Effectiveness of antimicrobial-coated sutures for the prevention of surgical site infection: a review of the literature

OBJECTIVE:Surgical site infections (SSIs) are the third most common hospital-acquired infections and account for 14% to 16% of all such infections, and suture material may play a role in SSI rate. Given this risk of infection, sutures with antimicrobial activity have been developed. Both in vitro and in vivo experiments have shown that triclosan-coated sutures (TCS) are effective in the prevention of SSIs. Our aim is to analyze currently available RCTs, comparing the effect of antimicrobial-coated suture (ACS) with uncoated suture on the occurrence of SSIs following surgical procedures, we highlighted major contributions of most significant studies and evaluate the current "state of the art" on antimicrobial-coated sutures.MATERIALS AND METHODS: We reviewed 15 RCTs comparing antimicrobial-coated sutures with conventional sutures and assessing the clinical effectiveness of antimicrobial sutures to decrease the risk for SSIs. We focused our attention on each variable in all the analyzed study. RESULTS:Our selected RCTs, produced controversial results: 7 RCTs demonstrated a significant benefit, on the contrary, 8 RCTs presented a comparison in which there was no difference.CONCLUSIONS:On the basis of our selected trial results and the heterogeneous findings of our 7 selected meta-analyses, we conclude that even though the question of whether TCSs could reduce the occurrence of SSI remains still open, the antimicrobial suture was effective in decreasing the risk for postoperative SSIs in a broad population of patients undergoing surgery. Alternative substances are becoming clinically relevant, such as Chlorhexidine (CHX) coated sutures and only 6 in vivo scientific studies evaluated them. In vivo studies, large and comparative clinical research trials are necessary to validate the efficacy of CHX-coated sutures thus allowing their use in clinical practice

Evaluation of the progression of visual field damage in patients suffering from early manifest glaucoma

Abstract BACKGROUND: This retrospective study aimed to determine how often a perimetric examination should be carried out in order to identify visual field (VF) changes in patients with relatively early manifestation glaucoma. MATERIALS AND METHODS: Patients included had a relatively recent manifestation of primary open-angle glaucoma. Patients with a minimum follow-up of 5 years and a minimum of seven VF tests were included. Statistical analysis was performed to verify the trend of variations in mean defect (MD) over time (PeriData). The results were subjected to a t-test for a comparative analysis of progression of VF changes over time. The annual rate of progression provided by PeriData considering all the VFs analyzed was compared with that obtained on half of the VF examinations during the same follow-up period. An analysis of the MD trend over time was also carried out in relationship to the number of VF tests done and by dividing the sample into a high-frequency group (more than eight VFs) and a low-frequency group (fewer than eight VFs) in the follow-up period. RESULTS: A total of 96 eyes of 96 patients were included, and overall 846 VFs were examined. The paired t-test performed comparing the MD index of all the VFs against half of them did not show statistical significance (P=0.537). The high-frequency group comprised 39 eyes (average VF 11.05±1.91, average time interval 0.76 years) while the low-frequency group comprised 57 eyes (average VF 6.95±0.6, average time interval 1.21 years). The analysis of the MD trend in the high-frequency patients showed significance (P=0.017); the low-frequency group did not show statistical significance (P=0.08). CONCLUSION: The number of VFs in a determined time interval was not significant. However, a greater frequency of tests provides a predictive evaluation of the rate of progression of early manifestation open-angle glaucoma

Ganglion cell complex analysis in glaucoma patients: what can it tell us?

Glaucoma is a group of optic neuropathies characterized by a progressive degeneration of retina ganglion cells (RGCs) and their axons that precedes functional changes detected on the visual field. The macular ganglion cell complex (GCC), available in commercial Fourier-domain optical coherence tomography, allows the quantification of the innermost retinal layers that are potentially involved in the glaucomatous damage, including the retinal nerve fiber (RNFL), ganglion cell and inner plexiform layers. The average GCC thickness and its related parameters represent a reliable biomarker in detecting preperimetric glaucomatous damage. The most accurate GCC parameters are represented by average and inferior GCC thicknesses, and they can be associated with progressive visual field loss. Although the diagnostic accuracy increases with more severe glaucomatous damage and higher signal strength values, it is not affected by increasing axial length, resulting in a more accurate discrimination of glaucomatous damage in myopic eyes with respect to the traditional RNFL thickness. The analysis of the structure-function relationship revealed a good agreement between the loss in retinal sensitivity and GCC thickness. The use of a 10-2° visual field grid, adjusted for the anatomical RGCs displacement, describes more accurately the relationship between RGCs thickness and visual field sensitivity loss

Quantification of a distributive fluvial system; the Salt Wash DFS of the Morrison Formation, SW USA

Peer reviewedPostprin

Iginio Tansini revisited

The origin of the muscolocutaneous latissimus dorsi flap dates back to 1906 when Igino Tansini, an Italian surgeon, described a procedure to reconstruct the mastectomy defect. After a detailed study of Tansini's original description and drawings, new insights about the pedicle of its compound flap have been found, showing that it has the same pedicle of the scapular flap. In the end, Tansini's flap should be more correctly considered as a compound musculocutaneous scapular flap

Two FEM-BEM methods for the numerical solution of 2D transient elastodynamics problems in unbounded domains

We consider wave propagation problems in 2D unbounded isotropic homogeneous elastic media, with rigid boundary conditions. For their solution, we propose and compare two alternative numerical approaches, both obtained by coupling the differential equation with the associated space-time boundary integral equation. The latter is defined on an artificial boundary, chosen to surround the (bounded) exterior computational domain of interest. The integral equation defines a boundary condition which is non-reflecting for incoming and also for outgoing waves. In both approaches, the differential equations are discretized by applying a finite element method combined with the Crank Nicolson time marching scheme, while the discretization of the integral equation is obtained by coupling a time convolution quadrature with a space collocation boundary element method. The construction of the two approaches is described and discussed. Some numerical tests are also presented

CAOS spectroscopy of Am stars Kepler targets

The {\it Kepler} space mission and its {\it K2} extension provide photometric time series data with unprecedented accuracy. These data challenge our current understanding of the metallic-lined A stars (Am stars) for what concerns the onset of pulsations in their atmospheres. It turns out that the predictions of current diffusion models do not agree with observations. To understand this discrepancy, it is of crucial importance to obtain ground-based spectroscopic observations of Am stars in the {\it Kepler} and {\it K2} fields in order to determine the best estimates of the stellar parameters. In this paper, we present a detailed analysis of high-resolution spectroscopic data for seven stars previously classified as Am stars. We determine the effective temperatures, surface gravities, projected rotational velocities, microturbulent velocities and chemical abundances of these stars using spectral synthesis. These spectra were obtained with {\it CAOS}, a new instrument recently installed at the observing station of the Catania Astrophysical Observatory on Mt. Etna. Three stars have already been observed during quarters Q0-Q17, namely: HD\,180347, HD\,181206, and HD\,185658, while HD\,43509 was already observed during {\it K2} C0 campaign. We confirm that HD\,43509 and HD\,180347 are Am stars, while HD 52403, HD\,50766, HD\,58246, HD\,181206 and HD\,185658 are marginal Am stars. By means of non-LTE analysis, we derived oxygen abundances from O{\sc I}$\lambda$7771--5{\AA} triplet and we also discussed the results obtained with both non-LTE and LTE approaches.Comment: accepted in MNRAS main journal 13 pages, 11 figures, 3 tables. arXiv admin note: text overlap with arXiv:1404.095

Controls on the apex location of large deltas

Acknowledgements and Funding We would like to acknowledge the sponsors of the Fluvial Systems Research Group consortium BP, BG, Chevron, ConocoPhillips and Total. We would like to thank A. Felicia for image generation and database management.Peer reviewedPublisher PD