Reduce Infection Risk Research Articles

Antibiotic prophylaxis in oral implant surgery in Germany: a cross-sectional study

PurposeProphylactic antibiotics are used in dental implants to reduce infection risk and implant failure, especially benefiting patients with risk factors. However, evidence suggests that using clindamycin or extending antibiotics postoperatively has an unfavorable risk–benefit ratio.MethodsThis national cross-sectional study analyzed antibiotic prophylaxis during implant insertion across Germany. Dentists from the German Society for Oral Implantology (DGOI) provided demographic information and data on the next 10 consecutive implant patients, including age, sex, risk factors, type of implantation, and antibiotic details.Results103 dentists participated, providing data on 1040 patients. Most dentists were male and aged 30–64. Patients were evenly split between genders, with an average age of 51 years. Antibiotics were administered in 87.6% of all cases, more frequently for patients undergoing bone augmentation (OR 7.01, p < 0.0001), immediate (OR 3.11, p = 0.002) or delayed (OR 5.30, p < 0.0001) implant insertion, and those with cardiovascular disease (OR 3.24, p = 0.009). 74.8% of implantologists tended to use antibiotic prophylaxis routinely, while the remaining implantologists decided on a case-by-case basis. Implantologists primarily used aminopenicillins for 63.8% of prescriptions and clindamycin for the remaining 35.6%. Additionally, 78.8% of patients with prophylaxis received postoperative, multi-day treatments.ConclusionsThe study reveals extensive antibiotic use for perioperative prophylaxis in implant surgery, often not justified by current recommendations, particularly concerning the choice of antibiotic (e.g., clindamycin) and duration (e.g., postoperative use). Specialized clinical guidelines and targeted training for dentists on antibiotic prophylaxis are needed.Graphical

HIV Infection Among Adolescent Girls and Young Women in Sub-Saharan Africa: Philosophical Perspectives of Sociostructural Risk Factors

Background and Objective Sociostructural risk factors influence human immunodeficiency virus (HIV) infection outcomes among adolescent girls and young women (AGYW) aged 15–24 in Sub-Saharan Africa. The philosophical perspectives on sociostructural risk factors can be helpful in reducing new HIV infections in this age group. This review aims to describe these perspectives to guide the development and implementation of targeted interventions at preventing new HIV infection among AGYW, while addressing age-gender inequalities in HIV infection risk reduction. Methods This literature review examined philosophical perspectives on sociostructural risk factors of HIV infection from June 1981 when improvements in HIV knowledge regarding clinical course and epidemiology began to November 2023. We utilized literature from peer-reviewed papers and books on HIV risk factors and infection outcomes among AGYW, gathered from search engines like PubMed, Google Scholar, and Medline. Results The philosophy of sexuality is linked to sociostructural tenets like seduction, early marriage, adultery, and prostitution. Ubuntu’s philosophy is influenced by Western culture, such as pornography and adolescent marriages. Realism is linked to sexual violence, HIV stigma, and unfavorable health policy decisions. The philosophy of health integrates natural and holistic phenomena to address HIV infection. Conclusion and Implications for Translation The literature reviews suggest that addressing philosophical issues like seduction, early marriages, adultery, prostitution, pornography exposure, sexual violence, and unfavorable policies are crucial for reducing new HIV infection among AGYW and recommend the Ministries of Health to review and adopt these considerations in their respective national HIV prevention guidelines.

Protective environment strategies for hematopoietic stem cell transplantation: progress and prospects.

With the progress of hematopoietic stem cell transplantation technology, the reduction of pretreatment intensity, the shortening of bone marrow suppression time and the reduction of infection risk, as well as the prominent physical and psychological stress for doctors and patients caused by rigorous protection procedures, the strategies for protective environment need to be reconsidered. Regardless of whether total environment protection is implemented, there is no significant difference in the outcomes of chemotherapy patients with neutropenia. The advantages and disadvantages of total environment protection have been weighed and reviewed for patients receiving hematopoietic stem cell transplantation. The protective environment strategies for hematopoietic stem cell transplantation patients have developed rapidly in the past two decades, from the initial replacement of laminar flow equipment by high-efficiency filtration devices to the development of home care after transplantation. In this article, the progress of protective environment strategies for hematopoietic stem cell transplantation patient was reviewed, and further reflections were posed, providing reference for future improvement.

The Usefulness of Vascularized Flap Craniotomy for Open-Wound Depressed Skull Fractures

BACKGROUND AND IMPORTANCE: Free bone flap craniotomy for open-wound depressed skull fractures poses a high risk of infection due to free bone fragments. This risk escalates in the presence of compound fractures with accompanying dural injuries. The primary objectives in managing depressed skull fractures include infection prevention and the correction of cosmetic deformities. This report describes the efficacy of vascularized flap craniotomy, which preserves blood flow to bone fragments, in reducing infection risks. CLINICAL PRESENTATION: In this study, we present a 54-year-old man with a head injury and a Glasgow Coma Scale score of 8. He had an open wound in the left parietal temporal area and depressed skull fractures with compound bone fragments. The patient underwent vascularized flap craniotomy, focusing on maintaining blood supply to the bone fragments, resulting in successful wound healing without acute infections. CONCLUSION: Vascularized flap craniotomy is an effective surgical option for treating open-wound depressed skull fractures, potentially reducing the risk of infection by maintaining blood flow to bone fragments. Further studies are required to validate its efficacy in larger patient populations.

Shoulder &amp; Elbow

The December 2024 Shoulder &amp; Elbow Roundup360 looks at: Predicting recurrence of instability after a primary traumatic anterior shoulder dislocation; Predictors of surgery and long-term outcomes in nonoperative management of full-thickness rotator cuff tears; Reverse shoulder arthroplasty viable despite acquired acromial compromise, but higher infection risk noted; LP-PRP reduces retear rates in rotator cuff repair but shows no functional outcome advantage; Long-term clinical outcomes of arthroscopic supraspinatus tendon repair using the single anchor tension band technique – minimum five-year follow-up; Arthroscopic stabilization for anterior shoulder dislocation shows low recurrence rates regardless of prior dislocations; ORIF outperforms arthroplasty for complex radial head fractures: mid-term outcomes; Routine use of surgical helmet systems may not reduce infection risk in shoulder arthroplasty.

Analysis of Feeding White Eggs, Cockfish, Binahong Leaves, Belt Leaf Soak, VCO, Pineapple Juice and Honey on Accelerate Healing of Perineum Wounds and Incidents Perineal Wound Infection

Perineal wounds, if not properly treated, are at risk of infection, especially with poor hygiene, inappropriate care, or comorbidities like diabetes. Symptoms of infection include worsening pain, swelling, redness, and fluid or pus discharge, sometimes accompanied by fever or chills. This research aimed to examine the effects of natural remedies—white eggs, snakehead fish, binahong leaves, soaked betel leaves, VCO, pineapple juice, and honey—on accelerating perineal wound healing and reducing infection risk. Using a quasi-experimental quantitative approach with purposive sampling, the study found that these remedies significantly accelerated wound healing compared to a control group, as indicated by a p-value of 0.000 from Mann-Whitney tests. While some in the control group experienced infections, those treated with the natural remedies showed faster healing and fewer infections. The study suggests that using these natural treatments can effectively speed up perineal wound healing and reduce the risk of infection.

Prevention of Pathogenesis of Infection in Postpartum Women Through Postpartum Care Culture

Cultural beliefs and practices significantly influence postpartum care, affecting maternal health outcomes both positively and negatively. In developing countries, around 70% of postpartum mothers lack adequate care and often only seek medical attention in severe cases, contributing to elevated maternal mortality rates during the postpartum period. This study investigates how cultural practices impact postpartum care and the incidence of postpartum infection pathogenesis. Using a cross-sectional study design, the research analyzed data from 141 participants with chi-square tests. Results reveal a significant relationship between postpartum care culture and infection incidence, with a p-value of 0.000. Participants were primarily aged 20-35 years (61%), had high school education (68.80%), and were non-working (72.30%). These factors suggest that education and employment status may affect postpartum care practices. A majority of respondents exhibited positive care practices, with 51.10% reporting good care and no postpartum infections. The findings highlight the necessity for developing culturally sensitive postpartum care guidelines to reduce infection risks and enhance maternal health outcomes by incorporating local cultural values into care practices.

CD71+ erythroid cells promote multiple myeloma progression andimpair anti-bacterial immune response.

Multiple myeloma (MM), one of the most frequent haematological malignancies, significantly increases the risk of bacterial infections due to treatment-related side effects, comorbidities and cancer-induced immune deficiencies. Recently, CD71+ erythroid cells (CECs) have been identified as key immunomodulators in neonates and cancer patients, but their role in MM progression remains unclear. Using a murine MM model, closely resembling human disease, we observed that MM progression is associated with anaemia and an increase in immature CECs, which are characterized by elevated arginase 2 (ARG2) expression. These MM-associated CECs suppress T-cell proliferation, contributing to impaired immune responses. Notably, ARG2 deficiency in mice led to slower MM progression and improved survival. Furthermore, MM-bearing mice exhibited higher susceptibility to Listeria monocytogenes infections, mirroring the increased infection risk in MM patients. Our findings suggest that ARG2-expressing CECs play a critical role in MM-associated immune suppression and infection susceptibility, pointing out ARG2 as a potential therapeutic target to enhance immune function and reduce infection risks in MM patients.

Central venous catheter-related infections: a systematic review, meta-analysis, trial sequential analysis and meta-regression comparing ultrasound guidance and landmark technique for insertion

BackgroundDuring central venous catheterization (CVC), ultrasound (US) guidance has been shown to reduce mechanical complications and increase success rates compared to the anatomical landmark (AL) technique. However, the impact of US guidance on catheter-related infections remains controversial. This systematic review and meta-analysis aimed to compare the risk of catheter-related infection with US-guided CVC versus AL technique.MethodsA systematic search on MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases was conducted until July 31, 2024. Randomized controlled trials (RCTs) and non-randomized studies of intervention (NRSI) comparing US-guided versus AL-guided CVC placement were included. The primary outcome was a composite outcome including all types of catheter-related infection: catheter-related bloodstream infections (CRBSIs), central line-associated bloodstream infections (CLABSIs), catheter colonization, or any other type of reported infection. The secondary outcomes included individual infection types and mortality at day-28. Subgroup analyses based on study type and operator experience were also performed.ResultsPooling twelve studies (8 RCTs and 4 NRSI), with a total of 5,092 CVC procedures (2072 US-guided and 3020 AL-guided), US-guided CVC was associated with a significant reduction in catheter-related infections compared with the AL technique (risk ratio (RR) = 0.68, 95% confidence interval (CI) 0.53–0.88). In the RCT subgroup, the pooled RR was 0.65 (95% CI 0.49–0.87). This effect was more pronounced in procedures performed by experienced operators (RR = 0.60, 95% CI 0.41–0.89). In inexperienced operators, the infection risk reduction was not statistically significant. The pooled analysis of CRBSIs and CLABSIs also favored US guidance (RR = 0.65, 95% CI 0.48–0.87).ConclusionUS-guided CVC placement significantly reduces the risk of catheter-related infections compared to the AL technique, particularly when performed by experienced operators.Trial registration PROSPERO CRD42022350884. Registered 13 August 2022.

Prevention of infectious complications after radical cystectomy: a systematic review and meta-analysis

The aim of this study was to conduct a systematic review and meta-analysis of the literature to evaluate the impact of different antibiotic prophylaxis (АР) strategies on the incidence of infectious complications within 30 days after radical cystectomy (RC).Material and Methods. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): ID-CRD42023480525. A systematic search for studies published in the last 10 years (November 2013 – November 2023) was conducted in the PubMed and Cochrane Library databases by two independent researchers. A total of 7 full-text articles were included in the final statistical analysis (data from 90,935 patients). The analysis focused on three aspects: comparison of the effectiveness of different durations of antibiotic prophylaxis (24 hours or more), the impact of the type of antibacterial agent used, and the application of Enhanced Recovery after Surgery (ERAS) protocols on the overall incidence of infectious complications, the development of soft tissue infections, and upper urinary tract infections (UTIs). Meta-analysis was performed using R 4.3.2 (R Foundation for Statistical Computing, Vienna, Austria) and the metafor 4.2-0 package.Results. The median overall incidence of infectious complications was 31.78 % (23.8–58.8 %), surgical site infections – 16.46 % (6.25–35.41 %), and UTIs – 25.11 % (3.86–35.7 %), including cases leading to urosepsis. The meta-analysis did not reveal a statistically signifшcant effect of the duration of AP (24 hours or more) on the risk of infectious complications: for overall infectious complications, the risk was OR 1.11 (95 % CI 0.92–1.33; p=0.27), for surgical site infection OR 1.00 (95 % CI 0.87–1.15; p=0.97), and for UTIs OR 0.96 (95 % CI 0.84–1.10; p=0.59). However, the overall incidence of infectious complications was significantly higher in the standard perioperative management group, without ERAS protocols (OR=3.02 [95 % CI 2.07; 4.39], p&lt;0.001, I 2 =93.1 %). Conclusion. The results of this study indicate that existing AP strategies may be ineffective in reducing postoperative infectious complications in patients undergoing cystectomy with urinary diversion. Extending AP beyond 24 hours, as well as the standard regimen, did not demonstrate a reduction in infection risk, highlighting the need for a revision of clinical guidelines in this area. The principles of the ERAS program may play a crucial role in reducing infectious complications, showing promising results and requiring further research and implementation in clinical practice. Key words: radical cystectomy, antibiotic prophylaxis, complications, surgical site infection, upper urinary tract infections, ERAS&gt; ˂ 0.001, I2 =93.1 %).Conclusion. The results of this study indicate that existing AP strategies may be ineffective in reducing postoperative infectious complications in patients undergoing cystectomy with urinary diversion. Extending AP beyond 24 hours, as well as the standard regimen, did not demonstrate a reduction in infection risk, highlighting the need for a revision of clinical guidelines in this area. The principles of the ERAS program may play a crucial role in reducing infectious complications, showing promising results and requiring further research and implementation in clinical practice.

Nanotechnology-Enhanced Orthopaedic Surgery

Nanomaterials hold significant promise for the future of orthopaedic implants due to their ability to mimic the nanoscale components of the bone, such as collagen fibrils and hydroxyapatite. Nanomaterials can regulate cell behaviour while offering mechanical strength and biocompatibility, making them ideal for bone repair and tissue regeneration. This comprehensive review explores the key existing and potential applications of nanotechnology in orthopaedics, including bone tissue engineering, drug delivery systems, systems combatting implant-related infections, and the surface preparation of implants to enhance osseointegration. These innovations are poised to revolutionise orthopaedic care by improving implant durability, reducing infection risks, and promoting bone regeneration to deliver personalised treatment and create better patient outcomes.

Preventing MRSA Infections in Sports: Effective Strategies and Approaches

Introduction: Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are a growing concern, particularly among asymptomatic individuals. CA-MRSA can lead to various conditions such as skin infections, septic arthritis, pyomyositis, endocarditis, and pubic osteomyelitis, with athletes being especially vulnerable due to shared equipment, close contact, and skin trauma. Prolonged colonization of the anterior nares and persistence on shared surfaces contribute to its spread. Purpose of work: This study aims to review MRSA prevalence in sports and provide effective strategies for prevention and management.The purpose of this paper is to evaluate MRSA prevalence in sports and provide effective strategies for prevention and management. Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar and Scopus was undertaken using the search terms encompassing the following keywords: Community- acquired MRSA / MRSA and Sport / MRSA and athletes / MRSA Prevention Strategies in Sports / MRSA Infection Risks in Athletes / MRSA Colonization and Sports Participation. Results: A meta-analysis found that about 6% of asymptomatic athletes are colonized with MRSA, though rates vary by sport and country. Decolonization methods may reduce infection risk, but their effects are often temporary. This study examines MRSA colonization and infections in athletes, stressing the importance of preventive measures.

OUTCOME OF BURIED VERSUS EXPOSED KIRCHNER WIRES IN TERMS OF INFECTION IN FRACTURE OF PHALANGES AND METACARPAL BONE OF HAND

Kirschner wire (K-wire) fixation is a common technique for treating phalangeal and metacarpal fractures due to its cost-effectiveness and efficiency. However, the risk of infection associated with exposed K-wires remains a significant concern. This study aimed to compare infection rates and clinical outcomes in hand fractures treated with buried versus exposed K-wires. Objective: To assess and compare infection rates, clinical interventions, and patient comfort between buried and exposed K-wires in phalangeal and metacarpal fractures. Method: This study was conducted at Bolan Medical Complex Hospital, Quetta, with 110 patients divided into two groups: Group A (55 patients with buried K-wires) and Group B (55 patients with exposed K-wires). Infection rates were evaluated by categorizing infections as superficial or deep. Clinical outcomes, including the need for antibiotics, K-wire removal, and patient comfort, were assessed for both groups. Results: Group A (buried K-wires) had significantly lower infection rates, with 3.6% of patients developing superficial infections and 1.8% deep infections. In contrast, Group B (exposed K-wires) had higher infection rates, with 10.9% experiencing superficial infections and 5.4% deep infections. Additionally, exposed K-wire patients required more clinical interventions, including increased antibiotic use and K-wire removal. Conclusion: Buried K-wires provide a safer and more comfortable alternative for hand fracture management, with significantly lower infection rates and reduced need for further medical intervention compared to exposed K-wires. Therefore, the use of buried K-wires is preferable for reducing infection risk and enhancing patient comfort.

Reducing Infection Risks of Anti-BCMA Bispecific Antibodies in Multiple Myeloma: In-Hospital Vs. Hospital-at-Home Treatment

Reducing Infection Risks of Anti-BCMA Bispecific Antibodies in Multiple Myeloma: In-Hospital Vs. Hospital-at-Home Treatment

Antibiotic Management After Neonatal Enteric Operations in US Children's Hospitals

BackgroundThere are few evidence-based guidelines for perioperative antibiotic management in neonates who undergo enteric operations. We sought to assess antibiotic administration practices in a large population of patients who underwent operations involving enteric anastomoses and evaluate the incidence of postoperative infection and other outcomes based on antibiotic approach. MethodsThe Pediatric Health Information Systems database was queried for patients who underwent repair of esophageal, duodenal or jejuno-ileal atresia in 2021. The type and number of consecutive days of perioperative antibiotics was determined and ICD-10 codes corresponding to infection were noted. The incidences of post operative infections (bacterial and fungal), antibiotic-resistant infections and anti-fungal medication administration were determined. Results516 infants were identified. A wide variety of antibiotics were administered and 39 % of patients received more than one day of treatment. There were no differences in the incidence of postoperative infection between those who received more or less than one day of perioperative antibiotics for any of the operations assessed. The incidence of bacterial infection in patients treated with cefazolin or cefoxitin monotherapy was no different than that for all other regimens. There were no significant differences in the incidence of post-operative fungal infection based on antibiotic type or duration. ConclusionThere was substantial variation in the duration and type of antibiotics administered after neonatal enteric operations. We identified a low incidence of infection with only one day of perioperative antibiotics and there was no evidence that longer treatment reduced infection risk. Cefazolin monotherapy was likewise associated with a low risk for perioperative infections. Study typeNon-interventional observational database study. Level of evidence3.

Use of Antibacterial Envelopes in Neuromodulation Surgeries With Implantable Device Insertion: A Systematic Review and Meta-Analysis.

Neuromodulation is an advanced therapeutic intervention for managing various neurological, psychiatric, and functional disorders. However, a significant challenge is the risk of infections at the device implantation site. Previous studies have shown that antibacterial envelopes used in cardiovascular surgeries significantly reduce infection risk. It is postulated that similar benefits could occur in neurosurgeries involving implant insertion, but the literature lacks studies analyzing this efficacy. This study aimed to evaluate the effectiveness of antibacterial envelopes in reducing infection rates associated with neuromodulation implants. We systematically searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases up to August 2024 for clinical trials comparing the use of antibacterial impregnated envelopes in patients undergoing neuromodulation-related implant insertion. This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Statistical analyses were performed using R version 4.3.2. Risk of bias was assessed using the Risk Of Bias In Nonrandomized Studies-of Interventions tool, and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation assessment. The study was registered in Prospective Register of Systematic Reviews. Four studies, comprising 1242 patients, were included, of whom 704 (56.7%) received antibacterial envelopes. The pooled analysis showed that the odds of infection were 77% lower in patients using the antibacterial envelope compared with the control group (odds ratios = 0.23; 95% CI = 0.10-0.51; P < .001; I2 = 2%). The use of an antibacterial envelope significantly reduces the odds of infection in patients undergoing neuromodulation-related implant insertion by 77%. These findings underscore the potential of antibacterial envelopes to improve postoperative outcomes.

Meta-Analysis of Transperineal and Transrectal Ultrasound-Guided Prostate Biopsy in the Detection of Prostate Cancer.

Transperineal (TP) biopsy is increasingly used as an alternative to standard transrectal (TR) biopsy for prostate cancer detection to reduce infection risks. However, evidence on comparative diagnostic accuracy remains inconclusive. The aim of this study was to perform an updated systematic review and meta-analysis of studies comparing prostate cancer detection rates between TP and TR ultrasound biopsies. PubMed, EMBASE, Web of Science and other databases were searched for relevant studies up to December 2023. Randomised trials and observational studies comparing TP and TR biopsies were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity was assessed, and subgroup analyses were conducted. Nine studies comprising four randomised controlled trials (RCTs) and five observational studies were analysed, including 2763 patients (1376 TP, 1387 TR). No significant difference was found in overall cancer detection rates between TP and TR biopsies (RR = 0.9762, 95% CI = 0.8225-1.1586 for random effects model). However, subgroup analysis found that the RCTs showed no difference (RR = 0.9681, 95% CI = 0.8491-1.1038), whereas the observational studies varied (RR = 0.9416, 95% CI = 0.8073-1.0983). Significant heterogeneity was present across studies (I2 = 64.3%, p = 0.0156). Details on the prostate specific antigen (PSA) levels in the included studies were provided, and no significant differences were found between TP and TR biopsies regardless of whether a PSA threshold of >10 ng/mL or <10 ng/mL was used. In summary, this updated meta-analysis found no significant difference between TP and TR biopsies in overall prostate cancer detection rates. The subgroup analysis highlighted that results from RCTs specifically indicated equivalence in diagnostic accuracy. TP biopsy may be considered an appropriate alternative to TR biopsy for patients requiring prostate biopsy.

CFD Evaluation of Respiratory Particle Dispersion and Associated Infection Risk in a Coach Bus with Different Ventilation Configurations

The COVID-19 pandemic has underscored the urgency of understanding virus transmission dynamics, particularly in indoor environments characterized by high occupancy and suboptimal ventilation systems. Airborne transmission, recognized by the World Health Organization (WHO), poses a significant risk, influenced by various factors, including contact duration, individual susceptibility, and environmental conditions. Respiratory particles play a pivotal role in viral spread, remaining suspended in the air for varying durations and distances. Experimental studies provide insights into particle dispersion characteristics, especially in indoor environments where ventilation systems may be inadequate. However, experimental challenges necessitate complementary numerical modeling approaches. Zero-dimensional models offer simplified estimations but lack spatial and temporal resolution, whereas Computational Fluid Dynamics, particularly with the Discrete Phase Model, overcomes these limitations by simulating airflow and particle dispersion comprehensively. This paper employs CFD-DPM to simulate airflow and particle dispersion in a coach bus, offering insights into virus transmission dynamics. This study evaluates the COVID-19 risk of infection for vulnerable individuals sharing space with an infected passenger and investigates the efficacy of personal ventilation in reducing infection risk. Indeed, the CFD simulations revealed the crucial role of ventilation systems in reducing COVID-19 transmission risk within coach buses: increasing clean airflow rate and implementing personal ventilation significantly decreased particle concentration. Overall, infection risk was negligible for scenarios involving only breathing but significant for prolonged exposure to a speaking infected individual. The findings contribute to understanding infection risk in public transportation, emphasizing the need for optimal ventilation strategies to ensure passenger safety and mitigate virus transmission.

The association of overweight, obesity, and long-term obesity with SARS-CoV-2 infection: a meta-analysis of 9 population-based cohorts from the Netherlands Cohorts Consortium.

Obesity may affect an individual's immune response and subsequent risk of infection, such as a SARS-CoV-2 infection. It is less clear whether overweight and long-term obesity also constitute risk factors. We investigated the association between the degree and duration of overweight and obesity and SARS-CoV-2 infection. We analyzed data from nine prospective population-based cohorts of the Netherlands Cohorts Consortium, with a total of 99,570 participants, following a standardized procedure. Body mass index (BMI) and waist circumference (WC) were assessed two times before the pandemic, with approximately 5 years between measurements. SARS-CoV-2 infection was defined by self-report as a positive PCR or rapid-antigen test or as COVID-19 ascertained by a physician between March 2020 and January 2023. For three cohorts, information on SARS-CoV-2 infection by serology was available. Results were pooled using random-effects meta-analyses and adjusted for age, sex, educational level, and number of SARS-CoV-2 infection measurements. Individuals with overweight (25 ≤ BMI < 30 kg/m2) (odds ratio (OR) = 1.08, 95%-confidence interval (CI) 1.04-1.13) or obesity (BMI ≥ 30 kg/m2) (OR = 1.43, 95%-CI 1.18-1.75) were more likely to report SARS-CoV-2 infection than individuals with a healthy body weight. We observed comparable ORs for abdominal overweight (men: 94 cm≤WC < 102 cm, women: 80 cm≤WC < 88 cm) (OR = 1.09, 95%-CI 1.04-1.14, I2 = 0%) and abdominal obesity (men: WC ≥ 102 cm, women: WC ≥ 88 cm) (OR = 1.24, 95%-CI 0.999-1.55, I2 = 57%). Individuals with obesity long before the pandemic, but with a healthy body weight or overweight just before the pandemic, were not at increased risk. Overweight and obesity were associated with increased risk of SARS-CoV-2 infection with stronger associations for obesity. Individuals with a healthier weight prior to the pandemic but previous obesity did not have an increased risk of SARS-CoV-2, suggesting that weight loss in those with obesity reduces infection risk. These results underline the importance of obesity prevention and weight management for public health.

Patient Blood Management: Mixing Versus Discard Methods for Central Venous Catheter Blood Specimen Collection.

A quasi-experimental study comparing the mixing and discard methods of laboratory specimen techniques in an adult acute care setting was conducted over a 30-month period. Primary end points were delta hemoglobin (Hgb) and transfusion rates. Secondary end points were redraws related to hemolysis and erroneous results, noting central venous access device (CVAD) type. Primary objectives included the comparison of hospital-acquired anemia and transfusion rates utilizing Hgb and venous sampling methods as part of a patient blood management (PBM) program. Secondary objectives tracked the type of CVAD used to acquire venous specimens and the impact on hemolysis rates or erroneous results. Considerations include exploring the benefits of utilizing the mixing method related to cost savings. In summary, the mixing versus discard method eliminates wasting blood to reduce hospital-acquired anemia as part of a PBM program. CVAD type did not influence hemolysis rates or impact erroneous results. The mixing method is easy to implement in any health care setting. Cost savings are feasible by elimination of external venous or arterial blood management protection devices. Removal of add-on devices supports standards by decreasing access points to reduce infection risk. Results, although inconclusive to superiority, demonstrated noninferiority and encouraged consideration of the mixing method for laboratory specimen collection.