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Periprosthetic joint infection is a rare but serious complication. Its management requires the collaboration between general practitioner, orthopaedic surgeon and infectious disease specialist. A delay in the diagnosis can result in complications, requiring complex surgical procedures. Identification of the causative pathogen and its susceptibility pattern is crucial, because it guides both the choice of antimicrobial treatment and the surgical strategy. Antimicrobial treatment without proper microbiological sampling must be avoided. Swabs from open wounds are not helpful, because microorganisms belonging to the skin flora will grow. The target audience of this review article on periprosthetic joint infections is the general practitioner. © 2014, Editions Medecine et Hygiene. All rights reserved. Source


Troillet N.,Institute Central
Revue Medicale Suisse | Year: 2014

The risk of zoonose transmitted from cats and dogs has increased as these animals have been more and more included in family life to become real household members. This paper reviews the main bacterial, parasitic, viral and fungal infections that could be transmitted to humans by these pet animals in different situations. Although the risk of human disease is relatively low for most of the presented infections, its recognition is important to prevent some exposures, to apply correct prophylactic measures after bites, and to include these zoonoses in the differential diagnosis in case of illnesses that could have an infectious origin, particularly in immunocompromised patients. © 2014, Editions Medecine et Hygiene. All rights reserved. Source


Molecular diagnostics methods are not limited to specialized centers anymore. They play an important role for the diagnostic of infections commonly encountered in the clinical practice. Especially the detection of pathogens difficult to cultivate, such as viruses, has been greatly improved by these methods. Often, PCR has become the gold standard for the diagnostics of these pathogens. However, PCR cannot be used in any case, and it is not fail proof. Therefore, it is important to know when to use molecular methods and what are their strengths and weaknesses, in order to prescribe them rationally. This article reviews the characteristics of molecular tests and their main indications in the ambulatory setting. © 2014, Editions Medecine et Hygiene. All rights reserved. Source


Benoit E.,Institute Central | Eckert P.,Center Hospitalier du Center du Valais | Beney J.,Institute Central
Farmaceutisch Tijdschrift voor Belgie | Year: 2012

Introduction: Medication errors (ME) can harm patients and increase costs. ME are frequent in the intensive care units HCU), where patients are critically ill and therefore more vulnerable. Publications about ME in the critical care setting are rare The differences between settings, the lack of standardized definitions and the use of different methods do not allow transposing published results to a specific ICU. The goal of this observational study is to analyse our local situation in relation to the literature findings and determine improvement opportunities. Outcomes: Rates of actual medication error (AME) and potential medication error (PME) per line of drug, and per patient-day. Distribution of errors among eight types considered clinically significant. Context: Intensive care unit, in a tertiary care hospital Method: Error detection was based on the comparison between the prescriptions, the scheduling of the administrations (PME) and the actual medication administrations (AME). Results: 229 lines with an AME were detected in 4636 lines of drugs administered to 144 patients during 373 patient-days. AME rate per line of drug was 5%. PME rate per line of drug was 17%. AME rate per patient-day was 61%. Dose omissions and not discontinued administrations accounted altogether for more than 50% of the total of AME. Conclusions: The literature does not consider the transcription stage as a priority target for error reduction, but this work shows that, depending on the context, transcriptions can significantly increase opportunities for errors. As transcription does not add any value, its suppression seems therefore to be an interesting target for medication safety improvement. Source


Benoit E.,Institute Central | Eckert P.,Center Hospitalier du Center du Valais | Beney J.,Institute Central
Journal de Pharmacie de Belgique | Year: 2012

Introduction: Medication errors (ME) can harm patients and increase costs. ME are frequent in the intensive care units (ICU), where patients are critically ill and therefore more vulnerable. Publications about ME in the critical care setting are rare. The differences between settings, the lack of standardized definitions and the use of different methods do not allow transposing published results to a specific ICU. The goal of this observational study is to analyse our local situation in relation to the literature findings and determine improvement opportunities. Outcomes: Rates of actual medication error (AME) and potential medication error (PME) per line of drug, and per patient-day. Distribution of errors among eight types considered clinically significant. Context: Intensive care unit, in a tertiary care hospital. Method: Error detection was based on the comparison between the prescriptions, the scheduling of the administrations (PME) and the actual medication administrations (AME). Results: 229 lines with an AME were detected in 4636 lines of drugs administered to 144 patients during 373 patient-days. AME rate per line of drug was 5%. PME rate per line of drug was 17%. AME rate per patient-day was 61%. Dose omissions and not discontinued administrations accounted altogether for more than 50% of the total of AME. Conclusions: The literature does not consider the transcription stage as a priority target for error reduction, but this work shows that, depending on the context, transcriptions can significantly increase opportunities for errors. As transcription does not add any value, its suppression seems therefore to be an interesting target for medication safety improvement. Source

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