ABSTRACT
INTRODUCTION@#Nosocomial infections such as surgical site infections (SSI) and postoperative pneumonia significantly contribute to a patient’s morbidity and mortality. This systematic review and meta-analysis evaluate the effectiveness of oral hygiene programs in reducing the incidence of nosocomial infections and related postoperative complications among all surgical patients. @*METHODS@#The systematic review and meta-analysis were conducted in line with the Cochrane Handbook for Systematic Reviews of Interventions. Medline and the Cochrane controlled trials (CENTRAL) databases were searched. Two review authors independently selected the trials and extracted the outcome data. The risk of bias of each included study was assessed independently by two review authors using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed when more than one trial reported the same outcome for the same comparison. @*RESULTS@#29 systematic reviews and 59 randomized controlled trials were included in the review. Thirty-two trials compared chlorhexidine with placebo, 7 trials povidone iodine with placebo, 7 trials topical antibiotics with placebo, 1 trial essential oils with placebo, 3 trials other agents with placebo, and 5 trials toothbrushing with no toothbrushing. Five trials compared one agent with another agent, and 1 trial compared dosings and frequencies of chlorhexidine use. Chlorhexidine was associated with a reduced risk of nosocomial infection, nosocomial pneumonia, ventilator-associated pneumonia (VAP), and shorter hosptial stay, and no significant impact on surgical site infection rates, ventilator days and mortality. Povidone iodine did not show any significant benefit on reducing VAP rates, ventilator days, ICU days, or mortality when compared against placebo. Hexetidine,when compared with placebo showed similar incidences of VAP. Topical oral antibiotics did not provide significant reduction on VAP rates, ventilator days, ICU days and mortality rates, compared with placebo.@*CONCLUSION@#Oral hygiene offers benefits in terms of lower rates of nosocomial infection, nosocomial pneumonia, ventilator-associated pneumonia, surgical site infection, shorter ICU stay, less ventilator days and lower oral colonization / colony counts.
ABSTRACT
Objective@#To compare the prevalence of diabetes mellitus (DM) and metabolic syndrome (MetS) in prostate cancer patients with or without androgen deprivation therapy (ADT). @*Methodology@#This is a cross-sectional analytic study of prostate cancer patients from the Integrated Surgical Information System database of the Philippine General Hospital from 2004-2010. Patients who received either continuous monthly GnRH agonist injection for at least 6 months or underwent bilateral orchiectomy at least 6 months prior (ADT group) were compared to those who did not (non-ADT group). Patients with DM and MetS were identified using the American Diabetes Association Standards of Medical Care in Diabetes 2010 and IDF Definition of Metabolic Syndrome. @*Results@#The prevalence of DM in the ADT group is 42% and 19% in the non-ADT group (p = 0.0460). The probability of having DM is 2.17x higher among prostate cancer patients who received ADT compared to those who did not. The prevalence of metabolic syndrome in the ADT and non-ADT group is 37% and 28%, respectively (p=0.4620). @*Conclusions@#Prostate cancer patients have become an important emerging population of medically at risk older men. Our study showed that the prevalence of DM is significantly higher among the ADT group, with a trend towards greater prevalence of metabolic syndrome in the same group. These men may benefit from closer monitoring for the development of these metabolic complications.