This document discusses surgical infections and the use of antibiotics. It defines surgical infections and notes they account for 1/3 of surgical patients and increased healthcare costs. Factors that contribute to infections include adequate microorganisms, virulence, suitable environment, and susceptible host. Common pathogens include Streptococcus, Staphylococcus, Enterobacteriaceae, Clostridia, Pseudomonas, and Bacteroides fragilis. Antibiotics are used both therapeutically to treat existing infections and prophylactically to reduce wound infection risk. Guidelines recommend different antibiotic regimens based on the surgical wound classification and infection type.
Surgical infections are a major challenge, accounting for 1 in 3 surgical patients. Factors like adequate microorganisms, virulence, suitable environment, and susceptible host contribute to infections. Common pathogens include Streptococci, Staphylococci, and Gram-negative organisms. Treatment involves debridement, drainage, antibiotic therapy tailored to the specific pathogen, and supportive measures. Antibiotic prophylaxis based on wound classification can help reduce postoperative infection risk.
This document discusses surgical infections and antibiotics. It defines a surgical infection as one requiring surgical treatment that developed before or after surgery. The main factors contributing to infections are adequate microorganisms, virulence, suitable environment, and host susceptibility. Common pathogens include Streptococci, Staphylococci, Enterobacteriaceae, Pseudomonas, and Clostridia. Antibiotics play an important role in treatment and prophylaxis of surgical infections. Guidelines recommend different antibiotic regimens based on the classification of surgical wounds.
This document discusses surgical infections and the use of antibiotics. It defines surgical infections and describes various pathogens that commonly cause infections, including Streptococcus, Staphylococcus, gram-negative organisms, and Clostridia. It also discusses specific infections such as surgical site infections, necrotizing fasciitis, tetanus, and pseudomembranous colitis. The document concludes by outlining guidelines for antibiotic prophylaxis and treatment based on the classification of surgical wounds.
This document discusses surgical site infections, including their definition, pathogenesis, clinical features, common pathogens, and treatment. A surgical site infection is an infection that develops before or after surgery and requires surgical treatment. They account for 1 in 3 surgical patients and increased healthcare costs. Common causes include adequate bacterial dose, virulence factors, and a suitable environment at the surgical site. Staphylococcus aureus is a frequent cause, and treatment involves debridement, drainage, antibiotics like penicillin and vancomycin, and supportive care. Preventing surgical site infections requires optimizing patient and surgical factors.
The document discusses several interesting clinicopathologic case studies involving fungal and parasitic skin infections:
1. A case of cutaneous protothecosis caused by the algae Prototheca wickerhamii in an immunocompromised patient.
2. A case of cutaneous zygomycosis caused by the fungus Rhizopus in a neutropenic patient.
3. A case of cutaneous alternariosis and candidiasis in a lung transplant recipient.
4. A case of disseminated penicilliosis caused by the dimorphic fungus Penicillium marneffei in an HIV-positive patient presenting with skin lesions.
This document discusses anti-fungal drugs. It begins by explaining that anti-fungal drugs are used to treat fungal infections, which can be superficial or systemic. It then classifies major types of anti-fungal drugs and describes several examples in detail. Ketoconazole, clotrimazole, fluconazole and griseofulvin are discussed regarding their mechanisms of action, indications, dosages and side effects. Amphotericin B is described as a broad-spectrum polyene used intravenously to treat serious fungal infections, though it can cause renal toxicity and other side effects. Nystatin is noted as a similar but less toxic polyene used topically for localized candid
Surgical infections are a major challenge, accounting for 1 in 3 surgical patients. Factors like adequate microorganisms, virulence, suitable environment, and susceptible host contribute to infections. Common pathogens include Streptococci, Staphylococci, and Gram-negative organisms. Treatment involves debridement, drainage, antibiotic therapy tailored to the specific pathogen, and supportive measures. Antibiotic prophylaxis based on wound classification can help reduce postoperative infection risk.
This document discusses surgical infections and antibiotics. It defines a surgical infection as one requiring surgical treatment that developed before or after surgery. The main factors contributing to infections are adequate microorganisms, virulence, suitable environment, and host susceptibility. Common pathogens include Streptococci, Staphylococci, Enterobacteriaceae, Pseudomonas, and Clostridia. Antibiotics play an important role in treatment and prophylaxis of surgical infections. Guidelines recommend different antibiotic regimens based on the classification of surgical wounds.
This document discusses surgical infections and the use of antibiotics. It defines surgical infections and describes various pathogens that commonly cause infections, including Streptococcus, Staphylococcus, gram-negative organisms, and Clostridia. It also discusses specific infections such as surgical site infections, necrotizing fasciitis, tetanus, and pseudomembranous colitis. The document concludes by outlining guidelines for antibiotic prophylaxis and treatment based on the classification of surgical wounds.
This document discusses surgical site infections, including their definition, pathogenesis, clinical features, common pathogens, and treatment. A surgical site infection is an infection that develops before or after surgery and requires surgical treatment. They account for 1 in 3 surgical patients and increased healthcare costs. Common causes include adequate bacterial dose, virulence factors, and a suitable environment at the surgical site. Staphylococcus aureus is a frequent cause, and treatment involves debridement, drainage, antibiotics like penicillin and vancomycin, and supportive care. Preventing surgical site infections requires optimizing patient and surgical factors.
The document discusses several interesting clinicopathologic case studies involving fungal and parasitic skin infections:
1. A case of cutaneous protothecosis caused by the algae Prototheca wickerhamii in an immunocompromised patient.
2. A case of cutaneous zygomycosis caused by the fungus Rhizopus in a neutropenic patient.
3. A case of cutaneous alternariosis and candidiasis in a lung transplant recipient.
4. A case of disseminated penicilliosis caused by the dimorphic fungus Penicillium marneffei in an HIV-positive patient presenting with skin lesions.
This document discusses anti-fungal drugs. It begins by explaining that anti-fungal drugs are used to treat fungal infections, which can be superficial or systemic. It then classifies major types of anti-fungal drugs and describes several examples in detail. Ketoconazole, clotrimazole, fluconazole and griseofulvin are discussed regarding their mechanisms of action, indications, dosages and side effects. Amphotericin B is described as a broad-spectrum polyene used intravenously to treat serious fungal infections, though it can cause renal toxicity and other side effects. Nystatin is noted as a similar but less toxic polyene used topically for localized candid
This document provides information on pleural empyema, including its definition, etiology, stages, symptoms, investigations, and management. Pleural empyema, also known as pyothorax, is the accumulation of pus in the pleural cavity. It can develop as a complication of conditions like pneumonia or following trauma. Management involves treating the infection with antibiotics, draining the pus via procedures like chest tube insertion or VATS, and re-expanding the lung. Treatment may also include procedures like thoracocentesis, fibrinolytics, or open drainage if more invasive measures are needed.
Surgical wound infection Dr Hatem El GoharyHatem Elgohary
1. Surgical wounds are at risk of infection if the protective epithelial surfaces are broken through trauma or surgery. The body has chemical, humoral, and cellular defenses against infection but these can be compromised by various risk factors.
2. Common signs of a surgical wound infection include fever, pain, pus or discharge, redness, swelling, and tenderness at the wound site. Infections are classified based on degree of contamination from clean to dirty.
3. Proper preventative measures include preoperative antibiotic prophylaxis, hygienic practices in the operating room, and careful postoperative wound management. Established infections require identification of causative organisms and targeted antibiotic treatment.
The document discusses fungal infections, with a focus on Candida infections. It describes how Candida infections are classified based on location and epidemiology. Common types include mucocutaneous infections, which affect the skin and mucous membranes, and deep organ infections. Risk factors for Candida infections include HIV/AIDS, antibiotics, steroids, diabetes, and malnutrition. Clinical manifestations vary depending on infection location and can include oral thrush, vaginal infections, skin infections, and deep organ infections affecting organs like the liver, kidneys, heart and brain. Diagnosis involves visualizing Candida in samples through staining techniques. Treatment depends on infection severity and location, but may include topical or oral antifungal medications like a
The document discusses the history and evolution of understanding of surgical site infections from ancient times through the present. Key developments include Hippocrates' view that disease was natural, the germ theory of Pasteur and Lister in the 19th century establishing the role of microorganisms, and advances in the 20th century including antibiotics and improved aseptic techniques reducing infection rates. Risk factors for surgical site infections include longer and more complex surgeries, older and immunosuppressed patients, and breaks in sterile technique.
Cellulitis is an acute bacterial skin infection that causes skin inflammation and swelling. It is usually caused by Streptococcus pyogenes or Staphylococcus aureus entering through a break in the skin. Risk factors include skin injuries, conditions like eczema, obesity, and diabetes. Signs include redness, pain, swelling and warmth in the infected area. Treatment involves antibiotics, wound care, elevation and rest. Complications can include tissue damage, gangrene and sepsis if not properly treated.
Chemotherapy involves treating infections with drugs that kill or suppress pathogens. This document discusses the general considerations of chemotherapy including definitions, classifications of antimicrobials, and problems that can arise with their use. It covers classifications based on the type of organism targeted, source of the drug, spectrum of activity, mechanism of action, and chemical structure. It also discusses issues like resistance, choice of drugs, combined therapy, and prophylactic use.
This document discusses various surgical infections including abscesses, cellulitis, erysipelas, tetanus, gas gangrene, necrotizing fasciitis, and surgical site infections. It describes the causative organisms, clinical features, complications, and treatment for each type of infection. Bacteraemia, septicaemia, and pyaemia which can result from surgical infections are also summarized. Sepsis is defined as a systemic inflammatory response to infection in the bloodstream or tissues.
This document discusses several types of fungal infections including superficial mycoses, subcutaneous mycoses, systemic mycoses, and opportunistic mycoses. It describes the classification, causative organisms, clinical presentations, diagnoses, and treatments for various specific fungal infections including candidiasis, cryptococcosis, aspergillosis, fusariosis, mucormycosis, and penicilliosis.
This document provides an overview of common bacterial skin infections, including impetigo, ecthyma, furuncles, carbuncles, erysipelas, cellulitis, staphylococcal scalded skin syndrome, toxic shock syndrome, erythrasma, pitted keratolysis, trichomycosis, scarlet fever, cutaneous anthrax, and syphilis. For each infection, the causative bacteria, signs and symptoms, management, and other key details are discussed.
This document discusses various antibiotics, their uses, and emerging issues with antibiotic resistance. It provides guidance on empiric treatment for common infections like community-acquired pneumonia and skin/soft tissue infections.
For a case of community-acquired pneumonia, the patient was initially treated empirically with Augmentin and clarithromycin per guidelines. Testing later found penicillin-resistant Streptococcus pneumoniae, requiring a change to higher dose beta-lactams, vancomycin, or fluoroquinolones.
A case of cellulitis grew methicillin-resistant Staphylococcus aureus despite initial Augmentin treatment. The drug of choice for MRSA is vancomycin,
Necrotising fasciitis is a life-threatening soft tissue infection that spreads rapidly along fascial planes. It is caused by bacteria such as group A Streptococcus and Clostridium perfringens entering through breaks in the skin or surgical wounds. Risk factors include diabetes, immunosuppression, and bacterial introduction through trauma. Diagnosis involves clinical features of pain, swelling, and skin changes. Laboratory tests show leukocytosis and imaging shows fascial inflammation and gas. Treatment requires aggressive surgical debridement of dead tissue, intravenous antibiotics, and supportive care. Without prompt treatment, necrotising fasciitis can cause sepsis, organ failure, and death.
The document discusses several acute specific surgical infections:
1. Erysipelas is an acute streptococcus bacterial skin infection characterized by fever and a raised, purple rash.
2. Gas gangrene is a deadly infection caused by Clostridium bacteria that produces tissue-damaging gas. It begins with pain and swelling around a skin injury and progresses rapidly.
3. Diphtheria is an upper respiratory illness caused by Corynebacterium diphtheriae bacteria, spread through contact. It is characterized by a sore throat and gray membrane in the throat. Prompt antitoxin treatment is needed.
Pathogenesis of bacterial infection and nosocomial infectionRegi Septian
Terima kasih atas masukannya. Saya akan mempelajari lebih lanjut tentang topik ini agar dapat memberikan penjelasan yang lebih lengkap dan akurat ke depannya.
1. Actinomyces and Nocardia are filamentous, Gram-positive bacteria found in the environment and as normal flora in humans.
2. Actinomyces causes cervicofacial and abdominal actinomycosis in humans through tissue invasion following trauma or medical procedures. Diagnosis involves identifying sulfur granules in biopsy specimens.
3. Nocardia is an opportunistic pathogen that can cause pulmonary, cutaneous, or disseminated nocardiosis through inhalation or skin inoculation. It is an important cause of infection in immunocompromised individuals.
Based on the information provided:
Diagnosis: Cervical lymphadenitis or tuberculous lymph node abscess.
Etiology: Mycobacterium tuberculosis infection. Primary infection from inhalation of droplets or secondary spread from infected site like dental infection in this case.
Management:
- Incision and drainage of abscess is contraindicated as it may cause dissemination of infection.
- Excision of lymph node intact under cover of anti-tubercular drugs.
- Start 4 drug anti-tubercular therapy (ATT) for minimum 6 months.
- Monitor for response to treatment.
- Advise complete course of ATT to prevent relapse.
The document discusses various infections that can affect newborns, categorized by type of pathogen. It describes bacterial infections such as those caused by Staphylococcus aureus and Streptococcus, which can cause skin conditions like impetigo, breast abscesses, and cellulitis. It also covers viral infections such as herpes simplex virus and TORCH infections that can be acquired prenatally, during delivery, or postnatally. Fungal and parasitic infections that may infect newborns are also mentioned. Treatment options are provided for some common bacterial skin infections.
This document provides information on various Clostridium bacteria including C. septicum, C. novyi, C. histolyticum, and C. tetani. It describes their morphological characteristics, toxins produced, diseases caused such as gas gangrene, and laboratory methods for diagnosis. Gas gangrene is defined as a rapidly spreading muscle tissue death caused by clostridial bacteria. Treatment involves surgery to remove damaged tissues, antibiotics such as metronidazole, and immunization to prevent further infection.
The document discusses Staphylococcus bacteria, including S. aureus, S. epidermidis, and S. saprophyticus. S. aureus is a common cause of skin infections and abscesses. It produces toxins that can cause food poisoning, scalded skin syndrome, and toxic shock syndrome. Treatment involves draining infections and antibiotics like penicillins, though antibiotic resistance is a problem. Prevention focuses on hygiene and proper wound care.
This document provides information on Staphylococcus aureus, including its classification, morphology, culture characteristics, biochemical properties, virulence factors, pathogenesis, clinical syndromes, laboratory diagnosis, treatment, and MRSA. S. aureus is a Gram-positive coccus that occurs in clusters and can cause a variety of infections on the skin and deeper tissues. It is classified based on pigment production and coagulase testing. Diagnosis involves culture, microscopy, and biochemical tests. Treatment depends on the infection type and may involve antibiotics, wound drainage, and device removal.
This document discusses several bacterial infections including Madura foot, necrotizing fasciitis, clostridial infections (tetanus and gas gangrene). Madura foot is a chronic fungal infection of the foot that causes bone destruction. Necrotizing fasciitis is an acute soft tissue infection characterized by tissue necrosis. Clostridial infections include tetanus, caused by C. tetani toxin, and gas gangrene, caused by C. perfringens, which causes muscle necrosis and systemic toxicity.
This document provides information on pleural empyema, including its definition, etiology, stages, symptoms, investigations, and management. Pleural empyema, also known as pyothorax, is the accumulation of pus in the pleural cavity. It can develop as a complication of conditions like pneumonia or following trauma. Management involves treating the infection with antibiotics, draining the pus via procedures like chest tube insertion or VATS, and re-expanding the lung. Treatment may also include procedures like thoracocentesis, fibrinolytics, or open drainage if more invasive measures are needed.
Surgical wound infection Dr Hatem El GoharyHatem Elgohary
1. Surgical wounds are at risk of infection if the protective epithelial surfaces are broken through trauma or surgery. The body has chemical, humoral, and cellular defenses against infection but these can be compromised by various risk factors.
2. Common signs of a surgical wound infection include fever, pain, pus or discharge, redness, swelling, and tenderness at the wound site. Infections are classified based on degree of contamination from clean to dirty.
3. Proper preventative measures include preoperative antibiotic prophylaxis, hygienic practices in the operating room, and careful postoperative wound management. Established infections require identification of causative organisms and targeted antibiotic treatment.
The document discusses fungal infections, with a focus on Candida infections. It describes how Candida infections are classified based on location and epidemiology. Common types include mucocutaneous infections, which affect the skin and mucous membranes, and deep organ infections. Risk factors for Candida infections include HIV/AIDS, antibiotics, steroids, diabetes, and malnutrition. Clinical manifestations vary depending on infection location and can include oral thrush, vaginal infections, skin infections, and deep organ infections affecting organs like the liver, kidneys, heart and brain. Diagnosis involves visualizing Candida in samples through staining techniques. Treatment depends on infection severity and location, but may include topical or oral antifungal medications like a
The document discusses the history and evolution of understanding of surgical site infections from ancient times through the present. Key developments include Hippocrates' view that disease was natural, the germ theory of Pasteur and Lister in the 19th century establishing the role of microorganisms, and advances in the 20th century including antibiotics and improved aseptic techniques reducing infection rates. Risk factors for surgical site infections include longer and more complex surgeries, older and immunosuppressed patients, and breaks in sterile technique.
Cellulitis is an acute bacterial skin infection that causes skin inflammation and swelling. It is usually caused by Streptococcus pyogenes or Staphylococcus aureus entering through a break in the skin. Risk factors include skin injuries, conditions like eczema, obesity, and diabetes. Signs include redness, pain, swelling and warmth in the infected area. Treatment involves antibiotics, wound care, elevation and rest. Complications can include tissue damage, gangrene and sepsis if not properly treated.
Chemotherapy involves treating infections with drugs that kill or suppress pathogens. This document discusses the general considerations of chemotherapy including definitions, classifications of antimicrobials, and problems that can arise with their use. It covers classifications based on the type of organism targeted, source of the drug, spectrum of activity, mechanism of action, and chemical structure. It also discusses issues like resistance, choice of drugs, combined therapy, and prophylactic use.
This document discusses various surgical infections including abscesses, cellulitis, erysipelas, tetanus, gas gangrene, necrotizing fasciitis, and surgical site infections. It describes the causative organisms, clinical features, complications, and treatment for each type of infection. Bacteraemia, septicaemia, and pyaemia which can result from surgical infections are also summarized. Sepsis is defined as a systemic inflammatory response to infection in the bloodstream or tissues.
This document discusses several types of fungal infections including superficial mycoses, subcutaneous mycoses, systemic mycoses, and opportunistic mycoses. It describes the classification, causative organisms, clinical presentations, diagnoses, and treatments for various specific fungal infections including candidiasis, cryptococcosis, aspergillosis, fusariosis, mucormycosis, and penicilliosis.
This document provides an overview of common bacterial skin infections, including impetigo, ecthyma, furuncles, carbuncles, erysipelas, cellulitis, staphylococcal scalded skin syndrome, toxic shock syndrome, erythrasma, pitted keratolysis, trichomycosis, scarlet fever, cutaneous anthrax, and syphilis. For each infection, the causative bacteria, signs and symptoms, management, and other key details are discussed.
This document discusses various antibiotics, their uses, and emerging issues with antibiotic resistance. It provides guidance on empiric treatment for common infections like community-acquired pneumonia and skin/soft tissue infections.
For a case of community-acquired pneumonia, the patient was initially treated empirically with Augmentin and clarithromycin per guidelines. Testing later found penicillin-resistant Streptococcus pneumoniae, requiring a change to higher dose beta-lactams, vancomycin, or fluoroquinolones.
A case of cellulitis grew methicillin-resistant Staphylococcus aureus despite initial Augmentin treatment. The drug of choice for MRSA is vancomycin,
Necrotising fasciitis is a life-threatening soft tissue infection that spreads rapidly along fascial planes. It is caused by bacteria such as group A Streptococcus and Clostridium perfringens entering through breaks in the skin or surgical wounds. Risk factors include diabetes, immunosuppression, and bacterial introduction through trauma. Diagnosis involves clinical features of pain, swelling, and skin changes. Laboratory tests show leukocytosis and imaging shows fascial inflammation and gas. Treatment requires aggressive surgical debridement of dead tissue, intravenous antibiotics, and supportive care. Without prompt treatment, necrotising fasciitis can cause sepsis, organ failure, and death.
The document discusses several acute specific surgical infections:
1. Erysipelas is an acute streptococcus bacterial skin infection characterized by fever and a raised, purple rash.
2. Gas gangrene is a deadly infection caused by Clostridium bacteria that produces tissue-damaging gas. It begins with pain and swelling around a skin injury and progresses rapidly.
3. Diphtheria is an upper respiratory illness caused by Corynebacterium diphtheriae bacteria, spread through contact. It is characterized by a sore throat and gray membrane in the throat. Prompt antitoxin treatment is needed.
Pathogenesis of bacterial infection and nosocomial infectionRegi Septian
Terima kasih atas masukannya. Saya akan mempelajari lebih lanjut tentang topik ini agar dapat memberikan penjelasan yang lebih lengkap dan akurat ke depannya.
1. Actinomyces and Nocardia are filamentous, Gram-positive bacteria found in the environment and as normal flora in humans.
2. Actinomyces causes cervicofacial and abdominal actinomycosis in humans through tissue invasion following trauma or medical procedures. Diagnosis involves identifying sulfur granules in biopsy specimens.
3. Nocardia is an opportunistic pathogen that can cause pulmonary, cutaneous, or disseminated nocardiosis through inhalation or skin inoculation. It is an important cause of infection in immunocompromised individuals.
Based on the information provided:
Diagnosis: Cervical lymphadenitis or tuberculous lymph node abscess.
Etiology: Mycobacterium tuberculosis infection. Primary infection from inhalation of droplets or secondary spread from infected site like dental infection in this case.
Management:
- Incision and drainage of abscess is contraindicated as it may cause dissemination of infection.
- Excision of lymph node intact under cover of anti-tubercular drugs.
- Start 4 drug anti-tubercular therapy (ATT) for minimum 6 months.
- Monitor for response to treatment.
- Advise complete course of ATT to prevent relapse.
The document discusses various infections that can affect newborns, categorized by type of pathogen. It describes bacterial infections such as those caused by Staphylococcus aureus and Streptococcus, which can cause skin conditions like impetigo, breast abscesses, and cellulitis. It also covers viral infections such as herpes simplex virus and TORCH infections that can be acquired prenatally, during delivery, or postnatally. Fungal and parasitic infections that may infect newborns are also mentioned. Treatment options are provided for some common bacterial skin infections.
This document provides information on various Clostridium bacteria including C. septicum, C. novyi, C. histolyticum, and C. tetani. It describes their morphological characteristics, toxins produced, diseases caused such as gas gangrene, and laboratory methods for diagnosis. Gas gangrene is defined as a rapidly spreading muscle tissue death caused by clostridial bacteria. Treatment involves surgery to remove damaged tissues, antibiotics such as metronidazole, and immunization to prevent further infection.
The document discusses Staphylococcus bacteria, including S. aureus, S. epidermidis, and S. saprophyticus. S. aureus is a common cause of skin infections and abscesses. It produces toxins that can cause food poisoning, scalded skin syndrome, and toxic shock syndrome. Treatment involves draining infections and antibiotics like penicillins, though antibiotic resistance is a problem. Prevention focuses on hygiene and proper wound care.
This document provides information on Staphylococcus aureus, including its classification, morphology, culture characteristics, biochemical properties, virulence factors, pathogenesis, clinical syndromes, laboratory diagnosis, treatment, and MRSA. S. aureus is a Gram-positive coccus that occurs in clusters and can cause a variety of infections on the skin and deeper tissues. It is classified based on pigment production and coagulase testing. Diagnosis involves culture, microscopy, and biochemical tests. Treatment depends on the infection type and may involve antibiotics, wound drainage, and device removal.
This document discusses several bacterial infections including Madura foot, necrotizing fasciitis, clostridial infections (tetanus and gas gangrene). Madura foot is a chronic fungal infection of the foot that causes bone destruction. Necrotizing fasciitis is an acute soft tissue infection characterized by tissue necrosis. Clostridial infections include tetanus, caused by C. tetani toxin, and gas gangrene, caused by C. perfringens, which causes muscle necrosis and systemic toxicity.
This document contains questions pertaining to the diagnosis and management of various clinical cases. It includes 10 slides with questions about cysts, lipomas, hernias, thyroid disorders, leg ulcers, abdominal masses, and breast examinations. The key topics covered are the pathognomonic features, common complications, differential diagnoses, and clinical findings and techniques for various clinical presentations.
A hiatus hernia occurs when part of the stomach protrudes through an enlarged opening in the diaphragm. There are two main types: sliding, where the esophagus-stomach junction slides up, and paraesophageal, where part of the stomach pushes through beside the esophagus. Risk factors include older age, obesity, and weak muscles. Symptoms are heartburn, regurgitation, difficulty swallowing, and chest pain. Diagnosis involves medical history, imaging like barium swallow, and endoscopy. Treatment options are lifestyle changes, medications like antacids or PPIs, and surgery to repair severe cases.
The document outlines the agenda for an oncosurgical unit meeting at Minia University discussing inflammatory bowel diseases (IBDs) from surgical and oncological perspectives. The meeting will cover an introduction to IBDs, the epidemiology and pathophysiology of these conditions, the differences between Crohn's disease and ulcerative colitis, management and surgical considerations for IBDs, and the oncological risks factors and surveillance recommendations for patients with IBDs. The document provides a structured outline of the topics to be discussed at the meeting.
This document discusses gastric cancer (GAC). It notes that GAC is the 1st most common primary malignant tumor of the stomach, 2nd most common gastrointestinal tumor, and 3rd leading cause of cancer death worldwide. Risk factors for GAC include smoking, H. pylori infection, atrophic gastritis, and hereditary syndromes. Histologically, GAC is classified as intestinal type, diffuse type, or otherwise based on the Lauren classification system. Staging is done using the TNM system. Investigation involves endoscopy, biopsy, and imaging. Management depends on stage - early cancers receive gastrectomy and chemotherapy while advanced or metastatic cancers receive chemotherapy or palliative care.
This document provides an overview of hepatocellular carcinoma (HCC) in Egypt, including treatment options and their selection criteria. The main treatment modalities discussed are resection, transplantation, radiofrequency ablation (RFA), transarterial chemoembolization (TACE), transarterial radio therapy (TART), yttrium-90 (Y-90) therapy, and stereotactic body radiation therapy (SBRT). Each treatment has specific criteria for patient eligibility and tumor characteristics, such as lesion size and location. The document compares advantages and disadvantages of the different treatments.
GIST are rare mesenchymal tumors that arise from interstitial cells of Cajal in the gastrointestinal tract. They commonly express the receptor tyrosine kinases KIT or PDGFRA, which are often mutated. Complete surgical resection is the main treatment for localized primary GIST, while targeted therapy with imatinib or sunitinib is used for advanced or metastatic disease. Factors like tumor size, mitotic rate, and site of origin determine prognosis and risk of recurrence to guide adjuvant targeted therapy or surveillance after surgery.
1. The liver and biliary ducts arise from a foregut diverticulum, with the cranial part forming the liver, caudal part forming the ventral pancreas, and intermediate bud forming the gallbladder.
2. The liver has 4 lobes and 8 segments, each supplied by its own branches of the hepatic artery, portal vein and bile duct, allowing surgical resection of individual segments.
3. Liver injuries are most often caused by blunt trauma or penetrating injuries, and may involve lacerations, hematomas or ruptures requiring laparotomy, suturing, and sometimes lobectomy or segmentectomy.
Dr. Abdelrahman Salah is a lecturer in general surgery at an unnamed department. His area of expertise is cancer of the esophagus. The document provides his name, title, area of specialization within general surgery, and medical condition he treats.
Three patient cases were presented for discussion at an oncosurgical unit meeting:
1. A 25-year-old male with a history of laparoscopic total colectomy for FAP, presenting with recurrent bleeding per rectum and anemia. Colonoscopy and labs were unremarkable except for internal piles.
2. A 39-year-old male with a history of repeated vomiting. Endoscopy found an inflammatory ulcer with H. pylori and gastritis. CT scan showed GB stones, reduced aortomesenteric distance and angle, and scanty fat.
3. A 17-year-old female with abdominal pain. Imaging found a large pelviabdominal cyst
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
3. INFECTION
Invasion of the body by pathogenic
microorganisms and reaction of the
host to organisms and their toxins
4. SURGICAL INFECTIONS
A surgical infection is an infection
which requires surgical treatment and
has developed befor, or as a
complication of surgical treatment.
5. Surgical Infection
A major challenge
Accounts for 1/3 of surgical patients
Increased cost to healthcare
6. Factors contributing to infections
Adequate dose of microorganisms
Virulence of microorganisms
Suitable environment ( closed space )
Susceptible host
7. Pathogenicity of bacteria
Exotoxins: specific, soluble proteins, remote cytotoxic effect
Cl.Tetani, Strep. pyogenes
Endotoxins: part of gram-negative bacterial wall,
lipopolysaccharides e.g., E coli
Resist phagocytosis: Protective capsule
Klebsiela and Strep. pneumoniae
9. Prevention of surgical infection
Patient in best general condition.
(host defense)
Minimize introduction of pathogens during
surgery.
Good surgical technique.
Peri-operative care (support defense)
10. Clinical features
Local- pain, heat, redness, swelling, loss of function
(apparent in superficial infections)
Systemic- fever, tachycardia, chills
Investigations:
Leukocytosis
Exudates- Gram stain, culture
Blood culture ( chills & fever )
Special investigations ( radiology, biopsy )
21. STAPHYLCOCCAL INFECTIONS
Abscess- localized pus collection
Treatment- drainage, antibiotics
Furuncle- infection of hair follicle / sweat glands
Carbuncle- extension of furuncle into subcut. tissue
common in diabetics
common sites- back, back of neck
Treatment: drainage, antibiotics, control diabetes
22.
23. Surgical site infection (SSI)
38% of all surgical infections
Infection within 30 days of operation
Classification:
Superficial: Superficial SSI–infection in subcutaneous plane (47%)
Deep: Subfascial SSI- muscle plane (23%)
Organ/ space SSI- intra-abdominal, other spaces (30%)
Staph. aureus- most common organism
E coli, Entercoccus ,other Entetobacteriaceae- deep infections
B fragilis – intrabd. abscess
24. Surgical site infection (SSI)
Risk factors: age, malnutrition, obesity,
immunocompromised, poor surg. tech,
prolonged surgery, preop. shaving and
type of surgery.
Diagnosis:
Sup.SSI- erythema, oedema, discharge and pain
Deep infections- no local signs, fever, pain, hypotension.
need investigations.
Treatment: surgical / radiological intervention.
28. GRAM NEGATIVE ORGANISMS
Pseudomonas
aerobes, occurs on skin surface
opportunistic pathogen
may cause serious & lethal infection
colonize ventilators, iv catheters, urinary catheters
Wound infection, burn, septicemia
Treatment: aminoglycosides, piperacillin, ceftazidime
29. CLOSTRIDIA
Gram positive, anaerobe
Rod shaped microorganisms
Live in bowel & soil
Produce exotoxin for pathogenicity
Important members:
Cl. Perfringens, Cl. Septicum ( gas gangrene )
Cl. Tetani ( tetanus )
Cl. Difficile ( pseudomembranous colitis )
30. GAS GANGRENE
Cl. Perfringens, Cl. Septicum
Exotoxins: lecithinase, collagenase, hyaluridase
Large wounds of muscle ( contaminated by soil, foreign body )
Rapid myonecrosis, crepitus in subcutaneous tissue
Seropurulent discharge, foul smell, swollen
Toxemia, tachycardia, ill looking
X-ray: gas in muscle and under skin
Penicillin, clindamycin, metronidazole
Wound exposure, debridement , drainage, amputation
Hyperbaric oxygen
31. TETANUS
Cl. Tetani, produce neurotoxin
Penetrating wound ( rusty nail, thorn )
Usually wound healed when symptoms appear
Incubation period: 7-10 days
Trismus- first symptom, stiffness in neck & back
Anxious look with mouth drawn up ( risus sardonicus)
Respiration & swallowing progressively difficult
Reflex convulsions along with tonic spasm
Death by exhaustion, aspiration or asphyxiation
32. TETANUS
Treatment:
wound debridement, penicillin
Muscle relaxants, ventilatory support
Nutritional support
Prophylaxis:
wound care, antibiotics
Human TIG in high risk ( un-immunized )
Commence active immunization ( T toxoid)
Previously immunized-
booster >10 years needs a booster dose
booster <10 years- no treatment in low risk wounds
33. PSEUDOMEMBRANOUS COLITIS
Cl. Difficile
Overtakes normal flora in patients on antibiotics
Watery diarrhea, abdominal pain, fever
Sigmoidoscopy: membrane of exudates (pseudomembranes)
Stool- culture and toxin assay
Treatment :
stop offending antibiotic
oral vancomycin/ metronidazole
rehydration, isolate patient
34.
35. GRAM NEGATVE ANAEROBES
Bacteroides fragilis
Normal flora in oral cavity, colon
Intra-abdominal & gynecologic infections ( 90% )
Foul smelling pus, gas in surrounding tissue, necrosis
Spiking fever, jaundice, Leukocytosis
No growth on standard culture
Needs anaerobe culture media
Treatment:
Surgical drainage
Antibiotics- clindamycin, metronidazole
36. ANTIBIOTICS
Chemotherapeutic agents that act on organisms
Bacteriocidal: Penicillin, Cephalosporin, Vancomycin
Aminoglycosides
Bacteriostatic: Erythromycin, Clindamycin,
Tetracycline
38. ROLE OF ANTIBIOTICS
Therapeutic:
To treat existing infection
Prophylactic:
To reduce the risk of wound
infection
39. ANTIBIOTIC THERAPY
( Guideline for surgical infections )
Pseudomembranous colitis- oral vancomycin/ metronidazole
Biliary-tract infection- cephalosporin or gentamycin
Peritonitis- cephalosporin/ gentamycin + metronidazole/ clindamycin
Septicemia- aminoglycoside + ceftazidime, Tazocin or imipenem,
( may add metronidazole )
Septicemia due to vascular catheter- Flucloxacillin/ vancomycin
or Cefuroxime
Cellulitis- penicillin, erythromycin
( flucloxacillin if Staphylococcus infection. Suspected )
40. ANTIBIOTIC PROPHYLAXIS
Prophylaxis in clean-contaminated/
high risk clean wounds
Antibiotic is given just before patient
sent for surgery
Duration of antibiotic is controversial
( one dose- 24 hour regimen )
41. ANTIBIOTIC PROPHYLAXIS
BASED ON SURGICAL WOUND CLASSIFICATION
A. Clean : CLASS I e.g. surgeries on thyroid gland,
breast, hernia,
• No need for prophylaxis in clean surgeries, except for :
oImmunucompromised patients, e.g. diabetics, patients
using corticosteroids.
oIf the surgery include inserting foreign materials such as
artificial valves.
o High risk patients like those with infective endocarditis.
The risk of postoperative wound infection is around
2%.
42. ANTIBIOTIC PROPHYLAXIS
B. Clean/Contaminated (minimal
contamination) : CLASS II
e.g., biliary,urinary, GI tract surgery
Prophylaxis is advisable, and the risk of
infection is about 5-10%.
43. ANTIBIOTIC PROPHYLAXIS
C. Contaminated (gross contamination) :
CLASS III e.g. during bowel surgery
Prophylaxis is advisable and the risk of infection
is up to 20%.
44. ANTIBIOTIC PROPHYLAXIS
D. Dirty : CLASS IV through established
infection
e.g., peritonitis ( up to 50% )
The use of antibiotic is considered to be of
therapeutic nature (not prophylactic).
The risk of infec@on is up to 5CD.