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Michael A Mont - One of the best experts on this subject based on the ideXlab platform.
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the effect of bladder Catheterization technique on postoperative urinary tract infections after primary total hip arthroplasty
Journal of Arthroplasty, 2020Co-Authors: Luke J Garbarino, Peter A Gold, Hiba K Anis, Nipun Sodhi, Joshua G Burshtein, Aaron L Burshtein, Jonathan R Danoff, Sreevathsa Boraiah, Vijay J Rasquinha, Michael A MontAbstract:Abstract Background Urinary bladder Catheters are potential sources of infection after total hip arthroplasty (THA). Therefore, the goal of this study was to determine if intermittent Catheterization provides a decreased risk of postoperative urinary tract infections (UTIs) compared with Indwelling Catheterization in THA patients. Methods Patients undergoing THA at 15 hospitals within a large health system were prospectively collected between 2017 and 2019 and then stratified based on Catheterization technique: no-Catheter; Indwelling Catheter–only; intermittent Catheter–only; and both intermittent and Indwelling Catheter. Patient demographics, medical comorbidities, anesthesia types, and postoperative UTIs were assessed. Independent Student t-tests were used to perform univariate analyses for the Catheterization groups. Multiple linear regression models were used to compare the different groups while controlling for confounding variables. Results There were a total of 7306 THA patients recorded with 5513 (75%) no-Catheter, 1181 (16%) Indwelling Catheter–only, 285 (3.9%) intermittent Catheter–only, and 327 (4.5%) Indwelling and intermittent Catheterization patients. A total of 580 patients experienced postoperative UTI. Urinary bladder Catheterization increased the risk of postoperative UTIs (P Conclusion This study found that patients treated with Indwelling Catheterization, with or without preceding intermittent Catheterization, were significantly more likely to experience UTIs. Therefore, in an effort to decrease the risk of UTIs, THA patients experiencing postoperative urinary retention should be treated with intermittent Catheterization.
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The Effect of Bladder Catheterization Technique on Postoperative Urinary Tract Infections After Primary Total Hip Arthroplasty.
The Journal of arthroplasty, 2020Co-Authors: Luke J Garbarino, Peter A Gold, Nipun Sodhi, Joshua G Burshtein, Aaron L Burshtein, Jonathan R Danoff, Sreevathsa Boraiah, Vijay J Rasquinha, Hiba Anis, Michael A MontAbstract:Urinary bladder Catheters are potential sources of infection after total hip arthroplasty (THA). Therefore, the goal of this study was to determine if intermittent Catheterization provides a decreased risk of postoperative urinary tract infections (UTIs) compared with Indwelling Catheterization in THA patients. Patients undergoing THA at 15 hospitals within a large health system were prospectively collected between 2017 and 2019 and then stratified based on Catheterization technique: no-Catheter; Indwelling Catheter-only; intermittent Catheter-only; and both intermittent and Indwelling Catheter. Patient demographics, medical comorbidities, anesthesia types, and postoperative UTIs were assessed. Independent Student t-tests were used to perform univariate analyses for the Catheterization groups. Multiple linear regression models were used to compare the different groups while controlling for confounding variables. There were a total of 7306 THA patients recorded with 5513 (75%) no-Catheter, 1181 (16%) Indwelling Catheter-only, 285 (3.9%) intermittent Catheter-only, and 327 (4.5%) Indwelling and intermittent Catheterization patients. A total of 580 patients experienced postoperative UTI. Urinary bladder Catheterization increased the risk of postoperative UTIs (P < .001) in univariate analyses. Multiple linear regression models showed that Indwelling Catheter-only (OR: 2.178, P < .001), intermittent Catheterization (OR: 1.975, P = .003), and both Indwelling and intermittent (OR: 2.372, P = .002) were more likely to experience UTIs compared with no Catheters. This study found that patients treated with Indwelling Catheterization, with or without preceding intermittent Catheterization, were significantly more likely to experience UTIs. Therefore, in an effort to decrease the risk of UTIs, THA patients experiencing postoperative urinary retention should be treated with intermittent Catheterization. Copyright © 2020 Elsevier Inc. All rights reserved.
Lindsay E Nicolle - One of the best experts on this subject based on the ideXlab platform.
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the chronic Indwelling Catheter and urinary infection in long term care facility residents
Infection Control and Hospital Epidemiology, 2001Co-Authors: Philip W. Smith, Lindsay E NicolleAbstract:From 5% to 10% of residents of long-term–care facilities have urinary drainage managed with chronic Indwelling Catheters. These residents are always bacteriuric, usually with a complex microbiological flora of two to five organisms and a biofilm on the Catheter that may contribute to obstruction. Residents with chronic Indwelling Catheters have increased morbidity from urinary infection compared to bacteriuric residents without chronic Catheters. The most effective means to prevent infection is limitation of chronic Indwelling Catheter use. While appropriate Catheter care and infection control precautions are recommended in managing these patients, the impact of these practices on the occurrence of urinary infection or prevention of symptomatic episodes has not been evaluated. Symptomatic infection can likely be prevented by attention to Catheter care, including early recognition and replacement of obstructed Catheters and prevention of Catheter trauma. Appropriate use of prophylactic antimicrobial therapy prior to invasive genitourinary procedures is also necessary. Asymptomatic bacteriuria should not be treated. When symptomatic episodes occur, patients should be evaluated clinically and microbiologically and treated with appropriate antimicrobial therapy. Further technological advances in Catheter material and urine drainage will be needed to have a substantial impact on the frequency of urinary infection with chronic Catheter use.
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chronic Indwelling Catheter replacement before antimicrobial therapy for symptomatic urinary tract infection
The Journal of Urology, 2000Co-Authors: Raul Raz, David Schiller, Lindsay E NicolleAbstract:Purpose: We determined whether routine replacement of a chronic Indwelling Catheter before instituting antimicrobial therapy leads to an improved bacteriological or clinical outcome when treating symptomatic urinary tract infection in elderly nursing home residents.Materials and Methods: We performed a prospective randomized open clinical trial at 2 long-term care facilities. Patients were randomized to Indwelling Catheter replacement before initiating antimicrobial therapy or no replacement. Urine and blood cultures were done before antimicrobial therapy began. Clinical and microbiological outcomes were assessed after 3 days of therapy, and 7 and 28 days after therapy was complete.Results: Enrolled in our study were 21 male and 33 female nursing home residents with a mean age of 72.6 years, a chronic Indwelling Catheter and a clinical diagnosis of urinary tract infection. A total of 27 cases were randomized to either Catheter replacement and no replacement before antimicrobial therapy. Polymicrobial bact...
Luke J Garbarino - One of the best experts on this subject based on the ideXlab platform.
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the effect of bladder Catheterization technique on postoperative urinary tract infections after primary total hip arthroplasty
Journal of Arthroplasty, 2020Co-Authors: Luke J Garbarino, Peter A Gold, Hiba K Anis, Nipun Sodhi, Joshua G Burshtein, Aaron L Burshtein, Jonathan R Danoff, Sreevathsa Boraiah, Vijay J Rasquinha, Michael A MontAbstract:Abstract Background Urinary bladder Catheters are potential sources of infection after total hip arthroplasty (THA). Therefore, the goal of this study was to determine if intermittent Catheterization provides a decreased risk of postoperative urinary tract infections (UTIs) compared with Indwelling Catheterization in THA patients. Methods Patients undergoing THA at 15 hospitals within a large health system were prospectively collected between 2017 and 2019 and then stratified based on Catheterization technique: no-Catheter; Indwelling Catheter–only; intermittent Catheter–only; and both intermittent and Indwelling Catheter. Patient demographics, medical comorbidities, anesthesia types, and postoperative UTIs were assessed. Independent Student t-tests were used to perform univariate analyses for the Catheterization groups. Multiple linear regression models were used to compare the different groups while controlling for confounding variables. Results There were a total of 7306 THA patients recorded with 5513 (75%) no-Catheter, 1181 (16%) Indwelling Catheter–only, 285 (3.9%) intermittent Catheter–only, and 327 (4.5%) Indwelling and intermittent Catheterization patients. A total of 580 patients experienced postoperative UTI. Urinary bladder Catheterization increased the risk of postoperative UTIs (P Conclusion This study found that patients treated with Indwelling Catheterization, with or without preceding intermittent Catheterization, were significantly more likely to experience UTIs. Therefore, in an effort to decrease the risk of UTIs, THA patients experiencing postoperative urinary retention should be treated with intermittent Catheterization.
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The Effect of Bladder Catheterization Technique on Postoperative Urinary Tract Infections After Primary Total Hip Arthroplasty.
The Journal of arthroplasty, 2020Co-Authors: Luke J Garbarino, Peter A Gold, Nipun Sodhi, Joshua G Burshtein, Aaron L Burshtein, Jonathan R Danoff, Sreevathsa Boraiah, Vijay J Rasquinha, Hiba Anis, Michael A MontAbstract:Urinary bladder Catheters are potential sources of infection after total hip arthroplasty (THA). Therefore, the goal of this study was to determine if intermittent Catheterization provides a decreased risk of postoperative urinary tract infections (UTIs) compared with Indwelling Catheterization in THA patients. Patients undergoing THA at 15 hospitals within a large health system were prospectively collected between 2017 and 2019 and then stratified based on Catheterization technique: no-Catheter; Indwelling Catheter-only; intermittent Catheter-only; and both intermittent and Indwelling Catheter. Patient demographics, medical comorbidities, anesthesia types, and postoperative UTIs were assessed. Independent Student t-tests were used to perform univariate analyses for the Catheterization groups. Multiple linear regression models were used to compare the different groups while controlling for confounding variables. There were a total of 7306 THA patients recorded with 5513 (75%) no-Catheter, 1181 (16%) Indwelling Catheter-only, 285 (3.9%) intermittent Catheter-only, and 327 (4.5%) Indwelling and intermittent Catheterization patients. A total of 580 patients experienced postoperative UTI. Urinary bladder Catheterization increased the risk of postoperative UTIs (P < .001) in univariate analyses. Multiple linear regression models showed that Indwelling Catheter-only (OR: 2.178, P < .001), intermittent Catheterization (OR: 1.975, P = .003), and both Indwelling and intermittent (OR: 2.372, P = .002) were more likely to experience UTIs compared with no Catheters. This study found that patients treated with Indwelling Catheterization, with or without preceding intermittent Catheterization, were significantly more likely to experience UTIs. Therefore, in an effort to decrease the risk of UTIs, THA patients experiencing postoperative urinary retention should be treated with intermittent Catheterization. Copyright © 2020 Elsevier Inc. All rights reserved.
Norio Sakurai - One of the best experts on this subject based on the ideXlab platform.
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long term pain control in trigeminal neuralgia with local anesthetics using an Indwelling Catheter in the mandibular nerve
The Clinical Journal of Pain, 2002Co-Authors: Masahiro Umino, Hikaru Kohase, Shigeru Ideguchi, Norio SakuraiAbstract:Objective The authors sought to determine the usefulness of long-term continuous trigeminal nerve block with local anesthetics using an Indwelling Catheter in a patient with trigeminal neuralgia. Design The study design included pain control in a patient with trigeminal neuralgia until the time of neurosurgical operation. Setting The study was conducted in the Dental Hospital of Tokyo Medical and Dental University. Patient The patient was a 78-year-old woman with trigeminal neuralgia in the right maxillary region. Her pain could not be controlled by carbamazepine and was unbearable. Intervention The authors estimated the patient's pain intensity, quality, and locality using a visual analog scale to determine the effectiveness of continuous nerve block. Outcome measures Visual analog scores were measured during treatment. The treatment term was divided into three periods according to the difference of the Catheter location and injection protocol (premandibular nerve block, infuser injection, and patient-controlled analgesia [PCA] pump injection). The authors also examined the patient's general condition and blood concentration of drugs. Results The visual analog values were 44.8 +/- 3.6, 26.7 +/- 3.5, and 11.9 +/- 3.1 mm in each period, respectively. The value in the PCA pump infusion period was significantly lower than that in the other periods. No side effects of the local anesthetics were observed on the patient's systemic condition. Conclusions The authors controlled trigeminal neuralgia pain by blocking the mandibular nerve with local anesthetics administered through an Indwelling Catheter. Because the continuous nerve block with local anesthetics is reversible and only mildly toxic, this method is beneficial for pain control in patients with trigeminal neuralgia scheduled to undergo microvascular decompression.
Benjamin A Lipsky - One of the best experts on this subject based on the ideXlab platform.
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condom versus Indwelling urinary Catheters a randomized trial
Journal of the American Geriatrics Society, 2006Co-Authors: Sanjay Saint, Samuel R Kaufman, Mary A M Rogers, Paul D Baker, Kathleen Ossenkop, Benjamin A LipskyAbstract:OBJECTIVES: To compare condom and Indwelling urinary Catheters in terms of infection risk and patient satisfaction. DESIGN: A prospective, randomized, unblinded, controlled trial. SETTING: An academically affiliated Veterans Affairs Medical Center. PARTICIPANTS: Hospitalized men aged 40 and older who required a urinary collection device. MEASUREMENTS: The incidence of adverse outcomes (bacteriuria, symptomatic urinary tract infection (UTI), or death) and patient device-related satisfaction as determined according to a questionnaire. Dementia status was recorded to assess effect modification by the presence of dementia. RESULTS: Seventy-five subjects were randomized: 41 receiving an Indwelling Catheter and 34 a condom Catheter. The incidence of an adverse outcome was 131/1,000 patient-days with an Indwelling Catheter and 70/1,000 patient-days with a condom Catheter (P=.07). The median time to an adverse event was 7 days in the Indwelling group and 11 days in the condom group. After adjusting for other risk factors, it was found that condom Catheter use reduced adverse outcomes (P=.04). Patients without dementia who had an Indwelling Catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die (hazard ratio=4.84, 95% confidence interval=1.46–16.02) as those with a condom Catheter (P=.01). Patients reported that condom Catheters were more comfortable (P=.02) and less painful (P=.02) than Indwelling Catheters. CONCLUSION: The use of condom Catheters is less likely to lead to bacteriuria, symptomatic UTI, or death than the use of Indwelling Catheters. This protection is especially apparent in men without dementia.