Der Urologe. Ausg. A
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Nosocomial infections (NI) may be a serious and mostly avoidable consequence of medical procedures and often cause a significant aggravation of the patients underlying disease. Following surgical site infections, urinary tract infections (UTI) represent the second most common fraction of NIs (22.4%) in Germany and contribute to approximately 155,000 nosocomial UTIs (nUTI) every year. Prevention of NI is of utmost individual as well as socioeconomic importance especially regarding the continuing worldwide increase in antibiotic resistance. ⋯ Their practical importance for various clinical settings in urology is outlined in this overview. The correct use of urinary catheters has the greatest impact for prevention and control as nUTIs are associated with urinary catheters in most of the cases (80%). The recently updated guidelines of the Commission for Hospital Hygiene and Infection Prevention of the Robert Koch Institute (KRINKO) and the Association of the Scientific Medical Societies in Germany (AWMF) provide detailed recommendations in an evidence-based and practice-oriented manner as summarized in this article.
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Der Urologe. Ausg. A · Oct 2014
[Perioperative antibiotic prophylaxis for major urological interventions].
With the emergence of multidrug resistant bacteria reaching alarming levels and the year-long developmental void of new antimicrobial drugs, the rational and appropriate use of antibiotics is of paramount importance. The number of surgical interventions is still increasing so that surgical site infections represent the most frequent form of nosocomial infection. ⋯ The indications for perioperative antibiotic prophylaxis depend on the type of surgical procedure, the classification of operative wounds as well as individual patient and operation-related risk factors.
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Der Urologe. Ausg. A · Aug 2014
[New transparency between physicians and the pharmaceutical industry].
The long-lasting trusting partnership between physicians and the pharmaceutical industry with respect to experience from applied research of medications and vocational training, was severely tested by campaign-like dissemination of collective accusations of corruption. Instead of standing by their responsibility to financing clinical research and vocational training of physicians, the health insurance companies in particular claim that physicians are being extensively bribed by the pharmaceutical industry. In order to continuously improve the mutual targets, i.e. the treatment options for patients, both groups have developed transparency regulations.
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Der Urologe. Ausg. A · Jul 2014
[Radical prostatectomy. Detection and management of intra- and postoperative complications].
Radical prostatectomy is the most common treatment for organ-confined prostate cancer. Performed without complications and limitations, surgery will allow complete removal of the tumor and, therefore, cure the patient. ⋯ To ensure rapid recovery of each patient, early detection of complications is highly relevant. Herein, different scenarios for peri- and postoperative complications are described, and recommendations for best practice solutions are reviewed.