Acta medica Indonesiana
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Acta medica Indonesiana · Oct 2011
The role of prophylactic antibiotics in preventing perioperative infection.
With the increasing number of surgery or operation, perioperative infection has become one of problems that have been found more often. Surgical site infection is the most common perioperative infection causing increased hospitalization stay, high cost, morbidity and mortality rate. Infection occurs within 30 days after the operation on surgical site or within one year if implant is in place. ⋯ The decision to administer antibiotic prophylaxis should be made by considering their risk and benefits. One of them includes utilization of the NNIS (National Nosocomial Infections Surveillance) score system, which considers three factors, such as wound class, ASA physical status scale, and duration of operation according to the NNIS Survey. The selection on timing and appropriately administered antibiotic prophylaxis is critical to maximize the benefits.
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Acta medica Indonesiana · Apr 2011
Randomized Controlled TrialSafety and feasibility of combined granulocyte colony stimulating factor and erythropoetin based-stem cell therapy using intracoronary infusion of peripheral blood stem cells in patients with recent anterior myocardial infarction: one-year follow-up of a phase 1 study.
to assess the safety and feasibility of combined granulocyte colony-stimulating factor (G-CSF) and erythropoietin (EPO) based intracoronary peripheral blood stem cells (PBSCs) therapy in patients with recent myocardial infarction (RMI) who had successful reperfusion therapy with drug-eluting stent. ⋯ combined G-CSF and EPO based- intracoronary infusion of PBSCs in patients RAMI is safe and feasible.
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Acta medica Indonesiana · Jan 2008
The impact of 'comprehensive geriatric assessment (CGA)' implementation on the effectiveness and cost (CEA) of healthcare in an acute geriatric ward.
to investigate the cost effectiveness of CGA in an acute geriatric ward. ⋯ the CGA approach is more cost effective compared to conventional approach. Quality adjusted life days are better in CGA group than in non-CGA group although survival is not statistically different. In CGA group, length of hospitalization was shorter, functional status and patient satisfaction is better in general. Working satisfaction of nurses in CGA group was not lower than in non CGA group.
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Around half of people aged 65 years and above will undergo surgery due to various indications. Several common types of surgery in the elderly are cataract extraction, joint replacement, cholecystectomy, and revascularization procedures. Elderly patients planned for surgery are at risk of having substandard or even terrible outcome due to decreased ability to maintain or recover physiologic homeostasis during surgery. ⋯ Special attention should be given for postoperative management in the elderly. The elderly might need longer time to recover compared to young patients, and management programs might be needed such as sub acute management, rehabilitation unit, or home-care treatment. In general the postoperative treatments consists of the use of analgesic agents, early mobilization, proper use of urine catheter, prevention and management of delirium, and use of anticoagulants.