days is non-inferior to intravenous antibiotics regarding intra-abdominal abscess formation or wound infection after surgery for complicated...... of surgery. Route of antibiotic administration for the first three post-operative days was registered for all patients. RESULTS: A total of 1141 patients were included in the study. The overall risk of developing an intra-abdominal abscess was 6.7% (95% CI 5.2%; 8.1%), and the risk of wound infection was 1...

  15. Imaging of Periprosthetic Infection.

    LENUS (Irish Health Repository)

    Carty, Fiona

    2013-05-22

    Periprosthetic infection is one of the most challenging and difficult complications in orthopaedics. It can result in significant patient distress and disability, with repeated surgeries, increased cost and utilization of medical resources, and in rare cases even mortality. The biggest challenge to date is the correct diagnosis of periprosthetic infection and implementation of effective treatment regimens capable of eradicating the organism. This article reviews the various modalities used in the imaging of periprosthetic and post-arthroplasty infection.

  16. Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access

    Directory of Open Access Journals (Sweden)

    Pil Young Jung

    Full Text Available Background: Totally implantable access port (TIAP provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92 and subclavian approach (Group 2, n = 79 between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868. Twenty four complications were occurred (14.0%, including pneumothorax (n = 1, 0.6%, migration/malposition (n = 4, 2.3%, pinch-off syndrome (n = 4, 2.3%, malfunction (n = 2, 1.1%, infection (n = 8, 4.7%, and venous thrombosis (n = 5, 2.9%. The overall incidence was 8.7% and 20.3% in each group (p = 0.030. Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033. The mechanical complication free probability is significantly higher in group 1 (p = 0.040. Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

  17. Infectious complications in chronic renal failure

    OpenAIRE

    Kielberger, Lukáš

    2014-01-01

    INFECTIOUS COMPLICATIONS IN CHRONIC RENAL FAILURE Infections represent a serious problem in chronic kidney disease (cohort and they are) associated with signifficant morbidity and mortality. The thesis originated in the nephrology division of the Department of Internal Medicine I., Charles University Teaching Hospital and Medical Faculty in Pilsen, an institution with a long standing research activity in the field. In the theoretical part of this work, a general summary of infectious complica...

  18. Radiotherapy complications and their possible management in the head and neck region

    Directory of Open Access Journals (Sweden)

    Pankaj Agarwal

    2012-01-01

    Full Text Available Oral complications from radiation to the head and neck or chemotherapy for any malignancy can compromise patients′ health and quality of life and affect their ability to complete planned cancer treatment. For some patients the complications can be so debilitating that they may tolerate only lower doses of therapy, postpone scheduled treatments, or discontinue treatment entirely. Oral complications can also lead to serious systemic infections. Medically necessary oral care before, during, and after cancer treatment can prevent or reduce the incidence and severity of oral complications, enhancing both patient survival and quality of life. In the present article we present an overview of oral complications, and their possible management, after radiation therapy in the head-and-neck region.

  19. Immuno-histochemical features of the structure of foetuses' ovarian from the mothers with pregnancy complications

    Directory of Open Access Journals (Sweden)

    Larisa Kupriianova

    2017-02-01

    Kharkiv National Medical University, Kharkov, Ukraine   Abstract As a material of our research, we took into account foetuses' ovarian at the gestation term from 21 to 42 weeks; and, as a result, all types of material we divided into few groups: foetuses from healthy mothers; foetuses from mothers with pre-eclampsia complications of pregnancy of different stages; foetuses from mothers with pregnancy's complications as a chronical infection. Research methods: organomethrical, histochemical, immuno-histochemical, statistical. As a result of the complex research, in foetuses' ovarian from mothers with pregnancy complications of different types, we can see reducing of indicators of structural and functional activity of organs, increasing of apoptotic index; increasing of endothelin-1 production; decreasing of hormones production. Key words: fetus, pregnancy, pre-eclampsia; infection, ovary.

  20. Experience versus complication rate in third molar surgery

    Directory of Open Access Journals (Sweden)

    Al-Khawalde Mohammed

    2006-05-01

    Full Text Available Abstract Objectives The records of 1087 patients who underwent surgical removal of third molar teeth were prospectively examined to analyse the possible relationship between postoperative complications and the surgeon's experience parameter. Method and materials Seven surgeons (three specialists in surgical dentistry [specialists SD] and four oral and maxillofacial Senior House Officers [OMFS residents] carried out the surgical procedures. For each patient, several variables were recorded including age, gender, radiographic position of extracted teeth, treating surgeon, duration of surgery and postoperative complications. Results Analysis of the data revealed some differences in the incidence of complications produced by the specialists SD and OMFS residents. The main statistically relevant differences were increase the incidences of trismus, nerve paraesthesia, alveolar osteitis and infection in the resident-treated group, while the specialist-treated group showed higher rates of post-operative bleeding. Conclusion The higher rate of postoperative complications in the resident-treated group suggests that at least some of the complications might be related to surgical experience. Further work needs to compare specialists of training programmes with different years of experience, using large cross – sectional studies.

  1. Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Paula Parás-Bravo

    Full Text Available The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs in a cohort of patients.In this retrospective cohort study, we included all patient carrying PICCs (n = 603 inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis.All patients were treated according to the same "nursing care" protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to "end of treatment" (48.42% and "exitus", (22.53% the most frequent cause of removal was migration (displacement towards the exterior of the catheter (5.80%.PICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant.

  2. AN OBSERVATIONAL STUDY ON COMPLICATIONS OF CHRONIC DIABETES ENCOUNTERED IN A PULMONOLOGIST CLINIC

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    V. Vinod Kumar Viswanathan

    2017-07-01

    Full Text Available BACKGROUND With the ever increasing prevalence of diabetes, complications of diabetes are encountered across all specialities. Hence, it is imperative that all specialists should have a working knowledge of diabetes mellitus. This study was done to understand the prevalence and complications of diabetes among patients attending a pulmonologist OPD. Knowledge of diabetes and its complications will help pulmonary medicine specialists to identify and manage the complications of diabetes better. MATERIALS AND METHODS All patients attending a pulmonologist’s clinic for a period of one month were enquired regarding their diabetes status and patients with known history of diabetes were questioned using a standard questionnaire and their available records examined regarding their complications pertaining to diabetes and the results analysed. RESULTS In this study, 18.7% of patients attending pulmonologist clinic had diabetes mellitus and 13.5% of patients had diabetes of more than 10 years duration. Most of the patients were in the age group of 40 to 60 years and were predominantly male. Among the diabetic patients, 71.9% had complications due to diabetes. Infections were the most commonly associated complication followed by pulmonary and cardiovascular complications. Many cases of pulmonary tuberculosis were observed among these patients. Other respiratory infections observed included pneumonias and flu. Cardiovascular complications like systemic hypertension, coronary artery disease and dyslipidaemia were observed. CONCLUSION With the rising prevalence of diabetes mellitus, such cases are frequently observed across all medical specialities. Hence, it is vital that all specialists should be trained in a management of diabetes, which is a frequent comorbidity observed by all specialists. Knowledge of diabetes, identifying diabetes early and management of complications will go a long way in reducing the morbidity and mortality due to diabetes and also

  3. Discussion of percutanous nephrostomy technique with prevention and treatment of complications

    International Nuclear Information System (INIS)

    Zhang Zefu; Liang Huiming; Zheng Chuansheng; Wu Hanpin; Zhou Guofeng

    2008-01-01

    Objective: To analyze the complications and treatment technique of percutaneous nephrostomy. Methods: 247 hydronephrosis eases treated with percutaneous nephrostomy guided by ultrosound and fluroseopy flora Januray 2007 to April 2008 were evaluated retrospectively and the causes of complications and suitable treatments were analyzed. Results: The successful rate of percutaneous nephrostomy in 247 hydronephrotic cases reached 100%. In all cases, 4 cases occurred with severe complications (1.6%) including 3 massive hemorrhage and 1 septic shock during the operation. The minor complications (25 cases, 10% ) were hematuria, urinary tract infection, local haematoma, perirenal haematoma, detachment of drainage tube with obstruction and exodus, internal double-J catheter displacement and obstruction, etc. Conclusion: The operative safety and treatment efficacy of percutaneous nephrostomy could be achieved through skillful management and comprehensive preoperative evaluation of the risk factors for the complications. (authors)

  4. Oral Complications in Hematopoietic Stem Cell Recipients: The Role of Inflammation

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    T. M. Haverman

    2014-01-01

    Full Text Available Hematopoietic stem cell transplantation (HSCT is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and in some cases with increased mortality and may significantly affect quality of life, even many years after HSCT. Inflammatory processes are key in the pathobiology of most oral complications in HSCT recipients. This review article will discuss frequently encountered oral complications associated with HSCT focusing on the inflammatory pathways and inflammatory mediators involved in their pathogenesis.

  5. Early infection and prognosis after acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Reith, J

    2001-01-01

    Infection is a frequent complication in the early course of acute stroke and may adversely affect stroke outcome. In the present study, we investigate early infection developing in patients within 3 days of admission to the hospital and its independent relation to recovery and stroke outcome....... In addition, we identify predictors for early infections, infection subtypes, and their relation to initial stroke severity....

  6. Purely transvaginal/perineal management of complications from commercial prolapse kits using a new prostheses/grafts complication classification system.

    Science.gov (United States)

    Firoozi, Farzeen; Ingber, Michael S; Moore, Courtenay K; Vasavada, Sandip P; Rackley, Raymond R; Goldman, Howard B

    2012-05-01

    Commercial prolapse mesh kits are increasingly used in the management of pelvic organ prolapse. We present our experience with the transvaginal/perineal management of synthetic mesh related complications from prolapse kits. In addition, we used the new ICS/IUGA (International Continence Society/International Urogynecological Association) prostheses/grafts complication classification system to report on our contemporary series. A retrospective chart review of all patients who underwent surgical removal of transvaginal mesh for mesh related complications after prolapse kit use from November 2006 to April 2010 at 1 institution was performed. We report our contemporary series of mesh complications using the new ICS/IUGA prostheses/grafts complication classification system. Postoperative pain, degree of improvement and presence of continued symptoms were reported by patients at last followup. A total of 23 patients underwent transvaginal removal of mesh during the study period. Mean patient age was 61 years. Median period of latency to mesh related complication was 10 months (range 1 to 27). Indications for mesh removal included vaginal/pelvic pain (39%), dyspareunia (39%), vaginal mesh extrusion/exposure (26%), urinary incontinence (35%), recurrent pelvic organ prolapse (22%), bladder mesh perforation with recurrent urinary tract infection (22%), rectal mesh perforation (4%), ureteral perforation injury (4%), retained foreign body (surgical sponge) in the bladder (4%) and vesicovaginal fistula (9%), with most patients citing more than 1 reason. Although technically difficult in some cases, purely transvaginal mesh excision appears to be safe with resolution of almost all presenting symptoms. Although slightly cumbersome, the new ICS/IUGA prostheses/graft complication classification system can be used to report and more accurately characterize mesh complications. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc

  7. Percutaneous nephrostomy and antegrade ureteral stenting: technique - indications - complications

    Energy Technology Data Exchange (ETDEWEB)

    Hausegger, Klaus A. [Klagenfurt General Hospital, Department of Radiology, Klagenfurt (Austria); Portugaller, Horst R. [University Hospital of Graz, Department of Radiology, Graz (Austria)

    2006-09-15

    In this review the technique, indication for and complications of percutaneous nephrostomy (PCN) and antegrade ureter stent insertion are described. In the majority of the cases PCN is performed to relieve urinary obstruction, which can be of benign or malignant nature. Another indication for PCN is for treatment of urinary fistulas. PCN can be performed under ultrasound and/or fluoroscopic guidance, with a success rate of more than 90%. The complication rate is approximately 10% for major and minor complications together and 4-5% for major complications only. Percutaneous antegrade double-J stent insertion usually is performed if retrograde ureter stenting has not been successful. However, especially in malignant obstructions, the success rate for antegrade stenting is higher than for retrograde transvesical double-J stent insertion. In the case of severe infection and bleeding after PCN JJ-stent insertion may be contraindicated so long as there is no sufficient concomitant drainage via a PCN. Lower urinary tract dysfunction should be excluded before stent placement. The complication rate is 2-4%. Consequent stent surveillance with regular stent exchange is mandatory. (orig.)

  8. Reconstruction of complicated skull base defects utilizing free tissue transfer.

    Science.gov (United States)

    Djalilian, Hamid R; Gapany, Markus; Levine, Samuel C

    2002-11-01

    We managed five patients with large skull base defects complicated by complex infections with microvascular free tissue transfer. The first patient developed an infection, cerebrospinal fluid (CSF) leak, and meningitis after undergoing a translabyrinthine resection of an acoustic neuroma. The second patient had a history of a gunshot wound to the temporal bone, with a large defect and an infected cholesteatoma that caused several episodes of meningitis. The third through the fifth patients had persistent CSF leakage and infection refractory to conventional therapy. In all cases prior attempts of closure with fat grafts or regional flaps had failed. Rectus abdominis myofascial free flap, radial forearm free flap or a gracilis muscle free flap was used after debridement of the infected cavities. The CSF leaks, local infections, and meningitis were controlled within a week. In our experience, microvascular free tissue provides the necessary bulk of viable, well-vascularized tissue, which not only assures a mechanical seal but also helps clear the local infection.

  9. Inappropriate use of urinary catheters and its common complications in different hospital wards

    Directory of Open Access Journals (Sweden)

    Parivash Davoodian

    2012-01-01

    Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

  10. Can avoidance of complications lead to biased healthcare decisions?

    Directory of Open Access Journals (Sweden)

    Jennifer Amsterlaw

    2006-07-01

    Full Text Available Imagine that you have just received a colon cancer diagnosis and need to choose between two different surgical treatments. One surgery, the ``complicated surgery,'' has a lower mortality rate (16\\% vs. 20\\% but compared to the other surgery, the ``uncomplicated surgery,'' also carries an additional 1\\% risk of each of four serious complications: colostomy, chronic diarrhea, wound infection, or an intermittent bowel obstruction. The complicated surgery dominates the uncomplicated surgery as long as life with complications is In our first survey, 51\\% of a sample (recruited from the cafeteria of a university medical center selected the dominated alternative, the uncomplicated surgery, justifying this choice by saying that the death risks for the two surgeries were essentially the same and that the uncomplicated surgery avoided the risk of complications. In follow-up surveys, preference for the uncomplicated surgery remained relatively consistent (39\\%--51\\% despite (a presenting the risks in frequencies rather than percents, (b grouping the 4 complications into a single category, or (c giving the uncomplicated surgery a small chance of complications as well. Even when a pre-decision ``focusing exercise'' required people to state directly their preferences between life with each complication versus death, 49\\% still chose the uncomplicated People's fear of complications leads them to ignore important differences between treatments. This tendency appears remarkably resistant to debiasing approaches and likely leads patients to make healthcare decisions that are inconsistent %Background: Imagine that you have just received a colon cancer diagnosis %and need to choose between two different surgical treatments. One %surgery, the ``complicated surgery,'' has a lower mortality rate (16\\% %vs. 20\\% but compared to the other surgery, the ``uncomplicated %surgery,'' also carries an additional 1\\% risk of each of four serious %complications

  11. Radiologic findings in cases involving complications arising from total knee arthroplasty

    International Nuclear Information System (INIS)

    Nam, Deok Ho; Ryu, Kyung Nam; Bae, Dae Kyung

    1999-01-01

    Total knee arthroplasty(TKA) has been used for the treatment of knee joint pain, deformity, and instability caused by osteoarthritis, rheumatoid arthritis, or tuberculous arthritis, and by virtue of good results and rapid development, the procedure has been increasingly employed. With the development of total knee prosthesis, complications have also increased, however, and due to complications occurring up to six years after surgery, fusion occurs in about 2% of all replaced knees. The most common complication of TKA is loosening, followed by infection. Others are thrombosis, subluxation, dislocation and fracture, and complications may be divided into four groups: biologic, technical, specific to type of components, and associated with certain diagnosis. Where these complications occur, a patient must undergo a second procedure, but the success rate is lower than for the initial procedure. Exact etiological evaluation important clinically and radiologically. We illustrate the etiologies and radiologic characteristics of TKA complications according to classification

  12. Radiologic findings in cases involving complications arising from total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Deok Ho; Ryu, Kyung Nam; Bae, Dae Kyung [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1999-09-01

    Total knee arthroplasty(TKA) has been used for the treatment of knee joint pain, deformity, and instability caused by osteoarthritis, rheumatoid arthritis, or tuberculous arthritis, and by virtue of good results and rapid development, the procedure has been increasingly employed. With the development of total knee prosthesis, complications have also increased, however, and due to complications occurring up to six years after surgery, fusion occurs in about 2% of all replaced knees. The most common complication of TKA is loosening, followed by infection. Others are thrombosis, subluxation, dislocation and fracture, and complications may be divided into four groups: biologic, technical, specific to type of components, and associated with certain diagnosis. Where these complications occur, a patient must undergo a second procedure, but the success rate is lower than for the initial procedure. Exact etiological evaluation important clinically and radiologically. We illustrate the etiologies and radiologic characteristics of TKA complications according to classification.

  13. Mechanisms involved in the association between periodontitis and complications in pregnancy.

    Directory of Open Access Journals (Sweden)

    Marcela eYang

    2015-01-01

    Full Text Available The association between periodontitis and gestation complications such as premature delivery, low weight at birth and preeclampsia has been suggested. Nevertheless, epidemiological data have shown contradictory data, mainly due to differences in clinical parameters of periodontitis assessment. Furthermore, differences in microbial composition and immune response between aggressive and chronic periodontitis are not addressed by these epidemiological studies. We aimed to review the current data on the association between gestation complications and periodontitis, and the mechanisms underlying this association. Shifts in the microbial composition of the subgingival biofilm may occur during pregnancy, leading to a potentially more hazardous microbial community. Pregnancy is characterized by physiological immune tolerance. However, the infection leads to a shift in maternal immune response to a pathogenic pro-inflammatory response, with production of inflammatory cytokines and toxic products. In women with periodontitis, the infected periodontal tissues may act as reservoirs of bacteria and their products which can disseminate to the fetus-placenta unit. In severe periodontitis patients, the infection agents and their products are able to activate inflammatory signaling pathways locally and in extra-oral sites, including the placenta-fetal unit, which may not only induce preterm labor, but also lead to preeclampsia and restrict intrauterine growth. Despite these evidences, the effectiveness of periodontal treatment in preventing gestational complications was still not established since it may be influenced by several factors such as severity of disease, composition of microbial community, treatment strategy, and period of treatment throughout pregnancy. This lack of scientific evidence does not exclude the need to control infection and inflammation in periodontitis patients during pregnancy, and treatment protocols should be validated.

  14. Pressure sores and underlying bone infection

    International Nuclear Information System (INIS)

    Sugarman, B.

    1987-01-01

    Pressure sores are a serious complication of hospitalized and chronically ill patients. Evaluation for underlying bone infection can be made difficult by radiographic, nuclear imaging, and soft-tissue culture studies that are abnormal and suggest the presence of bone infection, when no infection is present. Evaluation by bone biopsy with histologic and microbiological studies can accurately and promptly diagnose whether bone infection is present. This allows appropriate treatment when infection is present, and prevents unneeded and potentially toxic antibiotic therapy when preliminary studies incorrectly suggest that infection is present

  15. Oral Complications and Management Strategies for Patients Undergoing Cancer Therapy

    Science.gov (United States)

    2014-01-01

    With cancer survival rate climbing up over the past three decades, quality of life for cancer patients has become an issue of major concern. Oral health plays an important part in one's overall quality of life. However, oral health status can be severely hampered by side effects of cancer therapies including surgery, chemotherapy, radiotherapy, and hematopoietic stem cell transplantation. Moreover, prevention and treatment of these complications are often overlooked in clinical practice. The present paper aims at drawing health care professionals' attention to oral complications associated with cancer therapy by giving a comprehensive review. Brief comments on contemporary cancer therapies will be given first, followed by detailed description of oral complications associated with cancer therapy. Finally, a summary of preventive strategies and treatment options for common oral complications including oral mucositis, oral infections, xerostomia, and dysgeusia will be given. PMID:24511293

  16. Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children

    OpenAIRE

    Restrepo-Gualteros, Sonia; Jaramillo-Barberi, Lina; Gonzalez-Santos, Monica; Rodriguez-Martinez, Carlos; Perez, Geovanny; Gutierrez, Maria; Nino, Gustavo

    2014-01-01

    Cytomegalovirus (CMV) is a prevalent pathogen in the immunocompromised host and invasive pneumonia is a feared complication of the virus in this population. In this pediatric case series we characterized CMV lung infection in 15 non-HIV infected children (median age 3 years; IQR 0.2–4.9 years), using current molecular and imaging diagnostic modalities, in combination with respiratory signs and symptoms. The most prominent clinical and laboratory findings included cough (100%), hypoxemia (100%...

  17. COMPLICATIONS AFTER EXTRACTION OF IMPACTED THIRD MOLARS - LITERATURE REVIEW

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    Elitsa G. Deliverska

    2016-07-01

    Full Text Available Third molar surgery is the most common procedure performed by oral and maxillofacial surgeons worldwide. This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Complications, such as pain, dry socket, swelling, paresthesia of the lingual or inferior alveolar nerve, bleeding, and infection are most common. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anaesthetic technique. For the general dental practitioner, as well as the oral and maxillofacial surgeon, it is important to be familiar with all the possible complications after this procedure. This improves patient education and leads to prevention, early recognition and management.

  18. Postoperative complications with glycine and sterile distilled water after transurethral resection of prostate

    International Nuclear Information System (INIS)

    Pesha, M.T.; Khan, M.A.; Jamal, Y.; Waahab, F.

    2015-01-01

    Transurethral resection of prostate (TURP) is considered the gold standard for the surgical treatment of BPH. Irrigant fluid absorption by the patient is a potentially serious complication of TURP and can lead to dilutional hyponatremia and TURP syndrome. Other common complications of TURP include urinary tract infection and secondary haemorrhage. The objective of this study was to compare the frequency of postoperative complications (Urinary Tract infection and dilutional hyponatremia) between 1.5% glycine and sterile distilled water used as irrigant in BPH patients after TURP. Methods: This randomized controlled trial was conducted in department of Urology, PIMS Islamabad, from August 2013 to February 2014. A total of 170 adult male patients between 50-80 years of age undergoing TURP with prostate volume more than 30cc on ultrasound. 85 patients each were randomly allocated to two groups. In group-A, glycine was used as irrigant solution during TURP while in group-B distilled water was used. Serum sodium levels were measured at 6th postoperative hour to look for dilutional hyponatremia. On the 15th postoperative day they were inquired about any clinical features of urinary tract infection. Also urine routine examination was performed to look for the presence of WBCs in the urine. Results: Post-operative dilutional hyponatremia was observed in 13 (15.3%) patients in Group A and in 10 (11.8%) patients in group-B. The difference between both the groups being non-significant (p-value=0.501).Frequency of postoperative urinary tract infection on 15th postoperative day in group-A was 23(27.1%) while in group-B it was 16 (18.8%), the difference among both the groups being insignificant (p-value=0.202). Conclusion: Although the frequency of postoperative complications like UTI and dilutional hyponatremia was less with sterile distilled water, yet, the difference was statistically not significant. (author)

  19. Impact of surgical complications on length of stay after hip fracture surgery

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Palm, Henrik; Krasheninnikoff, Michael

    2006-01-01

    BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact...... of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall...... showed that 64 complications (55%) were due to suboptimal surgery, 18 (16%) to infection, 6 (5%) to falls and 28 (24%) to no obvious cause. CONCLUSION: Surgical complications secondary to primary hip fracture surgery account for 27.1% of total hospital bed consumption within 6 months. Approximately, 50...

  20. Infectious complications in chronic lymphocytic leukemia- a retrospective analysis: single institution experience.

    Science.gov (United States)

    Demitrovicova, L; Mikuskova, E; Oravcova, I; Cingelova, S; Drgona, L; Mladosievicova, B

    2017-01-01

    The aim of this study was to evaluate the incidence of a variety of infectious complications in patients with CLL regarding the duration of CLL and the type of treatment. We present the retrospective analysis of patients with CLL treated at our institution in years 2004-2016. We collected data about the type of infection, pathogenes, treatment and severity of infections surpassed in connection with administration treatment. In the study one hundred and ten patients were evaluated. The average age of patients was 61.7 years (range 34.5-91.9 years). Fludarabine was the most widely used regimen, followed by bendamustine and alemtuzumab. We recorded 393 episodes of infections, of which 114 (29%) were severe and life threatening of degree 3-5, and 279 (71%) of degree 2. The most common infections were the upper respiratory tract infections together with sinusitis (45.03%), pneumonia (26.20%), CMV reactivation occured in 8.14%, infections of the skin was in 7.6 %. Most infections have occurred with the administration of monoclonal antibody alemtuzumab, these patients were at significantly higher risk of infection [RR 2.59 (1.30 to 5.17)] than patients receiving obinutuzumab [RR 0.63 (0.48 to 0.82)] (p = 0.0001). On the contrary, the safety profile of BCR signaling pathway inhibitors was very acceptable [RR 1.17 (0.70 - 1.96)]. The number of infections have decreased during the first 12 months of treatment with ibrutinib. In the study group we recorded 19 deaths, 8 (7.27%) of them were of infectious etiology. The risk of infectious complications is lifelong in patients with CLL, it can be minimized by early detection and aggressive management. Novel targeted agents used in therapy of CLL have a good safety profile, even the risk of infection is decreased during administration.

  1. Perioperative surgical complications and learning curve associated with minimally invasive transforaminal lumbar interbody fusion: a single-institute experience.

    Science.gov (United States)

    Park, Yung; Lee, Soo Bin; Seok, Sang Ok; Jo, Byung Woo; Ha, Joong Won

    2015-03-01

    As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complications and their management in connection with minimally invasive transforaminal lumbar interbody fusion (TLIF). We performed a retrospective chart review of our first 124 patients who underwent minimally invasive TLIF. The primary outcome measure was adverse events during the perioperative period, including neurovascular injury, implant-related complications, and wound infection. Pseudarthroses and adjacent segment pathologies were not included in this review. Adverse events that were not specifically related to spinal surgery and did not affect recovery were also excluded. Perioperative complications occurred in 9% of patients (11/124); including three cases of temporary postoperative neuralgia, two deep wound infections, two pedicle screw misplacements, two cage migrations, one dural tear, and one grafted bone extrusion. No neurologic deficits were reported. Eight complications occurred in the first one-third of the series and only 3 complications occurred in the last two-thirds of the series. Additional surgeries were performed in 6% of patients (7/124); including four reoperations (two for cage migrations, one for a misplaced screw, and one for an extruded graft bone fragment) and three hardware removals (one for a misplaced screw and two for infected cages). We found perioperative complications occurred more often in the early period of a surgeon's experience with minimally invasive TLIF. Implant-related complications were common and successfully managed by additional surgeries in this series. We suggest greater caution should be exercised to avoid the potential complications, especially when surgeon is a novice to this procedure.

  2. Anemia as a complication of parvovirus b19 infection in renal transplant recipients.

    Science.gov (United States)

    Čapenko, Svetlana; Kozireva, Svetlana; Folkmane, Inese; Bernarde, Kristīna; Rozentāls, Rafails; Murovska, Modra

    2012-01-01

    The frequency of B19 infection in renal transplant donors and recipients was studied to determine the significance of active viral infection in the development of anemia. Serum, plasma, and peripheral blood leukocyte samples of 47 renal transplant donors, 38 recipients with anemia (Group 1), and 25 without anemia (Group 2) after renal transplantation were evaluated for the presence of anti-B19 specific antibodies (ELISA) and B19 DNA (nPCR). Active persistent B19 infection after renal transplantation was detected in 12 of the 38 in the Group 1 (10 had reactivation and 2 primary infection), and none of the recipients in the Group 2 had it. Of the 12 recipients in the Group 1, 10 were seropositive and 2 seronegative before renal transplantation; 10 received the transplants from the seropositive and 2 from seronegative donors. rHuEPO therapy-resistant severe anemia was detected only in the recipients with active B19 infection after renal transplantation in the Group 1 (7/12). The logistic regression analysis revealed a significant relationship between active B19 infection and severe anemia (OR, 0.039; 95% CI, 0.006-0.257; P=0.001). Active B19 infection was documented only in the anemic recipients and could be associated with the development of severe anemia after renal transplantation. This allows us to recommend concurrent screening for viral DNA in plasma and detection of anti-B19 IgM class antibodies. To find the association between B19 infection and the development of anemia, further investigations are necessary.

  3. Bladder management methods and urological complications in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Roop Singh

    2011-01-01

    Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions

  4. Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates

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    Mitzy Tannia Reichembach Danski

    2016-02-01

    Full Text Available Abstract OBJECTIVE To evaluate the incidence of complications related to the use of peripheral intravenous catheter in neonates and identify the associated risk factors. METHOD Prospective cohort study conducted in a Neonatal Intensive Care Unit. Participants were the hospitalized neonates undergoing peripheral intravenous puncture in the period from February to June 2013. RESULTS The incidence of complications was 63.15%, being infiltration/extravasation (69.89%, phlebitis (17.84% and obstruction (12.27%. The risk factors were the presence of infection (p = 0.0192 and weight at the puncture day (p = 0.0093, type of intermittent infusion associated with continuous infusion (p <0.0001, endotracheal intubation (p = 0.0008, infusion of basic plan (p = 0.0027, total parenteral nutrition (P = 0.0002, blood transfusion associated with other infusions (p = 0.0003 and other drugs (p = 0.0004. Higher risk of developing complications in the first 48 hours after puncture. CONCLUSION A high rate of complications related to the use of peripheral intravenous catheter, and risk factors associated with infection, weight, drugs and infused solutions, and type of infusion.

  5. Nurses' knowledge and attitudes regarding major immobility complications among bedridden patients: A prospective multicentre study.

    Science.gov (United States)

    Li, Zhen; Zhou, Xinmei; Cao, Jing; Li, Zheng; Wan, Xia; Li, Jiaqian; Jiao, Jing; Liu, Ge; Liu, Ying; Li, Fangfang; Song, Baoyun; Jin, Jingfen; Liu, Yilan; Wen, Xianxiu; Cheng, Shouzhen; Wu, Xinjuan

    2018-05-01

    To gain insight into nurses' knowledge and attitudes regarding major immobility complications (pressure ulcers, pneumonia, deep vein thrombosis and urinary tract infections) and explore the correlation of nurses' knowledge and attitudes with the incidence of these complications. Immobility complications have adverse consequences, and effective management requires appropriate knowledge, attitudes and skills. Evidence about nurses' knowledge and attitudes regarding immobility complications is lacking. Cross-sectional study. A total of 3,903 nurses and 21,333 bedridden patients from 25 hospitals in China were surveyed. Nurses' knowledge and attitudes regarding major immobility complications were assessed using researcher-developed questionnaires. The content validity, reliability and internal consistency of the questionnaires were validated through expert review and a pilot study. The incidence of major immobility complications among bedridden patients from selected wards was surveyed by trained investigators. Correlations between knowledge, attitudes and the incidence of major immobility complications were evaluated with multilevel regression models. Mean knowledge scores were 64.07% for pressure ulcers, 72.92% for deep vein thrombosis, 76.54% for pneumonia and 83.30% for urinary tract infections. Mean attitude scores for these complications were 86.25%, 84.31%, 85.00% and 84.53%, respectively. Knowledge and attitude scores were significantly higher among nurses with older age, longer employment duration, higher education level, previous training experience and those working in tertiary hospitals or critical care units. Nurses' knowledge about pressure ulcers was negatively related to the incidence of pressure ulcers, and attitude towards pneumonia was negatively correlated with the incidence of pneumonia. Clinical nurses have relatively positive attitudes but inadequate knowledge regarding major immobility complications. Improved knowledge and attitudes regarding

  6. Visceral, vascular, and wound complications following over 13,000 lateral interbody fusions: a survey study and literature review.

    Science.gov (United States)

    Uribe, Juan S; Deukmedjian, Armen R

    2015-04-01

    Minimally invasive lateral interbody fusion (MIS-LIF) has become a popular less invasive treatment option for degenerative spinal disease, deformity, and trauma. While MIS-LIF offers several advantages over traditional anterior and posterior approaches, the procedure is not without risk. The purpose of this study was to evaluate the incidence of visceral, vascular, and wound complications following MIS-LIF performed by experienced surgeons. A survey was conducted by experienced (more than 100 case experience) MIS-LIF surgeons active in the society of lateral access surgery (SOLAS) to collect data on wound infections and visceral and vascular injuries. Of 77 spine surgeons surveyed, 40 (52 %) responded, including 25 (63 %) orthopedic surgeons and 15 (38 %) neurosurgeons, with 20 % practicing at an academic institution and 80 % in community practice. Between 2003 and 2013, 13,004 patients were treated with MIS-LIF by the 40 surgeons who responded to the survey. Of those patients, 0.08 % experienced a visceral complication (bowel injury), 0.10 % experienced a vascular injury, 0.27 % experienced a superficial wound infection, and 0.14 % experienced a deep wound infection. The incidence of surgical site infections and vascular and visceral complications following MIS-LIF in this large series was low and compared favorably with rates for alternative interbody fusion approaches. Although technically demanding, MIS-LIF is a reproducible approach for interbody fusion with a low risk of vascular and visceral complications and infections.

  7. Managing urinary tract infections

    OpenAIRE

    Saadeh, Sermin A.; Mattoo, Tej K.

    2011-01-01

    Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-sta...

  8. Lysozyme-responsive polymer systems for detection of infection

    NARCIS (Netherlands)

    Schiffer, Doris; Verient, Vanessa; Luschnig, Daniel; Blokhuis-Arkes, Miriam H.E.; van der Palen, Job J.A.M.; Gamerith, Clemens; Burnet, Michael; Sigl, Eva; Heinzle, Andrea; Guebitz, Georg M.

    2015-01-01

    There is a strong need for new point-of-care systems for the detection of wound infection. Overseen infections in chronic wounds induce severe complications, such as delayed healing and high risks for the patients, while time-consuming common gold and silver standard methods for infection assessment

  9. Complications and risk factors in transrectal ultrasound-guided prostate biopsies

    Directory of Open Access Journals (Sweden)

    Carlos Márcio Nóbrega de Jesus

    Full Text Available CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE or levels higher than 4 ng/ml in prostate-specific antigen (PSA tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%, while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%. Urinary tract infection (UTI occurred in 16 patients (9.2%. Sepsis was observed in three patients (1.7%. The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05. Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05. The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

  10. Echocardiography in patients with complications related to pacemakers and cardiac defibrillators.

    Science.gov (United States)

    Almomani, Ahmed; Siddiqui, Khadija; Ahmad, Masood

    2014-03-01

    The evolving indications and uses for implantable cardiac devices have led to a significant increase in the number of implanted devices each year. Implantation of endocardial leads for permanent pacemakers and cardiac defibrillators can cause many delayed complications. Complications may be mechanical and related to the interaction of the device leads with the valves and endomyocardium, e.g., perforation, infection, and thrombosis, or due to the electrical pacing of the myocardium and conduction abnormalities, e.g., left ventricular dyssynchrony. Tricuspid regurgitation, another delayed complication in these patients, may be secondary to both mechanical and pacing effects of the device leads. Echocardiography plays an important role in the diagnosis of these device-related complications. Both two-dimensional transthoracic echocardiography and transesophageal echocardiography provide useful diagnostic information. Real time three-dimensional echocardiography is a novel technique that can further enhance the detection of lead-related complications. © 2013, Wiley Periodicals, Inc.

  11. Infected orbital cyst following exenteration.

    Science.gov (United States)

    Barak, A; Hirsh, A; Rosner, M; Rosen, N

    1996-09-01

    An orbital cyst is a rare complication of orbital trauma and exenteration. Infections of such cysts have not been described, and are potentially dangerous unless treated immediately. The authors describe a case of delayed treatment of such an infected cyst, which resolved following surgical drainage. The potentially hazardous outcome makes knowledge of such cases important.

  12. Catheter-related bloodstream infection.

    Science.gov (United States)

    Goede, Matthew R; Coopersmith, Craig M

    2009-04-01

    Catheter-related bloodstream infections (CR-BSIs) are a common, frequently preventable complication of central venous catheterization. CR-BSIs can be prevented by strict attention to insertion and maintenance of central venous catheters and removing unneeded catheters as soon as possible. Antiseptic- or antibiotic-impregnated catheters are also an effective tool to prevent infections. The diagnosis of CR-BSI is made largely based on culture results. CR-BSIs should always be treated with antibiotics, and except in rare circumstances the infected catheter needs to be removed.

  13. The Comparison of Open and Laparoscopic Appendectomy: Is There any Outcome Difference Between Non-Complicated and Complicated Appendicitis?

    Directory of Open Access Journals (Sweden)

    Ünal Bıçakcı

    2011-09-01

    Full Text Available Objective: The assessment of laparoscopic appendectomy (LA and open appendectomy (OA in patients with noncomplicated (NCA and complicated appendicitis (CA was aimed for. Material and Methods: Of 279 patients with appendectomy, 135 had NCA (48.3% (49 underwent LA (86M, 49F, median 9 years and144 had CA (51.7% (23 underwent LA (98M, 46F, median 11 years. Outcome measures: Wound infection (WI, intraabdominal abscess (IA, postoperative ileus (PI, requirement of reoperation (RO, time of surgery (TOS, length of stay (LOS, duration of postoperative pain (PP, nasogastric tube (NT, intraperitoneal drainage (ID were recorded.Results: Between OA and LA groups, there was no statistical significance in WI(3/86 vs 0/49, IA(2/86 vs 0/49, RO(2/86 vs 2/49, and PI rate (1/86 vs 2/49 in NCA group (p>0.05. The LOS(3±1.4 vs 4±1.3, NT (1.2±0.9 vs 1.8±0.6 days and PP(0.9±0.9 vs 2.3±1.1 days were lower in LA than OA (p0.05. In CA, patients with LA had less WI(0/23 vs 18/121 (p<0.05. NT (2±0.8 vs 2.7±1.5, PP (2.1±1.2 vs 3.2±1.5 and ID (3.1±2.3 vs 4.4±1.4 were lower in LA than OA (p<0.05.Conclusion: Laparoscopic appendectomy decreases wound infection, nasogastric tube duration, intraperitoneal drainage and pain in complicated appendicitis. The Laporoscopic approach is superior in complicated and noncomplicated appendicitis.

  14. Aortic Stent-Graft Infection Following Septic Complications of a Kidney Stone

    International Nuclear Information System (INIS)

    Berg, H. Rogier van den; Leijdekkers, Vanessa J.; Vahl, Anco

    2006-01-01

    A 73-year-old man was treated because of a renal pelvis blowout of the left kidney for which he received a nephrostomy catheter without antibiotic prophylaxis. Almost a year previously this patient had undergone endovascular repair of a symptomatic infrarenal abdominal aorta aneurysm. Four weeks after the diagnosis and treatment of the ruptured renal pelvis, a new computed tomography scan and ultrasound-guided fine needle aspiration confirmed the diagnosis of infected aortic stent-graft. An extra-anatomic axillo-uniiliac bypass and graft excision was performed. Two weeks after discharge the patient returned to the hospital with an occlusion of his left renal artery and died of renal failure. This is the first time an infected aortic stent-graft after a renal pelvis blowout has been reported. Although infections of aortic stent-grafts occur rarely, one should be aware of the possibility in aortic stent-graft patients undergoing abdominal procedures without antibiotic prophylaxis

  15. Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications

    International Nuclear Information System (INIS)

    Yaacob, Yazmin; Nguyen, Dang V; Mohamed, Zahiah; Ralib, A Razali A; Zakaria, Rozman; Muda, Sobri

    2013-01-01

    To report our early experience in image-guided chemoport insertions by interventional radiologists. This was a cross-sectional study conducted in a tertiary center with 161 chemoport insertions done from June 2008 to June 2010. The chemoports were inserted either at the angiography suite or at the mobile operation theater unit. Ninety percent of the chemoports had right internal jugular vein (IJV) as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava. Immediate and early complications were recorded. All insertions were performed under image guidance with the aid of ultrasound and fluoroscopy. The technical success rate was 99.4%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. Twenty-six early complications were recorded. The most common early complication was catheter blockage (12/161; 7.4%), followed by catheter-related infection (9/161; 5.6%). Other complications were catheter malposition, venous thrombosis and catheter dislodgement or leak. A total of 11 (6.8%) chemoports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the angiography suite and the mobile operation theater unit. Image-guided chemoport insertion by interventional radiologist gives low periprocedural complication rates. Using right IJV as the entry site, the image guidance gives good success rate with least complication

  16. Safety and Complications of Medical Thoracoscopy

    Directory of Open Access Journals (Sweden)

    Shimaa Nour Moursi Ahmed

    2016-01-01

    Full Text Available Objectives. To highlight the possible complications of medical thoracoscopy (MT and how to avoid them. Methods. A retrospective and prospective analysis of 127 patients undergoing MT in Nagoya Medical Center (NMC and Toyota Kosei Hospital. The data about complications was obtained from the patients, notes on the computer system, and radiographs. Results. The median age was 71.0 (range, 33.0–92.0 years and 101 (79.5% were males. The median time with chest drain after procedure was 7.0 (range, 0.0–47.0 days and cases with talc poudrage were 30 (23.6%. Malignant histology was reported in 69 (54.3%, including primary lung cancer in 35 (27.5, mesothelioma in 18 (14.2, and metastasis in 16 (12.6. 58 (45.7% revealed benign pleural diseases and TB was diagnosed in 15 (11.8%. 21 (16.5% patients suffered from complications including lung laceration in 3 (2.4%, fever in 5 (3.9% (due to hospital acquired infection (HAI in 2, talc poudrage in 2, and malignancy in 1, HAI in 2 (1.6%, prolonged air-leak in 14 (11.0%, and subcutaneous emphysema in 1 (0.8%. Conclusions. MT is generally a safe procedure. Lung laceration is the most serious complication and should be managed well. HAI is of low risk and can be controlled by medical treatment.

  17. Complications of decorative tattoo.

    Science.gov (United States)

    Shinohara, Michi M

    2016-01-01

    Decorative tattoo is a popular practice that is generally safe when performed in the professional setting but can be associated with a variety of inflammatory, infectious, and neoplastic complications, risks that may be increased with current trends in home tattooing. Modern tattoo inks contain azo dyes and are often of unknown composition and not currently regulated for content or purity. Biopsy of most (if not all) tattoo reactions presenting to the dermatologist is recommended, given recent clusters of nontuberculous mycobacterial infections occurring within tattoo, as well as associations between tattoo reactions and systemic diseases such as sarcoidosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Unusual imaging characteristics of complicated hydatid disease

    International Nuclear Information System (INIS)

    Turgut, Ahmet Tuncay; Altin, Levent; Topcu, Salih; Kilicoglu, Buelent; Altinok, Tamer; Kaptanoglu, Erkan; Karademir, Alp; Kosar, Ugur

    2007-01-01

    Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although the liver and the lungs are the most frequently involved organs in the body, hydatid cysts of other organs are unusual. Radiologically, they usually demonstrate typical imaging findings, but unusual imaging characteristics of complicated cyst of hydatid disease, associated with high morbidity and mortality, are rarely described in the literature. The purpose of this study is to review the general features of hydatidosis and to discuss atypical imaging characteristics of the complicated hydatid disease in the human, with an emphasis on structure and rupture of the cystic lesion as well as ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) features of the disease. In our study, the available literature and images of the cases with complicated hydatidosis involving liver, lung, brain, spine and orbit were reviewed retrospectively. In hydatid disease, there are many potential local and systemic complications due to secondary involvement in almost any anatomic location in humans. Radiologically, in addition to the presence of atypical findings such as perifocal edema, non-homogenous contrast enhancement, multiplicity or septations and calcification, various unusual manifestations due to rupture or infection of the cyst have been observed in our cases with complicated hydatid disease. To prevent subsequent acute catastrophic results and the development of recurrences in various organs, it should be kept in mind that complicated hydatid cysts can cause unusual USG, CT, and MRI findings, in addition to typical ones, in endemic areas. Therefore, familiarity with atypical radiological appearances of complicated hydatid disease may be valuable in making a correct diagnosis and treatment

  19. Unusual imaging characteristics of complicated hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Turgut, Ahmet Tuncay [Department of Radiology, Ankara Training and Research Hospital, Ankara (Turkey)]. E-mail: ahmettuncayturgut@yahoo.com; Altin, Levent [Department of Radiology, Numune Training and Research Hospital, Ankara (Turkey); Topcu, Salih [Department of Thoracic Surgery, Faculty of Medicine, Kocaeli University, Izmit (Turkey); Kilicoglu, Buelent [Department of 4th General Surgery, Ankara Training and Research Hospital, Ankara (Turkey); Altinok, Tamer [Department of Thoracic Surgery, Meram Faculty of Medicine, Selcuk University, Konya (Turkey); Kaptanoglu, Erkan [Department of Neurosurgery, Numune Training and Research Hospital, Ankara (Turkey); Karademir, Alp [Department of Radiology, Numune Training and Research Hospital, Ankara (Turkey); Kosar, Ugur [Department of Radiology, Ankara Training and Research Hospital, Ankara (Turkey)

    2007-07-15

    Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although the liver and the lungs are the most frequently involved organs in the body, hydatid cysts of other organs are unusual. Radiologically, they usually demonstrate typical imaging findings, but unusual imaging characteristics of complicated cyst of hydatid disease, associated with high morbidity and mortality, are rarely described in the literature. The purpose of this study is to review the general features of hydatidosis and to discuss atypical imaging characteristics of the complicated hydatid disease in the human, with an emphasis on structure and rupture of the cystic lesion as well as ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) features of the disease. In our study, the available literature and images of the cases with complicated hydatidosis involving liver, lung, brain, spine and orbit were reviewed retrospectively. In hydatid disease, there are many potential local and systemic complications due to secondary involvement in almost any anatomic location in humans. Radiologically, in addition to the presence of atypical findings such as perifocal edema, non-homogenous contrast enhancement, multiplicity or septations and calcification, various unusual manifestations due to rupture or infection of the cyst have been observed in our cases with complicated hydatid disease. To prevent subsequent acute catastrophic results and the development of recurrences in various organs, it should be kept in mind that complicated hydatid cysts can cause unusual USG, CT, and MRI findings, in addition to typical ones, in endemic areas. Therefore, familiarity with atypical radiological appearances of complicated hydatid disease may be valuable in making a correct diagnosis and treatment.

  20. Effect of Obesity on Complication Rate After Elbow Arthroscopy in a Medicare Population.

    Science.gov (United States)

    Werner, Brian C; Fashandi, Ahmad H; Chhabra, A Bobby; Deal, D Nicole

    2016-03-01

    To use a national insurance database to explore the association of obesity with the incidence of complications after elbow arthroscopy in a Medicare population. Using Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Revision (ICD-9) procedure codes, we queried the PearlDiver database for patients undergoing elbow arthroscopy. Patients were divided into obese (body mass index [BMI] >30) and nonobese (BMI arthroscopy were identified from 2005 to 2012; 628 patients (22.5%) were coded as obese or morbidly obese, and 628 matched nonobese patients formed the control group. There were no differences between the obese patients and matched control nonobese patients regarding type of elbow arthroscopy, previous elbow fracture or previous elbow arthroscopy. Obese patients had greater rates of all assessed complications, including infection (odds ratio [OR] 2.8, P = .037), nerve injury (OR 5.4, P = .001), stiffness (OR 1.9, P = .016) and medical complications (OR 6.9, P arthroscopy in a Medicare population, including infection, nerve injury, stiffness, and medical complications. Therapeutic Level III, case-control study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  1. Spontaneous fistulization of hepatic hydatid cyst into the duodenum: an exceptional complication

    International Nuclear Information System (INIS)

    Daldoul, S.; Moussi, A.; Zaouche, A.

    2013-01-01

    Hydatid disease is a worldwide zoonosis and is localized in the liver in most cases. Its complications are numerous and include those related to the compression of adjacent viscera, infection of the cyst's contents or perforation of the cyst. Spontaneous rupture of the hepatic hydatid cyst into the duodenum is an extremely rare complication. The communication is, typically, not discovered until surgery. We present two cases of perforation of a liver cyst into the duodenum. One of them was diagnosed pre-operatively by a barium study. The surgical treatment of the lesion and its complications was complex but successful in both cases. (author)

  2. Peripherally inserted central catheters in infants and children - indications, techniques, complications and clinical recommendations

    DEFF Research Database (Denmark)

    Westergaard, B; Classen, V; Walther-Larsen, S

    2013-01-01

    of perioperative complications. Assisted visualisation, preferably with ultrasound, yields high rates of insertion success. With good catheter care, rates of mechanical, infectious and thrombotic complications are low and compare favourably with those of traditional central venous catheters. Even in the case...... of occlusion or infection, fibrinolytics and antibiotic locks often allow the catheter to be retained....

  3. Loss of Renal Allografts Secondary to Candida Vascular Complications in Two Recipients from the Same Donor

    Directory of Open Access Journals (Sweden)

    Govardhana Rao Yannam

    2012-01-01

    Full Text Available Infections remain a major cause of morbidity and mortality in transplant patients. Organ recipients are also susceptible to donor-derived pathogens and the majority of donor infections are easily treatable. Rarely, some pathogens have produced life-threatening complications by compromising the vascular anastomosis. In this case series we report loss of two kidney allografts secondary to vascular complications due to Candida albicans. Both recipients received grafts from a common donor, in whom Candida bacteremia in the donor was not apparent at the time of organ acceptance but became apparent on delayed cultures.

  4. Incidence and risk factors of infections complications related to implantable venous-access ports

    International Nuclear Information System (INIS)

    Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul

    2014-01-01

    The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

  5. Incidence and risk factors of infections complications related to implantable venous-access ports

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2014-08-15

    The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

  6. POSTOPERATIVE INFECTIOUS COMPLICATIONS IN PATIENTS WITH URINARY DISEASE

    Directory of Open Access Journals (Sweden)

    A. Ch. Usupbaev

    2018-01-01

    Full Text Available The large proportion of postoperative infectious complications in urological hospitals makes extremely urgent the problem of its control. The high level of these complications in the postoperative period in patients with urolithiasis is caused by various endo- and exogenous factors.Purpose. To determine the frequency, structure, and features of postoperative infectious complications in patients with urolithiasis in urological hospitals.Materials and methods. As an object of research we used a medical card 232 of the operated patients with urolithiasis, which were copied out in individual registration card. Of 232 patients with urolithiasis 48.3% were men, their average age was 44.5 ± 9.4 years. Female patients were slightly larger (51.7%, respectively, the average age was 44.9 ± 8.1 years.Results. The most common postoperative infectious complications in urolithiasis was infection in the area of surgical intervention (36,2%, acute urethritis (20,7%, acute pyelonephritis (14.7 per cent, paranephritis (9,5%, acute orhoepididimit (7,8%, acute cystitis (6%, pionephrosis (3,4%, urosepsis (1.7 percent. In the etiological structure of infectious agents associated with medical care with the highest frequency, microorganisms of genera Escherichia coli (43%, Proteus (9.5%, Staphilococcus spp were isolated. (8.3% and Staphilococcus aureus (8.3%, and in 11.9% of cases, the Association of microorganisms. Analysis of the etiological structure of genera of the family Enterobacteriaceae resistant to β-lactam antibiotics showed that 63.2% of the amount to the genus strain of E. coli, 21% Proteus and 15.8% Klebsiella.Conclusion. The data obtained indicate the need for research on the prevalence of resistant strains of microorganisms, the introduction of more specifi c, sensitive methods and monitoring. This will increase the effectiveness of treatment, reduce the risk of the spread of resistant strains and increase nosocomial infections.

  7. Serious complication 1?year after sacrospinous ligament fixation

    OpenAIRE

    Faber, Violet J.; van der Vaart, Huub C.; Heggelman, Ben G. F.; Schraffordt Koops, Steven E.

    2008-01-01

    Myositis of the gluteal region caused by group A streptococci 1 year after a sacrospinous ligament fixation was recognised as a serious complication of this procedure. Most likely, the infection was spread to the gluteal region through a port d’entree caused by vaginal atrophy, via the non-resorbable sutures. The patient was treated successfully with antibiotics intravenous and local estrogens.

  8. Perforated duodenal ulcer: an unusual complication of gastroenteritis.

    OpenAIRE

    Wilson, J M; Darby, C R

    1990-01-01

    A 7 year old boy was admitted to hospital with gastroenteritis, which was complicated by an acute perforated duodenal ulcer. After oversewing of the perforation he made an uncomplicated recovery. Peptic ulceration is under-diagnosed in childhood and this leads to delay in diagnosis and appropriate management. Ulceration is associated with severe illness and viral infections, but perforation is rare.

  9. Using vacuum in the treatment of surgical wounds complications

    Directory of Open Access Journals (Sweden)

    Drašković Miroljub

    2011-01-01

    Full Text Available Background/Aim. Using vacuum in medicine has been known from long ago, however, it has not been used for the treatment of wounds. The first experiments in this field were performed by Wagner Fleischmann, University of Ulm, Ulm, West Germany, in 1993. The aim of this study was to present our clinical experience with the treatment of surgical wounds complications in vascular patients by the use of controled vacuum. Method. In a period October 2006 - December 2009 a total of 18 patients with infection and surgical wound dehiscence were treated by the use of vacuum. Vacuum was applied to wounds by placing a polyurethane sponge on them and by fixing a polyurethane foil and a sponge to the surrounding healthy skin so to completely airtight wounds. Over a foil vacuum of - 150 mmHg was applied for a 5-day period, and on the day 6 a foil and a sponge were removed. Results. In all the 18 wounds treated by the use of vacuum secondary wound closing was achieved with no complications and with a significantly shortened time period treatment. Wound infections were healed using this method and only in 2 patients antibiotics were used at the same time. Conclusion. The use of vacuum in the treatment of operative wounds complications is an easy and reliable method contributing significantly to wounds better healing.

  10. Pregnancy outcome and complications in women with spina bifida.

    Science.gov (United States)

    Arata, M; Grover, S; Dunne, K; Bryan, D

    2000-09-01

    To describe the antenatal complications, mode of delivery and outcome of pregnancy in women with spina bifida. Case series of women known to have attended the spina bifida clinic at the Royal Children's Hospital. Medical records, postal questionnaire and telephone interview were utilized to collect data on the effect of pregnancy on the health of women and the effect of spina bifida on pregnancy outcome. Of 207 women born between 1945 and 1975, 23 reported having a pregnancy, and 17 who had completed pregnancies agreed to participate. The 17 women had a total of 29 pregnancies, with 23 pregnancies progressing to births. Fourteen of 17 women had antenatal admissions, with wheelchair-dependent women requiring more-frequent and longer admissions. Recurrent urinary infections in pregnancy occurred in women with a prior history of urinary infections; stomal problems occurred but were not serious; mobility was reduced for two women during pregnancy, with full recovery afterwards; and preexisting pressure sores worsened during pregnancy. Vaginal deliveries occurred in one in five pregnancies of women who were wheelchair dependent and in ten of eighteen pregnancies in independently mobile women, including seven of eight pregnancies of independently mobile women without ileal conduits. Cesarean sections were accompanied by postoperative complications in 10 women. Women with spina bifida who become pregnant generally have a positive outcome, with relatively low complication rates.

  11. Endovascular aneurysm repair (EVAR) follow-up imaging: the assessment and treatment of common postoperative complications

    International Nuclear Information System (INIS)

    Ilyas, S.; Shaida, N.; Thakor, A.S.; Winterbottom, A.; Cousins, C.

    2015-01-01

    Endovascular abdominal aortic aneurysm repair (EVAR) is a well-established procedure, which has long-term mortality rates similar to that of open repair. It has the additional benefit of being less invasive, making it the favoured method of treating abdominal aortic aneurysms in elderly and high-risk patients with multiple co-morbidities. The main disadvantage of EVAR is the higher rate of re-intervention, due to device-related complications, including endoleaks, limb occlusion, stent migration, kinking, and infection. As a result lifelong surveillance is required. In order to avoid missing these complications, intricate knowledge of stent graft design, good-quality diagnostic ultrasound skills, multiplanar reformatting of CT images, and reproducible investigations are important. Most of these complications can be treated via an endovascular approach using cuff extensions, uncovered stents, coils, and liquid embolic agents. Open surgery is reserved for complex complications, where an endovascular approach is not feasible. - Highlights: • Comprehensive pictorial review of EVAR related complications. • Importance of life-long EVAR surveillance, to prevent aortic rupture or lower limb ischaemia. • Identification and management of endoleaks, rupture, migration, kink/infolding, occlusion and infection

  12. Osteonecrosis in HIV-infected patients

    International Nuclear Information System (INIS)

    Lama, E. de; Narvaez, J. A.; Roca, Y.; Pellicer, J. M.

    2001-01-01

    We present two cases of avascular osteonecrosis, one involving the knees and the other the hips, in patients with human immunodeficiency virus (HIV) infection who met the criteria for acquired immunodeficiency syndrome (AIDS). We review the literature concerning this rare complication of HIV infection, focussing especially on the clinical and radiological features and its possible etiopathogenesis. (Author) 30 refs

  13. Real money: complications and hospital costs in trauma patients.

    Science.gov (United States)

    Hemmila, Mark R; Jakubus, Jill L; Maggio, Paul M; Wahl, Wendy L; Dimick, Justin B; Campbell, Darrell A; Taheri, Paul A

    2008-08-01

    Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, duration of stay, and payment associated with complications in trauma patients. Using NSQIP principles, patient data were collected for 512 adult patients admitted to the trauma service for > 24 hours at a Level 1 trauma center (2004-2005). Patients were placed in 1 of 3 groups: no complications (none), >or=1 minor complication (minor, eg, urinary tract infection), or >or=1 major complication (major, eg, pneumonia). Total hospital charges, costs, payment, and duration of stay associated with each complication group were determined from a cost-accounting database. Multiple regression was used to determine the costs of each type of complication after adjusting for differences in age, sex, new injury severity score, Glasgow coma scale score, maximum head abbreviated injury scale, and first emergency department systolic blood pressure. A total of 330 (64%) patients had no complications, 53 (10%) had >or= 1 minor complication, and 129 (25%) had >or= 1 major complication. Median hospital charges increased from $33,833 (none) to $81,936 (minor) and $150,885 (major). The mean contribution to margin per day was similar for the no complication and minor complication groups ($994 vs $1,115, P = .7). Despite higher costs, the patients in the major complication group generated a higher mean contribution to margin per day compared to the no complication group ($2,168, P costs when adjusted for confounding variables was $19,915 for the minor complication group (P costs associated with traumatic injury provides a window for assessing the potential cost reductions associated with improved quality care. To optimize system benefits, payers and providers should develop integrated

  14. Complications and their risk factors following hip fracture surgery.

    Science.gov (United States)

    Poh, Keng Soon; Lingaraj, K

    2013-08-01

    PURPOSE. To evaluate various postoperative complications and their risk factors in hip fracture patients. METHODS. 207 female and 87 male consecutive patients (mean age, 78.1 years) who underwent surgical (n=242) or conservative (n=52) treatment for closed fractures of the femoral neck (n=157) or peritrochanter (n=137) were prospectively studied. The types of complication and outcome were recorded. The comorbidity status of the patients was categorised based on the American Society of Anesthesiologists (ASA) classification. Complications and their associations with various risk factors and mortality were analysed. RESULTS. For all patients, the mean length of hospitalisation was 14.6 days. For the 242 patients who underwent surgical treatment after a mean of 3.6 days, 56.8% of them had at least one complication. Acute urinary retention (39.3%) and urinary tract infection (24.0%) were most common. Patients with ASA grade III or higher had 2.3 fold higher risk of developing complications than those with lower-grade comorbidity, whereas patients with delayed operation (>48 hours after presentation) had 1.8 fold higher risk of developing complications than those without delayed operation. Four patients died in hospital: 2 from myocardial infarction and 2 from upper gastrointestinal bleeding. CONCLUSION. Complications after hip fracture surgery were common. Advanced age, high ASA status, and delay in surgery were associated with higher complication rates. Operations should be performed on medically fit patients as early as possible.

  15. Clinical experience of infective endocarditis complicated by acute cerebrovascular accidents

    Directory of Open Access Journals (Sweden)

    Chan-Yang Hsu

    2017-03-01

    Conclusion: Early surgical intervention for IE with ischemic stroke may prevent adverse events, particularly in patients with impaired renal function, diabetes, or staphylococcal infection. A delay in operation of > 30 days is recommended after hemorrhagic stroke.

  16. [Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied].

    Science.gov (United States)

    Tamarelle, B; Perrin, P; Devonec, M; Paparel, P; Ruffion, A

    To identify hospitalizations directly related to a complication occurring within 30 days following a transrectal prostate biopsy (PBP). Overall hospitalization rates, mortality rates, potential predisposing factors for complications. Single-center study including all patients who underwent PBP between January 2005 and January 2012. Any hospitalization occurring within 30 days of the PBP for urgent motive was considered potentially attributable to biopsy. We identified the reason for hospitalization with direct complications (urinary infection or fever, rectal bleeding, bladder caillotage, retention) and indirect (underlying comorbidities decompensation) of the biopsy. The contributing factors were anticoagulant or antiplatelet treatment well as waning immunity factors (corticosteroid therapy, HIV, chemotherapy or immunodulateur). Among 2715 men who underwent PBP, there were 120 (4.4%) hospitalizations including 28 (1.03%) caused by the biopsy. Twenty-five (0.92%) were related to a direct complication of biopsy: 14 (56%) for urinary tract infection or fever including 1 hospitalization in intensive care, 5 (20%) for rectal bleeding which required several transfusions 1, 10 (40%) urinary retention and 3 (0.11%) for an indirect complication (2 coronary syndromes and 1 respiratory failure). Several direct complications were associated in 3 cases. Only two hospitalizations associated with rectal bleeding were taking an antiplatelet or anticoagulant. There was no association between hospitalization for urinary tract infections and a decreased immune status. The first death observed in our study occurred at D31 of pulmonary embolism (advanced metastatic patient with bladder cancer). Twenty (60.6%) patients urgently hospitalized did not have prostate cancer. Within this large sample of patients the overall rate of hospitalization due to the realization of a PBP was 1%. It has not been found predictive of complications leading to hospitalization. 4. Copyright © 2016

  17. Mixed pyolaryngocele: Uncommon presentation of deep spaces neck infection

    Directory of Open Access Journals (Sweden)

    Rachid Mahdoufi

    2016-09-01

    Discussion and conclusion: A pyolaryngocele is an unusual complication of laryngocoele that becomes secondarily infected causing serious symptoms. Excision of the laryngocoele, still the best treatment option to prevent this complication and recurrence.

  18. Dental and oral complications of lip and tongue piercings.

    Science.gov (United States)

    De Moor, R J G; De Witte, A M J C; Delmé, K I M; De Bruyne, M A A; Hommez, G M G; Goyvaerts, D

    2005-10-22

    Piercing of the tongue and perioral regions is an increasingly popular expression of body art, with more patients coming in for a routine check-up with tongue and/or lip piercings. Several complications of oral piercing have been reported, some of which are life-threatening. In the present clinical survey the prevalence of both tongue and lip piercing complications in oral health was assessed in a group of 50 patients. The most common dental problem registered was chipping of the teeth, especially in association with tongue piercing. Gingival recession was seen as a result of lip piercing with studs. Post-procedural complications included oedema, haemorrhage and infection. Therefore, dentists and oral and maxillofacial surgeons should be given more authority to advise patients with oral and facial piercings or those who plan to acquire this type of body art.

  19. Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy.

    Science.gov (United States)

    Takagi, Kosei; Yoshida, Ryuichi; Yagi, Takahito; Umeda, Yuzo; Nobuoka, Daisuke; Kuise, Takashi; Fujiwara, Toshiyoshi

    2017-05-26

    Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD). We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes, especially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic factors (including sarcopenia) on postoperative infections. The mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and 47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a higher incidence of in-hospital mortality (P = 0.004) and infectious complications (P sarcopenia (odds ratio = 3.43; P Sarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical assessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and determining perioperative management strategies.

  20. Relationship between Neutrophil-to-Lymphocyte Ratio and Prognosis in Patients with Deep Neck Space Infection

    Directory of Open Access Journals (Sweden)

    Engin Şengül

    2016-03-01

    Full Text Available Objective: The aim of this study was to demonstrate if there is any relation between the neutrophil-to-lym­phocyte ratio and prognosis in patients with deep neck space infections Methods: One hundred eight patients who were interned and treated due to deep neck infection in department of otolaryngology between January 2010 and January 2015 were analyzed. Demographics, clini­cal data, complications and treatment results of patients were evaluated. Pediatric patients between the age of 0 and 14, the patients who had only peritonsillary abscess, infection secondary to trauma were excluded from study. During follow-up and treatment duration the patients with deep neck infections were divided into two groups ac­cording to whether they had any complication (group 1 or not (group 2. Results: Fourteen (13% patients with deep neck in­fections had life-threatening complications whereas 94 (87% did not have any complication during follow-up and treatment duration. The mean neutrophil-to-lymphocyte ratio in patients with complications was significantly high­er than the patients without any complications (p0.05. Conclusion: This study showed that the neutrophil-to-lymphocyte ratio can be used as a cheap, easily obtained and predictive prognostic factor in patients with deep neck infections.

  1. Cardiac complications in diphtheria and predictors of outcomes.

    Science.gov (United States)

    Samdani, Sunil; Jain, Avani; Meena, Vinod; Meena, C B

    2018-01-01

    To study the cardiac complications in diphtheria patients and to study the predictors of outcomes. Single centre prospective analysis of cardiac complications in diphtheria patients. In this study, there were 60 patients diagnosed with diphtheria with ECG changes. The ECG changes seen were sinus tachycardia (68.3%), T wave inversion (20%), ST segment depression (13.3%), right bundle branch block (5%), multiple atrial ectopics (3.3%). The case fatality rate in our study was 25% (15 patients). High CPK-MB, myoglobulin and cardiac troponin levels were associated with cardiac mortality. In our study, cardiac troponin T had the highest sensitivity (80%) and CK-MB had the highest specificity (95.56%). Cardiac involvement is a common complication of infection with C. diphtheria and is associated with high mortality. As diphtheria can be prevented by adequate vaccination, efforts should be maximized for high vaccine coverage with booster doses. Copyright © 2017. Published by Elsevier B.V.

  2. Prevalence of urinary tract infection among pregnant women at ...

    African Journals Online (AJOL)

    Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women ...

  3. Neurological complications following liver transplant: a pictorial review of radiological and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Kyung; Shin, Ji Hoon; Kim, Sang Joon; Lee, Deok Hee; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2005-07-15

    Neurological complications are a rare but important and significant source of information about morbidity and mortality in liver transplant patients. Based on the clinical and radiological findings of 21 patients, neurological complications were categorized into five main groups; focal hemorrhagic or occlusive complications (n=11); diffuse hypoxic-ischemic injury (n=3); hypertensive encephalopathy (n=1); central pontine or extra-pontine myelinolysis (n=4); and infection (n=2). Neurological manifestations varied according to the location of the lesion, although seizures were the most common manifestation. In this pictorial review, we illustrate the radiological findings, focusing on MR and CT images, of a spectrum of neurological complications following liver transplants, as well as their clinical correlations.

  4. Neurological complications following liver transplant: a pictorial review of radiological and clinical findings

    International Nuclear Information System (INIS)

    Lee, Young Kyung; Shin, Ji Hoon; Kim, Sang Joon; Lee, Deok Hee; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul

    2005-01-01

    Neurological complications are a rare but important and significant source of information about morbidity and mortality in liver transplant patients. Based on the clinical and radiological findings of 21 patients, neurological complications were categorized into five main groups; focal hemorrhagic or occlusive complications (n=11); diffuse hypoxic-ischemic injury (n=3); hypertensive encephalopathy (n=1); central pontine or extra-pontine myelinolysis (n=4); and infection (n=2). Neurological manifestations varied according to the location of the lesion, although seizures were the most common manifestation. In this pictorial review, we illustrate the radiological findings, focusing on MR and CT images, of a spectrum of neurological complications following liver transplants, as well as their clinical correlations

  5. Development and validation of a bedside risk score for MRSA among patients hospitalized with complicated skin and skin structure infections

    Directory of Open Access Journals (Sweden)

    Zilberberg Marya D

    2012-07-01

    Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA is a frequent cause of complicated skin and skin structure infections (cSSSI. Patients with MRSA require different empiric treatment than those with non-MRSA infections, yet no accurate tools exist to aid in stratifying the risk for a MRSA cSSSI. We sought to develop a simple bedside decision rule to tailor empiric coverage more accurately. Methods We conducted a large multicenter (N=62 hospitals retrospective cohort study in a US-based database between April 2005 and March 2009. All adult initial admissions with ICD-9-CM codes specific to cSSSI were included. Patients admitted with MRSA vs. non-MRSA were compared with regard to baseline demographic, clinical and hospital characteristics. We developed and validated a model to predict the risk of MRSA, and compared its performance via sensitivity, specificity and other classification statistics to the healthcare-associated (HCA infection risk factors. Results Of the 7,183 patients with cSSSI, 2,387 (33.2% had MRSA. Factors discriminating MRSA from non-MRSA were age, African-American race, no evidence of diabetes mellitus, cancer or renal dysfunction, and prior history of cardiac dysrhythmia. The score ranging from 0 to 8 points exhibited a consistent dose–response relationship. A MRSA score of 5 or higher was superior to the HCA classification in all characteristics, while that of 4 or higher was superior on all metrics except specificity. Conclusions MRSA is present in 1/3 of all hospitalized cSSSI. A simple bedside risk score can help discriminate the risk for MRSA vs. other pathogens with improved accuracy compared to the HCA definition.

  6. Analysis of adverse reactions and complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Luo Pengfei; Du Juan; Zuo Yuewei; Hu Xiaoping; Hong Danhua; Lin Huahuan; Li Gaowen; Liu Suyun

    2002-01-01

    Objective: To investigate the adverse reactions and complications as well as their preventive and therapeutic measures of TUAE for uterine fibroids. Methods: One hundred and eighty-two patients with uterine fibroids were treated by TUAE. Bilateral uterine arteries were embolized using lipiodol-pingyangmycin emulsion (LPE), together with Gelfoam particles. All patients were hospitalized for 3 to 10 days after TUAE and were followed up for 1 to 24 months to observe the adverse reactions and complications. Results: Adverse reactions of TUAE included postembolization syndrome ( n 182); urinary irritation ( n = 24), and hyporrhea of vagina ( n = 25 ) . Complications of TUAE included expelling of necrotic fibroids per vagina ( n = 5 ); urinary retention ( n = 10); urinary tract infection ( n = 1 ); ulcer of labia minora ( n = 1 ); ecchymosis and ulceration on buttock ( n = 1), and secondary infection of chocolate cyst of ovary. ( n = 1 ). All the above-mentioned side effects of TUAE recovered to normal after expectant or especial treatment without any sequels left. Conclusion: The adverse reactions of TUAE are reversible and the complications of TUAE are preventable and curable

  7. Periprosthetic Joint Infections: Clinical and Bench Research

    Directory of Open Access Journals (Sweden)

    Laurence Legout

    2013-01-01

    Full Text Available Prosthetic joint infection is a devastating complication with high morbidity and substantial cost. The incidence is low but probably underestimated. Despite a significant basic and clinical research in this field, many questions concerning the definition of prosthetic infection as well the diagnosis and the management of these infections remained unanswered. We review the current literature about the new diagnostic methods, the management and the prevention of prosthetic joint infections.

  8. Management Of Complications And Intensive Care: Guidelines Of Turkish Society Of Cerebrovascular Diseases – 2015

    Directory of Open Access Journals (Sweden)

    Ayşe Güler

    2015-12-01

    Full Text Available Clinical detoriation in ischemic stroke patients may develop because of several reasons. Deterioration may be caused by a recurrent brain infarction or cerebral hemorrhage. But increased intracranial pressure, infections especially pulmonary infections, embolic events, complications due to respiratory and feeding problems can cause worsening in clinical picture.

  9. Association of postdischarge complications with reoperation and mortality in general surgery.

    Science.gov (United States)

    Kazaure, Hadiza S; Roman, Sanziana A; Sosa, Julie A

    2012-11-01

    To describe procedure-specific types, rates, and risk factors for postdischarge (PD) complications occurring within 30 days after 21 groups of inpatient general surgery procedures. Retrospective cohort study. American College of Surgeons National Surgical Quality Improvement Program 2005 through 2010 Participant Use Data Files. A total of 551,510 adult patients who underwent one of 21 groups of general surgery procedures in the inpatient setting. Postdischarge complications, reoperation, and mortality. Of 551,510 patients (mean age, 54.6 years), 16.7% experienced a complication; 41.5% occurred PD. Of the PD complications, 75.0% occurred within 14 days PD. Proctectomy (14.5%), enteric fistula repair (12.6%), and pancreatic procedures (11.4%) had the highest PD complication rates. Breast, bariatric, and ventral hernia repair procedures had the highest proportions of complications that occurred PD (78.7%, 69.4%, and 62.0%, respectively). For all procedures, surgical site complications, infections, and thromboembolic events were the most common. Occurrence of an inpatient complication increased the likelihood of a PD complication (12.5% vs 6.2% without an inpatient complication; P surgery; those whose PD complication was preceded by an inpatient complication had the highest rates of reoperation (33.7%) and death (24.7%) (all P < .001). After adjustment, PD complications were associated with procedure type, American Society of Anesthesiologists class higher than 3, and steroid use. The PD complication rates vary by procedure, are commonly surgical site related, and are associated with mortality. Fastidious, procedure-specific patient triage at discharge as well as expedited patient follow-up could improve PD outcomes.

  10. In vitro activity of tigecycline against isolates collected from complicated skin and skin structure infections and intra-abdominal infections in Africa and Middle East countries: TEST 2007-2012.

    Science.gov (United States)

    Renteria, M I; Biedenbach, D J; Bouchillon, S K; Hoban, D J; Raghubir, N; Sajben, P; Mokaddas, E

    2014-05-01

    Complicated skin and skin structure infections (cSSSIs) and intra-abdominal infections (IAIs) are problematic due to decreasing therapeutic options available against multidrug-resistant pathogens common among these types of infections. A total of 2245 isolates from African and the Middle Eastern (AfME) countries were collected to determine in vitro activity for tigecycline and comparators during 2007-2012 as part of the Tigecycline Evaluation Surveillance Trial program. Tigecycline was launched in the AfME in 2007 and remains active against a wide range of targeted pathogens worldwide. Isolates were recovered from cSSSI (1990) and IAI (255) from 38 sites in 11 AfME countries. Staphylococcus aureus was the most common species from cSSSI (27.9%), and the methicillin-resistant S. aureus rate was 25%. Enterococcus spp. (7.1%) and Streptococcus agalactiae (2.9%) were other common Gram-positive pathogens represented. Enterobacter spp. (14.5%), Pseudomonas aeruginosa (13.9%), Escherichia coli (11.4%), Klebsiella spp. (10.9%), and Acinetobacter spp. (7.2 %) were the most common Gram-negative species collected. Tigecycline MIC(90) values were 0.25 μg/mL against S. aureus. E. coli and Enterobacter spp. had tigecycline MIC(90) values of 1 and 2 μg/mL, respectively. E. coli was the most frequently collected species from IAI (28.3%), followed by Klebsiella spp. (20.8%), Enterococcus spp. (11.8%), and Stenotrophomonas maltophilia (6.3%). Isolates collected from IAI had the following tigecycline MIC(90) values: E. coli (1 μg/mL), Klebsiella spp. and other Enterobacteriaceae (2 μg/mL), Enterococcus spp. (0.25 μg/mL), and S. maltophilia (1 μg/mL). Tigecycline in vitro activity was observed against a broad spectrum of bacterial species, including strains resistant to other antimicrobial classes. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Hospital preference of laparoscopic versus open appendectomy: Effects on outcomes in simple and complicated appendicitis.

    Science.gov (United States)

    Tashiro, Jun; Einstein, Stephanie A; Perez, Eduardo A; Bronson, Steven N; Lasko, David S; Sola, Juan E

    2016-05-01

    We hypothesize that laparoscopic (LA) or open appendectomy (OA) outcomes are associated with hospital procedure preference. We queried Kids' Inpatient Database (1997-2009) for simple (ICD-9-CM 540.9) and complicated (540.0, 540.1) appendicitis. On PS-matched analysis of simple appendicitis (91,118 LA vs. 97,496 OA), LA had increased transfusion (1.7) rates, but lower wound infection (0.6) and perforation/laceration (0.3) rates. LA had shorter length of stay (LOS; 1.7 vs. 2.1days), but higher total charges (TC; 19,501 vs. 13,089 USD) and cost (7121 vs. 5968) vs. OA. For complicated appendicitis (28,793 LA vs. 30,782 OA), LA had increased nausea/vomiting rates (1.9), but lower wound infection (0.5) and transfusion (0.6) rates. LA had shorter LOS (5.1 vs. 5.9), but higher TC (32,251 vs. 28,209). MVA demonstrated shorter LOS (0.9) for LA at laparoscopic-preferring hospitals vs. open-preferring hospitals for simple appendicitis. For complicated appendicitis, higher complication rates (1.1) were associated with OA at laparoscopic-preferring hospitals. Laparoscopic-preferring hospitals had higher TC in all categories. Complications and resource utilization for appendicitis are associated with surgical technique and hospital procedure preference. Laparoscopic-preferring hospitals had higher complication rates with OA for complicated appendicitis and higher charges regardless of appendectomy technique or appendicitis type. 2c, Outcomes Research. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Managing infection in the revision total hip replacement patient.

    Science.gov (United States)

    Halley, D K

    1993-01-01

    Deep infection is one of the most devastating complications in total hip replacement. This dreaded complication is presented in considerable detail with special emphasis on prevention, diagnosis, and various methods of surgical and antibiotic treatment. Basic fundamentals of antibiotic therapy are reviewed. In addition, guidelines are given for the indications of surgical intervention, the type and staging of operative procedures, with detailed techniques of the various operative procedures used to treat the infected total hip implant patient.

  13. Surgical Measures to Reduce Infection in Open Colorectal Surgery ...

    African Journals Online (AJOL)

    Post-operative infection is an important complication of colorectal surgery and continued efforts are needed to minimize the risk of infection. A better understanding about susceptibility to infections will explain why a patient with minimal bacterial contamination at surgery may develop a pelvic abscess whereas another ...

  14. Infectious Complications during Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Children with High-Risk or Recurrent Solid Tumors.

    Directory of Open Access Journals (Sweden)

    Young Bae Choi

    Full Text Available We retrospectively analyzed infectious complications during tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT in children and adolescents with high-risk or recurrent solid tumors. A total of 324 patients underwent their first HDCT/auto-SCT between October 2004 and September 2014, and 283 of them proceeded to their second HDCT/auto-SCT (a total of 607 HDCT/auto-SCTs. During the early transplant period of 607 HDCT/auto-SCTs (from the beginning of HDCT to day 30 post-transplant, bacteremia, urinary tract infection (UTI, respiratory virus infection, and varicella zoster virus (VZV reactivation occurred in 7.1%, 2.3%, 13.0%, and 2.5% of HDCT/auto-SCTs, respectively. The early transplant period of the second HDCT/auto-SCT had infectious complications similar to the first HDCT/auto-SCT. During the late transplant period of HDCT/auto-SCT (from day 31 to 1 year post-transplant, bacteremia, UTI, and VZV reactivation occurred in 7.5%, 2.5%, and 3.9% of patients, respectively. Most infectious complications in the late transplant period occurred during the first 6 months post-transplant. There were no invasive fungal infections during the study period. Six patients died from infectious complications (4 from bacterial sepsis and 2 from respiratory virus infection. Our study suggests that infectious complications are similar following second and first HDCT/auto-SCT in children.

  15. Placental histopathology after Coxiella burnetii infection during pregnancy

    NARCIS (Netherlands)

    Munster, J. M.; Leenders, A. C. A. P.; Hamilton, C. J. C. M.; Hak, E.; Aarnoudse, J. G.; Timmer, A.

    Symptomatic and asymptomatic Coxiella burnetii infection during pregnancy have been associated with obstetric complications. We described placental histopathology and clinical outcome of five cases with asymptomatic C burnetii infection during pregnancy and compared these cases with four symptomatic

  16. Urgent surgery for complicated colonic diverticula.

    Science.gov (United States)

    Funariu, Gheorghe; Binţinţan, Vasile; Seicean, Radu

    2006-03-01

    The AIM of this retrospective study was to evaluate the emergency surgical treatment of life-threatening complications of colonic diverticula. In the last 11 years, 22 of 101 patients with colonic diverticula (22.1%) underwent urgent surgery for acute complications: perforated gangrenous diverticulitis with generalized peritonitis (n=8) or pericolic abscess (n=8), acute bowel obstruction (n=4) and severe diverticular bleeding (n=2). In all patients with diffuse peritonitis or acute obstruction the indication for surgery was decided on clinical basis and the complicated diverticula were recognized only intra-operatively. Emergency surgical strategy differed according to the type of complication and the biologic condition of the patient: segmental colectomy and primary anastomosis for diverticular perforation (n=4), colonic stenosis (n=3) or diverticular bleeding (n=2); Hartmann resection with late reconnecting anastomosis in patients with diverticular perforation (n=5) or colonic obstruction (n=1); diverticulectomy with peritoneal drainage (n=2) and colostomy and drainage followed by secondary colectomy (n=5) for diverticular perforations in patients with poor general condition. Only one patient (4.5%) died post-operatively of multiple organ failure from generalized peritonitis. There was no anastomotic leakage in patients with primary anastomosis. Six patients (27.2%) developed wound infection. Hospital stay ranged between 11 and 60 days, significantly longer in cases with two-stage operations. Primary colectomy with immediate or delayed anastomosis is the best surgical procedure for acute divericular complications in patients with good biologic status. Two-stage operations such as colostomy and drainage coupled with late colectomy remain the viable alternative in patients with advanced disease and critical biologic condition.

  17. Alefacept and Allogeneic Hematopoietic Stem Cell Transplantation

    Science.gov (United States)

    2017-07-24

    Thalassemia; Sickle Cell Disease; Glanzmann Thrombasthenia; Wiskott-Aldrich Syndrome; Chronic-granulomatous Disease; Severe Congenital Neutropenia; Leukocyte Adhesion Deficiency; Schwachman-Diamond Syndrome; Diamond-Blackfan Anemia; Fanconi Anemia; Dyskeratosis-congenita; Chediak-Higashi Syndrome; Severe Aplastic Anemia

  18. Surgical Management of Infective Endocarditis Complicated by Embolic Stroke: Practical Recommendations for Clinicians.

    Science.gov (United States)

    Yanagawa, Bobby; Pettersson, Gosta B; Habib, Gilbert; Ruel, Marc; Saposnik, Gustavo; Latter, David A; Verma, Subodh

    2016-10-25

    There has been an overall improvement in surgical mortality for patients with infective endocarditis (IE), presumably because of improved diagnosis and management, centered around a more aggressive early surgical approach. Surgery is currently performed in approximately half of all cases of IE. Improved survival in surgery-treated patients is correlated with a reduction in heart failure and the prevention of embolic sequelae. It is reported that between 20% and 40% of patients with IE present with stroke or other neurological conditions. It is for these IE patients that the timing of surgical intervention remains a point of considerable discussion and debate. Despite evidence of improved survival in IE patients with earlier surgical treatment, a significant proportion of patients with IE and preexisting neurological complications either undergo delayed surgery or do not have surgery at all, even when surgery is indicated and guideline endorsed. Physicians and surgeons are caught in a common conundrum where the urgency of the heart operation must be balanced against the real or perceived risks of neurological exacerbation. Recent data suggest that the risk of neurological exacerbation may be lower than previously believed. Current guidelines reflect a shift toward early surgery for such patients, but there continue to be important areas of clinical equipoise. Individualized clinical assessment is of major importance for decision making, and, as such, we emphasize the need for the functioning of an endocarditis team, including cardiac surgeons, cardiologists, infectious diseases specialists, neurologists, neurosurgeons, and interventional neuroradiologists. Here, we present 2 illustrative cases, critically review contemporary data, and offer conceptual and practical suggestions for clinicians to address this important, common, and often fatal cardiac condition. © 2016 American Heart Association, Inc.

  19. Asymptomatic bacteriuria and symptomatic urinary tract infections during pregnancy.

    Science.gov (United States)

    Macejko, Amanda M; Schaeffer, Anthony J

    2007-02-01

    Urinary tract infections are common complications of pregnancy; upper tract infections in particular may lead to significant morbidity for both the mother and fetus. Bacteriuria is a significant risk factor for developing pyelonephritis in pregnant women. Therefore, proper screening and treatment of bacteriuria during pregnancy is necessary to prevent complications. All women should be screened for bacteriuria in the first trimester, and women with a history of recurrent urinary tract infections or anomalies should have repeat bacteriuria screening throughout pregnancy. Treatment of bacteriuria should include 3-day therapy with appropriate antimicrobials, and women should be followed closely after treatment because recurrence may occur in up to one third of patients.

  20. Splenic Abscess: A Rare Complication of the UVC in Newborn

    Directory of Open Access Journals (Sweden)

    Ameer Aslam

    2014-01-01

    Full Text Available Splenic abscess is one of the rarest complications of the UVC in a newborn and it is hypothesized that it could be due to an infection or trauma caused by a catheter. The case that is being reported presented with abdominal distension and recurrent desaturation with suspicion of neonatal sepsis versus necrotizing enterocolitis. However, the final diagnosis was splenic abscess as a complication of an inappropriate UVC insertion which was discovered by abdominal ultrasound. The patient was given broad spectrum antibiotics empirically and the symptoms were resolved without any surgical intervention. Such cases and controlled studies need to be reported in order to identify further causes and risk factors associated with splenic abscess in a patient with UVC which can eventually help us adopt preventive strategies to avoid such complications.

  1. Thoracostomy tubes: A comprehensive review of complications and related topics

    Science.gov (United States)

    Kwiatt, Michael; Tarbox, Abigail; Seamon, Mark J.; Swaroop, Mamta; Cipolla, James; Allen, Charles; Hallenbeck, Stacinoel; Davido, H. Tracy; Lindsey, David E.; Doraiswamy, Vijay A.; Galwankar, Sagar; Tulman, David; Latchana, Nicholas; Papadimos, Thomas J.; Cook, Charles H.; Stawicki, Stanislaw P.

    2014-01-01

    Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes. PMID:25024942

  2. A novel treatment approach to infected nonunion of long bones without systemic antibiotics.

    Science.gov (United States)

    Masrouha, Karim Z; Raad, Michael E; Saghieh, Said S

    2018-04-01

    Infected nonunion of long bones may require intravenous antibiotics over a lengthy period which may result in a high rate of complications. This study aims to assess the efficacy of local antibiotics used as a replacement to prolonged intravenous therapy. Thirteen patients with infected nonunion of long bones who failed at least one previous surgery were included. The infection was treated through extensive debridement, application of antibiotic-impregnated calcium sulphate pellets and the bone stabilized with external fixation. These patients were monitored for union and infection by clinical signs, laboratory values, and radiographs over a period of 24 months. The results support an eradication of infection and union in all patients with no antibiotic-associated complications. Local antibiotic delivery using calcium sulphate pellets provides an effective method for treatment of nonunion in long bones and is free of the complications from the intravenous route.

  3. Long-term risk of complications after mid-urethral sling IVS implantation

    Directory of Open Access Journals (Sweden)

    Grzegorz Surkont

    2015-02-01

    Full Text Available [b]Introduction[/b]. Results of short-term evaluation of multifilament microporous midurethral tape IVS differ a great deal. During the first year of implantation, erosions have been observed in 0%–26% of operated women. Long-term observations are rare. They suggest high risk of extrusion and infection even after years of implantation. [b]Objective[/b]. The purpose of the study was to evaluate long-term risk of complications after IVS implantation. Material and methods. Between 2001–2005, 72 women were operated on with the use of IVS mid-urethral tape. [b]Results[/b]. Two women had vaginal erosions during the first 3 months after the operation. Twelve women had vaginal erosions, purulent vaginal discharge, with IVS tape sticking out of the abdominal wall or vagina, and abdominal abscess. These complications were diagnosed between 9 months and 6 years after IVS implantation. The patients were operated on vaginally and open abdominally, 1–5 times because of complications after IVS implantation. [b]Conclusions[/b]. In the case of post-IVS complication, as much tape as possible should be excised. Long-term follow up on patients with IVS implantation should be recommended to the centres where IVS tape was used, even to patients after removal of the tape. Risk of erosion, extrusion and infection after midurethral multifilament microporous IVS tape implantation is too high – which is the reason it should no longer be used.

  4. Enterovirus 71 can directly infect the brainstem via cranial nerves and infection can be ameliorated by passive immunization.

    Science.gov (United States)

    Tan, Soon Hao; Ong, Kien Chai; Wong, Kum Thong

    2014-11-01

    Enterovirus 71 (EV71)-associated hand, foot, and mouth disease may be complicated by encephalomyelitis. We investigated EV71 brainstem infection and whether this infection could be ameliorated by passive immunization in a mouse model. Enterovirus 71 was injected into unilateral jaw/facial muscles of 2-week-old mice, and hyperimmune sera were given before or after infection. Harvested tissues were studied by light microscopy, immunohistochemistry, in situ hybridization, and viral titration. In unimmunized mice, viral antigen and RNA were detected within 24 hours after infection only in ipsilateral cranial nerves, motor trigeminal nucleus, reticular formation, and facial nucleus; viral titers were significantly higher in the brainstem than in the spinal cord samples. Mice given preinfection hyperimmune serum showed a marked reduction of ipsilateral viral antigen/RNA and viral titers in the brainstem in a dose-dependent manner. With optimum hyperimmune serum given after infection, brainstem infection was significantly reduced in a time-dependent manner. A delay in disease onset and a reduction of disease severity and mortality were also observed. Thus, EV71 can directly infect the brainstem, including the medulla, via cranial nerves, most likely by retrograde axonal transport. This may explain the sudden cardiorespiratory collapse in human patients with fatal encephalomyelitis. Moreover, our results suggest that passive immunization may still benefit EV71-infected patients who have neurologic complications.

  5. Postirradiation flap infection about the oral cavity

    International Nuclear Information System (INIS)

    Cabbabe, E.B.; Herbold, D.R.; Sunwoo, Y.C.; Baroudi, I.F.

    1983-01-01

    Postirradiation alteration of oral flora is well documented in the literature. Infection as a complication leading to partial or complete loss of a flap used to reconstruct a defect in the oral cavity is a worrisome outcome. We describe how a flap that was judged clinically to be viable became overwhelmingly infected with the Klebsiella oxytoca, an oral cavity pathogen encountered in this patient following irradiation. Local and systemic changes led to detachment of the flap. This complication may be explained, in view of the absence of venous congestion or arterial ischemia both clinically and pathologically, by the proven contamination of the flap by the Klebsiella pathogen. Local factors resulted in lower resistance and subsequent overwhelming infection. Discussion of the case, review of pertinent literature, and proposed solutions are presented

  6. Impact of surgical complications on length of stay after hip fracture surgery

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Palm, Henrik; Krasheninnikoff, Michael

    2006-01-01

    BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact...... of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall......, infection or suboptimal surgery, stratified into either requiring reoperation or not allowing mobilisation because of instability. RESULTS: Of the 600, 116 (19.3, 95% CI 16-22%) patients underwent reoperation or immobilisation; 27.1% of bed-day consumption resulted from surgical complications. The audit...

  7. Antibiotics to prevent complications following tooth extractions.

    Science.gov (United States)

    Lodi, Giovanni; Figini, Lara; Sardella, Andrea; Carrassi, Antonio; Del Fabbro, Massimo; Furness, Susan

    2012-11-14

    The most frequent indications for tooth extractions are dental caries and periodontal infections, and these extractions are generally done by general dental practitioners. Antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. To determine the effect of antibiotic prophylaxis on the development of infectious complications following tooth extractions. The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 25 January 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1948 to 25 January 2012), EMBASE via OVID (1980 to 25 January 2012) and LILACS via BIREME (1982 to 25 January 2012). There were no restrictions regarding language or date of publication. We included randomised double-blind placebo-controlled trials of antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication. Two review authors independently assessed risk of bias for the included studies and extracted data. We contacted trial authors for further details where these were unclear. For dichotomous outcomes we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. The quality of the body of evidence has been assessed using the GRADE tool. This review included 18 double-blind placebo-controlled trials with a total of 2456 participants. Five trials were assessed at unclear risk of bias, thirteen at high risk, and none at low risk of bias. Compared to placebo, antibiotics probably reduce the risk of infection in patients undergoing third molar extraction(s) by approximately 70% (RR 0.29 (95% CI 0.16 to 0.50) P antibiotics to prevent one infection following extraction of impacted wisdom teeth. There is evidence that antibiotics may reduce

  8. Late complications of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Masaki, Norie [Osaka Prefectural Center for Adult Diseases (Japan)

    1998-03-01

    There are cases in which, although all traces of acute radiation complications seem to have disappeared, late complications may appear months or years to become apparent. Trauma, infection or chemotherapy may sometimes recall radiation damage and irreversible change. There were two cases of breast cancer that received an estimated skin dose in the 6000 cGy range followed by extirpation of the residual tumor. The one (12 y.o.) developed atrophy of the breast and severe teleangiectasis 18 years later radiotherapy. The other one (42 y.o.) developed severe skin necrosis twenty years later radiotherapy after administration of chemotherapy and received skin graft. A case (52 y.o.) of adenoidcystic carcinoma of the trachea received radiation therapy. The field included the thoracic spinal cord which received 6800 cGy. Two years and 8 months after radiation therapy she developed complete paraplegia and died 5 years later. A truly successful therapeutic outcome requires that the patient be alive, cured and free of significant treatment-related morbidity. As such, it is important to assess quality of life in long-term survivors of cancer treatment. (author)

  9. Oral complications of radiation therapy

    International Nuclear Information System (INIS)

    Lockhart, P.B.

    1986-01-01

    Approximately 24,000 patients are diagnosed each year with malignant tumors of the head and neck. Many of these patients will be treated with radiotherapy, surgery, or chemotherapy, either singly or in combination. Certain predictable sequelae of radiotherapy exist that may be considered consequences of treatment rather than complications; these may be unavoidable consequences of curative radiotherapy to the head and neck. There are, however, additional problems that occur as a result of radiotherapy that are preventable in both incidence and severity, and are therefore avoidable complications. Cell kinetic factors, radiosensitivity of normal tissues, radiotherapeutic doses necessary for tumor control, and the complex anatomy of the maxillofacial region often predispose patients serious treatment morbidity. The potential for pain, infection, and long-term functional disability with decreased quality of life dictate conscientious management before, during, and after radiotherapy. This chapter discusses common problems that can arise, as well as current methods utilized both to improve patient tolerance to treatment and to decrease the risk of preventable and potentially dose-limiting morbidity

  10. Late complications of radiation therapy

    International Nuclear Information System (INIS)

    Masaki, Norie

    1998-01-01

    There are cases in which, although all traces of acute radiation complications seem to have disappeared, late complications may appear months or years to become apparent. Trauma, infection or chemotherapy may sometimes recall radiation damage and irreversible change. There were two cases of breast cancer that received an estimated skin dose in the 6000 cGy range followed by extirpation of the residual tumor. The one (12 y.o.) developed atrophy of the breast and severe teleangiectasis 18 years later radiotherapy. The other one (42 y.o.) developed severe skin necrosis twenty years later radiotherapy after administration of chemotherapy and received skin graft. A case (52 y.o.) of adenoidcystic carcinoma of the trachea received radiation therapy. The field included the thoracic spinal cord which received 6800 cGy. Two years and 8 months after radiation therapy she developed complete paraplegia and died 5 years later. A truly successful therapeutic outcome requires that the patient be alive, cured and free of significant treatment-related morbidity. As such, it is important to assess quality of life in long-term survivors of cancer treatment. (author)

  11. Neurological manifestations of Chikungunya and Zika infections

    Directory of Open Access Journals (Sweden)

    Talys J. Pinheiro

    Full Text Available ABSTRACT The epidemics of Chikungunya virus (CHIKV and Zika virus (ZIKV infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others. The diagnosis is based on clinical, epidemiological, and laboratory criteria. The most common symptoms of ZIKV infection are skin rash (mostly maculopapular, fever, arthralgia, myalgia, headache, and conjunctivitis. Some epidemics that have recently occurred in French Polynesia and Brazil, reported the most severe conditions, with involvement of the nervous system (Guillain-Barré syndrome, transverse myelitis, microcephaly and meningitis. The treatment for ZIKV and CHIKV infections are symptomatic and the management for neurological complications depends on the type of affliction. Intravenous immunoglobulin, plasmapheresis, and corticosteroid pulse therapy are options.

  12. Complications of Minimally Invasive, Tubular Access Surgery for Cervical, Thoracic, and Lumbar Surgery

    Directory of Open Access Journals (Sweden)

    Donald A. Ross

    2014-01-01

    Full Text Available The object of the study was to review the author’s large series of minimally invasive spine surgeries for complication rates. The author reviewed a personal operative database for minimally access spine surgeries done through nonexpandable tubular retractors for extradural, nonfusion procedures. Consecutive cases (n=1231 were reviewed for complications. There were no wound infections. Durotomy occurred in 33 cases (2.7% overall or 3.4% of lumbar cases. There were no external or symptomatic internal cerebrospinal fluid leaks or pseudomeningoceles requiring additional treatment. The only motor injuries were 3 C5 root palsies, 2 of which resolved. Minimally invasive spine surgery performed through tubular retractors can result in a low wound infection rate when compared to open surgery. Durotomy is no more common than open procedures and does not often result in the need for secondary procedures. New neurologic deficits are uncommon, with most observed at the C5 root. Minimally invasive spine surgery, even without benefits such as less pain or shorter hospital stays, can result in considerably lower complication rates than open surgery.

  13. Clinical Presentation of Soft-tissue Infections and its Management: A Study of 100 Cases.

    Science.gov (United States)

    Singh, Baldev; Singh, Sukha; Khichy, Sudhir; Ghatge, Avinash

    2017-01-01

    Soft-tissue infections vary widely in their nature and severity. A clear approach to the management must allow their rapid identification and treatment as they can be life-threatening. Clinical presentation of soft-tissue infections and its management. A prospective study based on 100 patients presenting with soft-tissue infections was done. All the cases of soft-tissue infections were considered irrespective of age, sex, etiological factors, or systemic disorders. The findings were evaluated regarding the pattern of soft-tissue infections in relation to age and sex, clinical presentation, complications, duration of hospital stay, management, and mortality. The most commonly involved age group was in the range of 41-60 years with male predominance. Abscess formation (45%) was the most common clinical presentation. Type 2 diabetes mellitus was the most common associated comorbid condition. Staphylococcus aureus was the most common culture isolate obtained. The most common complication seen was renal failure. Patients with surgical site infections had maximum duration of stay in the hospital. About 94% of the cases of soft-tissue infections were managed surgically. Mortality was mostly encountered in the cases of complications of cellulitis. Skin and soft-tissue infections are among the most common infections encountered by the emergency physicians. Ignorance, reluctance to treatment, economic constraints, and illiteracy delay the early detection and the initiation of proper treatment. Adequate and timely surgical intervention in most of the cases is of utmost importance to prevent the complications and reduce the mortality.

  14. Splenectomy is associated with higher infection and pneumonia rates among trauma laparotomy patients.

    Science.gov (United States)

    Fair, Kelly A; Connelly, Christopher R; Hart, Kyle D; Schreiber, Martin A; Watters, Jennifer M

    2017-05-01

    Splenectomy increases lifetime risk of thromboembolism (VTE) and is associated with long-term infectious complications, primarily, overwhelming post-splenectomy infection (OPSI). Our objective was to evaluate risk of VTE and infection at index hospitalization post-splenectomy. Retrospective review of all patients who received a laparotomy in the NTDB. Propensity score matching for splenectomy was performed, based on ISS, abdominal abbreviated injury score >3, GCS, sex and mechanism. Major complications, VTE, and infection rates were compared. Multiple logistic regression models were utilized to evaluate splenectomy-associated complications. 93,221 laparotomies were performed and 17% underwent splenectomy. Multiple logistic regression models did not demonstrate an association between splenectomy and major complications (OR 0.96, 95% CI 0.91-1.03, p = 0.25) or VTE (OR 1.05, 95% CI 0.96-1.14, p = 0.33). Splenectomy was independently associated with infection (OR 1.07, 95% CI 1.00-1.14, p = 0.045). Subgroup analysis of patients with infection demonstrated that splenectomy was most strongly associated with pneumonia (OR 1.41, 95% CI 1.26-1.57, p Splenectomy is not associated with higher overall complication or VTE rates during index hospitalization. However, splenectomy is associated with a higher rate of pneumonia. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  16. LEUKOCYTE AND BACTERIA IMAGING IN PROSTHETIC JOINT INFECTION

    NARCIS (Netherlands)

    Glaudemans, Andor W. J. M.; Galli, Filippo; Pacilio, Marta; Signore, Alberto

    2013-01-01

    There has been a significant increase in the number of joint prosthesis replacements worldwide. Although relatively uncommon, complications can occur with the most serious being an infection. Various radiological and nuclear imaging techniques are available to diagnose prosthetic joint infections

  17. Complications of bone tumors after multimodal therapy

    Energy Technology Data Exchange (ETDEWEB)

    Shapeero, L.G., E-mail: lshapeero@usuhs.edu [Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Bone and Soft Tissue Program, United States Military Cancer Institute, 6900 Georgia Ave, NW, Washington, DC 20307 (United States); Poffyn, B. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); De Visschere, P.J.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Sys, G. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Uyttendaele, D. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Vanel, D. [Department of Radiology, Rizzoli Institute, 40136 Bologna (Italy); Forsyth, R. [Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Verstraete, K.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2011-01-15

    Purpose: To define and compare the complications of bone tumors after resection, extracorporeal irradiation and re-implantation, with or without radiotherapy. Materials and methods: Eighty patients (40 males and 40 females, ages 4-77 years) with 61 malignant and 19 benign bone tumors were evaluated for local and distant complications after treatment. Two groups of patients were studied: (1) 53 patients had resection without (43 patients) or with external beam radiotherapy (RadRx) (10 patients) and (2) 27 patients underwent extracorporeal irradiation and re-implantation without (22 patients) or with RadRx (5 patients). Patient follow-up varied from 1 month to 13.63 years with mean follow-up of 4.7 years. Imaging studies included bone and chest radiography, spin echo T1- and T2-weighted (or STIR) magnetic resonance imaging (MRI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), computed tomography (CT) for thoracic and abdominopelvic metastases and 3-phase technetium-99m-labeled-methylene-diphosphonate (Tc99m MDP) scintigraphy for bone metastases. Results: DCE-MRI differentiated the rapidly enhancing recurrences, residual tumors and metastases from the slowly enhancing inflammation, and the non-enhancing seromas and fibrosis. Recurrences, metastases (mainly to lung and bone), and seromas were greater than twice as frequent in patients after resection than after ECCRI. Although 11.3% of post-resection patients had residual tumor, no ECRRI-treated patient had residual tumor. In contrast, after ECRRI, infection was almost three times as frequent and aseptic loosening twice as frequent as compared with the post-resection patients. Bones treated with RadRx and/or ECRRI showed increased prevalence of fractures and osteoporosis. In addition, muscle inflammation was more common in the externally irradiated patient as compared with the patient who did not receive this therapy. However, another soft tissue complication, heterotopic ossification, was rare in the

  18. Incidence of chemotherapy-induced neutropenia in HIV-infected and ...

    African Journals Online (AJOL)

    show an increased incidence of breast cancer among HIV-infected ... on CIN in patients with breast cancer and HIV infection are scarce, ...... Crawford J. Pegfilgrastim for the prevention of chemotherapy-induced neutropenic complications, with.

  19. A Cohort Study of Preoperative Single Dose Versus Four Doses of Antibiotics for Patients With Non-Complicated Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Salah H. Al Janaby

    2017-02-01

    Full Text Available Objective: To Test the efficacy of single preoperative dose of Cefotaxime 1gm and Metronidazole 500mg in reducing the surgical site infections (SSIs after open appendectomy in patients with non-complicated appendicitis (NCA Place and Duration of Study: Al Hilla General Teaching Hospital, Babel Governorate-Iraq, from January 2013 to January 2014. Patients & Methods: 100 patients, who underwent appendectomy for NCA and fulfilled the selection criteria, were randomized into two groups. The patients in group A received a single dose of pre-operative antibiotics (Cefotaxime sodium and metronidazole, while the group B patients received three more dose of the same antibiotics postoperatively. Patients of both groups were followed-up for 30 days to assess the postoperative infective complications. Results: Group A had 48, while group B comprised of 52 patients. The groups were comparable in the baseline characteristics. Statistically, P value in rates of SSIs between both the groups was 0.9182. None of the patients developed intra-abdominal collection. Conclusion: Single dose of pre-operative antibiotics (Cefotaxime and metronidazole was sufficient in reducing the SSIs after appendectomy for NPA. Postoperative antibiotics did not add an appreciable clinical benefit in these patients. Key words: Preoperative antibiotics, Appendectomy, Surgical site infection, Non-complicated appendicitis Abbreviations: SSI: Surgical Site Infection, NCA: non-complicated appendicitis CDC Center of Disease Control.

  20. Pregnancy and Toxoplasma Infection

    Directory of Open Access Journals (Sweden)

    Cihan Cetin

    2016-12-01

    Full Text Available Toxoplasmosis is an infectious disease caused by a protozoa named Toxoplasma gondii. It is a very important disease because it is related to fetal anomalies and poor perinatal outcomes like abortus and stillbirth. It spreads via uncooked meat and contaminated food. Timely and appropriate treatment and management of this infection prenatally reduces the risk of serious neurological sequelae. Therefore it is crucial that clinician who takes care of pregnant women know this infection deeply. In this review we aimed to summarize the prenatal diagnosis, complications and treatment of toxoplasma infection. [Archives Medical Review Journal 2016; 25(4.000: 457-466

  1. INFECTIOUS COMPLICATIONS IN PATIENTS WITH LUNG CANCER

    Directory of Open Access Journals (Sweden)

    Z. V. Grigoryevskaya

    2014-07-01

    Full Text Available Lung cancer (LC annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectiouscomplications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this categoryof patients and expand the possibilities of their specific antitumor treatment.

  2. INFECTIOUS COMPLICATIONS IN PATIENTS WITH LUNG CANCER

    Directory of Open Access Journals (Sweden)

    Z. V. Grigoryevskaya

    2011-01-01

    Full Text Available Lung cancer (LC annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectiouscomplications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this categoryof patients and expand the possibilities of their specific antitumor treatment.

  3. The Host Response in Patients with Sepsis Developing Intensive Care Unit-acquired Secondary Infections.

    Science.gov (United States)

    van Vught, Lonneke A; Wiewel, Maryse A; Hoogendijk, Arie J; Frencken, Jos F; Scicluna, Brendon P; Klein Klouwenberg, Peter M C; Zwinderman, Aeilko H; Lutter, Rene; Horn, Janneke; Schultz, Marcus J; Bonten, Marc M J; Cremer, Olaf L; van der Poll, Tom

    2017-08-15

    Sepsis can be complicated by secondary infections. We explored the possibility that patients with sepsis developing a secondary infection while in the intensive care unit (ICU) display sustained inflammatory, vascular, and procoagulant responses. To compare systemic proinflammatory host responses in patients with sepsis who acquire a new infection with those who do not. Consecutive patients with sepsis with a length of ICU stay greater than 48 hours were prospectively analyzed for the development of ICU-acquired infections. Twenty host response biomarkers reflective of key pathways implicated in sepsis pathogenesis were measured during the first 4 days after ICU admission and at the day of an ICU-acquired infection or noninfectious complication. Of 1,237 admissions for sepsis (1,089 patients), 178 (14.4%) admissions were complicated by ICU-acquired infections (at Day 10 [6-13], median with interquartile range). Patients who developed a secondary infection showed higher disease severity scores and higher mortality up to 1 year than those who did not. Analyses of biomarkers in patients who later went on to develop secondary infections revealed a more dysregulated host response during the first 4 days after admission, as reflected by enhanced inflammation, stronger endothelial cell activation, a more disturbed vascular integrity, and evidence for enhanced coagulation activation. Host response reactions were similar at the time of ICU-acquired infectious or noninfectious complications. Patients with sepsis who developed an ICU-acquired infection showed a more dysregulated proinflammatory and vascular host response during the first 4 days of ICU admission than those who did not develop a secondary infection.

  4. Intravenous piperacillin/tazobactam plus fluoroquinolone prophylaxis prior to prostate ultrasound biopsy reduces serious infectious complications and is cost effective

    Directory of Open Access Journals (Sweden)

    Remynse LC

    2011-08-01

    Full Text Available Louis C Remynse III, Patrick J Sweeney, Kevin A Brewton, Jay M LonswayUrology Associates of Battle Creek, PC, Battle Creek, MI, USAAbstract: Infectious complications related to prostate ultrasound and biopsy have increased in the past decade with the emergence of increasing fluoroquinolone bacterial resistance. We investigated the addition of intravenous (iv piperacillin/tazobactam immediately prior to prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis to determine if it would decrease the incidence of serious infectious complications after prostate ultrasound and biopsy. Group 1 patients were a historic control of 197 patients who underwent prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis. Group 2 patients, 104 patients, received standard fluoroquinolone prophylaxis and the addition of a single dose of iv piperacillin/tazobactam 30 minutes prior to prostate ultrasound and biopsy. There were ten serious bacterial infectious complications in group 1 patients. No patients in group 2 developed serious bacterial infections after prostate ultrasound and biopsy. There was approximately a 5% incidence of serious bacterial infection in group 1 patients. Subgroup analysis revealed an almost 2.5 times increased risk of infection in diabetes patients undergoing prostate ultrasound and biopsy. There was a 10% risk of serious bacterial infection in diabetics compared with a 3.8% risk group 1 nondiabetes patients. The addition of a single dose of iv piperacillin/tazobactam along with standard fluoroquinolone prophylaxis substantially reduces the risk of serious bacterial infection after prostate ultrasound and biopsy (P < 0.02.Keywords: piperacillin/tazobactam, fluoroquinolone, prostate biopsy, infectious complications

  5. Wound healing complications in brain tumor patients on Bevacizumab.

    Science.gov (United States)

    Ladha, Harshad; Pawar, Tushar; Gilbert, Mark R; Mandel, Jacob; O-Brien, Barbara; Conrad, Charles; Fields, Margaret; Hanna, Teresa; Loch, Carolyn; Armstrong, Terri S

    2015-09-01

    Bevacizumab (BEV) is commonly used for treating recurrent glioblastoma (GBM), and wound healing is a well-established adverse event. Retrospective analysis of GBM patients with and without wound healing complications while on BEV treatment is reported. 287 patients identified, majority were males (60 %) with median age of 52.5 years. 14 cases identified with wound healing problems, related to either craniotomy (n = 8) or other soft tissue wounds (n = 6). Median duration of BEV treatment to complication was 62 days (range 6-559). Majority received 10 mg/kg (n = 11) and nine (64.3 %) were on corticosteroids, with median daily dose of 6 mg (range 1-16 mg) for median of 473 days before starting BEV. For dehisced craniotomy wounds, median time for starting BEV from last surgery was 29 days (range 27-345). Median time from starting BEV to developing wound complication was 47 days (range 16-173). Seven (87.5 %) had infected wounds requiring antibiotics, hospitalization. Four (50 %) required plastic surgery. BEV stopped and safely resumed in 6 (75 %) patients; median delay was 70 days (range 34-346). Soft tissue wounds included decubitus ulcer, dehisced striae, herpes simplex, trauma to hand and back, and abscess. Median time from starting BEV to wound issues was 72 days (range 6-559). Five (83.3 %) were infected, requiring antibiotics. While three (50 %) required hospitalization, none required plastic surgery. Treatment stopped in five (83.3 %) and restarted in two (median delay 48 days, range 26-69). Wound healing complications are uncommon but associated with significant morbidity. Identifying those at risk and contributing factors warrants further investigation.

  6. Liver dysfunction after chemotherapy in lymphoma patients infected with hepatitis C.

    Science.gov (United States)

    Dizdar, Omer; Tapan, Umit; Aksoy, Sercan; Harputluoglu, Hakan; Kilickap, Saadettin; Barista, Ibrahim

    2008-05-01

    Reactivation of hepatitis B virus (HBV) infection in asymptomatic hepatitis B surface antigen carriers undergoing chemotherapy or immunosuppressive therapy is a well-documented complication. However, data on the consequence of chemotherapy on the course of hepatitis C virus (HCV) infection in HCV+ patients have been controversial. Here, we review the current knowledge about the complications related to HCV in lymphoma patients receiving chemotherapy/immunosuppressive therapy. Although less frequent than HBV, these complications occur in a subset of patients with mortality rates up to 45%. Therefore, baseline screening for HBV and HCV before initiation of chemotherapy is crucial. High-risk patients having chronic active hepatitis, high baseline HCV viral load, HBV co-infection and receiving cytotoxic drugs, corticosteroids and rituximab (particularly if combined) should be closely monitored for serum transaminase, bilirubin and HCV RNA levels.

  7. Classification of Tattoo Complications in a Hospital Material of 493 Adverse Events

    DEFF Research Database (Denmark)

    Serup, Jørgen; Sepehri, Mitra; Hutton Carlsen, Katrina

    2016-01-01

    agglomeration; 53 (11%) had bacterial infections; 46 (9%) were psycho-social complications; 144 (30%) belonged to several specific diagnostic entities, including photosensitivity, pain syndrome, and lymphopathy. We found no cases of cutaneous or other malignancies. Sarcoidosis was primarily seen in black...

  8. Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)—Patient Version

    Science.gov (United States)

    Oral complications of chemotherapy and head/neck radiation are common and should be considered before, during, and after treatment. Learn about preventing and managing mouth and throat problems like dryness, taste changes, pain, and infection in this expert-reviewed summary.

  9. Evaluation of parental perception of childhood urinary tract infection ...

    African Journals Online (AJOL)

    Background: Urinary tract infection (UTI) is common in children with possible severe complications, deserving public health interventions. Aims: To evaluate parental perception of symptoms, causes, complication and treatment of childhood UTI, and proposerelevant interventions. Methods: This is an ethicallyapproved ...

  10. Clostridium difficile Infection Worsens the Prognosis of Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    María E Negrón

    2014-01-01

    Full Text Available BACKGROUND: The impact of Clostridium difficile infections among ulcerative colitis (UC patients is well characterized. However, there is little knowledge regarding the association between C difficile infections and postoperative complications among UC patients.

  11. Lung Transplantation for Cystic Fibrosis: Results, Indications, Complications, and Controversies

    Science.gov (United States)

    Lynch, Joseph P.; Sayah, David M.; Belperio, John A.; Weigt, S. Sam

    2016-01-01

    Survival in patients with cystic fibrosis (CF) has improved dramatically over the past 30 to 40 years, with mean survival now approximately 40 years. Nonetheless, progressive respiratory insufficiency remains the major cause of mortality in CF patients, and lung transplantation (LT) is eventually required. Timing of listing for LT is critical, because up to 25 to 41% of CF patients have died while awaiting LT. Globally, approximately 16.4% of lung transplants are performed in adults with CF. Survival rates for LT recipients with CF are superior to other indications, yet LT is associated with substantial morbidity and mortality (~50% at 5-year survival rates). Myriad complications of LT include allograft failure (acute or chronic), opportunistic infections, and complications of chronic immunosuppressive medications (including malignancy). Determining which patients are candidates for LT is difficult, and survival benefit remains uncertain. In this review, we discuss when LT should be considered, criteria for identifying candidates, contraindications to LT, results post-LT, and specific complications that may be associated with LT. Infectious complications that may complicate CF (particularly Burkholderia cepacia spp., opportunistic fungi, and nontuberculous mycobacteria) are discussed. PMID:25826595

  12. Leveraging electronic health records for predictive modeling of post-surgical complications.

    Science.gov (United States)

    Weller, Grant B; Lovely, Jenna; Larson, David W; Earnshaw, Berton A; Huebner, Marianne

    2017-01-01

    Hospital-specific electronic health record systems are used to inform clinical practice about best practices and quality improvements. Many surgical centers have developed deterministic clinical decision rules to discover adverse events (e.g. postoperative complications) using electronic health record data. However, these data provide opportunities to use probabilistic methods for early prediction of adverse health events, which may be more informative than deterministic algorithms. Electronic health record data from a set of 9598 colorectal surgery cases from 2010 to 2014 were used to predict the occurrence of selected complications including surgical site infection, ileus, and bleeding. Consistent with previous studies, we find a high rate of missing values for both covariates and complication information (4-90%). Several machine learning classification methods are trained on an 80% random sample of cases and tested on a remaining holdout set. Predictive performance varies by complication, although an area under the receiver operating characteristic curve as high as 0.86 on testing data was achieved for bleeding complications, and accuracy for all complications compares favorably to existing clinical decision rules. Our results confirm that electronic health records provide opportunities for improved risk prediction of surgical complications; however, consideration of data quality and consistency standards is an important step in predictive modeling with such data.

  13. Study of renal stones complications in 200 patients in Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Hamid Noshad

    2014-11-01

    Full Text Available Introduction: Urinary stones are the third most common disease of the urinary. Renal stones may lead to some preventable complications. This study was designed to investigation and prediction of these complications. Methods: In this cross-sectional study, 200 patients with kidney stones were enrolled. Kidney stone was confirmed and proven in all patients referred to Sina and Shaikh Al-Rais clinics. Their demographic characteristics like gender, age, stone number, stone type, renal failure and bio-chemistry data were evaluated. Results: Of 200 patients, 130 cases (65.0% were male and 70 cases (35.0% were female. The mean age of patients was 41.30 ± 16.06 years. Type of stone was (when evaluation was possible was mixed (11.5%. However, the type of stone was not analyzed in 112 cases (56.0%. Among complications, recurrent infection was seen (16.0%, and staghorn stones were seen in 2.5% of patients. Dialysis was positive in 3 patients (1.5%. History of surgery was positive in 3 patients (1.5%. Extracorporeal shock wave lithotripsy (ESWL history was positive in 8%. In evaluated patients, the mean level of calcium was 8.83 ± 0.27, phosphorus was 4.60 ± 0.33, parathyroid hormone (PTH was 35.20 ± 14.22, uric acid was 4.98 ± 1.57, creatinine was 1.38 ± 1.02 and blood urea nitrogen level was 16.69 ± 11.54 mg/dl. Staghorn stones are significantly associated with progression to renal failure and subsequent complications such as hemodialysis (P = 0.001, surgery (P = 0.001. Recurrent infection was more frequent in calcium-containing stones (P = 0.001 and ESWL undergoing patients (P = 0.030. Stone numbers were more than 3 in hemodialyzed (HD patients (P = 0.001. Uric acid stones were more seen in HD patients (P = 0.170. Conclusion: According to results hemodialysis and recurrent infections are seen in patients with renal stones, and they may be detected in earlier with close periodic follow-up.

  14. Prevalence of Trichomonas vaginalis Infection among Pregnant ...

    African Journals Online (AJOL)

    Trichomoniasis caused by Trichomonas vaginalis has emerged as one of the most common sexually transmitted infections. The infection may lead to an important complication in pregnancy, as it has been related with prematurity and low birth weight. The aim of this study was to determine the prevalence of T. vaginalis ...

  15. Complications of decorative tattoos: recognition and management.

    Science.gov (United States)

    Simunovic, Carolina; Shinohara, Michi M

    2014-12-01

    Tattooing is an ancient practice that enjoys continued popularity. Although a modern, professionally performed tattoo is generally safe, complications can occur. A skin biopsy of all tattoo reactions is recommended as some tattoo reactions have systemic implications. Tattoo-related infections are seen days to decades after tattooing, and range from acute pyogenic infections to cutaneous tuberculosis. In particular, non-tuberculous mycobacterial infections happen in tattoos with increasing frequency and are introduced at the time of tattooing through contaminated ink or water used to dilute inks. Despite a transition in tattoo pigments from metal salts to industrial azo dyes, hypersensitivity reactions also persist, and include eczematous, granulomatous, lichenoid, and pseudoepitheliomatous patterns (among others). Granulomatous tattoo reactions can be a clue to cutaneous or systemic sarcoidosis, particularly in the setting of interferon use. Pseudoepitheliomatous tattoo reactions have substantial overlap with squamous cell carcinoma and keratoacanthoma, making diagnosis and management difficult. Other malignancies and their benign mimics can occur in tattoos, raising questions about the safety of tattoo ink and its role in carcinogenesis.

  16. [Zika virus infection during pregnancy].

    Science.gov (United States)

    Picone, O; Vauloup-Fellous, C; D'Ortenzio, E; Huissoud, C; Carles, G; Benachi, A; Faye, A; Luton, D; Paty, M-C; Ayoubi, J-M; Yazdanpanah, Y; Mandelbrot, L; Matheron, S

    2016-05-01

    A Zika virus epidemic is currently ongoing in the Americas. This virus is linked to congenital infections with potential severe neurodevelopmental dysfunction. However, incidence of fetal infection and whether this virus is responsible of other fetal complications are still unknown. National and international public health authorities recommend caution and several prevention measures. Declaration of Zika virus infection is now mandatory in France. Given the available knowledge on Zika virus, we suggest here a review of the current recommendations for management of pregnancy in case of suspicious or infection by Zika virus in a pregnant woman. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Thrombocytopenia during pregnancy in women with HIV infection ...

    African Journals Online (AJOL)

    Background. Thrombocytopenia (TCP) complicates 5 - 8% of pregnancies. Most cases of TCP are gestational, and the condition is usually mild and occurs in the latter part of pregnancy. Apart from pregnancy-associated medical complications such as pre-eclampsia, HIV infection is a recognised cause of TCP, and a ...

  18. Diabetic foot complications among patients attending a specialist diabetes clinic in Jamaica: prevalence and associated factors.

    Science.gov (United States)

    Ferguson, T S; Tulloch-Reid, M K; Younger, N O M; Wright-Pascoe, R A; Boyne, M S; McFarlane, S R; Francis, D K; Wilks, R J

    2013-03-01

    To estimate the prevalence of diabetic foot complications among patients at a specialist diabetes clinic in Jamaica and identify factors associated with foot complications. A stratified random sample of 188 patients were interviewed and examined between 2009 and 2010. Trained nurses obtained demographic and clinical data, measured anthropometrics and performedfoot examinations including inspection for amputations, ulcers or infection and assessment of pain, vibration and pressure perception. Participants included 143 women and 45 men (mean age 56years; mean diabetes duration 16 years). The prevalence of amputations was 8.5% (95% CI 4.5, 12.5%) and was higher among men (22.2%) compared to women (4.2%, p foot infections was 4.3% and 3.7%, respectively. Overall, 12% ofpatients had at least one of these foot complications. Foot complications were more prevalent among men, patients with high blood pressure (BP > or = 130/80 mmHg) or peripheral neuropathy In multivariable logistic regression models, factors associated with foot complications were: neuropathy (OR 9.3 [95% CI 2.8, 30.3]), high BP (OR 7.9 [1.3, 49.7]) and diabetes duration (OR 1.32 [1.02, 1.72]). Approximately one of every eight patients in this specialist clinic had a major foot complication. Associated factors were neuropathy, high blood pressure and longer duration of diabetes.

  19. MRI diagnosis of the complications of polyamide hydrogel injection for augmentation mammoplasty

    International Nuclear Information System (INIS)

    Chen Xueqiang; Chen Pingyou; Zhang Yunshu; Luo Qinghua; Xu Rong

    2005-01-01

    Objective: To analyze MRI findings and its clinical significance in complications of polyamide hydrogel injection for augmentation mammoplasty. Methods: The complication findings of MR imaging in 20 cases with polyamide hydrogel injection for augmentation mammoplasty were retrospectively reviewed and analyzed. Results: In 20 patients, 26 breasts suffered from complications, including infection (n=5) with pieces of long T 1 and long T 2 signals, aseptic inflammation (n=2) with pieces of slight long T 1 and moderate T 2 signals, hard nodule (n=10) with long T 1 and long T 2 signals, and rupture (n=5) with pieces and nodes of long T 1 and long T 2 signals on MR images. Conclusion: MRI has the great diagnostic value in the detection of complications after polyamide hydrogel injection for augmentation mammoplasty, and it should be taken as the first diagnostic choice. (authors)

  20. Complicated childhood inguinal hernias in UITH, Ilorin

    Directory of Open Access Journals (Sweden)

    Kayode T Bamigbola

    2012-01-01

    Full Text Available Background: Complicated inguinal hernias pose a threat to the life of the child as well as increase the morbidity associated with management of an otherwise straightforward condition. The aim of this study was to determine the presentation, treatment and management outcome of complicated inguinal hernias in children. Materials and Methods: A retrospective study of all children 15 years and less managed for complicated inguinal hernia between 2002 and 2010. Data obtained included demographic characteristics, presentation, operative findings and outcome. Results: Complicated hernia rate was 13.9%.There were 41 children, 38 boys (92.7% and 3 girls. Ages ranged between 4 days and 15 years (Median = 90days. Most were infants (48.8%, n = 20 and neonates accounted for 19.5% (n = 8. Median duration of symptoms prior to presentation was 18 h (range = 2-96 h. Seven patients had been scheduled for elective surgery. Hernia was right sided in 68.3% (n = 28. Symptoms included vomiting (68.3%, abdominal distension (34.1% and constipation (4.9%; one patient presented with seizures. In 19 (46.3% patients hernia was reducible while 22(53.7% had emergency surgery. Associated anomalies included undescended testis (12.2%, umbilical hernia (14.6%. Intestinal resection rate was 7.3% and testicular gangrene occurred in 14.6%. Mean duration of surgery was 60.3 ± 26.7 min. Wound infection occurred in six patients (14.6%. Overall complication rate was 24.4%, 30% in infants. The mortality rate was 2.4% (n = 1. Conclusions: Morbidity associated with complicated inguinal hernia is high in neonates and infants. Delayed presentation is common in our setting. Educating the parents as well as primary care physicians on the need for early presentation is necessary.

  1. Unusual primary HIV infection with colonic ulcer complicated by hemorrhagic shock: a case report

    Directory of Open Access Journals (Sweden)

    Emonet Stephane

    2010-08-01

    Full Text Available Abstract Introduction Timely diagnosis of primary HIV infection is important to prevent further transmission of HIV. Primary HIV infection may take place without symptoms or may be associated with fever, pharyngitis or headache. Sometimes, the clinical presentation includes aseptic meningitis or cutaneous lesions. Intestinal ulceration due to opportunistic pathogens (cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii has been described in patients with AIDS. However, although invasion of intestinal lymphoid tissue is a prominent feature of human and simian lentivirus infections, colonic ulceration has not been reported in acute HIV infection. Case description A 42-year-old Caucasian man was treated with amoxicillin-clavulanate for pharyngitis. He did not improve, and a rash developed. History taking revealed a negative HIV antibody test five months previously and unprotected sex with a male partner the month before admission. Repeated tests revealed primary HIV infection with an exceptionally high HIV-1 RNA plasma concentration (3.6 × 107 copies/mL and a low CD4 count (101 cells/mm3, seven percent of total lymphocytes. While being investigated, the patient had a life-threatening hematochezia. After angiographic occlusion of a branch of the ileocaecal artery and initiation of antiretroviral therapy, the patient became rapidly asymptomatic and could be discharged. Colonoscopy revealed a bleeding colonic ulcer. We were unable to identify an etiology other than HIV for this ulcer. Conclusion This case adds to the known protean manifestation of primary HIV infection. The lack of an alternative etiology, despite extensive investigations, suggests that this ulcer was directly caused by primary HIV infection. This conclusion is supported by the well-described extensive loss of intestinal mucosal CD4+ T cells associated with primary HIV infection, the extremely high HIV viral load observed in our patient, and the rapid improvement of the ulcer after

  2. Aesthetic Breast Surgery and Concomitant Procedures: Incidence and Risk Factors for Major Complications in 73,608 Cases.

    Science.gov (United States)

    Gupta, Varun; Yeslev, Max; Winocour, Julian; Bamba, Ravinder; Rodriguez-Feo, Charles; Grotting, James C; Higdon, K Kye

    2017-05-01

    Major complications following aesthetic breast surgery are uncommon and thus assessment of risk factors is challenging. To determine the incidence and risk factors of major complications following aesthetic breast surgery and concomitant procedures. A prospective cohort of patients who enrolled into the CosmetAssure (Birmingham, AL) insurance program and underwent aesthetic breast surgery between 2008 and 2013 was identified. Major complications (requiring reoperation, readmission, or emergency room visit) within 30 days of surgery were recorded. Risk factors including age, smoking, body mass index (BMI), diabetes, type of surgical facility, and combined procedures were evaluated. Among women, augmentation was the most common breast procedure (n = 41,651, 58.6%) followed by augmentation-mastopexy, mastopexy, and reduction. Overall, major complications occurred in 1.46% with hematoma (0.99%) and infection (0.25%) being most common. Augmentation-mastopexy had a higher risk of complications, particularly infection (relative risk [RR] 1.74, P procedures. Age was the only significant predictor for hematomas (RR 1.01, P procedures or abdominoplasty performed alone. Among men, correction of gynecomastia was the most common breast procedure (n = 1613, 64.6%) with a complication rate of 1.80% and smoking as a risk factor (RR 2.73, P = 0.03). Incidence of major complications after breast cosmetic surgical procedures is low. Risk factors for major complications include increasing age and BMI. Combining abdominoplasty with any breast procedure increases the risk of major complications. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  3. [Pott's puffy tumor: a rare complication of frontal sinusitis].

    Science.gov (United States)

    Aínsa Laguna, D; Pons Morales, S; Muñoz Tormo-Figueres, A; Vega Senra, M I; Otero Reigada, M C

    2014-05-01

    Pott's puffy tumor is a rare complication of frontal sinusitis characterized by swelling and edema in the brow due to a subperiosteal abscess associated with frontal osteomyelitis. Added complications are cellulitis by extension to the orbit and intracranial infection by posterior extension, with high risk of meningitis, intracranial abscess, and venous sinus thrombosis. Early diagnosis and aggressive medical or surgical treatment are essential for optimal recovery of affected patients. In the antibiotic age it is extremely rare, with very few cases described in the recent literature. A case is presented of a Pott inflammatory tumor in a 7 year-old boy, as a complication of acute pansinusitis who presented with front preseptal swelling and intracranial involvement with thrombosis of ophthalmic and superior orbital veins and frontal epidural abscess extending to the subarachnoid space. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. Clinical presentation of soft-tissue infections and its management: A study of 100 cases

    Directory of Open Access Journals (Sweden)

    Baldev Singh

    2017-01-01

    Full Text Available Background: Soft-tissue infections vary widely in their nature and severity. A clear approach to the management must allow their rapid identification and treatment as they can be life-threatening. Objective: Clinical presentation of soft-tissue infections and its management. Materials and Methods: A prospective study based on 100 patients presenting with soft-tissue infections was done. All the cases of soft-tissue infections were considered irrespective of age, sex, etiological factors, or systemic disorders. The findings were evaluated regarding the pattern of soft-tissue infections in relation to age and sex, clinical presentation, complications, duration of hospital stay, management, and mortality. Results: The most commonly involved age group was in the range of 41–60 years with male predominance. Abscess formation (45% was the most common clinical presentation. Type 2 diabetes mellitus was the most common associated comorbid condition. Staphylococcus aureus was the most common culture isolate obtained. The most common complication seen was renal failure. Patients with surgical site infections had maximum duration of stay in the hospital. About 94% of the cases of soft-tissue infections were managed surgically. Mortality was mostly encountered in the cases of complications of cellulitis. Conclusion: Skin and soft-tissue infections are among the most common infections encountered by the emergency physicians. Ignorance, reluctance to treatment, economic constraints, and illiteracy delay the early detection and the initiation of proper treatment. Adequate and timely surgical intervention in most of the cases is of utmost importance to prevent the complications and reduce the mortality.

  5. Ahmed glaucoma valve implant: surgical technique and complications.

    Science.gov (United States)

    Riva, Ivano; Roberti, Gloria; Oddone, Francesco; Konstas, Anastasios Gp; Quaranta, Luciano

    2017-01-01

    Implantation of Ahmed glaucoma valve is an effective surgical technique to reduce intraocular pressure in patients affected with glaucoma. While in the past, the use of this device was reserved to glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use also as a primary surgery for selected cases. Implantation of Ahmed glaucoma valve can be challenging for the surgeon, especially in patients who already underwent previous multiple surgeries. Several tips have to be acquired by the surgeon, and a long learning curve is always needed. Although the valve mechanism embedded in the Ahmed glaucoma valve decreases the risk of postoperative hypotony-related complications, it does not avoid the need of a careful follow-up. Complications related to this type of surgery include early and late postoperative hypotony, excessive capsule fibrosis around the plate, erosion of the tube or plate edge, and very rarely infection. The aim of this review is to describe surgical technique for Ahmed glaucoma valve implantation and to report related complications.

  6. Complications of ankle fracture in patients with diabetes.

    Science.gov (United States)

    Chaudhary, Saad B; Liporace, Frank A; Gandhi, Ankur; Donley, Brian G; Pinzur, Michael S; Lin, Sheldon S

    2008-03-01

    Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Complications of impaired wound healing, infection, malunion, delayed union, nonunion, and Charcot arthropathy are prevalent in this patient population. Controversy exists as to whether diabetic ankle fractures are best treated noninvasively or by open reduction and internal fixation. Patients with diabetes are at significant risk for soft-tissue complications. In addition, diabetic ankle fractures heal, but significant delays in bone healing exist. Also, Charcot ankle arthropathy occurs more commonly in patients who were initially undiagnosed and had a delay in immobilization and in patients treated nonsurgically for displaced ankle fractures. Several techniques have been described to minimize complications associated with diabetic ankle fractures (eg, rigid external fixation, use of Kirschner wires or Steinmann pins to increase rigidity). Regardless of the specifics of treatment, adherence to the basic principles of preoperative planning, meticulous soft-tissue management, and attention to stable, rigid fixation with prolonged, protected immobilization are paramount in minimizing problems and yielding good functional outcomes.

  7. Complications in the management of bladder trauma in a third level hospital.

    Science.gov (United States)

    Echeverría-García, Fernando Enrique; García-Perdomo, Herney Andrés; Barney, Erika

    2014-05-01

    To determine the frecuency of complications during the management of bladder trauma and its associated factors in a third level reference Hospital. A cross-sectional study of adult patients admitted in a reference Hospital from January 2006 to June 2011 with the diagnosis of bladder trauma. We identified demographic variables, type of trauma (blunt, penetrating), diagnostic method, associated traumatisms, management of bladder traumatism, frequency of complications and mortality. Univariate analysis was performed with frequency tables, measures of central tendency and dispersion. Similarly, bivariate analysis was performed to explore the association between variables. We used chi-square test for categorical variables and Student's t test to compare quantitative variables. We reviewed 40 medical records, which met the eligibility criteria. The median age was 27 years (range 16-;67) and 85% (34 patients) were male. Twenty-nine patients (72.5%) had penetrating injuries, being mainly firearm projectile (96.55%) and 11 patients (27.5%) blunt injuries. Most patients had intraoperative diagnosis (67.5%), while 25%, 5% and 2% were diagnosed by CT-cystography, cystoscopy and voiding cystography respectively. 70% (28 patients) had intraperitoneal bladder injuries. Of the forty patients enrolled, thirty six (90%) underwent surgery, while only four (10%) received conservative management. A total of ten patients (25%) had some type of complication. The most frequent was persistent hematuria (40%) followed by surgical site infection (30%), orchitis (20%), urinary tract infection (10%), urine leakage through the operative site, or to the peritoneal cavity (10%). No mortality was detected. On the bivariate logistic regression model type of trauma, number of injuries, performance of cystostomy, use of perivesical drainage tube, chest trauma and small bowel trauma, no association was found with the presence of complications. The frequency of complications was 25%. The presence of

  8. Elephantiasis nostras verrucosa: a rare complication of lower limb lymphoedema.

    Science.gov (United States)

    Kar Keong, Neoh; Siing Ngi, Angelina Tang; Muniandy, Pubalan; Voon Fei, Wong

    2017-08-28

    We reported a case of a 49-year-old man who had chronic lymphoedema of bilateral lower limbs for 30 years, but he did not seek treatment. His disease was complicated with irreversible changes of elephantiasis nostras verrucosa and had recurrent admissions due to infection. He was not keen for surgical intervention. This case report illustrated a rare and non-reversible complication of a common skin disease, lymphoedema and also the importance of identifying and treating it early. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. A review of the clinical implications of anti-infective biomaterials and infection-resistant surfaces.

    Science.gov (United States)

    Campoccia, Davide; Montanaro, Lucio; Arciola, Carla Renata

    2013-11-01

    Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. The important social, clinical and economic impacts of implant-related infections are promoting the efforts to obviate these severe diseases. In this context, the development of anti-infective biomaterials and of infection-resistant surfaces is being regarded as the main strategy to prevent the establishment of implant colonisation and biofilm formation by bacteria. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials. © 2013 Elsevier Ltd. All rights reserved.

  10. Complications to evaluate adult trauma care: An expert consensus study.

    Science.gov (United States)

    Moore, Lynne; Lauzier, François; Stelfox, Henry Thomas; Le Sage, Natalie; Bourgeois, Gilles; Clément, Julien; Shemilt, Michèle; Turgeon, Alexis F

    2014-08-01

    Complications affect up to 37% of patients hospitalized for injury and increase mortality, morbidity, and costs. One of the keys to controlling complications for injury admissions is to monitor in-hospital complication rates. However, there is no consensus on which complications should be used to evaluate the quality of trauma care. The objective of this study was to develop a consensus-based list of complications that can be used to assess the acute phase of adult trauma care. We used a three-round Web-based Delphi survey among experts in the field of trauma care quality with a broad range of clinical expertise and geographic diversity. The main outcome measure was median importance rating on a 5-point Likert scale (very low to very high); complications with a median of 4 or greater and no disagreement were retained. A secondary measure was the perceived quality of information on each complication available in patient files. Of 19 experts invited to participate, 17 completed the first (brainstorming) round and 16 (84%) completed all rounds. Of 73 complications generated in Round 1, a total of 25 were retained including adult respiratory distress syndrome, hospital-acquired pneumonia, sepsis, acute renal failure, deep vein thrombosis, pulmonary embolism, wound infection, decubitus ulcers, and delirium. Of these, 19 (76%) were perceived to have high-quality or very high-quality information in patient files by more than 50% of the panel members. This study proposes a consensus-based list of 25 complications that can be used to evaluate the quality of acute adult trauma care. These complications can be used to develop an informative and actionable quality indicator to evaluate trauma care with the goal of decreasing rates of hospital complications and thus improving patient outcomes and resource use. DRG International Classification of Diseases codes are provided.

  11. Mixed Pyolaryngocele: A Rare Case of Deep Neck Infection

    Directory of Open Access Journals (Sweden)

    Rachid Mahdoufi

    2017-07-01

    Full Text Available Introduction: Pyolaryngocele is a very rare and serious complication of laryngocele. It can present as deep neck space infection and mislead the diagnosis. Our aim is to bring this unusual entity to the attention of surgeons and describe its clinical features. Case Report: We report a case of a 45-year-old male patient with a five-week history of neck swelling, dysphonia, dyspnea and odynophagia. An urgent CT scan showed a mixed pyolaryngocele. The management consisted of a high dose antibiotic and an excision of the residual laryngocele via an external approach. Conclusion: A pyolaryngocele is an unusual complication of laryngocele, which becomes secondarily infected, causing many symptoms. Removing the laryngocele is still the best treatment option to prevent this complication and recurrence.

  12. How to Manage and Control Healthcare Associated Infections

    Science.gov (United States)

    Wijaya, L.

    2018-03-01

    Healthcare associated infections (HAI) are the major complications of modern medical therapy. The most important HAIs are related to invasive devices including central line- associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and surgical-site infections (SSI). Excessive use of antibiotics has also led to the emergence and the global dissemination of antibiotic resistant bacteria over the last few decades. Reducing HAIs will involve a multi-modal approach to infection control practices as well as antibiotic stewardship program.

  13. Primary Pulmonary Amebiasis Complicated with Multicystic Empyema

    Directory of Open Access Journals (Sweden)

    Ali Zakaria

    2016-01-01

    Full Text Available Amebiasis is a parasitic infection caused by the protozoan Entamoeba histolytica. While most infections are asymptomatic, the disease could manifest clinically as amebic dysentery and/or extraintestinal invasion in the form of amebic liver abscess or other more rare manifestations such as pulmonary, cardiac, or brain involvement. Herein we are reporting a case of a 24-year-old male with history of Down syndrome who presented with severe right side pneumonia complicated with multicystic empyema resistant to regular medical therapy. Further investigation revealed a positive pleural fluid for E. histolytica cysts and trophozoites. The patient was diagnosed with primary pleuropulmonary amebiasis and he responded promptly to surgical drainage and metronidazole therapy. In patients from endemic areas all physicians should keep a high index of suspicion of amebiasis as a cause of pulmonary disease.

  14. Nutrition and human immunodeficiency virus infection in children ...

    African Journals Online (AJOL)

    Objectives. To review the relationship between nutrition and paediatric HIV infection, and to discuss treatment options and their applicability to situations with scarce resources. Results. Growth failure and malnutrition are frequent complications of paediatric lllV infection. Intra-uterine growth of infants born to HIV-seropositive ...

  15. Pictorial essay: Acute neurological complications in children with acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Seema A Kembhavi

    2012-01-01

    Full Text Available Acute lymphoblastic leukemia (ALL is the commonest childhood malignancy with high cure rates due to recent advances in central nervous system (CNS prophylaxis. The disease per se, as well as the prophylactic therapy, predisposes the child to complications such as cerebrovascular events, infections, drug toxicities, etc. The purpose of this study is to highlight the pathophysiology and the imaging features (with appropriate examples of these complications and to propose a diagnostic algorithm based on MRI. Interpreting these scans in the light of clinical inputs very often helps the radiologist reach an appropriate diagnosis and help treatment and management.

  16. Pictorial essay: Acute neurological complications in children with acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Kembhavi, Seema A.; Somvanshi, Snehal; Banavali, Shripad; Kurkure, Purna; Arora, Brijesh

    2012-01-01

    Acute lymphoblastic leukemia (ALL) is the commonest childhood malignancy with high cure rates due to recent advances in central nervous system (CNS) prophylaxis. The disease per se, as well as the prophylactic therapy, predisposes the child to complications such as cerebrovascular events, infections, drug toxicities, etc. The purpose of this study is to highlight the pathophysiology and the imaging features (with appropriate examples) of these complications and to propose a diagnostic algorithm based on MRI. Interpreting these scans in the light of clinical inputs very often helps the radiologist reach an appropriate diagnosis and help treatment and management

  17. Commonly Prescribed Blood Thinner Associated with Higher Risk of Post-Surgery Complications

    Science.gov (United States)

    ... association between preventive anticoagulant use and post-surgery infections or other problems, but this is the first multi-site study addressing the issue. "Anticoagulant use must be balanced with the need to avoid excessive post-operative bleeding, which can lead to complications and delay ...

  18. General surgical complications associated with the use of long-term mechanical circulatory support devices: are we 'under-reporting' problems?

    Science.gov (United States)

    Tchantchaleishvili, Vakhtang; Umakanthan, Ramanan; Karp, Seth; Stulak, John M; Keebler, Mary E; Maltais, Simon

    2013-05-01

    Multiple complications are associated with use of ventricular assist devices (VADs). Cardiac-related complications and infections are most frequently reported. VADs, however, can also lead to a number of general surgical complications equally significant in terms of morbidity and mortality. The authors performed a systematic literature search to review current data that specifically relate general surgical complications to patients who undergo left VAD implantation. The review provides a relatively clear understanding of the spectrum of general surgical complications and shows that they contribute significantly to morbidity and mortality in these patients.

  19. Myriad presentations of a common viral infection

    International Nuclear Information System (INIS)

    Khan, M.B.; Iqbal, Z.; Iftikhar, R.

    2011-01-01

    In most of the patients Primary EBV infection occurs in childhood as subclinical illness or mild symptomatic disease. In adults EBV infection is almost always a secondary infection due to reactivation of EBV, seen in immunocom-promised patients. In third world countries like Pakistan most of the individuals are exposed to EBV infection in childhood and primary EBV infection in adults is rare. EBV is the primary agent of infectious mononucleosis (IM). We present a patient found to have primary complicated EBV infection in adulthood thus emphasizing that although rare, primary EBV can present in adulthood. Infectious mononucleosis should be suspected in any patient with pharyngitis, posterior cervical lymphadenopathy and splenomegaly.

  20. Current Role of Imaging in Diagnosing Aortic Graft Infections

    NARCIS (Netherlands)

    Bruggink, Janneke L. M.; Slart, Riemer H. J. A.; Pol, Jillis A.; Reijnen, Michel M. P. J.; Zeebregts, Clark J.

    2011-01-01

    Vascular prosthetic graft infection is a rare but serious complication after aortic graft replacement, with high morbidity and mortality rates. Therefore, adequate diagnostics are needed to detect and treat these infections as early as possible. Several imaging modalities provide different