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  • 1
    ISSN: 0942-0940
    Keywords: Keywords: Intensive care unit; neurosurgery; nosocomial infection; surveillance.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ In order to identify overall and site-specific nosocomial infection (NI) rates in patients receiving neurosurgical intensive care therapy, a prospective study was started in February 1997 in the eight-bed neurosurgical ICU of the University Hospital of Freiburg, Germany. Case records were reviewed twice a week, all microbiology reports were reviewed and ward staff was consulted. NI were defined according to the CDC-criteria and were categorised into specific infection sites. Within 20 months, 545 patients with a total of 5,117 patient days were investigated (mean length of stay: 9.4 days). 113 NI were identified in 90 patients (72 pts. with one, 13 with two and 5 with three infections, respectively). A moderate to high overall incidence (20.7/100 pts.) and a moderate incidence density (22.1/1,000 patient days) of NI in the neurosurgical ICU could be documented; these figures are well within the range of published data. Site specific incidence rates and incidence densities were: 1 bloodstream infection per 100 patients (0.9 central line-associated BSIs per 1,000 central line-days), 9 pneumonias per 100 patients (15.1 ventilator-associated pneumonias per 1,000 ventilator-days), 7.3 urinary tract infections per 100 patients (8.5 urinary catheter-associated UTIs per 1,000 urinary catheter-days). Additionally, 1.1 cases of meningitis, 0.7 brain abscesses/ventriculitis, and 1.7 other infections (surgical site infection, bronchitis, catheter related local infection, diarrhoea) were documented per 100 patients, respectively. 14.6% of isolated pathogens were E. coli, 10.2% enterococci, 9.6% S. aureus, 6.4% CNS, 6.4% Klebsiella spp., 5% Enterobacter spp. and 5% Pseudomonas spp.. In 11 cases of NI no pathogen could be isolated.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 52 (1980), S. 173-184 
    ISSN: 0942-0940
    Keywords: Pain ; thalamotomy ; radiosurgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thalamotomy aiming at the CM-Pf complex and using stereotactic gamma irradiation has been performed in a series of 52 patients with severe pain due to malignancy. Lesions were produced either contra- or ipsilaterally to the side of the pain as well as bilaterally. Eight patients experienced good pain relief, 18 had moderate relief, and in 24 the operation did not significantly influence the pain. A second operation following recurrence of pain was rarely of value. There was a tendency towards more efficient relief of pain located in the face or in the arm and shoulder than of pain in the lower part of the body. Although contralateral lesions seem to be most effective, ipsilateral operations may also give some relief. The best results were obtained when the lesions were placed close to the wall of the third ventricle and at the level of the posterior commissure. Postmortem examination of 21 brains disclosed that the mean error in the placing of the lesions was about 1 mm. It is concluded that medial thalamotomy may be tried as a last resort in the treatment of cancer pain in selected patients with a short life expectancy.
    Type of Medium: Electronic Resource
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