ABSTRACT
INTRODUCTION: Infectious complications play a prominent role in pancreaticoduodenectomy. Their incidence increases in cases with preoperative biliary drainage (PBD), due to the higher risk of bacterobilia. The aim of this study is to evaluate an antibiotherapy protocol based on intraoperative gram staining of bile and its impact on postoperative infectious complications. METHODS: A retrospective study analysing the incidence of infectious complications between two groups of 25 consecutive patients undergoing pancreaticoduodenectomy. In group 1, cefazolin prophylaxis was administered to patients without PBD. In cases with PBD a five days antibiotherapy with piperacillin-tazobactam was administered. In group 2, intraoperative gram staining of bile was routinely performed. If no microorganisms were detected, antibiotherapy was limited to cefazolin prophylaxis. If bacterobilia was detected, targeted antibiotherapy was administered for five days. RESULTS: The incidence of sepsis and organ/space infection in group 2 was 4% compared to 32% and 24% in group 1 respectively (p < 0.05). No differences were observed in the remaining morbimortality variables. The most prevalent microorganisms in bile were Enterococcus spp. and Klebsiella spp. In postoperative samples, they only appeared in 4% of cases in group 2 (p < 0.05), in favour of S. epidermidis, although they were also prevalent in group 1 (28 and 24% respectively). CONCLUSION: Intraoperative gram staining of bile fluid could be a useful tool to conduct personalised antibiotic therapy in pancreaticoduodenectomy and contribute to the control of infectious complications.
Subject(s)
Bile , Pancreaticoduodenectomy , Antibiotic Prophylaxis , Cefazolin/therapeutic use , Humans , Pancreaticoduodenectomy/adverse effects , Postoperative Complications/drug therapy , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Preoperative Care , Retrospective Studies , Staining and LabelingABSTRACT
INTRODUCTION: Infectious complications play a prominent role in pancreaticoduodenectomy. Their incidence increases in cases with preoperative biliary drainage (PBD), due to the higher risk of bacterobilia. The aim of this study is to evaluate an antibiotherapy protocol based on intraoperative gram staining of bile and its impact on postoperative infectious complications. METHODS: A retrospective study analysing the incidence of infectious complications between two groups of 25 consecutive patients undergoing pancreaticoduodenectomy. In group 1, cefazolin prophylaxis was administered to patients without PBD. In cases with PBD a five days antibiotherapy with piperacillin-tazobactam was administered. In group 2, intraoperative gram staining of bile was routinely performed. If no microorganisms were detected, antibiotherapy was limited to cefazolin prophylaxis. If bacterobilia was detected, targeted antibiotherapy was administered for five days. RESULTS: The incidence of sepsis and organ/space infection in group 2 was 4% compared to 32% and 24% in group 1 respectively (p<0.05). No differences were observed in the remaining morbimortality variables. The most prevalent microorganisms in bile were Enterococcus spp and Klebsiella spp. In postoperative samples, they only appeared in 4% of cases in group 2 (p<0.05), in favour of S. epidermidis, although they were also prevalent in group 1 (28 and 24% respectively). CONCLUSION: Intraoperative gram staining of bile fluid could be a useful tool to conduct personalised antibiotic therapy in pancreaticoduodenectomy and contribute to the control of infectious complications.
ABSTRACT
El objetivo de este estudio fue analizar los efectos de un programa de danza española sobre el nivel sintomático, la capacidad funcional, diversas variables psicológicas y la composición corporal en una muestra de mujeres con fibromialgia. Un total de 43 mujeres de 45 a 70 años participaron en el estudio. Se utilizó un diseño intra-sujeto con medidas pre y post-test. Los instrumentos utilizados fueron la Escala Analógica Visual (VAS), el Cuestionario de Impacto de la Fibromialgia (FIQ), el Inventario de Depresión de Beck (BDI), el Inventario de Ansiedad Estado-Rasgo (STAI), la Escala Hamilton de Ansiedad (HARS), la Escala de Inteligencia Emocional (TMMS-24), el cuestionario Autoconcepto Forma 5 (AF5), el cuestionario de Perfil del Estado de Ánimo (POMS) y un bioimpediciómetro Tanita(R) BC-601. Los resultados mostraron efectos positivos después del programa, con mejoras en el estado de ánimo, la ansiedad psíquica y somática, así como la depresión
The objective of this study was to analyze the effects of a Spanish dance program on symptomatic level, functional capacity, psychological variables and body composition in a sample of women with fibromyalgia. A total of 43 women aged 45 to 70 years participated in the study. An intra-subject design with pre and post-test measurements was used. The instruments used were the Visual Analogue Scale (VAS), the Fibromyalgia Impact Questionnaire (FIQ), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Hamilton Anxiety Rating Scale (HARS), the Trait Meta-Mood Scale-24 (TMMS-24), the Self-concept form 5 questionnaire (AF5), the Profile of Mood States questionnaire (POMS) and a bioimpediciometer Tanita(R) BC-601. The results showed positive effects after the program, with improvements in mood, psychic and somatic anxiety, as well as depression
O objetivo deste estudo foi analisar os efeitos de um programa de dança espanhola no nível sintomático, capacidade funcional, diversas variáveis psicológicas e composição corporal em uma amostra de mulheres com fibromialgia. Um total de 43 mulheres com idade entre 45 e 70 anos participaram do estudo. Um desenho intra-sujeito foi usado com medições pré e pós-teste. Os instrumentos foram a Escala Analógica Visual (VAS), o Impact Questionnaire Fibromialgia (FIQ), o Beck Depression Inventory (BDI) Ansiedade Traço Estado Inventory (IDATE), Hamilton Anxiety Scale ( HARS), Escala de inteligência emocional (TMMS-24), o Autoconcepto Form 5 (AF5) questionário Mood States (POMS) Perfil questionário e bioimpediciómetro Tanita 2 BC-601. Os resultados mostraram efeitos positivos após o programa, com melhorias no humor, ansiedade e depressão psíquica e somática
Subject(s)
Humans , Female , Middle Aged , Aged , Dancing/psychology , Dance Therapy/methods , Fibromyalgia/therapy , Affect , Anxiety/psychology , Chronic Pain/psychology , Pain Management/methods , Fibromyalgia/psychology , Controlled Before-After Studies/statistics & numerical data , Treatment Outcome , Pain Measurement/methodsABSTRACT
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