1. Hip hemiarthroplasty after displaced femoral neck fracture: a survivorship analysis Femoral neck fracture – broken knee joint Total Hip Arthroplasty

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  • Hip hemiarthroplasty after displaced femoral neck fracture: a survivorship analysis

    Femoral neck fracture broken knee joint Total Hip Arthroplasty Yes.better results for patients than internal fixation and hemiarthroplasty. Some Results for age group 60 + differ from this: 0-35 % dislocation cases quite highREASON ? Major one is comorbidities!*

  • Biomarkers as a Tool for Management of Immunosuppression in Transplant Patients

    Immuno-suppressive drugsWithout immunosuppression therapy, transplatation surgery could be fatal.Therapeutic drug monitoring DOES NOT reflect adverse effects to immune cells.Pharmacodynamic monitoring (biomarkers)

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  • Problem of infection in the ICU

    Infections possible - ventilator-associated pneumonia, catheter-associated urinary tract infection, catheter-related bloodstream infectionNeed to be attentive to horizontal infection and use proper antibiotics for multi-resistant bacteria like MRSA.

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  • Managing infection in the critical care unit: how can infection control make the ICU safe?

    Infection Control in the ICU

    Device Related Nosocomial Infection In ICU

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  • *Ventilator Associated PneumoniaAntibiotic Resistance PathogensCatheter-related Infections

  • ModifiableFrequency of ventilator circuit changesAntibiotic usage

    NonmodifiablePatient age and genderSeverity of illnessComa *Bronchoscopic techniques

    Nonbronchoscopic techniques

    Balance between initial antibiotic and overuseRisk FactorsPrevention

  • Decrease Infection in Neonatal Intensive Care Unit*Source: ImprovementReport: Reducing theIncidence of Nosocomial Infection of Very Low Birth Weight Infantshttp://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/ImprovementStories/ReduceIncidenceofNosocomialInfectionofVLBWInfants.htm

    Image: www.mauryregional.com/NICU.htm

  • Long-Term Acute Care Hospital*Source: Reducing Hospital-Acquired Infections in a Long-Term Acute Care Hospital

    http://www.ihi.org/IHI/Topics/HealthcareAssociatedInfections/InfectionsGeneral/ImprovementStories/ReducingHAIinLongTermAcuteCareHospital.htm

  • *Source: Pursuing Perfection: Report from HealthPartners Regions Hospital on Reducing Hospital-Acquired Infection: Ventilator-Associated Pneumonia and Catheter-Related Bloodstream Infection

    http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories/PursuingPerfectionReportfromHealthPartnersonReducingVAPCRBSI.htm Bundle MethodologyVAP: Ventilator-Associated PneumoniaCR-BSIs: Catheter-Related Bloodstream InfectionsPursuing perfection in fighting with VAP and CR-BSIs in ICU

    VAP rate per 1,000 device daysCR-BSI rate per 1,000 device daysYear1997200420022004Medical ICU29188.23.4Surgical ICUSimilar declines10.54.5Burn CenterSimilar declines9.51.85

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    The three papers that I researched were based on the most prevalent infections in the ICU these days, their risk factors and their control techniques. Nosocomial infections are those which occur when a patient is being treated at a hospital. *The most common types of infections in the ICU are VAP, ARP and CRI. VAP accounts for almost 50% of the mortality rate caused by nosocomial infections in the hospital, ARP are basically when the body gets immune to antibiotics, due to a wrong initial treatment or overuse of drugs/antibiotics, and CRI are due to surgery or indwelling catheters, which are basically tubes in the body. *Taking one example, VAP, which is the most fatal of all infections in the ICU, the risk factors can be classified into modifiable, which depend on the ICU conditions and are under the control of doctors and nurses. Examples are 1 and 2. The other kind is the nonmodifiable, which is related to the patient, such as 1,2,3. The control techniques are classified into bronchoscopic and nonbronchoscopic techniques, and a balance between the initial therapy and overuse.*The first story happened in neonatal intensive care unit (NICU). Their aim is to decrease the nosocomial infection rate to less than 10%. After several changes on year 2001, 2002, and 2003, there is continuous decline but they still not reach their aim.*The second story is in a long-term acute care hospital. The two basic change categories are hand hygiene and admission surveillance cultures(ASC).They applied several changes under each aspect, and finally leads to quite satisfying result. *The third story is about how a hospital keeps fighting with two specific infections in ICU. Here bundle methodology is applied to standardize patient care. Then one critical part in improvement is to change the set habits and existing patterns. As shown from the data in the table, these changes really work.*

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