[Drug resistance of Pseudomonas aeruginosa in four community hospitals: influence of antimicrobial use density].

We investigated the relation between hospital antimirobial use density (AUD) and minimum inhibitory concentrations (MIC) for Pseudomonas aeruginosa in four community hospitals. Subjects were a total of 476 strains isolated from urine, sputum, and pus during a total of seven years since 2002, for which 50- and 90-percentile MICs were analyzed. Hospitals A, B, and C moved in 2000, 2005, and 2009, respectively, but MIC50 and MIC90 were stable.

Does antimicrobial homogeneity index influence surgical site infection? A 10-year study in lung, breast, and general surgery.

To address whether hospital antimicrobial use influences surgical site infection (SSI), we investigated factors including antimicrobial homogeneity index (AHI), an indicator of prescription diversity, with a retrospective study during 120 months for patients undergoing lung, breast, and general surgery (n = 4,510). We analyzed the odds ratios of background factors for SSI and the correlation between AHI and drug susceptibility in isolates of SSI. A total of 243 cases of SSI (5.

Association between risk of bloodstream infection and duration of use of totally implantable access ports and central lines: a 24-month study.

Background: Prolonged use of totally implantable access ports (APs) and central lines (CLs) has been known to carry a risk of bloodstream infection (BSI), but the safe cutoff day for discontinuing use remains unknown. We performed a receiver operating characteristic (ROC) curve analysis to determine this cutoff.

Methods: A retrospective 24-month study covered a total of 22,481 days of device use.

Esophageal ruptures: triage using the systemic inflammatory response syndrome score.

Esophageal rupture is a rare entity. Delay in the diagnosis and treatment may threaten the patient's life. The decision for surgical or nonsurgical treatment, however, remains controversial because advocates of both treatments have reported comparable results.

Perioperative antimicrobials in chest surgery patients positive for methicillin-resistant Staphylococcus aureus.

In pulmonary surgery, methicillin-resistant Staphylococcus aureus (MRSA)-positive patients present an issue of perioperative antimicrobials. During 1996 to 2009 in a total of 1,080 pulmonary operations, MRSA was detected before 20 operations. Perioperatively, we followed the Sanford Guide using vancomycin (VCM) or arbekacin (ABK) in MRSA-positive cases at high risk (n = 14), including 1 with clinical infection and 13 with colonization.

Preventing a pitfall: no-knife staplers that require caution during handling.

For safer division of the pulmonary vessels at video-assisted thoracoscopic surgery (VATS), a no-knife stapler (NAW ENDOPATH Flex45 No Knife Endoscopic Linear Stapler, Ethicon Endo-Surgery) is of help. We have used it during 177 sessions in 156 patients and noted two incidences where several of the staples were malformed but did not cause a bleeding event. A close investigation revealed that the cause was excessive rotation of the articulation lever.

Central line-associated bloodstream infection: is the hospital epidemiology of methicillin-resistant Staphylococcus aureus relevant?

We aimed to evaluate the risk factors, including the hospital epidemiology of methicillin-resistant Staphylococcus aureus (MRSA), for central venous line-associated and laboratory-confirmed bloodstream infections (CLA-BSI and LC-BSI, respectively). The risk factors examined included the age and sex of patients, whether or not they were in the surgery service, the number of days of central line (CL) placement, the monthly number of inpatients and those positive for MRSA, and whether the standard or maximal barrier precautions were observed at CL insertion. As the outcome factors, we selected CLA-BSI and LC-BSI, while precluding repeated isolation within 28 days.

[Chemotherapy for non-small cell lung cancer: split-dose administration of Cisplatin over four consecutive days and Vinorelbine ditartrate].

Purpose: At present, combination chemotherapy with Cisplatin (CDDP) and Vinorelbine ditartrate (VNR) is one of the standard regimens for non-small cell lung cancer (NSLC). To avoid renal damage by CDDP, hydration and diuretic are indicated. But elderly/postoperative patients who have reduced lung vessel capacity are a high-risk group for pulmonary edema/right heart failure by hydration.

Risk factors for central venous catheter-related bloodstream infection: a 1073-patient study.

We intended to evaluate the risk factors for catheter-related bloodstream infection (CR-BSI) with central venous (CV) catheters. For the hub of the CV line, we used three-way stopcocks in the first year of the study and closed needleless connectors (NCs) in the second year. Background factors included the age and sex of patients; the ward; the specialty service; the CV catheter and its days of placement; and the staff compounding the intravenous infusion, i.

Sharp rib fragment threatening to lacerate the aorta in a patient with flail chest.

A 50-year-old man who was the victim of an accident during work was taken to the hospital. His chest radiograph and computed tomography (CT) scan showed pulmonary contusion, multiple rib fractures (left 5th to 1lth ribs), hemopneumothorax, and splenic rupture. On the fourth posttrauma day, CT showed bone particles of the ninth rib migrating to the thoracic aorta.

Simple methodology for detecting time shifts in surgical site infections: a study in digestive, breast, and thoracic surgery.

To simplify the data mining surveillance system for the monitoring of surgical site infections (SSIs), electronic analysis of a total of 3100 patients was done. Using Layered Analyses, the Cross-Table option of a globally available software detected emerging or disappearing SSIs according to specific parameters. This methodology may facilitate the detection of SSI shifts.

[A case of small cell carcinoma (oat-cell type) of the esophagus].

We experienced a case of small cell carcinoma of the esophagus treated by operation. A 57-year-old female was examined for a complaint of dysphagia. The radiologic and endoscopic examination revealed Borrmann III like tumor (8 cm long) at lower esophagus (EiEa).