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Biomedical subjects

S N Banerjee

Publications and source records attributed to S N Banerjee.

At least 19 recordsLinked to original sources
PubMed1991

Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. National Nosocomial Infections Surveillance System.

More than 25,000 primary bloodstream infections (BSIs) were identified by 124 National Nosocomial Infections Surveillance System hospitals performing hospital-wide surveillance during the 10-year period 1980-1989. These hospitals reported 6,729 hospital-months of data, during which time approximately 9 million patients were discharged. BSI rates by hospital stratum (based on bed size and teaching affiliation) and pathogen groups were calculated. In 1989, the overall BSI rates for small (less than 200 beds) nonteaching, large nonteaching, small (less than 500 beds) teaching, and large teaching hospitals were 1.3, 2.5, 3.8, and 6.5 BSIs per 1,000 discharges, respectively. Over the period 1980-1989, significant increases (p less than 0.0001) were observed within each hospital stratum, in the overall BSI rate and the BSI rate due to each of the following pathogen groups: coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida species. In contrast, the BSI rate due to gram-negative bacilli remained stable over the decade, in all strata. Except for small nonteaching hospitals, the greatest increase in BSI rates was observed in coagulase-negative staphylococci (the percentage increase ranged between 424% and 754%), followed by Candida species (219-487%). In small nonteaching hospitals, the greatest increase was for S. aureus (283%), followed by enterococci (169%) and coagulase-negative staphylococci (161%). Our analysis documents the emergence over the last decade of coagulase-negative staphylococci as one of the most frequently occurring pathogens in BSI.

Bacteremia↗
PubMed1991

The National Nosocomial Infections Surveillance System: plans for the 1990s and beyond.

The National Nosocomial Infections Surveillance (NNIS) System is an ongoing collaborative surveillance system among the Centers for Disease Control (CDC) and United States hospitals to obtain national data on nosocomial infections. This system provides comparative data for hospitals and can be used to identify changes in infection sites, risk factors, and pathogens, and develop efficient surveillance methods. Data are collected prospectively using four surveillance components: hospital-wide, intensive care unit, high-risk nursery, and surgical patient. The limitations of NNIS data include the variability in case-finding methods, infrequency or unavailability of culturing, and lack of consistent methods for post-discharge surveillance. Future plans include more routine feedback of data, studies on the validity of NNIS data, new components, a NNIS consultant group, and more rapid data exchange with NNIS hospitals. Increasing the number of NNIS hospitals and cooperating with other agencies to exchange data may allow NNIS data to be used better for generating benchmark nosocomial infection rates. The NNIS system will continue to evolve as it seeks to find more effective and efficient ways to measure the nosocomial infection experience and assess the influence of patient risk, changes in the delivery of hospital care, and changes in infection control practices on these measures.

Centers for Disease Control and Prevention, U.S.↗
PubMed1991

Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System.

To perform a valid comparison of rates among surgeons, among hospitals, or across time, surgical wound infection (SWI) rates must account for the variation in patients' underlying severity of illness and other important risk factors. From January 1987 through December 1990, 44 National Nosocomial Infections Surveillance System hospitals reported data collected under the detailed option of the surgical patient surveillance component protocol, which includes definitions of eligible patients, operations, and nosocomial infections. Pooled mean SWI rates (number of infections per 100 operations) within each of the categories of the traditional wound classification system were 2.1, 3.3, 6.4, and 7.1, respectively. A risk index was developed to predict a surgical patient's risk of acquiring an SWI. The risk index score, ranging from 0 to 3, is the number of risk factors present among the following: (1) a patient with an American Society of Anesthesiologists preoperative assessment score of 3, 4, or 5, (2) an operation classified as contaminated or dirty-infected, and (3) an operation lasting over T hours, where T depends upon the operative procedure being performed. The SWI rates for patients with scores of 0, 1, 2, and 3 were 1.5, 2.9, 6.8, and 13.0, respectively. The risk index is a significantly better predictor of SWI risk than the traditional wound classification system and performs well across a broad range of operative procedures.

Centers for Disease Control and Prevention, U.S.↗
PubMed1991

Comparison of rates of nosocomial infections in neonatal intensive care units in the United States. National Nosocomial Infections Surveillance System.

To determine nosocomial infection (NI) rates among neonatal intensive care units (NICUs) that are useful for interhospital comparison, we analyzed data reported in 1986-1990 from 35 hospitals that have level III NICUs and used standard National Nosocomial Infections Surveillance protocols and NI site definitions. Overall rates of NI were calculated as the number of NI per 100 patients (overall NI patient rates) or the number of NI per 1,000 NICU patient-days (overall NI patient-day rates). A strong positive association was found between overall NI patient rates and the neonates' average length of stay, a marker for duration of exposure to important risk factors. No correlation was found between overall NI patient-day rates and average length of stay. However, a strong positive correlation between overall NI patient-day rates and a measure of device utilization (total device-days/total patient-days x 100) was found. Additionally, a positive correlation between overall NI patient rates and device utilization was found. Stratification among the three birthweight groups (less than 1,500 g, 1,500-2,500 g, greater than 2,500 g) did not eliminate the need to control for variations in these factors among NICUs. Device-associated, device-day infection rates, calculated as the number of umbilical or central line-associated blood-stream infections per 1,000 umbilical or central line-days and the number of ventilator-associated pneumonias per 1,000 ventilator days, were not correlated with a unit's site-specific device utilization. These data suggest that calculation of device-associated NI rates in NICUs using device-days as the denominator helps to control for the duration of exposure to the primary risk factor and will be more meaningful for purposes of interhospital comparison.

Birth Weight↗
PubMed1991

Nosocomial infections in elderly patients in the United States, 1986-1990. National Nosocomial Infections Surveillance System.

We analyzed 101,479 nosocomial infections in 75,398 adult patients (greater than 15 years) that were reported to the National Nosocomial Infections Surveillance (NNIS) system between 1986 and 1990 by 89 hospitals using the NNIS hospital-wide surveillance component. Overall, 54% of the infections occurred in elderly patients (greater than or equal to 65 years). In the elderly, 44% of the infections were urinary tract infections (UTIs), 18% were pneumonias, 11% were surgical wound infections (SWIs), 8% were bloodstream infections (BSIs), and the remainder were infections at other sites. When we compared the infections in elderly patients with those in younger adult patients, ages 15 to 64 years, a far greater percentage of the infections in elderly patients were UTIs, and there were more pneumonias than SWIs. Elderly and younger patients with ventilator-associated pneumonia were about 1.5 times more likely to develop a secondary BSI than those with pneumonia not associated with ventilator use. When the pathogens isolated from the infections were compared to those reported to the NNIS system in 1984, the percentage that were coagulase-negative staphylococci had increased in both elderly and younger patients. The patient died in 12% of all of the infections. Surveillance personnel reported that 54% of the infections in elderly infected patients who died were related to death compared with 59% in younger infected patients who died. When the infection was related to the patient's death, it was most often pneumonia or a BSI. The risk of an infection-related death was significantly higher when the infected patient developed a secondary BSI. Infection prevention efforts should target infections that occur frequently, are amenable to intervention, and have an adverse outcome.

Age Factors↗
PubMed1989

A new technique for chronic venous ulcers of the lower limb: modified Felder-Rob procedure.

Subfascial ligation of perforating veins is a commonly performed operative procedure for chronic venous ulcers of the leg. The most widely adopted incision currently used is the posterior midline approach described by Felder. This, however, is associated with significant morbidity due to necrosis of skin overlying the tendo Achillis with consequent exposure-induced necrosis and contracture of the tendon. A new incision based on anatomical studies is described. The procedure was adopted in 45 limbs with chronic venous ulcers. The incision is associated with very minimal morbidity and has given excellent results in the form of a major necrosis rate of only 4.4% (none of which involved the skin over the tendo Achillis or the tendon itself) and an ulcer recurrence rate of 4.4% during the period of follow-up of 2-8 years.

Achilles Tendon↗
PubMed1989

Observations on spinal dysraphism.

An attempt has been made to look into the age at presentation, incidence and clinical presentation of 40 patients with spinal dysraphism. Thirteen cases of myelomeningocele and 11 cases of meningocele constituted the 'aperta' group and there were 16 'occulta' cases. Though among the 'aperta' cases male is to female ratio was 1:1, a marked male preponderance of 2.2:1 was seen among 'occulta' cases. First born child was found to be most frequently (44.50%) affected in the present series. Myelography remained a mainstay in deciding operation in 'occulta' cases. All 'aperta' cases and 11 out of 16 'occulta' cases were treated by operation. Regarding results of treatment, all cases with meningocele were fully cured, cases with myelomeningocele showed no improvement but further deterioration of the neurological status could be arrested. Hydrocephalus was associated in 8 out of 13 cases with myelomeningocele and ventriculoperitoneal (VP) shunt were instituted in all of them. Prognostic significance of presence of hydrocephalus was profoundly grave as was evident from the mortality rate (10%) in this series.

Adolescent↗
PubMed1987

99mTc-2,3-diaminopropionic acid complex as renal function agent: comparison of biological properties with 99mTc-DTPA and 131I-OIH.

The preparation, purification, biodistribution, blood disappearance kinetics and imaging characteristics of 99mTc-2,3-diamino propionic acid (99m-Tc-DAPA) is studied. The latter three studies were conducted on rabbits as the experimental animal and the data thus obtained were compared with 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) and 131I-orthoiodohippurate (131I-OIH) with a view to find a possible replacement of the latter radiopharmaceutical with a more convenient 99mTc based compound. Preliminary data indicates favourable results for 99mTc-2,3-diamino propionic acid which warrants further investigation.

Animals↗
PubMed1986

Preparation and biodistribution of 99mTc chelate of strophanthidin--a cardiac aglycone.

Cardiac glycosides are well known to exert a specific and powerful effect on myocardial tissue, and there is a possibility that this class of compound with a 99mTc radiolabel may behave as a superior myocardial imaging agent in comparison to 201Tl which is at present used clinically. Because of the extreme chemical complexity of cardiac glycosides a simpler aglycone, strophanthidin was selected as the pilot compound for preliminary labelling and in vivo distribution studies. Strophanthidin was converted to 19-thiosemicarbazone which nicely accommodated 99mTc to produce a pure radiopharmaceutical of high specific activity. The distribution pattern in animal models was studied which is in accordance with the metabolic studies performed earlier with the ligand itself.

Animals↗
PubMed1986

Gluteus maximus myocutaneous flap cover for sacral radiation ulcers.

Myocutaneous flap cover of postirradiation ulcers has recently been recognized as a useful and effective method of treating these non-healing ulcers. This study presents the results of three cases of postirradiation sacral ulcers treated by gluteus maximus myocutaneous flaps. In one case a conventional island flap was used, whereas in the other two cases a new technique of a total rotation gluteus maximus myocutaneous flap is described.

Adult↗
PubMed1986

Papillary carcinoma in a giant lateral thyroglossal cyst.

The development of carcinoma in a thyroglossal cyst is rare. This report describes the presence of papillary carcinoma in a giant thyroglossal cyst and reviews the literature regarding the clinico-pathological features of the disease and its management.

Carcinoma, Papillary↗
PubMed1979

[3-(1,4-Cyclohexadienyl)-L-alanine,8-lysine]vasopressin: synthesis and some pharmacological properties.

[3-(1,4-Cyclohexadienyl)-L-alanine,8-lysine]vasopressin, otherwise known as [3-(2,5-dihydrophenylalanine),8-lysine]vasopressin or [DiHPhe3]lysine-vasopressin, has been synthesized in an attempt to utilize 2,5-dihydrophenylalanine (DiHPhe) to evaluate the contribution of aromaticity in position 3 to biological activity. The analogue has the same primary structure as lysine-vasopressin, except that two additional hydrogen atoms are present on the ring moiety of the phenylalanine residue in position 3. The key intermediate was the protected nonapeptide N-carbobenzoxy-S-benzyl-L-cysteinyl-L-tyrosyldihydrophenyl-L-alanyl-L-glutaminyl-L-asparaginyl-S-benzyl-L-cysteinyl-L-prolyl-N epsilon-tosyl-L-lysylglycinamide that was synthesized stepwise by the solid-phase technique. Deprotection with sodium in liquid ammonia was followed by sulfhydryl oxidation with I2 to give the hormone analogue. [DiHPhe3]lysine-vasopressin exhibited 125--130 units/mg of antidiuretic, 129--132 units/mg of rat pressor, and 6 units/mg of rat uterus contracting activity. To confirm the presence of DiHPhe in the analogue, an enzymatic procedure employing Aspergillus oryzae was developed that liberates in high yield the amino acid residue in position 3 of the posterior pituitary hormone structure. This study should be applicable to other biologically active peptides.

Aminopeptidases↗