The Experts below are selected from a list of 222 Experts worldwide ranked by ideXlab platform
David A. Talan - One of the best experts on this subject based on the ideXlab platform.
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Antimicrobial Prophylaxis for Wounds and Procedures in the Emergency Department
Infectious disease clinics of North America, 2008Co-Authors: Gregory J. Moran, David A. Talan, Fredrick M. AbrahamianAbstract:Emergency physicians are often confronted with situations in which a patient with an acute injury is at high risk for an infection. Although most traumatic wounds have a low risk for developing infection, certain types of high-risk trauma justify antimicrobial Prophylaxis. This article reviews antimicrobial wound infection Prophylaxis for high-risk traumatic wounds, including the prevention of rabies and Tetanus. Prophylaxis to prevent infections related to invasive procedures in the emergency department is also addressed.
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Tetanus immunity and physician compliance with Tetanus Prophylaxis practices among emergency department patients presenting with wounds.
Annals of emergency medicine, 2004Co-Authors: David A. Talan, Fredrick M. Abrahamian, Gregory J. Moran, William R. Mower, Kumar Alagappan, Brian Tiffany, Charles V. Pollack, Mark T. Steele, Lala Dunbar, Mary D. BajaniAbstract:Abstract Study objective We determine Tetanus seroprotection rates and physician compliance with Tetanus Prophylaxis recommendations among patients presenting with wounds. Methods A prospective observational study of patients aged 18 years or older who presented to 5 university-affiliated emergency departments (EDs) because of wounds was conducted between March 1999 and August 2000. Serum antitoxin levels were measured by enzyme immunoassay with seroprotection defined as more than 0.15 IU/mL. Seroprotection rates, risk factors for lack of seroprotection, and rates of physician compliance with Tetanus Prophylaxis recommendations by the Advisory Committee on Immunization Practices were determined. Results The seroprotection rate among 1,988 patients was 90.2% (95% confidence interval 88.8% to 91.5%). Groups with significantly lower seroprotection rates were persons aged 70 years or older, 59.5% (risk ratio [RR] 5.2); immigrants from outside North America or Western Europe, 75.3% (RR 3.7); persons with a history of inadequate immunization, 86.3% (RR 2.9); and persons without education beyond grade school, 76.5% (RR 2.5). Despite a history of adequate immunization, 18% of immigrants lacked seroprotection. Overall, 60.9% of patients required Tetanus immunization, of whom 57.6% did not receive indicated immunization. Among patients with Tetanus-prone wounds, appropriate Prophylaxis (ie, Tetanus immunoglobulin and toxoid) was provided to none of 504 patients who gave a history of inadequate primary immunization (of whom 15.1% had nonprotective antibody titers) and to 218 (79%) of 276 patients who required only a toxoid booster. Conclusion Although seroprotection rates are generally high in the United States, the risk of Tetanus persists in the elderly, immigrants, and persons without education beyond grade school. There is substantial underimmunization in the ED (particularly with regard to use of Tetanus immunoglobulin), leaving many patients, especially those from high-risk groups, unprotected. Better awareness of Tetanus Prophylaxis recommendations is necessary, and future Tetanus Prophylaxis recommendations may be more effective if they are also based on demographic risk factors.
Italo F Angelillo - One of the best experts on this subject based on the ideXlab platform.
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Appropriate Tetanus Prophylaxis practices in patients attending Emergency Departments in Italy.
Vaccine, 2008Co-Authors: Rossella Abbate, Gabriella Di Giuseppe, Paolo Marinelli, Italo F AngelilloAbstract:This study evaluated the physician compliance with Tetanus Prophylaxis and immunization practices for patients with wounds attending Emergency Departments (EDs) of four randomly selected non-academic acute care public hospitals in Italy. All presenting patients (> or = 16 years) within randomly selected week periods were studied. Physician and nurse, who were not involved in care, interviewed each patient regarding: socio-demographics, wound characteristics, and Tetanus immunization history; they also collected, through direct observation, data of the physician practices for Tetanus Prophylaxis and immunization. A total of 29.8% patients had a wound Tetanus-prone and this was more frequently observed in those lower educated, who arrive at the ED with medical referral during daytime and in the weekday, whose injury occurred outdoor, who had not completed the primary vaccination series or has received a booster dose < or =10 years before, and for a wound in abdomen, pelvis, and lower extremity. Overall, 54% of the physicians recorded for each patient information about the characteristics of the wound and the Tetanus immunization history and this was more frequently for those patients traumatized outdoor, injured less than 1h before, when the wound was non-Tetanus-prone, and less frequently when the wound site was head and neck. Only 1.5% of the physicians correctly adhere to guidelines on Tetanus Prophylaxis and immunization in wound management and this more frequently adopted for younger patients' and when the physician recorded information about Tetanus immunization history. Health policies and programs should be aimed at improving the quality of health care.
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Appropriate Tetanus Prophylaxis practices in patients attending Emergency Departments in Italy
Vaccine, 2008Co-Authors: Rossella Abbate, Gabriella Di Giuseppe, Paolo Marinelli, Italo F AngelilloAbstract:Abstract Objective This study evaluated the physician compliance with Tetanus Prophylaxis and immunization practices for patients with wounds attending Emergency Departments (EDs) of four randomly selected non-academic acute care public hospitals in Italy. Methods All presenting patients (≥16 years) within randomly selected week periods were studied. Physician and nurse, who were not involved in care, interviewed each patient regarding: socio-demographics, wound characteristics, and Tetanus immunization history; they also collected, through direct observation, data of the physician practices for Tetanus Prophylaxis and immunization. Results A total of 29.8% patients had a wound Tetanus-prone and this was more frequently observed in those lower educated, who arrive at the ED with medical referral during daytime and in the weekday, whose injury occurred outdoor, who had not completed the primary vaccination series or has received a booster dose ≤10 years before, and for a wound in abdomen, pelvis, and lower extremity. Overall, 54% of the physicians recorded for each patient information about the characteristics of the wound and the Tetanus immunization history and this was more frequently for those patients traumatized outdoor, injured less than 1 h before, when the wound was non-Tetanus-prone, and less frequently when the wound site was head and neck. Only 1.5% of the physicians correctly adhere to guidelines on Tetanus Prophylaxis and immunization in wound management and this more frequently adopted for younger patients’ and when the physician recorded information about Tetanus immunization history. Conclusion Health policies and programs should be aimed at improving the quality of health care.
Mary D. Bajani - One of the best experts on this subject based on the ideXlab platform.
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Tetanus immunity and physician compliance with Tetanus Prophylaxis practices among emergency department patients presenting with wounds.
Annals of emergency medicine, 2004Co-Authors: David A. Talan, Fredrick M. Abrahamian, Gregory J. Moran, William R. Mower, Kumar Alagappan, Brian Tiffany, Charles V. Pollack, Mark T. Steele, Lala Dunbar, Mary D. BajaniAbstract:Abstract Study objective We determine Tetanus seroprotection rates and physician compliance with Tetanus Prophylaxis recommendations among patients presenting with wounds. Methods A prospective observational study of patients aged 18 years or older who presented to 5 university-affiliated emergency departments (EDs) because of wounds was conducted between March 1999 and August 2000. Serum antitoxin levels were measured by enzyme immunoassay with seroprotection defined as more than 0.15 IU/mL. Seroprotection rates, risk factors for lack of seroprotection, and rates of physician compliance with Tetanus Prophylaxis recommendations by the Advisory Committee on Immunization Practices were determined. Results The seroprotection rate among 1,988 patients was 90.2% (95% confidence interval 88.8% to 91.5%). Groups with significantly lower seroprotection rates were persons aged 70 years or older, 59.5% (risk ratio [RR] 5.2); immigrants from outside North America or Western Europe, 75.3% (RR 3.7); persons with a history of inadequate immunization, 86.3% (RR 2.9); and persons without education beyond grade school, 76.5% (RR 2.5). Despite a history of adequate immunization, 18% of immigrants lacked seroprotection. Overall, 60.9% of patients required Tetanus immunization, of whom 57.6% did not receive indicated immunization. Among patients with Tetanus-prone wounds, appropriate Prophylaxis (ie, Tetanus immunoglobulin and toxoid) was provided to none of 504 patients who gave a history of inadequate primary immunization (of whom 15.1% had nonprotective antibody titers) and to 218 (79%) of 276 patients who required only a toxoid booster. Conclusion Although seroprotection rates are generally high in the United States, the risk of Tetanus persists in the elderly, immigrants, and persons without education beyond grade school. There is substantial underimmunization in the ED (particularly with regard to use of Tetanus immunoglobulin), leaving many patients, especially those from high-risk groups, unprotected. Better awareness of Tetanus Prophylaxis recommendations is necessary, and future Tetanus Prophylaxis recommendations may be more effective if they are also based on demographic risk factors.
Fredrick M. Abrahamian - One of the best experts on this subject based on the ideXlab platform.
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Antimicrobial Prophylaxis for Wounds and Procedures in the Emergency Department
Infectious disease clinics of North America, 2008Co-Authors: Gregory J. Moran, David A. Talan, Fredrick M. AbrahamianAbstract:Emergency physicians are often confronted with situations in which a patient with an acute injury is at high risk for an infection. Although most traumatic wounds have a low risk for developing infection, certain types of high-risk trauma justify antimicrobial Prophylaxis. This article reviews antimicrobial wound infection Prophylaxis for high-risk traumatic wounds, including the prevention of rabies and Tetanus. Prophylaxis to prevent infections related to invasive procedures in the emergency department is also addressed.
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Tetanus immunity and physician compliance with Tetanus Prophylaxis practices among emergency department patients presenting with wounds.
Annals of emergency medicine, 2004Co-Authors: David A. Talan, Fredrick M. Abrahamian, Gregory J. Moran, William R. Mower, Kumar Alagappan, Brian Tiffany, Charles V. Pollack, Mark T. Steele, Lala Dunbar, Mary D. BajaniAbstract:Abstract Study objective We determine Tetanus seroprotection rates and physician compliance with Tetanus Prophylaxis recommendations among patients presenting with wounds. Methods A prospective observational study of patients aged 18 years or older who presented to 5 university-affiliated emergency departments (EDs) because of wounds was conducted between March 1999 and August 2000. Serum antitoxin levels were measured by enzyme immunoassay with seroprotection defined as more than 0.15 IU/mL. Seroprotection rates, risk factors for lack of seroprotection, and rates of physician compliance with Tetanus Prophylaxis recommendations by the Advisory Committee on Immunization Practices were determined. Results The seroprotection rate among 1,988 patients was 90.2% (95% confidence interval 88.8% to 91.5%). Groups with significantly lower seroprotection rates were persons aged 70 years or older, 59.5% (risk ratio [RR] 5.2); immigrants from outside North America or Western Europe, 75.3% (RR 3.7); persons with a history of inadequate immunization, 86.3% (RR 2.9); and persons without education beyond grade school, 76.5% (RR 2.5). Despite a history of adequate immunization, 18% of immigrants lacked seroprotection. Overall, 60.9% of patients required Tetanus immunization, of whom 57.6% did not receive indicated immunization. Among patients with Tetanus-prone wounds, appropriate Prophylaxis (ie, Tetanus immunoglobulin and toxoid) was provided to none of 504 patients who gave a history of inadequate primary immunization (of whom 15.1% had nonprotective antibody titers) and to 218 (79%) of 276 patients who required only a toxoid booster. Conclusion Although seroprotection rates are generally high in the United States, the risk of Tetanus persists in the elderly, immigrants, and persons without education beyond grade school. There is substantial underimmunization in the ED (particularly with regard to use of Tetanus immunoglobulin), leaving many patients, especially those from high-risk groups, unprotected. Better awareness of Tetanus Prophylaxis recommendations is necessary, and future Tetanus Prophylaxis recommendations may be more effective if they are also based on demographic risk factors.
Gregory J. Moran - One of the best experts on this subject based on the ideXlab platform.
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Antimicrobial Prophylaxis for Wounds and Procedures in the Emergency Department
Infectious disease clinics of North America, 2008Co-Authors: Gregory J. Moran, David A. Talan, Fredrick M. AbrahamianAbstract:Emergency physicians are often confronted with situations in which a patient with an acute injury is at high risk for an infection. Although most traumatic wounds have a low risk for developing infection, certain types of high-risk trauma justify antimicrobial Prophylaxis. This article reviews antimicrobial wound infection Prophylaxis for high-risk traumatic wounds, including the prevention of rabies and Tetanus. Prophylaxis to prevent infections related to invasive procedures in the emergency department is also addressed.
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Tetanus immunity and physician compliance with Tetanus Prophylaxis practices among emergency department patients presenting with wounds.
Annals of emergency medicine, 2004Co-Authors: David A. Talan, Fredrick M. Abrahamian, Gregory J. Moran, William R. Mower, Kumar Alagappan, Brian Tiffany, Charles V. Pollack, Mark T. Steele, Lala Dunbar, Mary D. BajaniAbstract:Abstract Study objective We determine Tetanus seroprotection rates and physician compliance with Tetanus Prophylaxis recommendations among patients presenting with wounds. Methods A prospective observational study of patients aged 18 years or older who presented to 5 university-affiliated emergency departments (EDs) because of wounds was conducted between March 1999 and August 2000. Serum antitoxin levels were measured by enzyme immunoassay with seroprotection defined as more than 0.15 IU/mL. Seroprotection rates, risk factors for lack of seroprotection, and rates of physician compliance with Tetanus Prophylaxis recommendations by the Advisory Committee on Immunization Practices were determined. Results The seroprotection rate among 1,988 patients was 90.2% (95% confidence interval 88.8% to 91.5%). Groups with significantly lower seroprotection rates were persons aged 70 years or older, 59.5% (risk ratio [RR] 5.2); immigrants from outside North America or Western Europe, 75.3% (RR 3.7); persons with a history of inadequate immunization, 86.3% (RR 2.9); and persons without education beyond grade school, 76.5% (RR 2.5). Despite a history of adequate immunization, 18% of immigrants lacked seroprotection. Overall, 60.9% of patients required Tetanus immunization, of whom 57.6% did not receive indicated immunization. Among patients with Tetanus-prone wounds, appropriate Prophylaxis (ie, Tetanus immunoglobulin and toxoid) was provided to none of 504 patients who gave a history of inadequate primary immunization (of whom 15.1% had nonprotective antibody titers) and to 218 (79%) of 276 patients who required only a toxoid booster. Conclusion Although seroprotection rates are generally high in the United States, the risk of Tetanus persists in the elderly, immigrants, and persons without education beyond grade school. There is substantial underimmunization in the ED (particularly with regard to use of Tetanus immunoglobulin), leaving many patients, especially those from high-risk groups, unprotected. Better awareness of Tetanus Prophylaxis recommendations is necessary, and future Tetanus Prophylaxis recommendations may be more effective if they are also based on demographic risk factors.