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Biomedical subjects

C K Chiu

Publications and source records attributed to C K Chiu.

6 recordsLinked to original sources

Prophylactic antibiotics in orthopaedic surgery: guidelines and practice.

The national clinical practice guideline has recommended that prophylactic antibiotic be given in orthopaedic surgery involving joint replacements and internal fixation of fractures. The aim of this study is to assess the current antibiotics prophylaxis practice in a state level hospital. One hundred and three patients (68 males, 35 females; mean age 41.6 +/- 22.2 years) undergoing internal fixation for closed fractures and joint replacement surgery were included in this prospective study. The choice of pre and post-operative antibiotics, their dosages and duration of administration were recorded. The pre-operative antibiotics were only deemed to have been given if it was documented in the case notes and in the case of post-operative antibiotics if it was signed on the drug chart. Eighty eight percent were given pre-operative prophylactic antibiotics and 92% were given post-operative antibiotics. For patients undergoing internal fixation of fractures, the most commonly used antibiotic for both pre and post-op is intravenous cefuroxime. For joint replacement surgery, the most commonly used antibiotic is intravenous cefoperazone. The duration or number of doses of post-operative antibiotics was highly variable. It was not stated in 56% of the post-operative instructions. Post-operative antibiotic was ordered for 48 hours or longer in 10%. In conclusion, prophylactic antibiotics appear to be widely practised. The first line antibiotics as recommended by the present guideline were not given in any of the patients. Second generation followed by third generation cephalosporins are the most popular antibiotics, with a trend towards using third generation cephalosporins in arthroplasty patients. Single dose prophylaxis was rarely practised.

Adolescent↗

Microbial contamination of femoral head allografts.

OBJECTIVE: To study the incidence of microbial contamination at the bone bank of the United Christian Hospital. DESIGN. Retrospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: A total of 151 patients (33 men and 118 women) who underwent hip arthroplasty surgery and from whom femoral head allografts were retrieved between January 1994 and March 2000; and 81 patients in whom allografts were implanted. MAIN OUTCOME MEASURES: Bone biopsies were taken from the femoral head and used to detect any microbial contamination that might have occurred during removal and after storage. The rates of infection among recipients and donors were also assessed. RESULTS: Of the 151 allografts, 94 non-contaminated allografts were implanted by the end of the study. Fourteen (9.3%) heads showed positive culture results after retrieval and were discarded. Four (4.3%) of the 94 stored allografts that were implanted tested positive for microbial growth, but the recipients of these allografts did not develop any clinical infection. Three (3.2%) had wound infections after implantation of the stored allografts although the grafts had previously been tested negative for any microbial contamination. CONCLUSION: Our centre has a low allograft contamination rate. The wound infection rate among recipients was also low. The culture of a bone biopsy sample is a reliable method to detect contamination of bone grafts. However, the contamination rate among stored allografts should prompt orthopaedics departments to review allograft handling procedures, so as to minimise the chance of contamination.

Anti-Bacterial Agents↗

Emergency department D-dimer testing.

Since the early 1980s, much attention has been paid to the development of a biochemical marker for venous thromboembolism. D-dimers are derivatives of fibrinolysis and recently have been touted as a means of screening for thromboemoblism. We review the physiologic, pathologic, and chemical bases for this new test, and outline the specific D-dimer assays currently available. We conclude with a discussion of the clinical utility of D-dimer in the evaluation of patients with venous thromboembolism.

Agglutination Tests↗

Identification of cervical neoplasia using a simulation of human vision.

OBJECTIVE: To determine whether a computer simulation of human vision could detect and discriminate cervical cancer precursors and cancer from normal epithelium. METHODS: The Georgia Tech Vision (GTV) system was trained to recognize normal and abnormal cervical features. GTV then assessed a new series of images to determine whether it could detect and diagnose cervical neoplasia without any a priori information about the images. RESULTS: After training on one set and testing on another set of images, GTV demonstrated 100% sensitivity and 98% specificity to detect cervical intraepithelial neoplasia 3 (CIN3). GTV also had 88% sensitivity and 93% specificity to detect cervical cancer following training on one set and testing on another set of digitized cervical colposcopic images. CONCLUSION: This study demonstrated that GTV can detect CIN3 and cancer from digitized cervical colposcopic images. Furthermore, GTV could discriminate cervical cancer precursors and cancer from normal cervical epithelium, including immature metaplasia.

Journal Article↗

Hepatoatrial anastomosis and tricuspid valve replacement in Budd-Chiari syndrome 8.

The rare complication of tricuspid valve stenosis due to displacement of a peritoneovenous shunt catheter developed in a patient with Budd-Chiari syndrome. Surgical management included shunt removal and tricuspid valve replacement combined with hepatoatrial anastomosis. The tricuspid valve was replaced with a bioprosthesis, and liver resection opened the stenotic confluence of the hepatic veins. The right atrium was sutured to the liver capsule, thereby restoring physiologic hepatic venous blood flow.

Aged↗