Antibacterial efficacy of silver nanoparticles against metallo-β-lactamase (blaNDM, blaVIM, blaOXA) producing clinically isolated Pseudomonas aeruginosa.

Carbapenem resistance in Pseudomonas aeruginosa is a major concern in the public health sector, primarily in developing countries such as Pakistan. Therefore, novel approaches such as Silver nanoparticles (AgNPs) can be used to address emerging concerns. Clinical isolates (n=200) were reconfirmed using selective media and API 20NE kit.

Thyroid cytology in Pakistan: An institutional audit of the atypia of undetermined significance/follicular lesion of undetermined significance category.

Introduction: Fine needle aspiration cytology (FNAC), along with thyroid ultrasound, is an important tool in evaluation of thyroid nodules that helps in further management of these patients in making a decision of surgical intervention vs follow-up. The Bethesda System for Reporting Thyroid Cytopathology category III of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) has risk of malignancy (ROM) ranging from 5% to 15%. The aim of the present study was to describe the frequency of AUS/FLUS in thyroid gland FNACs and the surgical outcomes of these cases.

Risk of Surgical Site Infection and Mortality Following Lumbar Fusion Surgery in Patients With Chronic Steroid Usage and Chronic Methicillin-Resistant Staphylococcus aureus Infection.

Study Design: A retrospective database analysis among Medicare beneficiaries OBJECTIVE.: The aim of this study was to determine the effect of chronic steroid use and chronic methicillin-resistant Staphylococcus aureus (MRSA) infection on rates of surgical site infection (SSI) and mortality in patients 65 years of age and older who were treated with lumbar spine fusion.

Summary Of Background Data: Systemic immunosuppression and infection focus elsewhere in the body are considered risk factors for SSI.

Molecular detection of blaVIM Metallo-β-lactamase producing clinically isolated Pseudomonas aeruginosa from tertiary care hospital, Faisalabad.

Metallo-β-lactamases (MBLs) producing Pseudomonas aeruginosa are major threat for public health. They produce resistance against various antibiotics and remain low or no therapeutic options. A total of 200 clinical isolates of P.

Risk Factors, Additional Length of Stay, and Cost Associated with Postoperative Ileus Following Anterior Lumbar Interbody Fusion in Elderly Patients.

Objective: To identify independent risk factors, additional length of stay, and additional cost associated with postoperative ileus following anterior lumbar interbody fusion in elderly patients.

Methods: The PearlDiver Patient Records Database was queried for all Medicare patients ≥65 years of age undergoing 1- or 2-level primary elective anterior lumbar interbody fusion from 2005 to 2014. Independent risk factors, additional length of stay, and additional cost associated with postoperative ileus were evaluated with multivariate analysis.

Predictors of adverse discharge disposition in adult spinal deformity and associated costs.

Background Context: With advances in the understanding of adult spinal deformity (ASD), more complex osteotomy and fusion techniques are being implemented with increasing frequency. Patients undergoing ASD corrections infrequently require extended acute care, longer inpatient stays, and are discharged to supervised care. Given the necessity of value-based health care, identification of clinical indicators of adverse discharge disposition in ASD surgeries is paramount.

Perioperative Nutritional Optimization in Spine Surgery.

Nutritional optimization in patients undergoing spine surgery is important as improved surgical outcomes and decreased rates of complications have been noted in optimized patients. With the increasingly high numbers of elderly patient and patients with metabolic comorbidities undergoing spine procedures, perioperative nutritional status should be enhanced for the best possible surgical outcomes. Methods of optimization include preoperative screening with Nutritional Risk Score or other scoring systems, looking for changes in body mass index, detecting sarcopenia, and screening for metabolic abnormalities.

Cost-utility analysis of cervical deformity surgeries using 1-year outcome.

Background Context: Cost-utility analysis, a special case of cost-effectiveness analysis, estimates the ratio between the cost of an intervention to the benefit it produces in number of quality-adjusted life years. Cervical deformity correction has not been evaluated in terms of cost-utility and in the context of value-based health care. Our objective, therefore, was to determine the cost-utility ratio of cervical deformity correction.

Outcomes following surgical management of femoral neck fractures in elderly dialysis-dependent patients.

Introduction: Proximal femur fractures are one of the most common fractures observed in dialysis-dependent patients. Given the large comorbidity burden present in this patient population, more information is needed regarding post-operative outcomes. The goal of this study was to assess morbidity and mortality following operative fixation of femoral neck fractures in the dialysis-dependent elderly.

Factors Affecting Long-Term Postoperative Narcotic Use in Discectomy Patients.

Background: Long-term narcotic use has risks and potentially life-threatening opioid-related side effects. Extended narcotic use in patients undergoing discectomy raises concerns of other underlying causes of pain or overprescription and/or abuse. The goal of this study was to determine which factors have an effect on active narcotic prescription >3 months after discectomy.

Use of the "dual construct" for the management of complex spinal reconstructions.

Background Context: Surgical management of complex spinal reconstructions remains a clinical challenge, as pseudoarthrosis with subsequent rod breakage can occur. Increased rod density in the form of "satellite" or "outrigger" rods have been described; however, rod-fracture above or below satellite rods persist and can result in dissociation of the construct, loss of correction, and recurrence of deformity. The use of four distinct and mechanically independent rods (dual construct) reduces this concern.

Lumbar Spine Fusion Surgery in Solid Organ Transplant Recipients Is Associated With Increased Medical Complications and Mortality.

Study Design: Retrospective database review.

Objective: To characterize the outcomes of solid organ transplant (SOT) patients after one- or two-level lumbar fusion surgery.

Summary Of Background Data: Over the past decade advances in SOT patients have improved graft survival.

A Comparison of Anterior and Posterior Lumbar Interbody Fusions: Complications, Readmissions, Discharge Dispositions, and Costs.

Study Design: Retrospective database review.

Objective: To understand medical complication rates, readmission rates, costs, and discharge dispositions in anterior lumbar interbody fusion (ALIFs) versus transforaminal lumbar interbody fusions (TLIFs)/posterior lumbar interbody fusions (PLIFs) for lumbar degenerative disease.

Summary Of Background Data: Indications for ALIFs versus PLIFs can vary, though benefits of anterior approach surgery include full access to the anterior column and ability to place fusion devices.

Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity.

Background: Adult spinal deformity (ASD) is an important problem to consider in the elderly. Although studies have examined the complications of ASD surgery and have compared functional and radiographic results of primary surgery versus revision, no studies have compared the costs of primary procedures with revisions. We assessed the in-hospital costs of these 2 surgery types in patients with ASD.

Perioperative Management of Blood Loss in Spine Surgery.

Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent.

Elective Thoracolumbar Spine Fusion Surgery in Patients with Parkinson Disease.

Objective: Few data are available concerning clinical outcomes in patients with Parkinson disease who undergo elective thoracolumbar spine fusion surgery. The goal of this study is to elucidate complication and revision rates after posterior thoracolumbar fusion surgery in patients with Parkinson disease, with a focus on how Parkinson disease modifies these rates.

Methods: The PearlDiver database (2005-2012) was queried for patients who underwent posterior approach thoracolumbar fusion from 2006 to 2011.

Traumatic Sports-Related Cervical Spine Injuries.

Cervical spine trauma in the athlete is not an insignificant occurrence with possibly catastrophic results. Football remains one of the most common and most well studied sporting activities associated with spine injuries. Transient spinal cord and peripheral nerve injuries may manifest as quadriparesis or burners/stingers with symptoms that resolve completely.