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HIV AND SURGERY:AN ISSUE ONLY FOR DEVELOPED COUNTRY? AN OVERVIEW FROM MOZAMBIQUE
Written by Afonso M.T. Fumo et Al.   
giovedì, 21 luglio 2016

The high incidence of HIV, especially in sub-Saharan African countries, and the in-crease of life expectancy due to effectiveness antiretroviral therapies, have led to an increase of patients undergoing surgery interventions. To date there is still no defini-tive data on role, outcome and management of HIV positive surgical subjects. This paper reviews the more recent literature about HIV infection, highlighting the main pathologies treated by thoracic, abdominal and orthopedic surgery, without forgetting about other surgery branches. Particular attention was paid to Mozambique, a devel-oping country with one of the highest levels of HIV incidence.

 
ROUTINARY FLUCONAZOLE PROPHYLAXIS IN VLBW NEONATES: IS A RIGHT CHOISE?
Written by A. Di Mauro, D. De Bellis, A. Foglianese, M. F. Gallone, N. Laforgia   
giovedì, 21 luglio 2016

This is a retrospective cohort study with the aim of evaluating fluconazole efficacy in preventing invasive fungal infections in very low birth weight newborns, in our NICU setting.  Neonates weighing less than 1500g at birth, born between January 2013 and Decem-ber 2014, were enrolled in the study.  The primary aim was to assess the prevalence of fungal infections. The secondary aim was to identify newborns with a higher risk of invasive fungal infections as well as the incidence of complications after invasive fungal infection.  59 newborns were included in the study. Routine fluconazole prophylaxis at the dose of 3mg/kg i.v. every 72 hours was administered to 47/59 (79,7%). The overall pro-portion of invasive fungal infections was 17%, with no significant difference between neonates who underwent fluconazole prophylaxis (19,1%) and those who did not (8,3%) (p = 0,4). Candida parapsilosis was the most common isolated strain (90%). Lower gestational age, lower birth weight, surgery interventions and delayed initiation of enteral feeding were associated with invasive fungal infections.  All septic newborns developed complications: bronchopulmonary dysplasia, retinopa-thy of prematurity and periventricular leukomalacia. None died due to Candida infec-tion.  Our findings do not appear to support routine fluconazole prophylaxis in very-low-birth-weight infants.

 
THE MANAGEMENT OF PIN-CARE IN EXTERNAL FIXATION TECHNIQUE
Written by Michele Bisaccia et Al.   
giovedì, 21 luglio 2016

Purpose: Currently, there is no universal approach to pin-site care for preventing infection. The medication of these pins is essential for obtaining good external fixation results. The purpose of this study is to evaluate the results obtained after pins were medicated with two different disinfectants: povidone-iodine (10%) and sodium hypochlorite 0,05% (Amukina-med®).

Methods: 237 pins of 40 patients treated with Hoffmann II external fixation have been analyzed in our study. The average age was 41.3 (ranging from 19-71). All pins were inserted by hand pre-drilling together with continuous irrigation with cold saline to reduce the risk of thermal necrosis. Patients were divided into 2 groups consisting of 20 patients each: in group A, 109 pins were medicated with povidone-iodine and in group B, 128 pins were medicated with sodium hypochlorite 0,05%.

Results: 24 pins (22%) medicated with povidone-iodine became infected, as well as 13 pins (10,1%) medicated with sodium hypochlorite. A few pins mobilized: 13 in group A and 6 in group B. In all cases, infections were resolved with oral antibiotic therapy.

Conclusions: Our study showed that medication with sodium hypochlorite 0,05% reduced the per-centage of pin-tract infection and mobilization with respect to povidone-iodine, dem-onstrated by significant statistical evidence (Chi-square's test: p<0.05).

 
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