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Deep infection in total hip arthroplasty.

https://arctichealth.org/en/permalink/ahliterature157994
Source
Can J Surg. 2008 Apr;51(2):111-7
Publication Type
Article
Date
Apr-2008
Author
Henry Hamilton
John Jamieson
Author Affiliation
Port Arthur Health Centre, Lakehead University, Thunder Bay, Ontario, Canada. drhenryhamilton@hotmail.com
Source
Can J Surg. 2008 Apr;51(2):111-7
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Antibiotic Prophylaxis
Arthroplasty, Replacement, Hip - statistics & numerical data
Asepsis
Bacterial Infections - epidemiology - prevention & control
Comorbidity
Cross-Sectional Studies
Follow-Up Studies
Hospitals, Community - statistics & numerical data
Humans
Incidence
Ontario
Prospective Studies
Reoperation
Risk factors
Staphylococcal Infections - epidemiology - prevention & control
Staphylococcus epidermidis
Surgical Wound Infection - epidemiology - prevention & control
Abstract
To report on a 30-year prospective study of deep infection in 1993 consecutive total hip arthroplasties performed by a single surgeon.
The relations of numerous variables to the incidence of deep infection were studied.
The cumulative infection rate after the index total hip arthroplasties rose from 0.8% at 2 years to 1.4% at 20 years; 9.6% of the index operations required further surgery. When infections attributed to these secondary procedures were included, the infection rate rose from 0.9% at 2 years to 2% at 20 years. Although the usual variables increased the incidence of infection, the significant and most precise predictors of infection were radiologic diagnoses of upper pole grade III and protrusio acetabuli, an elevated erythrocyte sedimentation rate, alcoholism and units of blood transfused.
From 2-20 years, the incidence of deep infection doubled. Preoperative recognition of the first 4 risk factors permits the use of additional prophylactic measures. Spinal or epidural anesthesia reduced the units of blood transfused (the fifth risk factor) and, hence, the risk of infection. Although most deep infections are seeded while the wound is open, there are many possible postoperative causes. In this study, fewer than one-third of the infections that presented after 2 years were related to hematogenous spread. The efficacy of clean air technology was supported, and it is recommended that all measures that may reduce the incidence of deep infection be employed.
Notes
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PubMed ID
18377751 View in PubMed
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[Infection problems connected to child day care centers]

https://arctichealth.org/en/permalink/ahliterature35752
Source
Tidsskr Nor Laegeforen. 1994 Jun 30;114(17):1936-8
Publication Type
Article
Date
Jun-30-1994
Author
K K Lie
Author Affiliation
Avdeling for Samfunnsmedisin Statens Institutt for Folkehelse, Oslo.
Source
Tidsskr Nor Laegeforen. 1994 Jun 30;114(17):1936-8
Date
Jun-30-1994
Language
Norwegian
Publication Type
Article
Keywords
Bacterial Infections - epidemiology - prevention & control - transmission
Child Day Care Centers
Child, Preschool
English Abstract
Humans
Infant
Infection Control
Norway - epidemiology
Risk factors
Virus Diseases - epidemiology - prevention & control - transmission
Abstract
International studies show that children in day care centres have approximately twice as many episodes of infectious diseases as children cared for at home, while, according to most studies, children in family day care experience an intermediate number of infections. After some months in day care the risk of infection decreases. The diseases in question are usually transferred from person to person through close physical contact. Children's general mode of behaviour tends to favour such transmission. The risk of infection in pregnant women on the day care staff and among parents is considered. Finally, the author discusses the potential to control infection in a day care setting. Strict rules for isolation of sick children probably have little effect on the spread of the infections. Good routines for washing hands and for changing nappies are considered to be the most important ways of controlling infection in day care centres.
PubMed ID
8079320 View in PubMed
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[Infectious diseases and climate change]

https://arctichealth.org/en/permalink/ahliterature95348
Source
Ugeskr Laeger. 2009 Oct 26;171(44):3178-81
Publication Type
Article
Date
Oct-26-2009
Author
Valentiner-Branth Palle
Glismann Steffen Offersen
Mølbak Kåre
Author Affiliation
Statens Serum Institut, Epidemiologisk Afdeling, DK-2300 København S, Denmark.
Source
Ugeskr Laeger. 2009 Oct 26;171(44):3178-81
Date
Oct-26-2009
Language
Danish
Publication Type
Article
Keywords
Animals
Bacterial Infections - epidemiology - prevention & control - transmission
Climate
Communicable disease control
Denmark - epidemiology
Disease Vectors
Europe - epidemiology
Food Microbiology
Greenhouse Effect
Humans
Insect Vectors
Risk factors
Rodentia
Virus Diseases - epidemiology - prevention & control - transmission
Water Microbiology
Abstract
Climate changes will likely have an impact on the spectrum of infectious diseases in Europe. We may see an increase in vector-borne diseases, diseases spread by rodents such as Hantavirus, and food- and water-borne diseases. As the effects of climate changes are likely to occur gradually, a modern industrialised country such as Denmark will have the opportunity to adapt to the expected changes.
PubMed ID
19857396 View in PubMed
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Peritonitis in continuous ambulatory peritoneal dialysis (CAPD): a multi-centre randomized clinical trial comparing the Y connector disinfectant system to standard systems. Canadian CAPD Clinical Trials Group.

https://arctichealth.org/en/permalink/ahliterature231980
Source
Perit Dial Int. 1989;9(3):159-63
Publication Type
Article
Date
1989
Source
Perit Dial Int. 1989;9(3):159-63
Date
1989
Language
English
Publication Type
Article
Keywords
Bacterial Infections - epidemiology - prevention & control
Canada - epidemiology
Catheters, Indwelling
Disinfectants
Humans
Kidney Failure, Chronic - therapy
Peritoneal Dialysis, Continuous Ambulatory - adverse effects - instrumentation
Peritonitis - epidemiology - prevention & control
Risk factors
Survival Analysis
Abstract
Sixty-one new continuous ambulatory peritoneal dialysis (CAPD) patients were allocated to a Y connector-disinfectant (Amuchina, Italy) and 63 to standard systems (Baxter Systems II & III) in a randomized clinical trial addressing peritonitis rates in 8 CAPD programs in 6 Canadian cities. In the Y connector-disinfectant group, 15 patients experienced 21 episodes of peritonitis in 452 15 patients experienced 21 episodes of peritonitis in 452 patient-months or 1 per 21.53 patient-months. In the standard systems group, 30 patients experienced 47 episodes of peritonitis in 467 patient-months or 1 per 9.93 patient-months (p = 0.009). The peritonitis risk reduction was 61% (95% confidence limits 27-79%). Exit-site infections occurred in 36% of each group. Prior to the development of exit-site infection, the monthly risk for peritonitis was 3.12% for the Y connector disinfectant system and 7.37% for the standard system. After an exit-site infection, these probabilities increased to 6.15% and 15.47%, respectively. Skin organisms were responsible for peritonitis in 8/21 (38%) in the Y connector-disinfectant group and 30/47 (64%) in the standard group. There were 75 days hospitalized for peritonitis in the Y connector-disinfectant group compared to 257 days for the standard group. The Y connector disinfectant system decreases the peritonitis rate through its effect on skin organisms. Exit-site injections are a major source of organisms responsible for peritonitis.
Notes
Comment In: Perit Dial Int. 1989;9(3):149-502488358
PubMed ID
2488361 View in PubMed
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Risk factors for surgical-site infection following primary total knee arthroplasty.

https://arctichealth.org/en/permalink/ahliterature179260
Source
Infect Control Hosp Epidemiol. 2004 Jun;25(6):477-80
Publication Type
Article
Date
Jun-2004
Author
Brian Minnema
Mary Vearncombe
Anne Augustin
Jeffrey Gollish
Andrew E Simor
Author Affiliation
Department of Microbiology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Source
Infect Control Hosp Epidemiol. 2004 Jun;25(6):477-80
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibiotic Prophylaxis
Anticoagulants - pharmacology - standards
Arthroplasty, Replacement, Knee - adverse effects
Bacterial Infections - epidemiology - prevention & control
Case-Control Studies
Cross Infection - epidemiology - microbiology - prevention & control
Female
Hospitals, Teaching - statistics & numerical data
Humans
International Normalized Ratio - standards
Logistic Models
Male
Medical Records
Middle Aged
Ontario - epidemiology
Premedication
Risk factors
Sentinel Surveillance
Suction - adverse effects - utilization
Surgical Wound Infection - epidemiology - microbiology - prevention & control
Time Factors
Abstract
To identify risk factors associated with the development of surgical-site infection (SSI) following total knee arthroplasty (TKA).
A case-control study.
A 1,100-bed, university-affiliated, tertiary-care teaching hospital.
Case-patients with SSI occurring up to 1 year following primary TKA performed between January 1999 and December 2001 were identified prospectively by infection control practitioners using National Nosocomial Infections Surveillance (NNIS) System methods. Three control-patients were selected for each case-patient, matched by date of surgery. Stepwise logistic regression analysis was used to determine the relation of potential risk factors to the development of infection.
Twenty-two patients with infections (6 superficial and 16 deep) were identified. Infection rates per year were 0.95%, 1.07%, and 1.19% in 1999, 2000, and 2001, respectively. Logistic regression analysis identified two variables independently associated with the development of infection: the use of closed suction drainage (odds ratio [OR], 7.0; 95% confidence interval [CI95], 2.1-25.0; P = .0015) and increased international normalized ratio (INR) (OR, 2.4; CI95, 1.1-5.7; P = .035). Factors not statistically associated with the development of infection included age, NNIS System risk index score, presence of various comorbidities, surgeon, duration of procedure or tourniquet time, type of bone cement or prosthesis used, or receipt of blood product transfusions.
The use of closed suction drainage and a high postoperative INR were associated with the development of SSI following TKA. Avoiding the use of surgical drains and careful monitoring of anticoagulant prophylaxis in patients undergoing TKA should reduce the risk of infection.
PubMed ID
15242195 View in PubMed
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Short summary of Swedres 2008, a report on antimicrobial utilisation and resistance in humans in Sweden.

https://arctichealth.org/en/permalink/ahliterature150070
Source
Euro Surveill. 2009 Jun 25;14(25)
Publication Type
Article
Date
Jun-25-2009
Author
J. Struwe
B. Olsson-Liljequist
Author Affiliation
Smittskyddsinstitutet (Swedish Institute for Infectious Disease Control), Stockholm, Sweden. johan.struwe@smi.se
Source
Euro Surveill. 2009 Jun 25;14(25)
Date
Jun-25-2009
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - epidemiology - prevention & control
Disease Outbreaks - prevention & control - statistics & numerical data
Humans
Incidence
Population Surveillance
Risk Assessment - methods
Risk factors
Sweden - epidemiology
PubMed ID
19555593 View in PubMed
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7 records – page 1 of 1.