In total, 244 patients aged between 18 and 75 years, American society of anesthesiology II-III, underwent hepatobiliary pancreatic surgery, were classified into two groups and retrospectively analyzed: group R (Ropivacaine) included 152 patients whose surgical incision was fitted with a preperitoneal catheter continuously infusing ropivacaine. Chi-square or Fisher’s exact test were used to analyze categorical variables. SSI are responsible of nuisance for patients, and can lead to important complications and disability, often needing prolonged postoperative stay with specific treatment and recovery in Intensive Care Units. Informazioni e strumenti per essere un cittadino attivo. The primary efficacy endpoint was the clinical response (cure, failure and indeterminate) in the co-primary, microbiologically evaluable (ME) and microbiologically modified intent-to-treat (m-mITT) populations at the TOC assessment. Local infiltration of an anesthetic agent was associated with substantially reduced odds of SSI (OR = 0.4; 95% CI, 0.1 to 0.9). You also have the option to opt-out of these cookies. could be attributed to infection, early recognition and treatment are warranted to ensure favorable outcome. <> Prefazione . In the same years, there were respectively 105, 93, and 165 Gram-positive isolated, Enterococcus faecalis, Staphylococcus epidermidis and Staphylococcus aureus being the most commonly found. SSI cases within 1 year after operation were identified using ICD-9-CM diagnosis codes for wound infection and complication or positive wound cultures, or both. 2007. mailto:olivericonti@unict.it. Abbiamo conservato per te il libro Igiene. 0000004613 00000 n endstream endobj 18 0 obj <>/Metadata 15 0 R/Pages 14 0 R/Type/Catalog/PageLabels 12 0 R>> endobj 19 0 obj <>/Font<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 20 0 obj <> endobj 21 0 obj <> endobj 22 0 obj <> endobj 23 0 obj [/ICCBased 40 0 R] endobj 24 0 obj <> endobj 25 0 obj <>stream Continuous surgical wound infusion with local anesthetics is an effective and widely used technique in postoperative pain management. endobj Overuse of antibiotics in ambulatory care persists despite many efforts to address this problem. Compliance with these generally accepted preventive principles may lead to overall decreases in the incidence of these infections. stream Some explicative real life cases are presented. General and Applied Hygiene 1. Formato 17×24 di 106 pagine con alcune immagini, Responsabilità penale in emergenza sanitaria, Manuale di Programmazione e Organizzazione Sanitaria – TERZA EDIZIONE, Formato 17×24,5 di pagine XXVI-432 con 50 figure e 30 tabelle – III Edizione. Maria Triassi, Indice Medicina del lavoro 4. Pubblicato da Idelson-Gnocchi, brossura, 2019, 9788879476911. Diagnosi, clinica, ricerca, Nuovo prontuario per calcoli finanziari e attuariali in euro, Percorsi di storia della sociologia: i classici, Il teatro e il suo Sud. Preferirebbero trovare uno stretto confidente per rivelare il loro stato con la speranza di trovare soluzioni istantanee e mantenere il segreto. However, it is unclear how long we need to continue perioperative prophylaxis for gastrointestinal surgery. All of the microbiology laboratories are equipped to identify microorganisms and to perform susceptibility test; 33.3% have protocols for the preservation of isolates. x�b```b``>�����������b�,;�n��������Y�B����,'on�ȡh��ϭΉi5����Ј[PP�e �h��\�niI ��(3�r?�`�``��=`�v��ao�i������k��k�^t3)�D���[x6�a {����~Ҍ@� � }K3� The risk of NHL in the case of an underlying HIV infection is estimated to be 100 times greater than in the general population, and it increases with the progression of the retrovirus-related immunosuppression. Wound conditions were inspected in 113 wounds (95 patients) on postoperative day 1, 107 wounds (92 patients) on postoperative day 3, 92 wounds (79 patients) on postoperative day 5, and 75 wounds (73 patients) on postoperative day 10. © 2008-2020 ResearchGate GmbH. The search for healthcare-associated infections (HAIs) is conducted by nursing assistants in 68.8% of these institutions. '|07�' �)��. The authors prospectively evaluated the incidence of CSF shunt infection following shunt procedures performed using either antimicrobial suture (AMS) or conventional suture. Acquista Libri di Igiene su Libreria Universitaria: oltre 8 milioni di libri a catalogo. Prof.ssa Maria Triassi Programma Avanzato per la candidatura alla Vice-Presidenza S.It.I. Following the latter diagnosis, the patient tested positive for HIV. Medicina preventiva e del territorio dell'autore Maria Triassi in formato elettronico. Organizzazione, programmazione e valutazione dei Servizi Sanitari 7. The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Best Practices Initiative compared process and structural characteristics among 117 private sector hospitals in an effort to define best practices aimed at preventing SSI. Prophylactic administration of antibiotics can decrease postoperative morbidity, shorten hospitalization, and reduce overall costs. xref The duration of prophylactic antibiotics was significantly longer in 28 patients with SSI than in the 200 non-SSI patients (3.5 +/- 1.8 vs. 2.3 +/- 1.7 days; p<0.05). A survey, adapted from the Rapid Evaluation Guide for Hospital Programs for Prevention and. Medicina preventiva e del territorio PDF Maria Triassi. The most common complications are: superficial and deep wound infection, dehiscence, cellulitis, lymphangitis, and chronic edema. La continua evoluzione e l’aggiornamento della Sanità Pubblica richiedono un’efficace risposta multidisciplinare ai problemi ed alle sfide odierne e future. Non-Hodgkin's lymphomas (NHLs) are frequent malignancies in AIDS patients. Conclusions: Our results show no significant increase in antimicrobial resistance over the period in question, and a higher rate of both MRSA isolates and resistance to carbapenems in A. baumannii compared with other European data. Igiene. Il testo è organizzato in capitoli a firma di più Autori, allo scopo di offrire allo studente il valore aggiunto del contributo di più professionisti all’arricchimento delle conoscenze in continua evoluzione della disciplina “Igiene e Medicina del Territorio”, attribuibile soprattutto: Definizione, finalità e contenuti dell'Igiene!! But opting out of some of these cookies may affect your browsing experience. These justify the higher costs due to SSI. We studied 228 patients who underwent digestive surgery including 94 with gastric cancer, 85 with colon cancer and 49 with rectal cancer. stream There were no statistically significant differences in shunt infection risk factors between the groups (procedure type and time, age < 6 months, weight < 4 kg, recent history of shunt infection). Diese sind Gegenstand der Diskussionen in der SIA Kommission, die Resultate liegen voraussichtlich A STUm degli STUDI di CATAMA . Formato 17×24 di pagine XII-348. Health care surveillance: what should be included. Each participant was asked to fill up questionnaire regarding patterns of usage. Among SSIs prevention strategies, surveillance has been proved to be very incisive. It is suggested that the problem of hospital acquired infections in Lagos University Teaching Hospital should be met by appropriate preventive measures through a multi-disciplinary approach. Comparisons between the low and high outlier hospitals were made with regard to patient characteristics, operative variables, structural variables, and processes of care. 4 0 obj Both nonpharmacologic measures and antimicrobial prophylaxis for selected procedures are used to prevent development of these infections. The third patient died a few days after beginning antiretroviral therapy. The shunt infection rate in the study group was 2 (4.3%) of 46 procedures and 8 (21%) of 38 procedures in the control group (p = 0.038). Medicina di comunità 4 0 obj Necessary cookies are absolutely essential for the website to function properly. Con Fascicolo, Storia insieme. – alla necessità di adeguamento della metodologia epidemiologica come strumento essenziale per il monitoraggio e la valutazione dei bisogni di salute, e delle strategie preventive in Sanità Pubblica e dell’offerta sanitaria; Infections resulting from this exposure may not be limited to the surgical site but may produce widespread systemic effects. Significant independent risk factors for breast incisional SSI included insertion of a breast implant or tissue expander (odds ratio [OR] = 5.3; 95% CI, 2.5 to 11.1), suboptimal prophylactic antibiotic dosing (OR = 5.1; 95% CI, 2.5 to 10.2), transfusion (OR = 3.4; 95% CI, 1.3 to 9.0), mastectomy (OR = 3.3; 95% CI, 1.4 to 7.7), previous chest irradiation (OR = 2.8; 95% CI, 1.2 to 6.5), and current or recent smoking (OR = 2.1; 95% CI, 0.9 to 4.9). Download PDF: Sorry, we are unable to provide the full text but you may find it at the following location(s): http://hdl.handle.net/11588/36... (external link) È convinzione dell’Autore e dei Coautori che è proprio sulle risposte alle sfide della Sanità Pubblica che si giocherà il futuro non solo dell’Assistenza Sanitaria sia a livello Nazionale che Internazionale, ma anche della qualità della vita delle popolazioni presenti e future. The most common pathogenic agents are human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. We also use third-party cookies that help us analyze and understand how you use this website. %%EOF The most recent surveillance study carried out at a national level in Italy is SNICh protocol (National Surveillance System of Surgical Site Infections), which analyses data received from 127 Italian hospitals, from the 2009 to 2011 and the entire 2013. Libri di Igiene. Wiley Periodicals, Inc. Little is known about the effectiveness of antibiotic prophylaxis for prevention of surgical site infections (SSIs) in paediatric abdominopelvic surgical oncology. 0000013089 00000 n Medical records of 57 patients with breast SSI and 268 randomly selected uninfected control patients were reviewed. Sconto 5% e Spedizione gratuita. Material and methods. 1 • METODOLOGIA EPIDEMIOLOGICA a spirale. Methods: This study was performed by a local surveillance network for antibiotic resistance (GERMEN Group), with technical and financial support from the Secretaría de Salud de Medellín. The only application of a surveillance strategy, observing the recommended prophylaxis protocols, brought to a reduction of SSIs: their incidence has been shown to be comparable to European or American one. Igiene. 17 0 obj <> endobj Medicina preventiva e del territorio. 0000003337 00000 n NNIS Dipartimento di Chirurgia Generale, Oncologia, Geriatrica e Tecniche, Dipartimento di Igiene Ospedaliera, Medicina del Lavoro e, Centers for Diseases Control National, a ferita veniva lasciata intenzionalmente, e per categoria si sono dimostrati più eleva-, Piperacillina-tazobactam + aminoglicoside, Cotrimossazolo; in caso di resistenza, associazione, onfronto tra materiale riassorbibile Mono-, oated sutures for reduction of sternal wound infec-. ܄��t���F�%�x���~�,�'>�E��Աu�0i%��s����� �����tk�b����xj��0V`�?��. %PDF-1.4 %���� From our findings, SSI rate did not decrease with longer duration of antimicrobial prophylaxis. The increased probability of infection and/or superinfection in dehiscent surgical wounds is a frequent complication in the postoperative period and may prolong the need for treatment. HANDICAP ED INVALIDITÀ CIVILE. Hospitals from all parts of Germany took part voluntarily. (ICA) 8. Asterix. classification, and patient-related variables, such as preexisting medical conditions. Patients were treated for 7-28 days and the test-of-cure (TOC) assessment was made 12-37 days after the last dose. Conclusion. – all’evoluzione continua delle normative e dei modelli organizzativi dei Servizi Sanitari nazionali e regionali; But structural and process of care characteristics of hospitals were found to have a significant association with good results. This information can be used to develop a specific risk stratification index to predict SSI and infection-preventive strategies tailored for breast surgery patients. 0000005552 00000 n <> Despite the growing body of evidence concerning SSI in general surgery, literature dealing with SSI after colorectal surgery is scarce, reflecting in suboptimal perception of such a relevant issue by colorectal surgeons and health authorities in Italy, though colorectal surgery is associated with higher rates of SSI. Gram-positive cocci, particularly staphylococci, cause many of these infections, although gram-negative organisms are also frequently involved. Compared with studies targeting specific conditions or patient populations, broad-based interventions extrapolated to larger community-level impacts on total antibiotic use, with savings of 17-117 prescriptions per 1000 person-years. The first patient received antiretroviral therapy (ART) and EPOCH (etoposide, pharmarubicin, vincristin, endoxane, uromitexan) plus radiotherapy, while the second received ART and CHOEP (endoxan, epirubicin, vincristin, etoposide, prednisolone). In a single-center, prospective, double-blinded, randomized controlled trial, the authors enrolled 61 patients, among whom 84 CSF shunt procedures were performed over 21 months. Access scientific knowledge from anywhere. Idelson-Gnocchi, 2006 - Medical - 462 pages. This policy has been showed to significantly reduce the rates of SSI. However, there was a lackof standardization and shortcomings in the training of personnel and in the programs for the rational use of antibiotics. – alla necessità di riorganizzare la rete della assistenza sanitaria con nuove modalità che consentano, a costi sostenibili, di offrire: la integrazione ospedale-territorio e socio-sanitaria, la medicina territoriale, le cure primarie, la prevenzione degli stili di vita e delle malattie cronico-degenerative di area specialistica;
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