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1. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship—results from an international cross-sectional survey

Author

Massimo Sartelli, Francesco M. Labricciosa, Pamela Barbadoro, Leonardo Pagani, Luca Ansaloni, Adrian J. Brink, Jean Carlet, Ashish Khanna, Alain Chichom-Mefire, Federico Coccolini, Salomone Di Saverio, Addison K. May, Pierluigi Viale, Richard R. Watkins, Luigia Scudeller, Lilian M. Abbo, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Sara Al-Dahir, Majdi N. Al-Hasan, Halil Alis, Carlos Alves, André R. Araujo da Silva, Goran Augustin, Miklosh Bala, Philip S. Barie, Marcelo A. Beltrán, Aneel Bhangu, Belefquih Bouchra, Stephen M. Brecher, Miguel A. Caínzos, Adrian Camacho-Ortiz, Marco Catani, Sujith J. Chandy, Asri Che Jusoh, Jill R. Cherry-Bukowiec, Osvaldo Chiara, Elif Colak, Oliver A. Cornely, Yunfeng Cui, Zaza Demetrashvili, Belinda De Simone, Jan J. De Waele, Sameer Dhingra, Francesco Di Marzo, Agron Dogjani, Gereltuya Dorj, Laurent Dortet, Therese M. Duane, Mutasim M. Elmangory, Mushira A. Enani, Paula Ferrada, J. Esteban Foianini, Mahir Gachabayov, Chinmay Gandhi, Wagih Mommtaz Ghnnam, Helen Giamarellou, Georgios Gkiokas, Harumi Gomi, Tatjana Goranovic, Ewen A. Griffiths, Rosio I. Guerra Gronerth, Julio C. Haidamus Monteiro, Timothy C. Hardcastle, Andreas Hecker, Adrien M. Hodonou, Orestis Ioannidis, Arda Isik, Katia A. Iskandar, Hossein S. Kafil, Souha S. Kanj, Lewis J. Kaplan, Garima Kapoor, Aleksandar R. Karamarkovic, Jakub Kenig, Ivan Kerschaever, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Hong B. Kim, Wen-Chien Ko, Kaoru Koike, Iryna Kozlovska, Anand Kumar, Leonel Lagunes, Rifat Latifi, Jae G. Lee, Young R. Lee, Ari Leppäniemi, Yousheng Li, Stephen Y. Liang, Warren Lowman, Gustavo M. Machain, Marc Maegele, Piotr Major, Sydney Malama, Ramiro Manzano-Nunez, Athanasios Marinis, Isidro Martinez Casas, Sanjay Marwah, Emilio Maseda, Michael E. McFarlane, Ziad Memish, Dominik Mertz, Cristian Mesina, Shyam K. Mishra, Ernest E. Moore, Akutu Munyika, Eleftherios Mylonakis, Lena Napolitano, Ionut Negoi, Milica D. Nestorovic, David P. Nicolau, Abdelkarim H. Omari, Carlos A. Ordonez, José-Artur Paiva, Narayan D. Pant, Jose G. Parreira, Michal Pędziwiatr, Bruno M. Pereira, Alfredo Ponce-de-Leon, Garyphallia Poulakou, Jacobus Preller, Céline Pulcini, Guntars Pupelis, Martha Quiodettis, Timothy M. Rawson, Tarcisio Reis, Miran Rems, Sandro Rizoli, Jason Roberts, Nuno Rocha Pereira, Jesús Rodríguez-Baño, Boris Sakakushev, James Sanders, Natalia Santos, Norio Sato, Robert G. Sawyer, Sandro Scarpelini, Loredana Scoccia, Nusrat Shafiq, Vishalkumar Shelat, Costi D. Sifri, Boonying Siribumrungwong, Kjetil Søreide, Rodolfo Soto, Hamilton P. de Souza, Peep Talving, Ngo Tat Trung, Jeffrey M. Tessier, Mario Tumbarello, Jan Ulrych, Selman Uranues, Harry Van Goor, Andras Vereczkei, Florian Wagenlehner, Yonghong Xiao, Kuo-Ching Yuan, Agnes Wechsler-Fördös, Jean-Ralph Zahar, Tanya L. Zakrison, Brian Zuckerbraun, Wietse P. Zuidema, and Fausto Catena

Subjects
Antibiotics, Infections, Surgery, Antimicrobial stewardship, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p

Published
2017
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2. Da-Silva, Malmo Peritoneal Flap in Ventral and Incisional Hernia Repair Our Experience

Author

Chinmay Gandhi and Mahesh Zaware

Subjects
medicine.medical_specialty, business.industry, Ventral hernia repair, Incisional hernia, Incisional hernia repair, Abdominal wall repair, medicine.disease, digestive system diseases, Surgery, stomatognathic diseases, surgical procedures, operative, Ventral hernia, Medicine, Local population, business
Abstract

Large ventral hernia is a challenge to operate in tier 3 cities of India, because of economic constrains of local population. Here author reports three large ventral hernias operated with use of Da-Silva, Malmo peritoneal flap technique. Peritoneal flap should be integral part of abdominal wall repair procedures. It reduces cost, morbidity and mortality of a large ventral hernia repair. It is a useful method for repair of large ventral and incisional hernia when primary fascial closer is not achievable. Key words: peritoneal flap, ventral hernia, incisional hernia.

Published
2021

3. Linitis Plastica of Terminal Ileum

Author

S Kalyan Kumar, Chinmay Gandhi, and Mahesh Zavare

Subjects
Abdominal pain, medicine.medical_specialty, Linitis plastica, business.industry, Stomach, digestive, oral, and skin physiology, Ileum, Anastomosis, medicine.disease, Surgery, Lesion, medicine.anatomical_structure, medicine, Vomiting, Adenocarcinoma, medicine.symptom, business
Abstract

Linitis plastica generally involves stomach. Most common cause is diffuse signet ring adenocarcinoma, metastatic disease from breast and lungs can also lead to Linitis plastica and also caustic burns. In Linitis plastica the stomach becomes rigid and pipe like (leather bottle). We are presenting a rare case of Linitis plastica of terminal ileum. Ours is a 55-year female patient presenting in casualty with abdominal pain, distension, vomiting and bilious vomiting. Her terminal ileum had stricturous rigid tube-like lesion with multiple mesenteric lymphadenitis. We did curative resection (ileoascending colon) and anastomosis. She had uneventful recovery. Though small bowel malignancies are rare, one should have high index of suspicion when one encounters rigid pipe like strictures lesion of ileum, as these can be malignant lesion and one should perform curative resection. Surgery improves survival rate along with adjuvant chemotherapy as required. Key words: Linitis plastica, small bowel malignancy, Linitis plastica ileum, Linitis plastica stomach.

Published
2021

4. Male Breast Carcinoma Presenting As a Lump in Axilla: Case Report

Author

Kamepalli Venkateswarlu, Chinmay Gandhi, Prithviraj Vivek Patil, and S Kalyan Kumar

Subjects
medicine.medical_specialty, Axilla, medicine.anatomical_structure, business.industry, medicine, Male Breast Carcinoma, General Medicine, Radiology, business
Published
2020

6. Urethral diverticulum with proximal urethral stricture: An unusual presentation

Author

Chinmay Gandhi, Padmanabh Inamdar, Sadanand Prasadi, and Shashikant Kulkarni

Subjects
Perineal urethrocutaneous fistula, urethral calculus, urethral diverticulum, urethral stricture, Medicine
Abstract

Urethral diverticulum with distal stricture is a common entity. We are presenting a rare case of urethral diverticulum with proximal stricture. This is an uncommon case of a 55- year-old male paraplegic patient, who had urethrocutaneous fistula with distal urethral diverticulum and proximal urethral stricture. The patient was successfully managed by single-stage diverticulectomy and urethroplasty.

Published
2013
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7. Study of laparoscopic cholecystectomy in rural hospital

Author

Padmanabh Inamdar, Chinmay Gandhi, and Sudhanva R. Pathak

Subjects
Laparoscopic surgery, medicine.medical_specialty, Common bile duct, business.industry, Bile duct, General surgery, medicine.medical_treatment, Abdominal Abscess, Retrospective cohort study, Surgery, Port (medical), medicine.anatomical_structure, medicine, Cystic duct, business, Laparoscopic cholecystectomy
Abstract

Background: Laparoscopic cholecystectomy is the preferred mode of treatment for gall stone diseases. This study is the audit of 125 laparoscopic cholecystectomy done in our institute between year 2013 to year 2014. In laparoscopic cholecystectomy common bile duct injuries were more common than open surgery. Objective of this study is to find out intra and postoperative complications in laparoscopic cholecystectomy and to find the reasons for conversion to open cholecystectomy. Methods: This is the retrospective study of standard four port laparoscopic cholecystectomy done during year 2013 to year 2014 in our institute. The result and complications of laparoscopic surgery were documented in audit form for each laparoscopic cholecystectomy and at the end the results are analyzed. Results: There were no common bile duct injury in our study of 125 cases and we had 5.6% conversion to open cholecystectomy due to various reasons discussed in the paper. There were no cases of postoperative abdominal abscess, port site hernia, common bile duct stricture or mortality in our study. One patient with cystic duct leak was managed successfully with post-operative endoscopic spincterotomy and stenting of common bile duct. Conclusions: Laparoscopic cholecystectomy as treatment of choice is associated with high success rate at our institute with added benefits of minimal invasive surgery. Our results are comparable to international standards. Critical view of safety is an essential prerequisite for prevention of bile duct injuries.

Published
2016

8. Traumatic abdominal wall hernia: a rare case report and review

Author

Chinmay Gandhi, Dajiram Govinda Mote, Prameyratna Kadam, and Gautam Ingle

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, Hernia repair, medicine.disease, 030227 psychiatry, Surgery, Abdominal wall, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Blunt, Abdominal trauma, Rare case, Medicine, Abdomen, Hernia, 030216 legal & forensic medicine, Complication, business
Abstract

Blunt abdominal trauma is common in surgical practice. Traumatic abdominal wall hernia is a rare complication of blunt abdominal injury. Hear the patient had a high kinetic energy injury leading to traumatic abdominal wall hernia with intraabdominal complication. Due to high index of clinical suspicion, early CECT of abdomen and emergency surgery, patient had excellent recovery from surgery.

Published
2016

9. The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Federico Coccolini, Leonel Lagunes, André Ricardo Araujo da Silva, Massimo Sartelli, Sara Al-Dahir, Young R. Lee, Mario Tumbarello, Faryal Khamis, Natalia Santos, Jean Carlet, Fausto Catena, Agron Dogjani, Jan Ulrych, Isidro Martinez Casas, András Vereczkei, Salomone Di Saverio, Sydney Malama, Harry van Goor, Garima Kapoor, Hong Bin Kim, Norio Sato, Gustavo M. Machain, Chinmay Gandhi, Iryna Kozlovska, Ramiro Manzano-Nunez, Katia Iskandar, Fikri M. Abu-Zidan, Sujith J Chandy, Rosio Isabel Guerra Gronerth, Therese M. Duane, Lena M. Napolitano, Carlos A. Ordoñez, Yonghong Xiao, Michael McFarlane, Cristian Mesina, Sanjay Marwah, Goran Augustin, Tatjana Goranovic, Bruno M. Pereira, Ivan Kerschaever, Timothy Craig Hardcastle, Marcelo A. Beltrán, Stephen Y. Liang, Julio C. Haidamus Monteiro, Vishalkumar G Shelat, Kuo Ching Yuan, Sandro Scarpelini, Narayan Dutt Pant, Martha Quiodettis, Carlos Alves, Mutasim M. Elmangory, Céline Pulcini, Addison K. May, Guntars Pupelis, Selman Uranues, Pamela Barbadoro, Sandro Rizoli, Ernest E. Moore, Rifat Latifi, Ashish Khanna, Hossein Samadi Kafil, Richard R. Watkins, Boonying Siribumrungwong, Abdelkarim H. Omari, Agnes Wechsler-Fördös, Lewis J. Kaplan, Nusrat Shafiq, Jason A. Roberts, Warren Lowman, Laurent Dortet, Stephen M. Brecher, Luca Ansaloni, Rodolfo Soto, Tanya L. Zakrison, Sameer Dhingra, Jacobus Preller, Eleftherios Mylonakis, Wagih Ghnnam, Asri Che Jusoh, Pierluigi Viale, Costi D. Sifri, Miklosh Bala, José Gustavo Parreira, Alfredo Ponce-de-León, Jae G. Lee, Jakub Kenig, Kjetil Søreide, Halil Alis, Lilian M. Abbo, Mahir Gachabayov, Marco Catani, Ronald Kiguba, Jean-Ralph Zahar, Wietse P. Zuidema, Robert G. Sawyer, Loredana Scoccia, Nuno Pereira, Vladimir Khokha, Ionut Negoi, Aneel Bhangu, Michał Pędziwiatr, Helen Giamarellou, Garyphallia Poulakou, Shyam Kumar Mishra, Francesco Di Marzo, Jeffrey M. Tessier, Boris Sakakushev, Milica D. Nestorovic, Hamilton Petry de Souza, Tarcisio Reis, Yousheng Li, Dominik Mertz, Andreas Hecker, Ngo Tat Trung, Anand Kumar, Belefquih Bouchra, Leonardo Pagani, James M. Sanders, AA Munyika, Brian S. Zuckerbraun, Souha S. Kanj, Arda Isik, Luigia Scudeller, Adrien Hodonou, Philip S. Barie, Marc Maegele, Jill R. Cherry-Bukowiec, Peep Talving, Orestis Ioannidis, Miran Rems, Oliver A. Cornely, Harumi Gomi, Ewen A. Griffiths, Mushira Enani, Zaza Demetrashvili, Gereltuya Dorj, Piotr Major, Miguel Caínzos, Ari Leppäniemi, Jesús Rodríguez-Baño, Wen Chien Ko, Ziad A. Memish, Osvaldo Chiara, Elif Colak, José Artur Paiva, A R K Adesunkanmi, Timothy M. Rawson, Georgios Gkiokas, Paula Ferrada, Francesco M. Labricciosa, Alain Chichom-Mefire, Jan J. De Waele, Yunfeng Cui, Adrián Camacho-Ortiz, J. Esteban Foianini, Majdi N. Al-Hasan, Belinda De Simone, David P. Nicolau, Kaoru Koike, Athanasios Marinis, Florian M.E. Wagenlehner, Aleksandar Karamarkovic, Adrian Brink, Emilio Maseda, II kirurgian klinikka, Department of Surgery, Clinicum, HUS Abdominal Center, Surgery, Other Research, Università degli Studi di Macerata = University of Macerata (UNIMC), Università Politecnica delle Marche [Ancona] (UNIVPM), Central Hospital [Bolzano, Italy], Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Milpark Hospital (Milpark Hospital), Milpark Hospital, University of Cape Town, World Alliance against Antibiotics Resistance, Cleveland Clinic, Regional Hospital, Limbe, Rimini Infermi Hospital, Maggiore Hospital, Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], University of Bologna, Northeastern Ohio Medical University (NEOMED), Foundation IRCCS Policlinico San Matteo, University of Miami Leonard M. Miller School of Medicine (UMMSM), United Arab Emirates University (UAEU), Obafemi Awolowo University (OAU), Xavier University of Louisiana, University of South Carolina School of Medicine, Columbia, South Carolina, Training Hospital Istanbul, Hospital de São João [Porto], Centro de Investigação em Estudos da Criança (CIEC), Universidade do Minho, University Hospital Center Zagreb, Hadassah Hebrew University Medical Center [Jerusalem], Weill Cornell Medicine [New York], Universidad de La Serena (USERENA), Queens Elizabeth Hospital [Birmingham], Université Internationale de Casablanca (UIC), VA Boston Healthcare System, Boston University School of Medicine (BUSM), Boston University [Boston] (BU), Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of psychiatry-King‘s College London, University Hospital of Cologne [Cologne], 4th Department of Internal Medicine, University of Athens Medical School [Athens], Center for Visual Information Technology [Hyderabad] (CVIT), International Institute of Information Technology, Hyderabad [Hyderabad] (IIIT-H), Chonnam National University [Gwangju], Shanghai Jiaotong University, University of Houston, Centro Hospitalar Universitário São João - Faculty of Medicine - University of Porto - Grupo de Infecção e Sepsis, Porto, Unité de biostatistiques, CHU Clermont-Ferrand, ATTIKON University General Hospital, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Duke University Marine Laboratory, University Hospital Virgen Macarena, Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sartelli, M, Labricciosa, FM, Barbadoro, P, Pagani, L, Dorj, G, Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlo, Araujo da Silva, André R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltrán, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Caínzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Esteban Foianini, J., Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgio, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andrea, Hodonou, Adrien M., Ioannidis, Oresti, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppäniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasio, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, Shyam K., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherio, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, José-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, Bruno M., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobu, Pulcini, Céline, Pupelis, Guntar, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodríguez-Baño, Jesú, Sakakushev, Bori, Sanders, Jame, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Søreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andra, Wagenlehner, Florian, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Fördös, Agne, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, and Zuidema, Wietse P.

Subjects
0301 basic medicine, Cross-sectional study, Psychological intervention, Antibiotics, Antimicrobial stewardship, Infections, Surgery, Anti-Infective Agents, Antimicrobial Stewardship, Cross-Sectional Studies, Global Health, Humans, Intraabdominal Infections, Postoperative Complications, Surveys and Questionnaires, GUIDELINES, HEALTH-CARE EPIDEMIOLOGY, 0302 clinical medicine, Global health, Medicine and Health Sciences, PROGRAM, Infection control, Medicine, 030212 general & internal medicine, Response rate (survey), DISEASES SOCIETY, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 3. Good health, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], CIRURGIA, Emergency Medicine, Infection, Life Sciences & Biomedicine, medicine.medical_specialty, 030106 microbiology, lcsh:Surgery, MEDLINE, 03 medical and health sciences, Antibiotic resistance, AMERICA, Science & Technology, business.industry, Antibiotic, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, HOSPITALS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Contains fulltext : 177987.pdf (Publisher’s version ) (Open Access) BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.

Published
2017

10. The

Author

Massimo, Sartelli, Francesco M, Labricciosa, Pamela, Barbadoro, Leonardo, Pagani, Luca, Ansaloni, Adrian J, Brink, Jean, Carlet, Ashish, Khanna, Alain, Chichom-Mefire, Federico, Coccolini, Salomone, Di Saverio, Addison K, May, Pierluigi, Viale, Richard R, Watkins, Luigia, Scudeller, Lilian M, Abbo, Fikri M, Abu-Zidan, Abdulrashid K, Adesunkanmi, Sara, Al-Dahir, Majdi N, Al-Hasan, Halil, Alis, Carlos, Alves, André R, Araujo da Silva, Goran, Augustin, Miklosh, Bala, Philip S, Barie, Marcelo A, Beltrán, Aneel, Bhangu, Belefquih, Bouchra, Stephen M, Brecher, Miguel A, Caínzos, Adrian, Camacho-Ortiz, Marco, Catani, Sujith J, Chandy, Asri Che, Jusoh, Jill R, Cherry-Bukowiec, Osvaldo, Chiara, Elif, Colak, Oliver A, Cornely, Yunfeng, Cui, Zaza, Demetrashvili, Belinda, De Simone, Jan J, De Waele, Sameer, Dhingra, Francesco, Di Marzo, Agron, Dogjani, Gereltuya, Dorj, Laurent, Dortet, Therese M, Duane, Mutasim M, Elmangory, Mushira A, Enani, Paula, Ferrada, J, Esteban Foianini, Mahir, Gachabayov, Chinmay, Gandhi, Wagih Mommtaz, Ghnnam, Helen, Giamarellou, Georgios, Gkiokas, Harumi, Gomi, Tatjana, Goranovic, Ewen A, Griffiths, Rosio I, Guerra Gronerth, Julio C, Haidamus Monteiro, Timothy C, Hardcastle, Andreas, Hecker, Adrien M, Hodonou, Orestis, Ioannidis, Arda, Isik, Katia A, Iskandar, Hossein S, Kafil, Souha S, Kanj, Lewis J, Kaplan, Garima, Kapoor, Aleksandar R, Karamarkovic, Jakub, Kenig, Ivan, Kerschaever, Faryal, Khamis, Vladimir, Khokha, Ronald, Kiguba, Hong B, Kim, Wen-Chien, Ko, Kaoru, Koike, Iryna, Kozlovska, Anand, Kumar, Leonel, Lagunes, Rifat, Latifi, Jae G, Lee, Young R, Lee, Ari, Leppäniemi, Yousheng, Li, Stephen Y, Liang, Warren, Lowman, Gustavo M, Machain, Marc, Maegele, Piotr, Major, Sydney, Malama, Ramiro, Manzano-Nunez, Athanasios, Marinis, Isidro, Martinez Casas, Sanjay, Marwah, Emilio, Maseda, Michael E, McFarlane, Ziad, Memish, Dominik, Mertz, Cristian, Mesina, Shyam K, Mishra, Ernest E, Moore, Akutu, Munyika, Eleftherios, Mylonakis, Lena, Napolitano, Ionut, Negoi, Milica D, Nestorovic, David P, Nicolau, Abdelkarim H, Omari, Carlos A, Ordonez, José-Artur, Paiva, Narayan D, Pant, Jose G, Parreira, Michal, Pędziwiatr, Bruno M, Pereira, Alfredo, Ponce-de-Leon, Garyphallia, Poulakou, Jacobus, Preller, Céline, Pulcini, Guntars, Pupelis, Martha, Quiodettis, Timothy M, Rawson, Tarcisio, Reis, Miran, Rems, Sandro, Rizoli, Jason, Roberts, Nuno Rocha, Pereira, Jesús, Rodríguez-Baño, Boris, Sakakushev, James, Sanders, Natalia, Santos, Norio, Sato, Robert G, Sawyer, Sandro, Scarpelini, Loredana, Scoccia, Nusrat, Shafiq, Vishalkumar, Shelat, Costi D, Sifri, Boonying, Siribumrungwong, Kjetil, Søreide, Rodolfo, Soto, Hamilton P, de Souza, Peep, Talving, Ngo Tat, Trung, Jeffrey M, Tessier, Mario, Tumbarello, Jan, Ulrych, Selman, Uranues, Harry, Van Goor, Andras, Vereczkei, Florian, Wagenlehner, Yonghong, Xiao, Kuo-Ching, Yuan, Agnes, Wechsler-Fördös, Jean-Ralph, Zahar, Tanya L, Zakrison, Brian, Zuckerbraun, Wietse P, Zuidema, and Fausto, Catena

Subjects
Antimicrobial Stewardship, Cross-Sectional Studies, Postoperative Complications, Anti-Infective Agents, Antibiotics, Surveys and Questionnaires, Humans, Intraabdominal Infections, Surgery, Global Health, Infections, Research Article
Abstract

Background Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p

Published
2017

11. Additional file 1: of The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardshipâ results from an international cross-sectional survey

Author

Sartelli, Massimo, Labricciosa, Francesco, Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian, Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Salomone Di Saverio, May, Addison, Viale, Pierluigi, Watkins, Richard, Scudeller, Luigia, Abbo, Lilian, Abu-Zidan, Fikri, Abdulrashid Adesunkanmi, Al-Dahir, Sara, Al-Hasan, Majdi, Alis, Halil, Alves, Carlos, André Araujo Da Silva, Augustin, Goran, Miklosh Bala, Barie, Philip, Beltrán, Marcelo, Bhangu, Aneel, Belefquih Bouchra, Brecher, Stephen, CaíNzos, Miguel, Camacho-Ortiz, Adrian, Catani, Marco, Sujith Chandy, Asri Jusoh, Cherry-Bukowiec, Jill, Chiara, Osvaldo, Colak, Elif, Cornely, Oliver, Yunfeng Cui, Demetrashvili, Zaza, Simone, Belinda De, Waele, Jan De, Dhingra, Sameer, Marzo, Francesco Di, Dogjani, Agron, Gereltuya Dorj, Dortet, Laurent, Duane, Therese, Elmangory, Mutasim, Mushira Enani, Ferrada, Paula, J. Esteban Foianini, Gachabayov, Mahir, Chinmay Gandhi, Wagih Ghnnam, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen, Rosio Guerra Gronerth, Monteiro, Julio Haidamus, Hardcastle, Timothy, Hecker, Andreas, Hodonou, Adrien, Orestis Ioannidis, Isik, Arda, Iskandar, Katia, Kafil, Hossein, Kanj, Souha, Kaplan, Lewis, Kapoor, Garima, Karamarkovic, Aleksandar, Kenig, Jakub, Kerschaever, Ivan, Faryal Khamis, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong, Wen-Chien Ko, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae, Lee, Young, LeppäNiemi, Ari, Yousheng Li, Liang, Stephen, Lowman, Warren, Machain, Gustavo, Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Casas, Isidro Martinez, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael, Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, Shyam, Moore, Ernest, Akutu Munyika, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica, Nicolau, David, Abdelkarim Omari, Ordonez, Carlos, José-Artur Paiva, Pant, Narayan, Parreira, Jose, PęDziwiatr, Michal, Pereira, Bruno, Ponce-De-Leon, Alfredo, Garyphallia Poulakou, Preller, Jacobus, Céline Pulcini, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy, Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno, Jesús RodríGuez-Baño, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert, Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Vishalkumar Shelat, Costi Sifri, Boonying Siribumrungwong, SøReide, Kjetil, Soto, Rodolfo, Souza, Hamilton De, Talving, Peep, Ngo Trung, Tessier, Jeffrey, Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Goor, Harry Van, Andras Vereczkei, Wagenlehner, Florian, Yonghong Xiao, Kuo-Ching Yuan, Wechsler-Fördös, Agnes, Jean-Ralph Zahar, Zakrison, Tanya, Zuckerbraun, Brian, Zuidema, Wietse, and Catena, Fausto

Abstract

The international cross-sectional survey. (DOC 56 kb)

Published
2017
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12. PEDIS grading and its role in diabetic foot ulcer management

Author

Chinmay Gandhi, Prameyratna Kadam, Yugantara Kadam, and Venkateswarlu Kamepalli

Subjects
medicine.medical_specialty, Diabetic foot ulcer, business.industry, Medicine, business, medicine.disease, Grading (tumors), Dermatology
Abstract

Background: Diabetic foot ulcer is the commonest cause of hospitalization in diabetic patients. Amputation is one of its dreaded complications, which deteriorates quality of life and increases mortality. Most of amputations are preventable and it is essential to define standard and efficient approach to treat diabetic foot ulcer in a timely manner. The first step is to define correct grade of diabetic foot ulcer and its risk of developing complications. Aim was to assess the outcome of treatment of diabetic foot ulcer with the given PEDIS score and to find the role of PEDIS score in predicting the outcome.Methods: This is a prospective cohort study. PEDIS score was calculated after all variables were categorized for a give patient and documented. PEDIS score was recorded for each patient. Patients followed up for 6 months and outcome was categorized as healed, unhealed, amputed, or death. Study was carried out till adequate sample size was achieved.Results: High PEDIS score in diabetic foot ulcer was associated with peripheral neuropathy. Adverse outcome like amputation and unhealed ulcer were more seen with high PEDIS score. All amputed patients were having high PEDIS score.Conclusions: PEDIS score is more useful in clinical practice for diabetic foot ulcer grading and can be uniformly applied to compare outcome all over the world.

Published
2019

13. Urethral diverticulum with proximal urethral stricture: An unusual presentation

Author

Padmanabh Inamdar, Shashikant H Kulkarni, Sadanand Prasadi, and Chinmay Gandhi

Subjects
medicine.medical_specialty, urethral calculus, Urethral stricture, Urethroplasty, medicine.medical_treatment, lcsh:Medicine, digestive system, Urethral Calculus, Rare case, otorhinolaryngologic diseases, medicine, Urethral diverticulum, business.industry, lcsh:R, General Medicine, medicine.disease, digestive system diseases, urethral diverticulum, Surgery, Urethrocutaneous fistula, surgical procedures, operative, Perineal urethrocutaneous fistula, urethral stricture, Presentation (obstetrics), medicine.symptom, business
Abstract

Urethral diverticulum with distal stricture is a common entity. We are presenting a rare case of urethral diverticulum with proximal stricture. This is an uncommon case of a 55- year-old male paraplegic patient, who had urethrocutaneous fistula with distal urethral diverticulum and proximal urethral stricture. The patient was successfully managed by single-stage diverticulectomy and urethroplasty.

Published
2013

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