scholarly journals CLINICO-EPIDEMIOLOGICAL PROFILE OF BRAIN ABSCESS- A SINGLE CENTER STUDY

2020 ◽  
pp. 66-68
Author(s):  
Jagminder Singh ◽  
Monique Garg ◽  
Shivender Sobti ◽  
Ajay Choudhary ◽  
Rupinder Kaur
Keyword(s):  
Hospital Stay ◽  
Brain Abscess ◽  
Antimicrobial Agents ◽  
Length Of Hospital Stay ◽  
Suppurative Otitis Media ◽  
Group 13 ◽  
Stereotactic Aspiration ◽  
Underlying Factor ◽  
Streptococcus Milleri ◽  
Epidemiological Profile

INTRODUCTION: The overall incidence of bacterial brain abscess has remained relatively constant despite improved treatment of underlying systemic infections and development of more effective antibiotics. The systemic antibiotics are generally given for 6-8 weeks. The Choice of surgery varies from stereotactic aspiration /open surgical method including twist drill aspiration, burr hole aspiration with or without drainage, small craniectomy with aspiration and drainage to craniotomy and excision of abscess. The purpose of this article is to share authors’ experience regarding clinico epidemiological profile of brain abscess. MATERIAL AND METHODS: Total 30 patients with brain abscess who presented to the Department of Neurosurgery, PGIMER Dr. RML Hospital Delhi, from November 2016 to April 2018 analyzed for clinical, epidemiological, microbiological profile of brain abscess patients along with modes of treatment and their outcome. RESULTS: Total 30 patients of Brain Abscess were evaluated with males outnumbering females. Predominated symptoms were fever (96.7%), headache (83.3%) and nausea and vomiting (40%). The chronic suppurative otitis media (CSOM) was predominately underlying factor in 18 patients i.e. (60%) and commonest organism isolated was streptococcus pneumonia (66.6%) followed by streptococcus Milleri (33.33%). The length of hospital stay was longer in aspiration group {21.2 days (SD ± 4.1)} compared to excision group {13 days (SD ± 1.1)}. Total 20 (66.7%) patients survived, 2 (6.7%) patients died and 8 (26.7%) were lost to follow up. CONCLUSION: Majority of time there is an underlying factor for brain abscess. The treatment of brain abscess involves both medical and surgical modalities. Third generation cephalosporins and metronidazole are the most commonly used antimicrobial agents in the treatment of brain abscesses. The length of hospital stay in excision group was less as compared to medical group and aspiration group.

scholarly journals EPIDEMIOLOGICAL PROFILE AND OUTCOMES IN POSTOPERATIVE NEUROMUSCULAR ESCOLIOSIS

2020 ◽  
Vol 19 (1) ◽  
pp. 26-29
Author(s):  
FABIANA FLAVIA DA SILVA ROSA ◽  
MÁRCIA ALMEIDA LIMA MENDOZA ◽  
JOSÉ CARLOS BALDOCCHI PONTIN
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Neuromuscular Scoliosis ◽  
Main Diagnosis ◽  
Level Of Evidence ◽  
Hospital Outcomes ◽  
Scoliosis Correction ◽  
Duration Of Surgery ◽  
Correction Surgery ◽  
Epidemiological Profile

ABSTRACT Objective To outline the epidemiological profile and identify the hospital outcomes of patients submitted to neuromuscular scoliosis correction surgery. Methods This was a descriptive study that included 50 patients hospitalized following surgery for neuromuscular scoliosis in a tertiary-level hospital in São Paulo from January 2017 to July 2017. The variables were collected retrospectively from the patients’ medical records: age, sex, main diagnosis, length of hospital stay, duration of surgery, hospital complications, and mobility. Results Surgeries were performed in boys and girls in similar proportions, adolescents, many with cerebral palsy (42%), with mean hospital stay of 10.8 days. Fifty-two percent presented some complication, such as constipation. Infection of the surgical site was present in 12% of the sample. Forty-two percent had moderate to intense pain and only 2% did not achieve the proposed mobility goals. Conclusion We observed that the epidemiological profile presented data consistent with the scarce literature available, while the definitions of complications, incidence, and hospital outcomes available in the literature were varied quite a bit from the findings in this study. Level of evidence III; Retrospective study.

scholarly journals Profile of Patients with Brain Abscess

2020 ◽  
Vol 5 (3) ◽  
pp. 1220-1223
Author(s):  
Roshan Khatiwada ◽  
Prakash Bista ◽  
Rajiv Jha ◽  
Nilam Kumar Khadka ◽  
Rajendra Shrestha ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Brain Abscess ◽  
Clinical Features ◽  
Postoperative Outcome ◽  
Complete Recovery ◽  
Burr Hole ◽  
Male Dominance ◽  
Neurological Deficits ◽  
Suppurative Otitis Media ◽  
Ultimate Outcome

Introduction:  Despite of the advent of modern neurosurgical techniques and antibiotics, brain abscess possesses a major neurosurgical challenge in treatment. In this study we present the profile , clinical features , radiological features , treatment received and their outcome of cases of brain abscess that we managed in our center.   Methods:  Total 30 patients diagnosed with brain abscess who underwent treatment in last four months were included in this study.  A descriptive observational data of brain abscess and the outcome variables in the form of Glasgow Outcome Scale (GOS) at discharge ,  hospital stay, and mortality were studied. The ultimate outcome was measured in Glasgow Outcome Score.   Results: Total number of cases was 30, outwith male dominance 19 (63.3%) .  Age ranged from 2 months to 60 years. Twenty-five patients were of acute pyogenic abscess while and rest were tubercular abscess.  Common clinical features were headache (70%), fever (30%), vomiting (23%), seizure (23%) and focal neurological deficits (16.7%). Overall mean hospital stay was 31 days. The common aetogenic factors included chronic suppurative otitis media (16.7%), tuberculosis (16.7%), post-traumatic (10%), congenital heart disease (10%) and rest (46%) were of unknown source. lobe Temporal lobe and cerebellar were most common site involved (20%) each followed by frontal (16.7%). Surgery was done in 25 (83.3%) cases out of which 12 underwent burr hole and aspiration and 12 patients underwent craniotomy and excision and one patient underwent burr hole and followed by craniotomy. Five patients were managed conservatively. Complete resolution of abscess with complete recovery of preoperative neurological-deficit was seen n 28 (93.3%) cases.   Conclusion:  Early diagnosis and timely intervention improves the outcome of brain abscess. Most of the cases required surgical intervention and drainage of pus and had good postoperative outcome.

scholarly journals Significance of Streptococcus milleri in acute rhinosinusitis with complications

2007 ◽  
Vol 122 (8) ◽  
pp. 810-813 ◽  
Author(s):  
N M Rankhethoa ◽  
C A J Prescott
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Length Of Hospital Stay ◽  
Case Note ◽  
Red Cross ◽  
Retrospective Case ◽  
Acute Rhinosinusitis ◽  
Streptococcus Milleri ◽  
Male Patients ◽  
Case Note Review

AbstractObjectives:To assess the significance of Streptococcus milleri in acute rhinosinusitis with complications.Methods:A retrospective case note review was undertaken of in-patients at both the Red Cross Children's Hopital and the Groote Schuur Hospital (for adults), Cape Town, South Africa, between 1999 and 2003, with a diagnosis of acute rhinosinusitis with complications. The following were documented: age, gender, complications, organisms cultured and their sensitivity, type and number of operations, and length of hospital stay.Results:Seventy-one case notes were reviewed, for 30 female and 41 male patients, representing 38 adults and 33 children. Streptococcus milleri was the most commonly implicated organism (52.1 per cent; 37/71). Patients from whom this organism was isolated tended to require more than one operative procedure, and had a protracted hospital stay.

scholarly journals 1483. Comparison of Outcomes in Urinary Tract Infections Caused by SPICE Organisms Treated with Non-Carbapenem-β-lactams vs. Non-β-lactams Agents

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S540-S541
Author(s):  
Julia Sapozhnikov ◽  
Angela Huang ◽  
Kelsey Powell ◽  
Allison Gibble
Keyword(s):  
Urinary Tract ◽  
Hospital Stay ◽  
Clinical Response ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
Length Of Hospital Stay ◽  
Mortality Rates ◽  
All Cause Mortality ◽  
Tract Infections ◽  
Infection Recurrence

Abstract Background The “SPICE organisms” intrinsically produce low levels of a chromosomally encoded β-lactamase enzyme, AmpC. When SPICE organisms are exposed to certain antimicrobial agents, they can select for de-repressed mutants and induce the AmpC gene. No study to date has determined the optimal treatment of lower inoculum infections such as urinary tract infections (UTIs) caused by SPICE organisms. Methods This study is a single-center, retrospective observational review of adult hospitalized patients with a UTI caused by a SPICE organism from November 2012 to November 2015. The objective of this study was to compare outcomes amongst patients with UTIs caused by select SPICE organisms treated with drugs susceptible to AmpC hydrolysis (penicillins, cephalosporins except cefepime, and monobactams) vs. drugs stable against AmpC (carbapenems, cefepime, and non-β-lactam agents). The primary outcome was clinical response, defined as resolution of signs and symptoms of UTI without requiring escalation of antimicrobial therapy after 48 hours of therapy initiation. Secondary outcomes include 30-day infection-related readmission, 30-day infection recurrence rate, 30-day all-cause mortality, and length of hospital stay. Patients with resistance to ceftriaxone were reviewed for β-lactam exposure (≥7 days) within the last month. Results One-hundred 56 patients were identified. Clinical response, 30-day infection-related readmission, 30-day infection recurrence, 30-day mortality rates, and median length of hospital stay were similar between the AmpC stable and AmpC susceptible groups (Table 1). Notably, 39.1% of patients with ceftriaxone resistance reported had recent β-lactam exposure vs. only 11.6% of patients without ceftriaxone resistance (P = 0.0028). Conclusion Based our data, there does not appear to be a difference in clinical response, 30-day-related readmission, 30-day infection recurrence, 30-day all-cause mortality rates, or length of stay in patients with UTIs treated with AmpC stable and AmpC susceptible agents. AmpC induction can be seen with at least 7 days of β-lactam use in the past 30 days as demonstrated by more frequent use of recent β-lactam agents in those with ceftriaxone resistance detected. Disclosures All authors: No reported disclosures.

scholarly journals Clinical-epidemiological profile of acute appendicitis: retrospective analysis of 638 cases

2016 ◽  
Vol 43 (4) ◽  
pp. 248-253 ◽  
Author(s):  
AMANDA PEREIRA LIMA ◽  
FELIPE JOSÉ VIEIRA ◽  
GABRIELA PROCÓPIO DE MORAES OLIVEIRA ◽  
PLÍNIO DOS SANTOS RAMOS ◽  
MARIELLE ELISA AVELINO ◽  
...  
Keyword(s):  
Young Adults ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Histopathological Diagnosis ◽  
Minas Gerais State ◽  
Evolutionary Phase ◽  
Antibiotics Use ◽  
Epidemiological Profile ◽  
Complications And Mortality

ABSTRACT Objective: to describe the clinical and epidemiological profile of acute appendicitis (AA) of the patients treated at a referral center in the Juiz de Fora macro-region, Minas Gerais State, Brazil. Methods: we conducted a retrospective, observational study in the Dr. Mozart Geraldo TeixeiraEmergency Hospital. We selected 638 patients diagnosed with AA, and analyzed the variables gender, age, evolutionary phase, length of hospital stay, pathological diagnosis, use of antibiotics, use of drains, complications and mortality. Results: AA was more prevalent in young adults (19-44 years) and males (65.20%). The mean hospital stay was seven days and phase II was the most prevalent. We found the histopathological diagnosis of primary tumor of the appendix in six patients (0.94%), adenocarcinoma being the most common histologic type (66.7%). Regarding the use of antibiotics, 196 patients underwent antibiotic prophylaxis and 306 received antibiotic therapy. Eighty-one patients used some kind of drain, for an average of 4.8 days. Seventeen patients died (2.67%), predominantly males (70.59%), with mean age of 38.47 years. Conclusion: AA has a higher prevalence in males and young adults. The length of stay is directly associated with the evolutionary phase. The most common complication is infection of the surgical site. Mortality in our service is still high when compared with developed centers.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Indications and practice of enteral nutrition

2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Enteral Nutrition ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Present Review ◽  
Hospitalised Patients ◽  
Impact On Treatment ◽  
Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr.Randa Mohammed AboBaker
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Chewing Gum ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bowel Motility ◽  
Gum Chewing ◽  
Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

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