| 106781. |
- Grabe, Magnus J., et al.
(författare)
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Antimicrobial Stewardship : What We All Just Need to Know
- 2019
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Ingår i: European Urology Focus. - : Elsevier BV. - 2405-4569. ; 5:1, s. 46-49
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Tidskriftsartikel (refereegranskat)abstract
- Antimicrobial stewardship programmes including a multidisciplinary team of urologists, infectious disease specialists, and microbiologists reduce the total use of antibiotics in urological care without jeopardising the patient outcome. It is a recommended tool for education and feedback.
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| 106782. |
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| 106783. |
- Grabe, Magnus J., et al.
(författare)
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Tailored perioperative antimicrobial prophylaxis in urological surgery : myth or reality?
- 2017
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Ingår i: Current Opinion in Urology. - 0963-0643 .- 1473-6586. ; 27:2, s. 112-119
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed.Recent findings A series of studies have shown that infectious complications and healthcare-associated infections remain consistently at an average of 10%, with a great variation in frequency dependent on the patients' preoperative status and the type, severity and contamination level of the surgical procedure. Preoperative patient assessment and preparation are key factors for well tolerated surgery and recovery. Adherence to the guidelines appears to reduce both the prescription of antimicrobials and the total costs without risking the patient outcome. Several studies of a series of interventions such as cystoscopy, endoscopic stone surgery and selected clean-contaminated interventions give support to the model. Bacteriuria, upgrading the patient to the contaminated level, requires preoperative control.Summary The discussed model assists the urologists in decision-making on perioperative AMP and contributes to a responsible use of antibiotics.
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| 106784. |
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| 106785. |
- Grabe, Magnus, et al.
(författare)
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Preoperative assessment of the patient and risk factors for infectious complications and tentative classification of surgical field contamination of urological procedures.
- 2011
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Ingår i: World Journal of Urology. - : Springer Science and Business Media LLC. - 1433-8726 .- 0724-4983.
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess the patient and identify the risk factors for infectious complications in conjunction with urological procedures and suggest a model for classification of the procedures. METHOD: Review of literature, critical analysis of data and tentative model for reducing infectious complications. RESULTS: Risk factors are bound to the patient and to the procedure itself and are associated with the environment where the healthcare is provided. Assuming a clean environment and sterile operation field, a five-level assessment ladder related to the patient and type of surgery is useful, considering: (1) the ASA score, (2) the general risk factors, (3) the individual endogenous and exogenous risk factors, (4) the class of surgery and the potential bacterial contamination burden and (5) the level of severity and difficulty of the surgical intervention. A cumulative approach will identify the level of risk for each patient and define preventive measures, such as the type of antibiotic prophylaxis or therapeutic measures before surgery. There are data suggesting that the higher the ASA score, the higher is the risk of infectious complication. Age, dysfunction of the immune system, hypo-albuminaemia/malnutrition and overweight, uncontrolled blood glucose level and smoking are independent general risk factors, whilst bacteriuria, indwelling catheter treatment, urinary tract stone disease, urinary tract obstruction and a history of urogenital infection are specific urological risk factors. There is inconclusive evidence for most other reported risk factors. The level of contamination of the surgical field is of utmost importance as are the procedure-related factors, and the sum of these have to be reflected on for the subsequent perioperative management of the patient. CONCLUSIONS: It is essential to identify and control risk factors to minimize infectious complications in conjunction with urological procedures. Our knowledge is limited and clinical research and quality registries analysing risk factors must be undertaken. We propose a working basis for assessment of patients' risk factors and classification of urological procedures.
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| 106786. |
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| 106787. |
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| 106788. |
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| 106789. |
- Grabow, Desiree, et al.
(författare)
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The PanCareSurFup cohort of 83,333 five-year survivors of childhood cancer : a cohort from 12 European countries
- 2018
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 33:3, s. 335-349
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Tidskriftsartikel (refereegranskat)abstract
- Childhood cancer survivors face risks from a variety of late effects, including cardiac events, second cancers, and late mortality. The aim of the pan-European PanCare Childhood and Adolescent Cancer Survivor Care and Follow-Up Studies (PanCareSurFup) Consortium was to collect data on incidence and risk factors for these late effects among childhood cancer survivors in Europe. This paper describes the methodology of the data collection for the overall PanCareSurFup cohort and the outcome-related cohorts. In PanCareSurFup 13 data providers from 12 countries delivered data to the data centre in Mainz. Data providers used a single variable list that covered all three outcomes. After validity and plausibility checks data was provided to the outcome-specific working groups. In total, we collected data on 115,596 patients diagnosed with cancer from 1940 to 2011, of whom 83,333 had survived 5 years or more. Due to the eligibility criteria and other requirements different numbers of survivors were eligible for the analysis of each of the outcomes. Thus, 1014 patients with at least one cardiac event were identified from a cohort of 39,152 5-year survivors; for second cancers 3995 survivors developed at least one second cancer from a cohort of 71,494 individuals, and from the late mortality cohort of 79,441 who had survived at least 5 years, 9247 died subsequently. Through the close cooperation of many European countries and the establishment of one central data collection and harmonising centre, the project succeeded in generating the largest cohort of children with cancer to date.
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| 106790. |
- Gracely, Richard H., et al.
(författare)
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Neuroimaging of Pain
- 2023
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Ingår i: Functional Neuroradiology : Principles and Clinical Applications, Second Edition - Principles and Clinical Applications, Second Edition. - 9783031109089 - 9783031109096 ; , s. 407-431
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Bokkapitel (refereegranskat)abstract
- The underlying mechanisms of many pain conditions are not known and many conditions have no effective treatment. Modern dynamic neuroimaging has increased the understanding of altered nervous system (CNS) processing in multiple pain conditions. This chapter describes the potential and the limitations of functional neuroimaging in the evaluation and treatment of clinical pain syndromes. It considers the wide range of neuroimaging methods (positron emission tomography (PET), single photon emission computed tomography (SPECT), functional magnetic resonance imaging (fMRI), magnetic resonance (MR) spectroscopy, diffusion weighted, and diffusion tensor imaging) for common clinical conditions such as low back pain and the use of these methods in a group of pain conditions that include temporomandibular disorder, irritable bowel syndrome, fibromyalgia, and vulvodynia. While technically not a pain syndrome, chronic fatigue syndrome is included due to extensive symptom overlap with these conditions.
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