ABSTRACT
Ameloblastoma of the mandible is a rare odontogenic tumour that rarely metastasizes. We report a patient with a slowly progressing ameloblastoma of the mandible diagnosed at the age of seven and resected multiple times due to tumour recurrence. Multiple pulmonary metastatic nodules were resected at thoracotomy 27 years after the initial diagnosis; however, further pulmonary disease was discovered. The patient was admitted with chest pain due to pulmonary metastases 45 years after the initial diagnosis. The metastases were intraluminal and could be attributed to tumour cell aspiration during the surgical procedures on the mandible. The patient also suffered from hypercalcaemia which was attributed to a parathormone-like substance secreted by the tumour.
Subject(s)
Ameloblastoma/diagnosis , Ameloblastoma/secondary , Lung Neoplasms/diagnosis , Lung Neoplasms/secondary , Mandibular Neoplasms/pathology , Female , Humans , Mandibular Neoplasms/surgery , Middle Aged , Neoplasm Recurrence, Local/surgery , Time FactorsABSTRACT
Site-specific, risk-adjusted incidence rates of intensive care unit (ICU)-acquired infections were obtained through standardized surveillance in 8 ICUs in Greece. High rates were observed for central line-associated bloodstream infection (12.1 infections per 1,000 device-days) and ventilator-associated pneumonia (12.5 infections per 1,000 device-days). Gram-negative microorganisms accounted for 60.4% of the isolates recovered, and Acinetobacter species were predominant. To reduce infection rates in Greek ICUs, comprehensive infection control programs are required.
Subject(s)
Cross Infection/epidemiology , Equipment Contamination/economics , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Intensive Care Units/statistics & numerical data , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Cross Infection/microbiology , Equipment Contamination/statistics & numerical data , Equipment and Supplies/microbiology , Female , Greece/epidemiology , Health Care Surveys , Humans , Infection Control , Male , Middle Aged , Pneumonia, Ventilator-Associated/microbiology , Sentinel SurveillanceABSTRACT
From 1,246 specimens collected from 13 Greek hospitals, 266 vancomycin-resistant enterococci strains were isolated from 255 patients (20.5%). The VanA phenotype was present in 82 (30.8%) strains, the VanB phenotype in 17 (6.4%) strains, the VanC1 phenotype in 152 (57.1%) strains, and the VanC2/C3 phenotypes in 15 (5.6%) strains. When only VanA and VanB phenotypes were considered, the overall prevalence was 7.5%. Eighty-six isolates exhibiting the VanA or VanB phenotype were analyzed by pulsed-field gel electrophoresis (PFGE), and 46 PFGE groups were found.
Subject(s)
Enterococcus faecalis/genetics , Gram-Positive Bacterial Infections/epidemiology , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Electrophoresis, Gel, Pulsed-Field , Enterococcus faecalis/drug effects , Greece/epidemiology , Hospitals, District , Hospitals, University , Humans , Molecular Epidemiology , Peptide Synthases/genetics , Random Allocation , Vancomycin/pharmacology , Vancomycin Resistance/geneticsABSTRACT
OBJECTIVE: To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals. DESIGN: Two point-prevalence studies. SETTING: Fourteen Greek hospitals. PATIENTS: Those in the hospitals during two prevalence surveys undergoing surgery during their stay. RESULTS: In the 1999 survey, 129 of 1,037 surgical patients had developed 148 NIs (14.3%). A total of 1,093 operations were registered, and 49 SSIs (4.5%) were found. In the 2000 survey, 82 of 868 surgical patients had developed 88 NIs (10.1%). A total of 902 operations were registered, and 38 SSIs were detected (4.2%). The median length of stay (LOS) for surgical patients without SSI was 10.0 days (range, 1-19 days); for patients who developed SSI it was 30 days (range, 1-52 days; P < .001). The median LOS prior to surgery for patients without SSI was 1 day (range, 0-4 days); for patients who developed SSI it was 3 days (range, 0-7.5 days; P < .001). Among 30 possible risk factors studied, wound class, LOS prior to surgery, and central venous catheterization were independent predictors of SSI. Median durations of prophylactic antibiotic therapy were 4 days (range, 1-14 days) and 6 days (range, 1-16 days) in the 1999 and 2000 surveys, respectively. CONCLUSION: Surgical patients in Greek hospitals suffered higher rates of SSI than did surgical patients in other developed countries while prophylactic antibiotics were used excessively.
